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.  

Honor the Process

Each year, I ask the Lord to give me a word to bless the new year.  (Yeah, I'm cheezey like that.)  I was reflecting and meditating with a dear friend on New Year ’s Eve, hoping (as always) for a really positive word heralding achievements and abundance.  Alas, this year, I received a challenging phrase:  “honor the process.”

"Dude, that sounds like some sort of hippie dippie mantra" I thought.  "Are you serious?"

I’m pretty sure He’s serious.

I am not really into “honoring the process.”  I like my results to be fast and measurable.  I’m the kind of person who writes things like “brush teeth” and “finish to-do list” onto my to-do list, so I have something to cross off.  

This is going to be rough.

My patients and their families also express frustration when “the process” doesn’t seem to have a steady upward trend.  “I could to this yesterday!  Why can’t I do it today?”  “Why can’t she just learn this?”  “Why is this week worse than last week?”  I can definitely relate to this impatience, although my struggles are very different from their struggles.

A very wise person shared something with me, and I’m going to share it with you:

Progress does NOT look like this:

True progress looks like this: 

We have to get through the “bad” days to move forward. 

What does this look like?  Accepting when our progress looks like the clichéd one step forward, two steps back.  Allowing ourselves (and others) to mess up.  Practicing patience with ourselves, others, and God.  This is easier said than done, especially in a society that is obsessed with productivity and optimization.

This also means we should be kind to ourselves when we aren’t practicing patience.  Learning to “honor the process” is a process.  (oooh, meta)

I’m including a full page printout of the graphs above in the SLP tab.  SLPs and other therapists, I encourage you to give these to your patients.  The wise sage who taught me about what progress looks like gave me permission to put this printout on the website.