6. Awareness of self

CHAPTER OBJECTIVES

Upon completing this chapter, students should be able to

• Recognise the importance and benefits of self-awareness for a health professional

• Demonstrate awareness of their abilities and ‘inabilities’

• State some of their own values, characteristics and abilities

• List the values, characteristics and abilities that benefit a health professional

• Demonstrate understanding of their own basic dominant need(s)

• Recognise the effect of conflict between needs and values

• Understand the concept of listening barriers and their effect on communication

• Listen and speak more effectively

• Recognise differences in learning and processing preferences

• Understand their own learning and processing preferences.

Self-awareness: An essential tool

Self-awareness equips individuals for life. It also equips relevant individuals for an effective career as a health professional. Self-awareness allows a person to know and understand themself. It allows a person to know how they will react in any situation and assists them to understand why they react as they do in those situations (Egan 2007). Self-awareness increases self-understanding and results in increased control of thoughts and behaviours (Devito 2003). The information resulting from self-awareness helps health professionals achieve effective practice for those seeking their assistance. Self-awareness potentially enables the individual to use this information to relate positively. Schore (2005) suggests that awareness of personal emotional states increases the ability of health professionals to recognise and respond appropriately to the needs of others. Stein-Parbury (2006) states that self-awareness is essential for developing a therapeutic relationship and promotes open, honest and genuine health professionals who are not afraid to be caring human beings. Self-awareness potentially facilitates unconditional positive regard for others without prejudice, judgement or negativity (Rogers 1967). Health professionals who seek to achieve positive outcomes in every interaction will increasingly reach this goal through the practice of self-awareness.

Becoming self-aware is a life-long journey that requires commitment and perseverance (Taylor 2000). When embarking on the journey towards self-awareness it is important to remember that even the most self-aware individuals sometimes interact inappropriately; even in these individuals the level of self-awareness varies and thus they may experience negative outcomes when interacting. Such times are inevitable and should motivate those committed to self-awareness to persevere in their attempts to achieve self-awareness. Self-awareness allows health professionals to respond to the needs of the person seeking assistance, rather than responding to their own needs. This response ultimately facilitates family/person-centred practice, the desired outcome of any interaction with a health professional.

The benefits of achieving self-awareness

While achieving self-awareness is sometimes uncomfortable, there are many resultant benefits. Self-awareness allows health professionals to recognise, know, understand and resolve their emotional needs. It frees health professionals to choose how to react rather than reacting to fulfil unconscious emotional needs at any given time. Self-awareness provides understanding of the inadequacies and fears that unconsciously manipulate and direct thoughts and responses while interacting (Ben-Arye et al 2007). This understanding facilitates greater control while relating and decreases regrets after interactions. The greatest benefit of self-awareness is self-acceptance and valuing of self. Self-acceptance empowers health professionals to value and respect others regardless of the situation (Davis 2006). Reflection is a key component for achieving self-awareness (see Ch 5). In this chapter (Ch 6) the reader is encouraged to begin the journey of practising self-awareness. Chapter 6 seeks to demonstrate the benefits of being self-aware for both the health professional and those around them.

Beginning the journey of self-awareness

A journal is a helpful learning tool when developing self-awareness. Recording answers to questions and thoughts while reflecting assists in highlighting information and learning about self (Ellis et al 2004, Mohan et al 2004). It is helpful to revisit a journal at later times as a reminder of the growth and change achieved through a commitment to self-awareness.

Answering questions about ‘self’ is essential for achieving self-awareness. Honest answers to such questions inform individuals and empower them to choose appropriate responses and behaviours when communicating. Answering questions about personal characteristics and related abilities begins the process of self-awareness.

REFLECTIVE ACTIVITY

This is an extension of the reflective activity on page 43 of Chapter 5.

Part 1

• Make a list of things you enjoy doing. Of those things, what do you do well? What do you not do well?

• Make a list of things you dislike doing. Of those things, what do you do well? What do you not do well?

• Do you like the things you naturally perform well?

• Do you dislike the ones you perform badly?

• List the characteristics and abilities that assist your performance in these activities.

• List the characteristics and abilities that limit your performance in these activities.

Part 2

• Make a list of all the things you feel you do well and those you feel you do not do well, whether you enjoy doing them or not.

• Share this list with someone who knows you well and ask if they agree. If they disagree, ask them for examples to demonstrate their understanding of what you do well and what you do not do well.

• Does this interaction change the way you see your abilities?

• Are you able to believe the other person’s understanding of you?

• Why or why not?

Sometimes an individual has the characteristics and abilities to perform an activity well but experiences have clouded their accurate knowledge about and understanding of those characteristics and abilities.

CASE STUDY

During the process of learning to read, a 6-year-old child changes schools. The new teacher notices that the report from the previous school states the child reads well. The teacher asks the new child to read to the whole class from a reader (booklet) considered an advanced reader for that class. The new child – presented with an unfamiliar reader and a sea of unfamiliar faces – stands in horror staring at the book. The words are so unfamiliar that the child really is not sure that the book is not upside down. Several attempts to pronounce words find the child standing alone, in silence. The teacher says Well obviously you can’t read – sit down.

GROUP DISCUSSION

• Discuss how the child is likely to react.

• Discuss how each member of the group would react if this had been them.

• Discuss any similar experiences that group members are willing to share and the effect of such negative experiences on the ability to perform the activity.

It took several years after that experience for the child to enjoy reading. Now an adult, that ‘bad’ reader is today a successful author of readers for children who do not enjoy reading!

REFLECTION

• What do you think facilitated this person to become an author of readers (booklets) for children?

• Could this have resulted from unresolved emotions or does this require resolved emotions concerning the incident years ago?

• Do you like any of the activities you listed in Part 2 of the previous reflective activity because you were encouraged in doing them? Are there any you dislike because you had negative experiences that made you feel unable to do them successfully?

REFLECTIVE ACTIVITY

• Make a list of those things you perform well because of encouragement.

• Make a list of those things you perform well because you have persevered despite discouraging feedback.

– Do you agree with the negative feedback you received in the past?

– Have you proved to yourself that you can do these activities well?

– What did you do to prove your abilities in these activities?

• Make a list of activities you do not do well because you have experienced discouraging feedback.

– Have you stopped doing these as a result?

– Do you think you could ever attempt them again? Why or why not?

– Is there any skill you feel you could never perform well?

– What might you do to develop your skills in this area?

When told they do not perform an activity well, some people decide to practise that activity until they do perform it well. Many activities can be conquered with practice (e.g. playing basketball; creating a chair from timber; writing assignments, presentations and reports; teaching; managing others; providing leadership; and communicating). Other people, when told they cannot perform something well, withdraw from performing that activity and never conquer it. Such decisions might not be significant where the ability is something that is not essential to quality of life (e.g. knitting or washing a car). Some abilities (e.g. communication and self-control) are necessary for daily life, however, and thus perseverance is required to improve skills in those activities. There are particular characteristics that individuals develop because of personality and experience that promote the development of abilities. An awareness of self provides information about those characteristics and allows thoughtful control to enhance communication.

REFLECTION

• Is there a characteristic that you do not demonstrate well that you feel you need to develop to become an excellent health professional (e.g. patience or confidence when communicating with strangers)?

• What can you do to develop this characteristic and the associated abilities?

Individual values

All people have values that influence their thoughts and actions. A value is the measure of worth, importance or usefulness of something or someone (Banks 2006). Values develop as an individual experiences life. They originate from families, friends, teachers, the media, religious leaders and caregivers (Purtilo & Haddad 2002). Values influence thoughts, desires, dreams, decisions and actions. They contribute to the development of particular characteristics and thus abilities or inabilities. If an individual values hand-made garments, they may persevere to learn knitting. If they do not they may never begin the process of testing their abilities in knitting. If a person values respect of self and others when interacting they will take action to both demonstrate and expect respect (Harms 2007).

ACTIVITY

What do I value?

Make a list of what is important to you. The items on the list may be objects (e.g. car, computer), specific people (e.g. son, sister, father, partner), characteristics (e.g. perseverance, organisation, aggression), states of being (e.g. health, wellbeing, safety) and particular activities (e.g. shopping, travelling, volunteering).

REFLECTION

Why do I value?

• Consider the items on the list and decide why you value them. One reason might be the way they make you feel, while another reason may be that your family or friends think these things are important.

• Have your values changed over time? List how they have changed and what caused the change.

GROUP ACTIVITY

Sharing the reasons for valuing

• Together share the reasons why you value the things on your list.

• Are there any common values among the members of the group?

• Are any of these values essential for a health professional?

Is a health profession an appropriate choice?

There are particular values, characteristics and abilities that facilitate effective practice in the health professions. It is important to be aware of these values, characteristics and abilities because this awareness assists in verifying the choice to become a health professional. Some individuals pursue a career in a health profession because someone they admire is a health professional. These individuals may be seeking a career that does not suit their interests, values or abilities. Other individuals pursue a career in a health profession because they are aware of the role, the values and the required characteristics and abilities of the profession and feel they meet the necessary requirements. Others may not pursue a career in the health professions because they are unaware that their interests, values, characteristics and abilities are well suited to such a career. Still others do not pursue a career in the health professions because it does not provide the economic return they desire or because it is too consuming of time and emotions. The reasons for the choice about whether or not to become a health professional usually indicate the values of the individual.

Values of a health professional

The overall purpose of the health professions centres on people (see Ch 2). Sometimes this overall purpose focuses on individuals and at other times on individuals within the context of a family. If people are the central focus of all health professions, it seems appropriate to assume that all health professionals must value and appreciate people. If health professionals do not value and appreciate people and their associated needs, the outcome of their intervention may be inappropriate and ineffective.

GROUP ACTIVITY

• Together define ‘health’. Does your health profession value health? How does your health profession demonstrate this value?

• Now define ‘quality of life’. Does your health profession value quality of life? How does your health profession demonstrate this value?

INDIVIDUAL OR GROUP ACTIVITY

• List and define other values of your health profession.

• Does your health profession have these values in common with any other health profession?

It is important that health professionals value both themselves and others. A health professional must have a desire to understand and assist people with their needs through expressions of empathy, demonstrations of respect and development of trust. It is important that health professionals value a therapeutic relationship that collaborates, empowers and develops rapport. This value promotes family/person-centred practice and is essential for all health professionals. It is also essential that health professionals value the knowledge and skills specific to their profession and those of other health professions. If these values are not important to an individual, that individual should not consider a career as a health professional.

Characteristics and abilities that enhance the practice of a health professional

While particular health professions require specific interests and abilities, there are characteristics and associated abilities that benefit individuals in all health professions. The following questions highlight some of these characteristics and abilities.

REFLECTION

Am I suited to a health profession?

Answer the following and list characteristics or events that validate your answer.

• Do I generally enjoy relating to people?

• Do I enjoy relating to people who are different to me, regardless of the difference?

• Do I enjoy relating to people who require assistance?

• Am I able to relate to people who are expressing negative emotions?

• Can I generally think clearly when others are expressing negative emotions?

• Do I generally enjoy communicating with people?

• Am I an effective and good communicator?

• Do I enjoy creative problem-solving?

• Do I enjoy helping people to help themselves?

• Do I enjoy encouraging people?

• Do I enjoy assisting in solving problems for other people?

• Do I enjoy challenges?

• Am I generally patient with myself and others?

• Am I a good listener?

• Do I usually attempt to understand myself and other people?

GROUP ACTIVITY

Consider each question and name the characteristic(s) and/or ability(ies) highlighted in the question. Does your health profession value these? Decide whether all health professions value these characteristics and abilities.

REFLECTION

Do you feel you exhibit these characteristics and abilities?

• Which ones do you feel you do well?

• What has contributed to your development of these?

• Which ones do you feel you do not do well?

• What has limited your development of these characteristics and abilities?

• What can you do to develop those you feel you do not do well?

Personal unconscious needs

There are needs every individual has that contribute to ‘inabilities’ or limitations in relationships (Stein-Parbury 2006). These unconscious needs create typical ways of relating and affect the characteristics and outcomes of relationships. This reality indicates that health professionals must be aware of the basic needs that dominate their expectations of relationships and ways of relating. There are three basic human relationship needs:

1. The need to be accepted and valued – to have a ‘place’, feel special and know that others care (Brill & Levine 2005, Milliken & Honeycutt 2004)

2. The need to be in control

3. The need for affection and affirmation (Stein-Parbury 2006).

All humans have these needs. At different times individuals long to feel valued for who they are – to feel accepted and special. This need expresses itself through relationships in which the person is always fulfilling the needs of others and doing for others, regardless of whether the other can do for themself. These people find it difficult to say no when asked to assist. Some people have a predominant need for control and thus will limit involvement in relationships and situations that are unpredictable. This need expresses itself in relationships with others who are happy to do exactly what the person demands, in the exact manner. These people find it difficult to enter situations that involve change or risk-taking. Other individuals predominantly seek affection and affirmation. This need expresses itself through the seeking of relationships that protect them and affirm whatever they do. These people may also find it difficult to say no, because they crave affirmation and fear rejection. While everyone experiences these needs, some people have a consistently dominant area of need that influences all their relationships and interactions. The dominant need of individuals may vary according to the events in their lives at a particular time. It is important for individuals who choose a career in a health profession to be aware of which of these needs dominate their relationships.