Back to Basics (March 2016): Dr. James Mooney, M.D.

“The higher we are placed, the more humbly we should walk.”

                                                                   -Marcus Tullius Cicero

 Change is inevitable. Change can be uncomfortable. Change can be exciting. Change can be managed. Change can be feared. Change can be evolutionary. Change can be revolutionary. What then should we do? Should we attempt to implement change or direct it once it happens? Does change seem less threatening with leadership? Should change come from the masses instead? Few things need change more urgently than our country’s healthcare delivery system. It stands on the foreground of virtually every political and ethical discussion in society. It has the potential to drain the financial resources of our society. Can we implement a revolutionary change in healthcare without collateral damage and blood in the streets? I think we can. The beauty of the healthcare interaction stems from a relationship between two individuals at the most basic level; the one who needs help and the one there to offer it. What if our system recognized that the one offering help needs as much help as the one asking for it? Change then would be profound.

 In his essay titled, “Relations Between the Ego and the Unconscious1”, Carl Jung describes an important issue for people in leadership positions. It serves as both a reminder and a challenge. It stands at the center of the discussion regarding the necessary change required in healthcare, as it clarifies the relationship between the helper and the one needing help. The individual asking for help is the more vulnerable. Therefore, it is incumbent on the helper to have awareness of that vulnerability. Jung states, “Identification with one’s office or one’s title is very attractive indeed, which is precisely why so many men are nothing more than the decorum accorded to them by society. In vain would one look for a personality behind the husk. Underneath all the padding one would find a very pitiable little creature. That is why the office-or whatever this outer husk may be-is so attractive: it offers easy compensation for personal deficiencies.” This excerpt can be a simple litmus test for the helper who happens to be in the more dominant position. Does it offend you or comfort you? It may be especially painful for physicians and administrators in the executive suite. If systems plan healthcare policy and implement the plan without an awareness of the personal deficiencies of the decision makers, is it any wonder why the policy is so far from the individual needing help. The fact is that a solution is already in place. We just need to breathe some life into it. It is called the Employee Assistance Program (EAP for short). The EAP is a benefit program intended to help employees deal with personal problems that might adversely impact an employee’s work performance or health. Virtually all businesses have one, including and especially healthcare delivery systems. How then can we make them better? Many EAP programs are most evident during crisis situations. Few events demand attention more than crisis. However, how many leaders and decision makers (or helpers) in an organization actually seek out the EAP for understanding his or her own emotional health prior to a crisis? How could routine assessment of organizational emotional health prevent crisis? What would that do for the other employees of an organization? Would there be a trickle-down effect of emotional health in an organization?

 Given the complexity of change, some seek it and some retract from it. Does Jung’s perspective empower you to have introspection, comfort you by clarifying a long-standing emotional pain, or upset you because of its poignancy? Leadership can be defined by having followers. Recognizing and assessing our “personal deficiencies” may be uncomfortable. Nevertheless, it shows the vulnerable that we are vulnerable too. Leadership can drive change. Conscious awareness of emotional health by those in leadership positions will positively influence those in need. Change is coming. Are you ready for it?

About the author:

Dr. James H. Mooney, M.D. is a Hospitalist physician in central Ohio who explores the connection between a person's emotional and physical health.

 1The relations between the ego and the unconscious. Prefaces. In: Jung, C., Collected Works of C. G. Jung, Vol. 7. 2nd ed., Princeton University Press, 1966. 349 p. (p. 123-125).

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