AVMA Positive Changes Evident at Convention's Keynote Address
The 2016 annual convention of the American Veterinary
Medical Association (AVMA) was the best convention I’ve experienced; hands
down. I’ve been a veterinarian for 33 years and have never been more proud to
be an AVMA member than I am right now. The keynote address and many
presentations associated with wellbeing were instrumental in this result. I met
many people intent on helping veterinarians improve our wellbeing and continue
to practice the profession we love. I am so grateful. There is a wellspring of support
sprouting in our midst.
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| Joseph Kinnarney - AVMA.ORG |
When introducing the keynote address, Joseph Kinnarney, AVMA
President 2015-2016, spoke about our profession’s high incidence of depression
and stress. Kinnarney is not just another in a long line of white, male, elder-statesmen to lead our association. As the AVMA’s first openly gay president, he
heralds in a new era that promises more openness and diversity, something our
organization has been lacking. He spoke of the AVMA’s initiatives to address depression
and suicide via the Wellness Roundtable and Future Leaders Program.
The 2014-2015 Future Leaders class introduced the
AVMA’sWellness and Peer Assistance page,
which was a good start. I’ve noticed it has consistently improved. Currently
the page offers a Professional Quality of Life Self Assessment test and
subpages with information on Work & Compassion Fatigue, Stress Management,
Financial Wellness, Work-life Balance, Physical Health, Learning About
Self-care, Setting Up a Wellness Program, as well as a Get Help page with
mental health resources.
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| Ellen Lowery - Linked-in photo |
Next up was Ellen Lowery, Director, US Professional &
Veterinary Affairs at Hill's Pet Nutrition, the company that sponsored our
keynote address speaker. Lowrey spoke about her company’s mission to help
enrich and lengthen the special relationships between people and their pets and
about their Food, Shelter, Love® program, which is one example of
how they bring their mission to life. The company has provided over $240
million worth of food to nearly 1,000 shelters, helping over 6 million pets
find a new home.
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| Dan Siegel - www.drdansiegel.com |
Lowery introduced
Dan Siegel,
renowned psychiatry professor and author, to give the keynote address. Siegel
gave the audience pause when he started by stating the term “mind,” which is
also called soul, psyche, and intellect, has no accepted definition in the
mental health field. Yet mind is the center of wellbeing. When “mind” is not
cared for the result is lack of control and ineffectiveness, he said. He
correlated burn out, depression, and suicide with increased stress, something
veterinarians should be cognizant of since we have the highest suicide rate of
all professions. Then he explained that “mind” involves more than Hippocrates’
mind-definition of it being the head, or William James mind-definition of it
being, “the brain, obviously.”
Siegel, a pioneer in the field of interpersonal neurobiology,
explained mind is not limited to the head, but includes subjective experience,
consciousness awareness, and emotional meaning and information processing done
outside of awareness; explained that mind includes the neural processing in the
entire body, at a minimum including powerful influences from the heart’s
intrinsic nervous system and the gut’s biome, which can influence moods and
emotions. He stated this is based on physiologic realities and if a person is
unaware of what the heart and gut are telling them, then it is more likely that
the associated information processing will be done outside of the brain, a
fascinating proposal to consider. He encourages people to literally become more
aware of their body and what is going on in their heart and gut as a path to
development of both more self-awareness and empathy.
Siegel went on to state that “mind” may not be even be
limited to the body as he described how relationship interactions between
parents and children impact the brain development of the child; that flow and
patterns of energy and information change over time and profoundly impact
mental life, making for a complex nonlinear system. This system is open to inputs
from outside. The healthy mind has optimal self-organization that comes from integration
and creates integration, whereby differences are not only allowed and even
honored, but also linked. He described the five qualities of an integrated
system using the acronym FACES, Flexible, Adaptive, Coherent, Energized, and
Stable.
But people in the healing professions are not taught to help
themselves, Siegel said. They are excessively differentiated. They are so
focused on the physical side of life and spend such little time and effort on
the emotional side and on self-care that problems are inevitable. This leads to
faltering relationships, self-retaliation, isolation, despair, and shame.
While I believe this is true, there is different kind of
differentiation we need to be aware of that is lacking in those of us who
suffer with compassion fatigue or with family members who have substance use
disorders that impact us.
Gabor Mate defines differentiation as “the ability to be in emotional contact with others
yet still autonomous in one’s emotional functioning.” In veterinary medicine
and other helping and health care professions a lack of this kind of
differentiation runs rampant in practitioners, results from excessive exposure
to trauma, especially trauma that could be addressed if only finances or some
other situation were different, and results in compassion fatigue.
Siegel shone a light on the path toward wellbeing that
starts with identification of something that is not right, becoming aware. This
path sounded reminiscent of the 3 A’s of change described in Al-Anon
literature: Awareness, Acceptance, and Action. It is premature to take action
to change a problem unless you understand fully that the problem exists and
accept that the difficulty is a characteristic that is part of your makeup.
Siegel went on to say that all mental illness is impaired integration that is
either the result of chaos, rigidity, or both. As an example of chaos he
pointed to overwhelming feelings of too much to do and for rigidity he
described a shutdown from connecting. Health and wellbeing will be somewhere in
between the chaos and rigidity ends of the spectrum.
I believe all humans have a void to fill or face. We use a
variety of behaviors to fill the void: shopping, food, immersion in work,
romance, etc. The list is as variable as human imagination will allow, but all
result in a similar bliss that carries us away, at least momentarily, from the
certain knowledge that we will all get sick and die, as will our loved ones.
That, my friend, is certain. We will do nearly anything to avoid the void.
When
Pema Chödrön speaks of leaning into fear, facing it, and
becoming intimate with it, she is guiding us to the void and leaving us there,
bare and raw. This is an alternative, really the only viable alternative, to
the ultimately meaningless rush of activity we generate in our futile,
Sisyphean, attempts to fill that void. I don’t believe the integration Siegel
speaks of is possible without learning to face the fear of certain illness,
physical death, and destruction. Religion may be helpful, but does not
typically provide complete relief from fear. In my experience, the ability to
face the void is gradated, rather than all-or-nothing, and it is proportional
to my ability to be integrated as an individual (emotional, intellectual,
physical), with family members, with team members, with professionals, with
humans, and with all other living beings on Earth.
So we have some issues to address. Siegel stated that ultimately
the answer to, “What can we do about it?” is that we can 1) care for our inner
selves via awareness that comes from meditation and mindfulness and 2) attend
to our relational awareness.
Siegel stated there is scientific evidence that practicing
mindfulness will result in:
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Reduction of burn out and increase in empathy
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Increased wellbeing
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Positive change in brain function and structure
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Brain integration
- ·
Improved immune system
- ·
Increased telomerase, which repairs chromosome
telomere caps
- ·
Changes in epigenetic regulators that help
prevent autoimmune problems
He challenged us to consider the worth and popularity of a
drug that had similar claims. Would we promote such a drug? Would we take the pill?
Siegel closed out the keynote address by leading the
audience in a guided meditation starting with having people first pay attention
to the front of the room, then the middle, and finally the rear of the
auditorium. Shuffling could be heard as we moved our heads and some scooted
chairs a bit. He then asked us to realize and acknowledge that we are in
control of our awareness, a powerful lesson. When I described this process to a
friend of mine he said we should also acknowledge that we should be very
careful whom we pay attention to. As a group we all turned our heads in unison
on command.
I thought Siegel had a powerful message. I also had a
feeling of oneness with the auditorium of people I had just meditated with, a
feeling described by Siegel as “mwe” (me and we combined) in the 3-hour session
he led shortly thereafter. In a later post I’ll delve more into his teachings
in that session and the groundswell of veterinarians, technicians, and allied
professionals in attendance who were addressing their own wellbeing and that of
our profession.
It’s true. We should be very careful whom we allow inside
our heads and whom we pay attention to. My impression is that Dan Siegel is a
person we should pay attention to, most definitely.
