Lack of Insight

Sometimes, the brain doesn’t accurately analyze reality.

Take this scenario:

   

When this happens for clinical reasons, it’s called “lack of insight.” Patients whose field of vision has been cut in half don’t realize they’re ignoring their clinician sitting to their left. Patients with newly amputated legs try to get up to go to the restroom—and fall.  Patients whose swallow muscles are impaired insist that they can take five pills at a time—and end up coughing and spluttering as something goes down the wrong pipe to the lungs. Patients who can't balance to walk ten feet beg to go home without any help or medical equipment. They fail to recognize their confusion, dysphagia, aphasia, visual impairments….

In my own life, this is called “lack of insight.” I take on tasks far too difficult too handle. I walk into emotionally triggering situations without preparing myself, and I end up exploding. I strike up sensitive conversations, unaware that I’m saying insensitive things and causing a lot of hurt. I fail to recognize my hubris, my weaknesses, my biases and prejudices, my selfishness.

Can you relate?

How can we overcome our lack of insight?

Honestly, I’m not sure I ever will, not really. I imagine I’ll always have biases and prejudices, hubris and weaknesses, and of course selfishness.

But I’d like to be intentional about gaining insight. I try to read articles and books written by people of different perspectives, especially marginalized perspectives. For folks without books and articles to speak for them (I’m thinking of my patients and their families), I have to listen intentionally to their individual needs in the moment. I try to find out what they need me to say or not say, do or not do. And often I find out what I thought was helpful was actually not really so helpful at all—in fact, I’ve been hurtful.

I’m doing a lot of praying for humility these days.

What should I do when I gain some insight? When I realize I’ve been rude or hurtful, I’d like to own up to it and apologize. When I’ve made someone else’s story of suffering about me and my response to it, I’d like to stop and listen. When I’ve put myself on a pedestal, I’d like to step down.

I’m never going to get this exactly right. And my insight will never be perfect. But I can strive for what the Greek philosophers called arête—always seeking to better myself and knowing that I will never be perfect here on this Earth.

I'm sure I'll always suffer from lack of insight.  But every day I'll pray and try to do a little bit better.