Unhooking

A professor in my PhD program said something during a discussion we had last term, when I shared some of the internal struggles chiropractic faces around our identity, values, and worth. Specifically, his input (from a non-chiropractic outsider’s perspective) was:

How can the two sides or spectrum of views gain a shared sense of mission that would allow them to have deeper conversations and framing so that they can find ways to gain a sense of Shared Vision? […] it entails shifting the point of attention to a larger ecosystem view that allows deeper listening for all. If one group mainly looks at the historical legacy, and the other group focuses on Western health care legitimacy, how could there be a different place of attention that connects with and articulates the contribution of the profession to its clients, and others? How can a shared awareness of the crisis bring about a shift in the place of attention and allow for an opening to a shared vision?

I’ve been reflecting on these questions for weeks.

Not because I disagree. Because I think he’s right, and at the same time tackling the decades-old internal chiropractic debate from a different place also feels scary and overwhelming on some level.

The bigger question that keeps coming up–is there a shared purpose all chiropractors can connect to, regardless of our philosophical differences?

The context of our current reality

The identity debate in chiropractic has been running since the beginning. Straight vs. mixer. Science vs. philosophy. Evidence-based vs. subluxation-based. We’ve been arguing about who we are for over 100 years, and the argument has become the thing we do instead of the thing we are.

Every few years, a new version of the same fight surfaces. Right now it’s about education — the CCE parting ways with the Department of Education, Life Georgia and Life West in financial (and other) trouble, the NBC/FCLB merger. Very few voices in the profession actually talk about what is happening in the ecosystem that is the chiropractic profession’s governance system. And in response, when enough people decide to pay attention, the same tired arguments tend to crop up:

• We need more evidence! This will solve all our problems. My biased opinion: isn’t this what all of our school programs are based on and part of why we’re in the mess we’re currently in? What’s really under this argument– a fear that we’re not legitimate and the need to prove our worth by fitting into healthcare standards we didn’t create and don’t fit into.

• They need a DE seminar! This will solve all their problems. My biased opinion: DE is great, but if it were the answer to the chiropractic profession’s identity crisis, we’d be in a different position now. What’s really under this one–a fear that without our philosophy we’re not only not legitimate, we cease to exist.

• We…wait, what the heck is happening right now? My biased opinion: the majority of our profession keeps our head down, feeling frustrated and unfulfilled in practice by the red tape and hoops we continually have to jump through as part of the healthcare system and our lack of business education, while simultaneously struggling to find our own professional identity and make sense of our role in the world and our profession. What’s really underneath this one–the results of a profession in a dialectic organizational identity conflict with no path towards synthesis.

Here’s what I’ve come to understand through my dissertation work: the argument isn’t the problem. The argument is the defense mechanism. It’s what we do instead of asking the harder question: who are we, actually, if we move above all that noise? Why do we exist? What are we here to do that unites us rather than divides us?

Moving above the reactionary identity to a generative one

Think about it this way. Every position the profession has taken — straight, mixer, evidence-based, vitalistic — has been a response to something else. A reaction to a critique. A defense against an accusation or the AMA’s desire to eradicate us back in the 1950’s-1990’s. Even our identity statements are reactive. “We’re not anti-medicine.” “We’re evidence-based too.” “We’re doctors too!”

Every one of those statements is a response to someone else’s question. Ie “Why aren’t you a real doctor?” “Is that a two-year degree?”

What would it look like to ask our own questions?

In organizational change theory, this is the difference between reactive identity and generative identity. Reactive identity is who you are in response to external pressure. Generative identity is who you are when you stop reacting and start creating. The research on organizational identity shows that organizations that stay in reactive mode don’t transform. They just cycle through versions of the same argument until the environment forces them to change anyway.

We’re at that point. The environment of our profession is the middle of a big change. Schools are in crisis. The cartel that governs our profession has made some bold and questionable moves. The healthcare landscape is changing. We can keep arguing about who we are while the rest of the world leaves us behind and one faction of our profession drives us “forward”, or we can get involved and work to create who we’re going to be.

The unhooking that has to happen first

You can’t create something new while you’re still hooked into reactivity. This is something I have started to address in my dissertation. If we can’t transcend the state of reactivity we tend to have as a profession, towards ourselves, each other, and the world at large, it won’t be possible to transform. I ended up developing a process I call unhooking through coursework I completed in the psychology of judgment and decision-making (JDM).

The short of it is, reactivity brings narrow-minded focus and a decrease in possibilities and creativity. On the other hand, a growing body of research on coherence, positive emotions, and neuroscience has demonstrated that what I refer to as a coherence-based intuitive state increases access to creative thought and possibilities, allowing a new realm of possibilities to be accessed with discernment.

I am continuing to develop this concept as part of my dissertation research, specifically using it as an access point to transform organizations like the chiropractic profession who are caught in a loop of reactivity and conflict that prevents moving forward. For now, I want to leave you with a simple three step process you can use in your own practice when you find yourself approaching decisions from a place of reactivity:

1. Notice and name what’s there. The frustration. The defensiveness. The need to be taken seriously. The anger at the other side. You don’t have to fix it. Just acknowledge it.

2. Find coherence. Get back into your body. Focus on your heart, slow your breathing, access a renewing emotion like gratitude, love, or compassion for yourself or someone else. This isn’t about being calm. It’s about getting access to the part of your brain that can see new options.

3. Then assume the position of observer and ask, from that place of objective coherence: what’s one step I can take that would be new? Not from the stress response. Rather, from coherence-based intuition.

This is where our access to a different conversation and creating a shared vision to move forward together will start. Not with one side finally winning the argument. Not with mediation. Not with trying to change the organization from the inside out. With one step that comes from a different place than reactivity and creates something entirely new.

I’m not saying I have the answer for the profession. I don’t think any one person does. But I do think we need to stop looking for the answer and start creating one instead.

Final thought: this isn’t just about the profession; it also applies to your practice

Talking about the profession as a whole doing something differently can be esoteric, fantastical, and often feels like a hopeless pipedream. I’m working to change that at the group/organizational/systems-thinking level. But there’s also something we can do on our own that will help us get there collectively.

Most chiropractors I talk to didn’t build a practice from a place of generative identity (I’m raising both of my hands here). They built it from a reaction. To insurance. To patient expectations. To their spouse or parents. To what the coach or consultant said. To what the school said. To what the profession said a successful practice looks like. To not having a clue about running a business.

And then we get to a point — usually after having enough success to finally pick our heads up from the grind for a minute — where we realize the practice we built isn’t actually what we wanted. Or what we thought it would be. Not because we necessarily made bad decisions, but because we were making decisions based on someone else’s input the entire time, from a narrowly focused, reactive state.

This is what I call practice misalignment. It’s not a marketing problem. It’s not a systems problem. It’s an identity problem. You built a practice in response to external definitions of what a chiropractic practice should be, and now you’re trying to find yourself inside it.

Actually creating and building what you really want requires letting go of those external definitions and asking: what would I build if I weren’t trying to prove anything to anyone?

My challenge to you: next time you’re facing a decision in practice, use the unhooking process above before you take any action. You might be surprised what starts to shift in your experience of practice if you do.

And if that feels scary or you need help, helping others work through the deeper parts of what makes us tick and transcend our limiting beliefs and reactive choices is something I’m really good at helping others do. I would be happy to connect with you to help you start approaching your practice differently first. Jump on my calendar or reach out.

What would your practice look like if you stopped measuring it by someone else’s standard and started asking what alignment actually means for you?

What would it look like if we stopped trying to belong to a system that was never built for us and started building the thing we actually are?

If this spoke to you, share it with another DC. Rebuilding our identity is a movement that needs all of us.