Week 5

Context

In recent years, science has discovered a tremendous amount about the role emotions play in our lives. Researchers have found that even more than IQ, your emotional awareness and abilities to handle feelings will determine your success and happiness in all walks of life, including family relationships. Goleman (1996), developed a framework of five elements that define emotional intelligence. The first of these was self-awareness – people with high emotional intelligence are usually very self-aware . They understand their emotions, and because of this, they do not let their feelings rule them. They are confident – because they trust their intuition and don't let their emotions get out of control. Gottman (1998) believes that when you help your child understand and handle overwhelming feelings such as anger, frustration, or confusion, you develop his emotional intelligence quotient, or emotional IQ (EQ), and that a child with a high EQ is better able to cope with his feelings, can bring himself down from emotional high-wire acts, understands and relates well with others, and can form strong friendships more easily than a child with a lower EQ.

Content

What is self awareness?

There are no simple definitions of the terms “self” or “awareness”. In the context of caring for people with a mental illness, the work of Burnard (1984) and Rawlinson (1990), began initial identification of influences on self-awareness. Thrower (2002) comments on self awareness being “the condition of being able to analyse motives for behaviour.” Therefore, if a health care professional is conscious of their own actions and the resulting consequences, they can constantly reflect to improve their practice. Crisp & Turner, (2010) defined self-awareness as " ... a psychological state in which people are aware of their traits, feelings and behaviour. Alternately, it can be defined as the realization of oneself as an individual entity." Another definition is that of Franzoi (1996: p61), "..a psychological state in which one takes oneself as an object of attention."

In simple terms, self-awareness is about trying to understand who we really are and why we do the things we do, in the way that we do them. By becoming more self-aware, we can gain a greater degree of control over how we are operating in the present - instead of reacting to something conditioned by our past experiences.

Areas Of Self Awareness. Take a look at the awareness wheel below. Given any moment in time or specific event (referred to as 'issue' in the wheel), you can become aware of several different areas of your internal world.

Sensory data is all the information we receive through our five physical senses, i.e. our eyes, ears, nose, tongue and skin. This data, once received, is immediately processed in our mind by comparing it with previous experiences.

Thoughts are automatically formed with very little conscious awareness through this inner processing involving past memories. Within this process, assumptions, beliefs, concepts, expectations, meanings and judgments are made. Our thoughts, then, are the story we tell ourselves and others about the sensory data that we have interpreted. Unless we are fully aware of this process, we are unlikely to be able to see things as they really are. Instead, it will be a story we have created from our own perceptions, coming from our own perspectives.

Feelings are our physiological responses to those thoughts, resulting in pleasant or unpleasant sensations which we described as fear, sadness, anger, joy or guilt, or all the other variations of emotion.

Wants are our desires, expectations, hopes and yearnings that we have for ourselves.

Actions are our behaviors, in words or actions, that follow through as a result of how we interpret and perceive the data, and whether they are compatible with what we want.

Why should we seek to improve self awareness?

Caring for those with mental illness is founded on the ability to cultivate positive relationships with people who may be very different from us. There may be differences in age, race, personality, gender, socioeconomic status, health, sexual orientation, rank, power, and privilege, as well as beliefs regarding religion and politics. The experience of these differences can cause us to feel emotionally and cognitively disturbed. The ability to become aware of and consciously attend to these internal disturbances will affect the quality of relationship we are able to establish with the people we serve. A compassionate cultivation of self-awareness is an essential skill vital to the professional growth and development of being a competent carer. It requires dedication and commitment to an on-going practice of mindful non-judgmental attention to what is happening inside of us as we interact with others. Also, " ... personal values and professional behaviors are continuously tested as a result of workload issues and health care reform efforts. ... use of self has been thought to be an underutilized resource in a health care milieu sorely in need of creative and useful approaches to providing high-quality, cost-effective health care" (Eckroth-Bucher, 2010: p306).

Who am I?

There are many theories of 'self' and 'self conceptualisation', and these are beyond the scope of this short course. Gordon (1976) useful brings together four different schools of thought., each of which he conceptualises as the person's subjective interpretation of his standing in relation to: adaptation (the sense of competence, based on the work of White); goal attainment (the sense of self-determination, based on the work of Maslow); integration (the sense of unity, based on the work of Erikson); and, pattern maintenance (the sense of moral worth, based on the work of Baldwin). He gives us this table (p.410) showing the hypothesised parallels between functional problem, sense of self, and symbolic reward:

Functional Problem
Adaptation
Goal-Attainment
Integration
Pattern Maintenance

Systemic Sense
Competence
Self-determination
Unity
Moral worth

Symbolic Reward
Approval
Response
Acceptance
Respect

Maslow's 'Hierarch of Needs'

The Maslow's Hierarchy of Needs five-stage model below (structure and terminology - not the precise pyramid diagram itself) is clearly and directly attributable to Maslow (1954, 1970, 1987); later versions of the theory with added motivational stages are not so clearly attributable to Maslow. These extended models have instead been inferred by others from Maslow's work. Specifically Maslow refers to the needs Cognitive, Aesthetic and Transcendence (subsequently shown as distinct needs levels in some interpretations of his theory) as additional aspects of motivation, but not as distinct levels in the Hierarchy of Needs.

Each of us is motivated by needs. Our most basic needs are inborn, having evolved over tens of thousands of years. Maslow's Hierarchy of Needs helps to explain how these needs motivate us all. Maslow states that we must satisfy each need in turn, starting with the first, which deals with the most obvious needs for survival itself. Only when the lower order needs of physical and emotional well-being are satisfied are we concerned with the higher order needs of influence and personal development. Conversely, if the things that satisfy our lower order needs are swept away, we are no longer concerned about the maintenance of our higher order needs. Maslow said that needs must be satisfied in the given order. Aims and drive always shift to next higher order needs. Levels 1 to 4 are deficiency motivators; level 5 is a growth motivator and relatively rarely found. The thwarting of needs is usually a cause of stress, and is particularly so at level 4.

Johari Windows

The Johari Window model (Luft & Ingham, 1955) is a simple and useful tool for illustrating and improving self-awareness, and mutual understanding between individuals within a group. The Johari Window model can also be used to assess and improve a group's relationship with other groups. The window has four panes, derived from the knowledge, or lack of it, that we have about ourselves and that others have about us.

The Open area, sometimes called ‘the Arena’, is what we know about ourselves and the people around us also know about us. This is shared knowledge and is the basis of effective communication. Luft and Ingham worked from the assumption that the more of our life that is in this quadrant, the better our relationships will be. The Hidden area is the information we keep from the world. In the context of my relationship with you, it is what I have not revealed to you about myself. This quadrant has also been called ‘façade’ or the ‘avoided area’. It may be a trivial fact, like my enjoyment of movies, or something deeply personal. There is also an area, called the Blind area or ‘Blind spot’, in which the people around us are able to recognise traits, habits or characteristics to which we ourselves are oblivious. These can be both strengths and failings. Finally, there is the Unknown zone. Here are the things that neither we nor other people are aware of. Perhaps these things are repressed; perhaps they are simply unexpressed. Examples of the latter are latent capabilities.

We can enhance our knowledge of ourselves by seeking feedback, to make use of the insights others have. We can also increase our awareness by a process of self discovery, to learn about the contents of our unknown area. A group discovery process can open up the Unknown area to both ourselves and the group. Likewise, we can enlarge our Open area by disclosing information about ourselves to other people, removing it f rom the Hidden area.

Reflective Self & Reflective Practice

Reflection is the examination of personal thoughts and actions. For us this means focusing on how we interact with our colleagues and with the environment to obtain a clearer picture of our own behaviour. It is therefore a process by which we can better understand ourselves in order to be able to build on existing strengths and take appropriate future action; and the word ‘action’ is vital (Somerville & Keeling, 2004). The Johns model (Johns, 2000) identifies particular areas of reflective practice:

Describing an experience significant to us;
Identifying personal issues arising from the experience;
Pinpointing personal intentions;
Empathising with others in the experience;
Recognising our own values and beliefs;
Linking this experience with previous experiences;
Creating new options for future behaviour;
Looking at ways to improve working with patients, families, and staff in order to meet patients’ needs.

Gimenez (2011: p45) looked at reflective practice and reflective practitioners. He identified ideas that practitioners have when asked to define reflection on practice; 'learning from past experience', 'evaluating what happened', applying practice wisdom', 'examining what was done', 'getting better prepared for the future', and, 'empowering'. Gimenez feels that these re all to do with being a reflective practitioner, and "that through reflection you can learn to change aspects of yourself, your practice, or both".

References and Further Reading

Burnard P. (1984) Developing self-awareness. Nursing Mirror. 158:30-31

Cassidy, P. (2010) First Steps in Clinical Supervision: a guide for healthcare professionals. Mc Graw-Hill Open University Press.

Eckroth-Bucher, M. (2010) Self-Awareness: A Review and Analysis of a Basic Nursing Concept. Advances in Nursing Science Vol. 33, No. 4, pp. 297–309

Franzoi, SL. (1996) Social Psychology Chicago: Brown & Benchmark

Gimenez, J. (2011) Writing for Nursing and Midwifery Students. 2nd Edition. Palgrave Macmillan

Goleman, D. (1996) Emotional Intelligence: Why it Can Matter More Than IQ. London: Bloomsbury Publishing

Rungapadiachy, D.M. (2008) Self Awareness in Health Care: engaging in helping relationships. NY Palgrave Macmillan.

Somerville, D., Keeling, J. (2004) A practical approach to promote reflective practice within nursing. Nursing Times; 100: 12, 42–45