Dicken’s Therapy

Once in a while it’s worthwhile therapy to ponder your own death, Charles Dickens’ style.

The world ain’t so focused on you that it wouldn’t keep going if you died, so it’s a valuable exercise to try it out your mortality for a while.

When I suggest this to people in counseling I often call it Dicken’s Therapy.

It comes from the Dicken’s story of “A Christmas Carol” where elderly miser Scrooge is made to examine his life.

Scrooge is not swayed by reviewing his past life, nor by seeing the life of those around him in the present, but he is moved to massive change by being taken to his future funeral and finding that it is not at all what he hoped for.

The therapy of imagining your own death.

I also call it Mark Twain therapy, based on the Huckleberry Finn and Tom Sawyer version that has the two boys go off on wild adventures and come back to find everyone in the town’s church giving them a funeral because they have been given up as dead.

At their funeral they listen in and hear people speak about them in ways they’d never known when they were alive.

Therapy by mentally extrapolating on from your own death is a common enough idea.

Visit your own funeral Dicken’s style. Hover over your casket. Write out your own eulogy.

What would you WANT people to be saying about you?

What would they ACTUALLY say about you?

Are these two the same? And if not what can you do to close the gap?

What will you leave behind when you are gone, ie what is your legacy?

I often add in a sense of urgency and comparison by asking, “What if you died tomorrow?”

And yes I ask myself these questions too.

In fact it helped me make a decision just last week.

This online self help work is part of the legacy I want to leave to the world, but much of it is still being developed. I have much more I want to offer here.

However when I asked myself the “What if I died tomorrow?’ question, it cleared up one piece.

Hopefully this piece will be ready this week.

When I announce it, if you agree it’s worthwhile then you can join in. You’ll be able to make a difference to the lives of others and add it as another part your legacy too.

Oh, and if I do die tomorrow, then the few people who I’ve already spoken to about this can take this as part of my last will and testament. Go-ahead to find a way to do it for me. Thanks.

-Dr Martin Russell

There Is No Success Only Feedback

You’ve probably heard the saying “There is no failure, only feedback”, but what about success?

Failure and success are really flip sides of the same coin.

It’s a bit like love and hate. With either love or hate you have to care deeply about something, so on that basis they are the same core emotion.

Failure and success are similarly alike.

Both depend on you having a preconceived idea of the outcome you want.

Both also depend on you stopping at some particular point and making the comparison with your preconceived idea so that you can assess, did you fail or succeed?

So what happens if you treat success, like failure, as simply feedback?

Success is then no longer a stop point. Instead it is a benchmark for what to repeat, and for the outcomes you get in future.

Success then becomes more along the lines of “continuous improvement”.

If you are aiming for “success” in your life then here are two suggestions with this feedback model in mind.

1. ALWAYS have a goal beyond the goal.

If you don’t have this in place you risk reaching a goal… and then asking yourself, “Now what?”, or even worse, “So what? Who cares. What was all that for.”

Someone having a mid-life crisis is simply realizing they have no goal beyond the one they are current working on, and that current one doesn’t seem so important any more.

2. Set at least some goals in your life that are never going to be achieved.

This may strike you as counterintuitive.

After all we are taught that we are meant to reach our goals.

However I think it’s worth having never-ending aims like “world peace”, ending poverty, protecting the environment, contributing and helping others, and spreading the word about something that is important to you.

These are natural examples where final success is unachievable, and therefore feedback is a more accurate description anyway.

Unlike the first suggestion I’m not convinced this one is actually necessary for mental health and happiness. It might be. I just am not sure.

Here’s the more fundamental life issue however.

Can you really have a mindset of feedback instead of failure, if you are still holding on to the concept of “success”?

Do you have to give up on “success”?

-Dr Martin Russell

Influencing Doctors

Survey after survey of doctors says that they don’t think that gifts influence their behavior.

Study after study says they are totally wrong.

The big pharmaceutical companies spend millions upon billions on advertising and promoting to doctors and one of the biggest ways they do so is by using gifts of all types.

Sometimes it’s pens, sometimes it’s meals and nights out, sometimes it’s travel and accommodation, there are various rules and guidelines in place but historically it can be almost anything.

The evidence is overwhelming that this sort of practice is highly effective at altering doctor’s behavior.

The most obvious evidence is that so much money is spent on it. Drug companies do have ways of monitoring the effect of their marketing to doctors. They have been able to study the results for themselves inside their own companies, and they clearly just want to do more of it.

Some of the research is done outside drug companies and therefore is available for us to analyze, and this research too comes up showing that doctors become more willing to prescribe drugs rather than non-drug treatments, pay less attention to the scientific evidence, and bias to favor a particular company’s drug.

That would be much less of a problem if it wasn’t for the perception that is widely held by doctor’s themselves that they are somehow “immune” to this influence, and that they are “too clever” to be swayed.

This self-delusion is wrong, and dangerous.

It’s easy for me. I’m in the luxurious position of not prescribing much at all these days, so I can accept as many gifts as I like for a new medication and my prescriptions still are zero.

I don’t get as many invitations or gifts these days.

Back when I did prescribe a lot more and did get more gifts I looked into this.

In my time I’ve come across a few doctors who do in fact acknowledge the influence of gifts in their own practice, and one in particular got taken to task by my local newspaper.

One of the most senior surgeons at my city’s biggest hospital wrote a book on how to prepare for surgery.

A tiny piece in the book suggested that patients should give a gift, like an expensive bottle of brandy, to their surgeon before they had an operation.

Among all his recommendations, this “bribe” got the attention.

The outcry was huge.

“Doctor’s are already rich enough, and now they are asking you to give them bribes too!”

“You can buy off your doctor with booze!”

Well, the newspaper didn’t quite go that far, but that was the impression they were giving. I bet it sold a few newspapers and demonstrated a lot about what influences them. But that’s not my field so I won’t go into that.

I was working as a volunteer with a local radio station at the time and I took the chance to interview this surgeon.

He was bemused as to what all the fuss was about. He openly acknowledged that surgeons get influenced by gifts, and he put it something like this…

“When you yourself need surgery and you are being wheeled into the operating theater, do you want your surgeon to think of you as the Xth case of Y operation for that day?

Or do you want to be thought of as ‘the patient who gave me ……’?

Surgeons are human too and it DOES influence how they handle you and your surgery.”

Unfortunately I’ve never seen this particular technique studied, so this is one piece of self help that I simply recommend from my own experience with doctors and other human beings.

-Dr Martin Russell

Immersion Feedback

The phrase “feedback is the breakfast of champions” is one that sticks for me.

I’ve found for myself that the level of feedback I get does indeed relate remarkably well to the speed at which I improve.

If I don’t know what to do in a situation I go for the option that will give me the most feedback. Often that means working out how to fail faster.

Micro-feedback. Feedback on the smallest little aspects of what I do.

Fast feedback. Feedback that comes in as soon as I’ve done something so that I can judge how I am going.

Clear feedback. Knowing that there is a direct relationship between what I did and what results came up.

Universal feedback. The good, the bad, the awkward, the painful, the surprising – all of it and more.

Safe feedback. Feedback that doesn’t cripple me from trying again, either emotionally (and that’s for me to handle mostly), but also physically, financially, practically as well.

I’ve watched my 3 children learn how to have a bath as they grew up.

At first I put in all the work. Holding them up in a sitting position with their head out of the water.

Then they are sitting for themselves, and with all their wobbling and wavering they are mostly okay. They just look shakey and have me reaching my hands out every few seconds, then every few minutes.

My goal was to catch them only when they couldn’t recover for themselves.

If I thought there was no way they could find their own way out of it, then I’d help them, but otherwise…

I remember my youngest daughter as a baby falling back and ending face up at the bottom of the bath where for a brief moment her surprised face was staring at me through the water above.

I brought her up and she was fine but she didn’t like it one bit.

One time after this when she fell back she managed to grab a hand rail on the side of the bath as she did so. Her outstretched arm was saving her, but she was stuck, hanging in midair just above the water surface. She knew that this wasn’t right, but she’d never been in this position before so she just hung there.

I watched, moved close enough to catch her, and waited until she unfroze and started to wriggle.

The first time this happened she wriggled so much her hand came loose and she fell into the water again where I plucked her out. The second time she found a wriggle that got her out of it and my hands never touched her.

If you’re going to practice you need feedback.

Gravity is ideal feedback.

Water is ideal feedback too.

Almost everyone learns to walk and manage a bath safely, but in reality both these skills are immensely complicated ones.

Anyway I’m heading off to my counseling practice now.

How much of YOUR life do you think of as practicing?

-Dr Martin Russell

Forcing Function… WillPower Made Easy

Most people have never heard of a Forcing Function, because it’s not commonly thought of as a self-help principle.

However of the 1001 reasons you might want more willpower, my claim to you is that almost always willpower is the wrong tool for the job.

On some of these occasions a Forcing Function will do much better.

But what is a Forcing Function anyway?

If you have ever gone to get money from an ATM you will probably have had the experience of sticking in your card, entering all the details, reaching for the money… and then realizing the money wasn’t going to come until you had first taken out your card.

This is a Forcing Function.

When ATMs first became popular, one of the biggest frustrations for users was accidentally leaving their card in the machine. The banks didn’t like it either. Each morning their staff were handling these upset customers who had “been in a hurry and stupidly forgotten to take my card out.”

Banks tried putting bigger signs on their ATMs, with arrows pointing at the place you were meant to pick up your card. They installed beeping reminders into the machines. They changed the display message to tell people to take their card. They still had problems.

In the end they solved it with a Forcing Function.

They changed the sequence so that you don’t get what you came for ie the money, until you have done all the incidental bits, including take your card.

Of course this doesn’t entirely stop people from forgetting their card. They can always put it down on the machine and leave it there, or drop it, or reinsert the card and walk away, but all these are much less likely to happen.

People want their card. They just need to be reminded about it. They don’t need to have more will power, or spend more time beating up on themselves for being stupid or lazy or worse.

The system can just be changed, so human beings can stay the same.

This is allowed!

Self help can be about changing the world around you, not just changing yourself.

Let me give you an example from my counseling practice.

I had a woman complaining that she was struggling to keep a diary. She only wanted to write a few lines and check the inspirational quote for the following day. She enjoyed doing it, she just seemed to “fall off the wagon”, and forget.

She wanted more willpower.

I said she could use a Forcing Function instead.

If she put her diary on her pillow then she would only be able to go to sleep at night by picking up the diary.

It wouldn’t mean she had to read it or write in it, but she enjoyed doing that part of it so she probably would.

She was much more pleased.

But then she thought it through a bit more and got all down in the mouth again.

“But how will I remember to put the diary on my pillow in the first place? It will sit on my bedside table, ignored just like it is now. I need will power again!”

My answer was to add another forcing function.

I told her to put the diary on the floor right where her feet would land when she got out of bed in the morning.

If she forgot the diary she would step on it when she got up in the morning and be reminded to move it onto the pillow then.

She preferred that to my other suggestion.

My other suggestion was to get her to put up signs all around the house saying in big letters “You stupid idiot. You’ve forgotten something. Why do you always forget such simple things…”

But since she’d already tried something very similar for herself, she thought she’d go along with being “forced” instead.

“Forcing Function”.

Strange name. Vital self help skill.

Find a place for it today in your life, and you can report back your experiences with it on this blog.

-Dr Martin Russell