Global Health Experience

The problem with self

June 2016

The problem with self

“Through pride we are ever deceiving ourselves. But deep down below the surface of the average conscience a still, small voice says to us, something is out of tune” (C J Jung)

I’m not much of a science fiction fan, perhaps due to a preference for focusing on the present, but I recently read an article in which the author Philip K Dick — famous for adaptations of his books into films such as Blade Runner and Total Recall — was credited with suggesting that “the problem with introspection is that it has no end”. This aphorism must have been lurking in the back of my mind on a trip to Beijing last month.

Several months of diligent planning, supported ably by Foreign Office colleagues at the British embassy in the capital, preceded the visit of a group of Public Health England (PHE) staff to our sister national agency, the Chinese Center for Disease Control and Prevention (CDC). Through a series of workshops over two days — covering nutrition, HIV, emergency response, and climate change — the purpose of this coming together was to enhance collaboration between our institutes and scientists on operational and research aspects of public health. It was the first ever bilateral meeting of this kind between the two organisations.

Our hosts could not have been more hospitable, and each and every detail was attended to carefully: the programming was meticulous; busy staff had prioritised their time to be present; rooms and food were excellent; and wonderful banners had been specially made with artistry of the Great Wall of China and Tower Bridge in London. All of this created an atmosphere in which cooperation and intellectual creativity could flourish.

Amongst many stimulating debates, one particular moment triggered a flicker in my mind. In the session around responding to public health emergencies a PHE friend and colleague, Ian Rufus, presented his experiences in Sierra Leone, where PHE has been involved since the Ebola epidemic and now has an ongoing presence supporting the building of the country’s health system. Ian described a meeting he’d recently had with the Sierra Leone Chief Medical Officer (CMO), in which Ian had asked the CMO how he’d managed — in the turbulent early period of the outbreak when international experts were arriving from across the globe — to keep those authority figures on track during meetings. The response the CMO gave Ian was telling: ‘I greet them as they enter the room, and ask them to leave their egos at the door.’

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In crisis situations people are generally better at putting aside personal interests for the greater good. When the chips are really down, embracing the oft-used adage There’s no “i” in team seems more natural and less problematic, but most of the time we are not in such emergency scenarios. And it is here, in the more routine day-to-day setting, that the ego readily gets in the way of optimal human functioning.

Although the word ego has Freudian origins, it is colloquially used now to represent interest in, or orientation around, the self. On a basic evolutionary level such interest is understandable, but the common-place modern attention to self goes way beyond survival needs, and is pervasive and limiting. Standard examples in the workplace include speaking out to be heard, rather than because you have something useful to say; opinions stubbornly held to avoid losing face; actions not grounded in what is best for the organisation or society, but in what is best for you; and struggles for promotion.

Far more prevalent and subtle, however, to the degree that it is accepted as norm, is the excessive thinking that people do about their personal circumstances and what can be done to improve those circumstances. The British philosopher, Mary Midgley, in her stunning book Science and Poetry, describes how over several centuries in the west we have gradually become ‘social atoms’, divorced from the environment, community and others, obsessed with ourselves. In some spheres of the coaching world this preoccupation is referred to as being caught up in your ‘personal thinking’. To gauge the degree of your own immersion, it is worth spending a day — at home and at work — trying to notice how often your thoughts drift inwardly. At the same time, check what emotions are connected to those thoughts: invariably, they tend to be more negative feelings such as irritability, anger, distaste, anxiety or stress.

The fallacy of absorption in personal thinking is multi-fold, and I will touch on just a couple of aspects here. First, such thinking is generally premised on the belief that sufficient attention to self will lead to knowledge of what needs to be done externally to improve one’s own situation (i.e. if I think about the problem enough, I will know what needs changing out there to make things better for me). But controlling one’s external circumstances is a never-ending task and, regardless of the occasional apparent success, we live in a thought-created reality, where our experiences are generated from the inside: in other words, the world appears differently to us depending on the quality of our thinking in the moment. Second, immersion in introspection has no end, as Philip K Dick articulated — and also comes at a cost. All that time spent self-interestedly is time not spent — whether at work or home — in ‘impersonal thinking’, tapping into the space within us that houses the innate human abilities that we are all gifted: to share, to learn, to nurture, to support, to create, to develop, and to love. Through my own management experience, many of the problems staff present to me are problems with their thinking rather than problems to be solved out there.

For those few days in China, it felt like the collective esprit-de-corps created a mind-set in which everyone was on the same side and anything was possible. Perhaps China’s particular communitarian history supported this aura. Or perhaps it was something else, a ripple-effect of the guidance from Sierra Leone. Either way, as Carl Jung has so beautifully put it, deep down we know that excessive orientation towards self puts us all out of tune. And being out of tune constrains both our own experience of the world, as well as the outcomes we so hope to achieve.