Has the word resilience become synonymous with institutional gaslighting and denialism of system-based abuse? Can I ask- what would accountability look like?

A reminder to everyone who thinks they can influence change in a toxic culture. Unless you’re anointed with that task and you have carte blanche to implement anti-oppressive strategies & social power to do so, your efforts will be perceived as threat to the institution. I share exactly what I mean here:

nathaliemartinekphd.substack.com/p/from-pet-to-…

One of the first things to do before exiting a toxic relationship is to plan the transition out.

Here are some pointers for choosing who is on your team and the commitment required of them.

[THREAD] Whether it's ending a relationship with an intimate partner, workplace, friend, health professional, therapist or your own professional identity, you need to put support in place to stabilise you while you undergo this de-stabilizing process to break from a co-dependence pattern.

THREAD about #narcissistic behaviours

These behaviours are warning signs that a relationship you're in is heading into territory/ indicators of 𝐞𝐦𝐨𝐭𝐢𝐨𝐧𝐚𝐥 & 𝐩𝐬𝐲𝐜𝐡𝐨𝐥𝐨𝐠𝐢𝐜𝐚𝐥 𝐚𝐛𝐮𝐬𝐞.

It's likely you have at least one person in your life who does this. These behaviours can be present in:

✴️intimate relationships
✴️friendships
✴️professional relationships
✴️personal, cultural & professional communities
✴️family relationships.

In other words, anyone in your life can be controlling and abuse their power.

Hot tip: People are not binary ok/not ok.

We're complex and can experience both, neither or anything outside those states.

If you sense someone is struggling, your openness to hearing where they're at helps them feel seen and reassured.

Some alternative questions 🧵 Share your observations using non-stigmatizing language:

"I notice a difference in you today. What's been going on?"

"There's a difference in your tone of voice/body language today that makes me wonder about how you're doing."

GASLIGHTING

I've spent the last month writing/editing a guide for #medical students to respond to casual #sexism and #misogyny as an addendum to my Little Book of Assertiveness.

I want to say a few things about GASLIGHTING

🧵

1/ The person, often male, doing the gaslighting occurs when a woman or other gendered person responds to a sexist/misogynistic comment to:

💪shut it down
💪challenge it
💪expose it
💪call it out

in a culture or relationship dynamic where that hasn't happened before.

2/

I coach physicians to gain shared understanding about their suffering and facilitate shifts in perception that reveal opportunities for behavioral change and transformation. It means I'm frequently exposed to stories of deep suffering & pain.

How I maintain my energy

🧵

https://twitter.com/SonjaCowling/status/1278784136367529991

1. Clear boundaries.

I know what territory I can cover and when to refer onward. I'm clear about my limits and communicate that at the beginning of the relationship and as we co-create our working together agreement.

I break from work when I'm in the thick of my own process.

I have a beautiful friend in ICU in NY.

I urge all frontline workers to please refer to the people who have been intubated as 'the person with/who is...'
rather than 'the Covid' 'the Intubated' 'the patient who's not going to make it'.

I understand why this happens... 1/ Depersonalisation is a necessary coping skill while managing internal dilemmas, fear, external pressures, inadequate health system, discomfort wearing PPE for long periods and constant exposure to patients with deteriorating health due to COVID19.

It's a nightmare.

2/

Reduced empathy is an unintended biproduct of the educational process. What happens in first year? The first exposure to a patient is a dead body. No info about their lives, families, stories of triumph. Only cause of death. No way of creating empathic connection w/ the dead. 1/

https://twitter.com/psirides/status/1072812103281635328

This & other bodies become tools to create emotional distance between the future Dr and patients. Students can’t get feedback from this lifeless body about the level of pain, discomfort, care or love that can be felt from the interaction.

I mentor & coach physicians on their wellbeing & how to use their energy wisely.

Just as there are people called to work in healthcare, it's my calling to serve those who help people in their most vulnerable times & phases of life to continually have the capacity to do it. Somewhere along the journey to becoming a physician, students started believing that they should be able to handle everything they're exposed to & developed messy coping habits that impact on their ability to connect with others & self in healthy ways.

THREAD:

Being an entrepreneur comes with a sense of freedom & none of the institutional limits on creativity. Yet unless I'm consulting within an organisation or connected to community, it can feel lonely & isolating. Online communities are great for support but it's not enough. I've seen the negative effects of people investing all their time/energy in networking online & draining group dynamics. I realised that one of my values is to participate in collaborations that involve physical meet ups or at least in the potential of physical meetups. 2/

#FridayNightMusings
The end of my week involves reflecting on my week and what I've learned from my experiences & conversations with others. Topics in my awareness are gender inequality in medicine, physician burnout, abuse in healthcare & sharing/oversharing our stories 1/ There are those here who strive to inspire peers, provide a space for connection & rally for change through the various discussion threads. It's clear to me that there's a lot of passion & desire to do great things in the world by those who I follow/see in my feed. 2/

This is my commentary on #twitter #movements. Before I go I want to preface this with a statement: I love humans. We're amazing creative & powerful beings. I'm fascinated by human behaviour and the hidden motivations underlying our basic need to belong. 1/ I've observed some movements taking off on Twitter. Some for #MedEd, raising awareness, knowledge sharing, inspiration and sharing failings, wounds & triumphs. Generally they support creative expression in 280 characters. Awesome! 2/

I’m going to pitch in here. A lot of what’s considered burnout is actually compassion fatigue. Poor understanding of either which affects types of interventions, prevention & support available. Let’s also remember how boys are socialised to be ‘men’.

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Depersonalisation: shut down of empathy to cope. Emotional exhaustion: too much empathy & absorbing emotional burden + vicarious trauma thrown in. Both contribute to compassion fatigue-looks like burnout but isn’t.

Some thoughts: There seems to be an assumption in #medicine that patients receive the best care based on best evidence, where evidence usually means quantitative research (my assumption). Yet quality of care is dependent on personal characteristics of each health professional 1/ Knowledge derived from evidence is insufficient to translate into behavioural changes that support the 'best care' intention. Science-based evidence must be channeled through unquantifiable characteristics expressed by each individual health professional to provide best care 2/

Wellbeing preservation in healthcare (within your control)

1. Stable & trusting connections to others
2. Connection to self - meditation, self-reflection, self-examination ie. quiet time
3. Connection to your environment/Nature

#medtwitter #phdchat #MH4Docs #womeninmedicine
1/ 4. Connection to your purpose (your Why) & desire to serve wellbeing of others
5. Peer support & group reflective practice w/ agreements to preserve confidentiality, respect, non-judgement & openness
6. Mentoring by someone who has qualities you want/admire & skills you need

2/