Category: Writing

Posts on writing by a writer Jano Klimas, primarily on books, poetry, slams and science writing.

The mystery of change (-ing others): article in the Irish Psychologist

How may I help you– change you?* 

“Change is the Law of Life. And those who look only to the past or present are certain to miss the future.” – John F. Kennedy


Trying to help somebody to change their bad habits is an admirable act of kindness. It shows our compassion and care for the less fortunate. The best is when it comes from the person’s own initiative. Motivated helpers are assumed to be good helpers. Some of us help others pro bono, while others do it as part of their job description. But what if the professional helper doesn’t want to help? How do you help the helper with change in others?

Encouraging professional helpers to address excessive drinking is a complex problem. It’s so complex and resistant to change, that their unwillingness to adopt these new practices can be viewed as a bad habit. Many experts called for complex strategies to persuade their clinician colleagues to address alcohol. But complex strategies did not help.
Professors Anderson, Laurant, Kaner, Wensing and Grol reviewed available scientific evidence and claimed it was possible to increase the engagement of doctors in screening and advice-giving for excessive drinking. They saw a potential in programs which were specifically focussed on alcohol and that were multi-component. Later, some of the original team tested this theory by doing a clinical trial, which is a type of study considered as a golden-standard by many experts. Their Swedish experiment “failed to show an effect and proved difficult to implement”. Are the Swedish too stubborn to embrace change? Let’s not be harsh by accepting this cultural stereotype as a plausible explanation for their negative findings, before we look at more perplexing findings from other countries.
When scientists ask doctors and other professional helpers about what’s so difficult in talking alcohol with their patients, they give the same reasons all over the world. The World Health Organisation (WHO) commissioned a multi-state study, at the beginning of the millennium, which documented all of these reasons – the myths about alcohol care. The myths were lack of time, inadequate training, a view that alcohol is not a matter that needs to be addressed by medical doctors, conviction that doctors’ advice won’t work and fear of talking about such sensitive issue. It seems that the next twist in the story of change brings us to helpers’ beliefs.
Recent research at the University of Michigan, cardiovascular centre demonstrated how doctors’ confidence in their ability to advise patients on diet and exercise correspond with their own personal health and fitness levels. Could this apply to alcohol too? Would it help if we use some evidence-based strategy to boost their confidence or ambivalence about drinking behaviours?
Motivational enhancement therapy (MET) is an evidence-based treatment which targets person’s ambivalence about unwanted behaviours including their attitudes and beliefs. A team supervised by Professors Hettema and Sorensen used this Swiss-army knife of addiction counselling to help doctors-to-be to resolve their ambivalence around managing alcohol and drug problems. They’ve put a group of nine medical residents through a brief MET therapy before they learned more about alcohol consulting and advice-giving. Five weeks later, their consulting and advice-giving went up, but due to the small numbers, the researchers called for caution with interpretation of their results.
Resident education was combined with a team-based approach to systems change in the Richmond clinic – a busy family practice in the south-east Portland, Oregon. Dr Muench led his team to change the way they deal with drinking issues – from receptionists, through medical assistants to physicians.
Dr Muench is a slim, middle-aged physician with a passion for teaching young doctors and helping patients from difficult backgrounds. Explaining their approach to practice change, he points out, ‘we’ve strengthened our practice systems, but the system leaks at three points. They are at the front desk, in the consultation room and in the teaching modules.’ In making these comments, Dr Muench argues that while their project led to many improvements, there are things that can be improved. Ultimately, Muench conveys a positive message about systems change being possible, although not without some obstacles. In the Richmond team-based approach, the receptionists should give patients alcohol check-ups while they wait for the consultation, but they often forget because the PC fails to remind them of this. When the receptionist doesn’t forget to hand out the form, and the patient brings it to a medical assistant, she frequently forgets to complete the full assessment. It is no surprise then that the next ‘cog in the machine’ – the doctors – ‘forget’ to discuss alcohol with patients.
What science tells us about implementing change is reassuringly similar to the traditional knowledge of common folk. If you can’t change others, change yourself. “We must become the change we want to see”, said Gandhi. Richmond truly became the change they wanted to see in others. And yet, the project’s 75% yardstick of engaging patients into alcohol discussions wasn’t met. Why was Richmond below targets? Embracing change in healthcare requires system changes and education on several levels – multi-level changes.

*This is a shortened version of my article published in the Irish Psychologist, Volume 40, Issue 2/3. Dennis McCarty, PhD gave me feedback on drafts of this blog post.

Citation for the full version of this article:

Klimas, J. (2013). The mystery of change(ing) others. Irish Psychologist, 40(2-3), 78-79. http://www.psihq.ie/irish-psychologist-journal-of-psychology

Facing the fear: alcohol and mental health conference in Ireland (#facingthefear)

On Wednesday, 20 November 2013, I’ve attended this conference in the Royal College of Physicians in Dublin, Ireland. The conference was organized by alcohol action Ireland. What were the fears that the presenters encouraged us to face? Read about them below

Dr Bobby Smyth started his talk with a brief intro into the ways by which culture and language shape attitudes about drinking – a cultural learning to drink. He saw teens as apprentice adults, learning by observation. The age when they start to drink has gradually lowered during the Irish boom. Who’s fault is that? The alcohol industry and crazy sports sponsorships play a role. Also, “our culture encourages us to drink to overcome low mood”.

Teens learn to wipe on the shoulder of vodka. If they continue to “bathe” their brain in alcohol soup, they are rolling the dice – can we stop it rolling or roll it safely? Dr Smyth provided their book as a guide for dealing with some of these issues (see Fig 1).

One of the key drinking motives is the social motive – alcohol is a social lubricant. This is reflected in the language too. Eskimos are surrounded by snow all year round and have 100 words for it. There are 120 words for the state of alcohol intoxication in Ireland. People have stopped having fun sober. Moral language of industry-sponsored sites is often substituted for more effective strategies. Slogans like drink sensibly can hardly foster behavior change.

Prof Ella Arensman spoke about the focused on health& women, especially on the seasonal patterns of self-harm and public holidays.

Dr Conor Farren addressed the relationship between alcohol and mental health issues, including depression. He also showcased his book (see Fig 2).

Dr Philip McGarry spoke about alcohol’s impact on mental health in Northern Ireland.

After lunch, the delegates came back for a panel discussion featuring Dr Claire Hayes, John Higgins and Fr Pat Seaver.

Watch the speakers’ presentations here

7th All Ireland Poetry Slam Championship final

Monday 9th December 2013 – 7th All Ireland Poetry Slam Championship final

Venue: North Beach Poetry Nights in The Crane Bar, Sea Road, at 6.30pm

Galway, Connacht

Ireland’s eight 2013/14 slam champions – 2 each who won the 4 regional heats – go head-to-head for the prestigious title of All Ireland Live Poetry Slam Champion 2013/14.

Two weeks in advance of the slam, the information about this prime event of Irish poetry is scarce.

As a response to this vacuum, this blog collates everything that I could find today on the web about this slam.

The facebook pageof the slam describes: “Open live poetry competition. Six province heats. Eight poets, four Province Champions, compete in rotating All Ireland poet slam final. Samhain, Nov/Dec. Eight poets, two from Connacht, Leinster, Munster and Ulster, winners of open-heats in Belfast, Cork, Derry, Dublin, Galway and Limerick, the sixth all Ireland slam championship final, the second in Munster, Samhain, Oct/Nov, Cork.”

“The All Ireland Poetry Slam Championships are in their seventh year. We began in 2007, and since then have held annual provincial heats in six cities, Belfast, Cork, Derry, Dublin, Galway and Limerick, which return eight finalists, two from each province, who then go forward into a rotating final modelled on the idea of the old ollamh (poetry professor) circuit.

The competition is run by Ireland’s most well respected grass roots poetry organisers with a wealth of experience in hosting live poetry events across the island of Ireland. By the third year we have been pretty much well established and the competition is wholly democratic, transparent, and open to all.

Regional heats are held in the above six cities at the end of the summer and this year’s turn at hosting the final is Connacht, in Galway on 16th December, hosted by North Beach Nights’ John Walsh.

Last year’s final was the biggest yet, with 250 people witnessing it in Cypress Avenue, Cork, hosted by Ó Bhéal. Last year we also published, for the first time, the 14 poems recited on the night, in a special edition run of 100 chapbooks. We managed this because we crowd sourced 1000 euro funding. Up till last year the competition had been run on the goodwill and generosity of its organisers and so this year is hoping to secure funding that will raise the profile even more and make the event more visible.

A wide range of poets have won, some going on to bigger and brighter things, 2010 Champion Colm Keegan is a regular on RTE Arena, along with previous Leinster champions Karl Parkinson and John Cummins.

Two winners, 2008 champion Donal O’ Siadhach and 2011 champion Séamuas Barra Ó Suilleabháin, won reciting as Gaeilge.

This competition is a genuine grass roots phenomenon, enabling poets to share and compete in a truly democratic forum and has played a vital part in many poets development. Most countries national Slam projects are well supported by the various arts councils but Ireland is special in that it has evolved from the ground up, with no funding whatsoever until last year; proving our commitment to grass roots poetry advocacy.

The regional organisers are:

Source: unnamed alcohol industry

 

“Congratulations to the new 2013/14 Leinster Poetry Slam Champions John Cummins and John Moynes (watch rec. below), who will join: 

2013/13 Munster Slam Champions

Fergus Costello (Tipperary)

Julie Fields (Cork)

 
Ulster Slam Champions 

Colin Hassard (winner of the Belfast heat) 

Geraldine O’Kane (winner of Derry/Londonderry heat))

Connacht Slam Champions

To Be Decided

@The 2013 All Ireland Poetry Slam Final, North Beach Nights, Galway, Monday 9th December 2013.

Thanks very much to Aidan Murphy of Monday Echo for organising the event and Kit Fryatt of Wurm Press for co-hosting with Aidan.” source: https://www.facebook.com/pages/Ireland-Poetry-Slam/338399146209479

“I just got confirmation of the date from John Walsh for the 7th All Ireland Slam Final and it is Monday December 9th 2013.

9th December 2013 – 7th All Ireland Poetry Slam Championship final, North Beach Nights, Galway, Connacht. Ireland’s eight 2013/14 slam champions, two each who won the Connacht, Leinster, Munster and Ulster Heats, go head to head for what’s in the pot and a prestigious title of All Ireland Live Poetry Slam Champion 2013/14.” source: https://www.facebook.com/desmond.swords

See also:

The David and Goliath tour: Gladwell live in Dublin

The unmissable Malcolm Gladwell showcased his book in RDS hall, Dublin, on 1 November 2013. After the show, he signed hundreds of books for his perserverant fans.

David and GoliathI’ve got it. His face was much paler than his photos on the book covers. After 27 minutes of queuing and reading the 1st chapter of his most recent book, I got Malcolm Gladwell’s signature. I waited patiently as hundreds of people in the queue ahead of me got their books signed and photographs taken. When he finished, he said to me: “These two are yours?” and the magical moment passed away.

Cycling back home, I passed by the US embassy where I got my visas for the sabbatical in Portland, Oregon, only 9 months ago. I loved Portland and thought it was a strange coincidence when I met Malcolm personally just next door from a place where my latest life story started. The cycle closed.

Pondering these coincidences, I almost hit a jaywalker. Jaywalking in Ireland is the norm and it illustrates one of the key points of Gladwell’s talk – the principle of legitimacy.

Malcolm lectured about why people obey rules or become radical. Citing from his new book, he argued that people will comply with the system if they believe it’s legitimate. 

“Legitimacy is based on fairness, voice and legitimacy” (p.293) he continues: ”People accept authority when they see that it treats everyone equally, when it is possible to speak up and be heard, and when there are rules in place” that don’t change radically from day to day.


Irish pedestrians must be convinced that the traffic lights system is not legitimate and that one must jaywalk to get where they want to be in time. There must be something seriously wrong with the traffic lights in Dublin if they are disrespected there, but respected in most other countries. In fact, the pedestrian lights have 3 symbols instead of 2 – one more than most countries. There is an orange-coloured light between the red& green lights. The green light is very short an orange flashes for the most of the walking interval. See figure below 

The 2nd principle of legitimacy theory says that people will break the rules if they don’t see the negative consequences of breaking the law as outweighing the benefits of obeying the rules. The enforcement of traffic light law for pedestrians in Dublin is virtually non-existent. Jaywalking will remain legitimate in Dublin until the system becomes more legitimate.

Literature:

Gladwell, M (2013). David and Goliath. Penguin books
Tyler, T (2006). Why people obey the law. Princeton University Press
Kennedy, D (2008). Deference and crime prevention. Routlege

Sherman, L (2006). Evidence-based crime prevention. Routlege

Does enthusiasm improve outcomes?

What drives you at your research work?

What do you want to do when you grow up?

What jobs did you have before your career in research?

These, and other, questions came to me during my recent sabbatical in Portland, Oregon. I had time to reflect and step back from the hectic research life. The frenetic chase for money and articles can disconnect researchers from their internal motivation – their primary drive.

If goals are too distant, and are obstructed by too many obstacles, they can get out of site. Continuous re-connection with personal motivated and awareness of own goals keep us driven. Enthusiasm can improve professional performance.

In his book, Clueless in Academe (2003), Gerald Graff argues that schools should use students’ drive to read sports or music magazines for academic purposes. Their interest, if directed properly, should one day bring them to libraries, he hopes.

Many students are not interested in academic topics. Their motivation is weak and affects results. At my final undergraduate exam from personality psychology, the examining professor disagreed with Graff’s assertion. He was convinced that students should spend more time studying subjects which they disliked than their favourite subjects.

Although I disagreed with him, I fully endorsed his conclusion that the disliked subjects are likely to attract less practice time, followed by academic failure, provided that students’ talents do not compensate for lack of practice. At the same time, I think that students need not to excel in every subject. Each day has only 24 hours and no one can do everything – some things have to be neglected. Students need to prioritize their activities. The decisions about preferences shape their lives and future careers. Natural interests are likely to draw students closer to themselves, leading to better self-understanding. Natural interests should be supported.

Book:
Gerald Graff (2003). Clueless in Academe: How Schooling Obscures the Life of the Mind. New Haven, CT: Yale University Press, 2003, 320 pages