Design Think Paradigm

Assignment

Select an article that inspires or contributes to the focus of your paper and apply the Design Thinking paradigm. Your blog post may cover all or one phase of the framework and should total 3-4 paragraphs in length. At the end of your post, invite your audience to provide feedback.

The title of my final paper is ‘Silence Pedagogy in Life and Clinical Practice: The Embodied Experience’. The practice of Silence was initially a point of interest due to its reverence in spirituality, as in prayer, solitude or in transcendational practices. Research revealed a much larger body of interest in this subject ranging from Silence in the classrooms and educational settings, in Law as in the Right to Silence (the Miranda Rights), in Linguistics and Music, and silence used in clinical encounters such as in psychotherapy and medicine. The original article “Compassion Silence in the Patient-Clinician Encounter: A Contemplative Approach” was selected to analyze using the Design Thinking Paradigm (Empathize- Define-Ideate-Prototype-Tests).

Empathize: does the article reflect needs?

This article calls upon the need to improve communication skills of clinicians. It examines how silence is currently used amongst clinicians, and between clinicians and patients for well intentioned purposes, but instead can create an awkwardness or indifference that can be interpreted as judgmental, disapproval or uncaring.

Define: How does the author define the problem?

The article begins by describing how a resident physician gives a 67 –year old woman the news that her colon cancer had spread to the peritoneum, and the resulting awkward silence that followed. The authors (Black, Bauer-Wu, Rushton, & Halifax, 2009) describe two types of patient encountered silence; first the awkward silence, a type of silence that does not have clear intentions and is viewed as untherapeutic, and secondly, an invitational silence where patients are given a few moments to reflect or feel what is happening. They noted that within the palliative care context silence has not been empirically studied and they believe that clinicians are primarily responsible for the effects of silence during the patient encounter.

Ideate: What are the authors’ recommendations to the problem?

The authors introduce the concept of a ‘contemplative silence’, one that draws on the wisdom of contemplative practices of Buddhist and Christian traditions. This type of silence is characterized by the clinician’s ability to be attentive, to maintain a stable focus and to show clarity of perception of clinical issues. These mental qualities are likened to mindfulness and compassion practices where the moment –to- moment experience engages the clinician to better understand the patient’s narrative, be more receptive of the patient’s experience and be more insightful in making diagnostic, prescribing and other patient related decisions. To cultivate these mind qualities the authors suggest physicians take moments for introspection and ‘anchor silence in the breath’. By introducing breath awareness, the clinician’s awareness of their senses, perceptions and even biases become more apparent to them, they are able to attune to and reduce their tension levels, and, in doing so can cultivate attitudes of understanding and compassion for their patients.

Prototype: a new practice, program, protocol, procedure, or policy

While the paper did not offer any specific guidelines for developing the techniques or attitudes necessary for a contemplative silence, the authors made reference to the “ Being With Dying Program” (Upaya Zen Center). After taking this program a clinician reported, “ I feel that my sense of being able to … enter into a very non judgmental space is different as a result... Now I have the ability to create a space of receptivity…”

How does one develop a contemplative silence practice? Begin by knowing that silence is

omnipresent and permeates every single cell, what we must do is cultivate awareness of it. Silence and sound, reside in the spaces that surrounds us, our homes, cars, offices, schools, malls, gardens, parks, trails, and in the spaces within us, lungs, heart, digestive tract, glands, bladder, nostrils etc. Below are six activities I practice to cultivate Silence awareness; I invite you to sit with me:

1.     Sit quietly and take a few moments to observe all the sounds you hear, near and far. As you begin to hear these sounds you will eventually begin to hear the silence between the sounds.

2.     Play your favorite song and this time you listen for the spaces and silences between the words, between the music.

3.     Read from 3 -6 first then practice them. Sit comfortably with back upright, your chin slightly tucked in and gently close your eyes. Bring all your awareness to the space that surrounds your body; what sounds do you hear

4.     After a few minutes of (3) above, bring your awareness to your scalp and forehead…relax them, relax your eyebrows, relax your eyes, relax your nose, relax your cheeks, relax your jaw, relax the corners of your mouth, relax your chin, relax your neck, relax your shoulders… relax your mind

5.     Feel and follow the flow of breath in your nostrils with each inhale and exhale…relax your nose, and gently quiet the sounds of your breath. Keep this awareness for about 3 minutes

6.     Slowly open your eyes, maintain the awareness on the quiet breath

Practice, Practice, Practice

In conclusion, if as the authors suggests that Contemplative Silence and anchoring in the breath can cultivate a deep healing and therapeutic encounter, then I pose this question and ask that you contemplate on it before answering: Are you in control of your breath?

Namaste to all,

Stay safe until the next post

Bibliography

Black, A. L., Bauer-Wu, S. M., Rushton, C. H., & Halifax, J. (2009). Compassion Silence in the Patient -Clinician Encounter: A Contemplative Approach. Journal of Palliative Medicine , 1113-1117.

Upaya Zen Center. (n.d.). Retrieved November 20, 2013, from http://www.upaya.org/