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  • drnicoladepaul

Learning to "see" the air we breathe and reclaiming interdependence

Updated: Aug 15, 2022

Talking with Dr. Julia Mackaronis, clinical psychologist and lead mental health provider for the Quinault Indian Nation, about learning to step back and become aware of our cultural assumptions in healthcare reminded me of my time working in the Population Leadership Program at the University of Washington.

At the time I was fresh out of undergrad and I knew very little about community development, international capacity building, leadership, or public health. But I had found my people, and I was eager to learn from the dynamic and fun international health professionals who were a part of the program.

And I still remember one of the most valuable lessons from that time.

One of the wise fellows sat me down one day and explained the basic principles of community building and cultural transformation through the following story.

He said, “imagine a small and impoverished community struggling with domestic violence. Now think for a moment, “What does the community need?”

I said, “I don’t know, a women’s shelter, a hotline?”

He said, “You need to ask the community. And if you do, they might tell you something surprising!”

“Ask the women in this town, and they might say, ‘We need a playground! We need a space to gather for support and to share ideas and information. We need a place to watch our children and feel safe.’ “

Such deep wisdom.

What he said still resounds in my ears whenever I meet a new team or healthcare community!

Experts from the outside rarely know the actual needs of a community without taking the time to listen deeply to the individuals who make up the community. And paying attention to the most minority voices is a crucial step in conducting an equitable listening process.

This is as true in international capacity building as in cultural transformation within health systems.

Taking the time to listen deeply, whether that’s in a one-on-one interaction, a listening circle, or an employee well-being survey, may lead you to cock your head and think, “really, that’s what they need?” And the more you are surprised, the more often you will be able to respond with deep caring and compassion as you go about caring for and building relationships with your people.

Now think for a moment:

  • How often do you sit down and listen to your people (and I mean, listen without judgment or jumping in with yes-buts)?

  • When was the last time you heard something surprising from your team and took it seriously?

  • What listening rituals could you build so that your team has the experience of being heard weekly (at least)?

I hope you take the time to listen to Menders episode 19, where Dr. Julia Mackaronis shares some of the experiences that have shaped her approach to working in healthcare in a unique indigenous environment.

Julia shares how beginning to see her cultural frame has helped her to acknowledge the reality of her own blind spots as a white Western female psychologist. She also describes the beauty of creating welcoming rituals within her current clinical environment. And, she explores how she has learned to acknowledge and value her interdependence within her local indigenous and global communities.

  • How she has learned to value welcoming as a critical step in the healing process!

  • How she is currently working to practice cultural humility, recognize and respond to her internalized racism and the ongoing harm of settler colonialism, and stay focused on relationship-building.

  • And why she believes it is time for clinicians to focus on self-care (but not for the sake of being a more efficient or resilient clinician)!

Here are a couple of my favorite quotable moments from this episode:

“If we take that interdependence seriously, then there are no truly individual problems. And I think that means that the health of the provider is not truly separate from the person receiving the care. When we get that, good and more radical things will happen.”

- Dr. Julia Mackaronis (Menders, episode 19)

“Providers get this very sneaky message about self-care, engage in self-care so that you can be more efficient….No! Engage in self-care, period. As all humans, as all living beings should!”

- Dr. Julia Mackaronis (Menders, episode 19)

“I believe our institutions have a responsibility to ensure that that [engagement in self-care] is easefully possible for all clinicians… allowing self-care to be inherent within a clinician’s life, day or daily clinical practice is something that I think is critically necessary.”

- Me! (Dr. Nicola De Paul - Menders, episode 19)

This episode will get you wondering about your cultural assumptions and how caring for yourself might be a radical act of compassion for our planet.

It’s time to recognize the beauty and freedom of our interdependence!

*And a quick correction, it was Wilfred Bion who spoke about letting go of memory and desire -


Wednesday, September 21st at 1200 PST, I will be hosting a brand-new (FREE) masterclass!

I will teach you how to move from survival mode to sustainability as you learn to reorient your organization to prioritize easeful relationships and effective communication between leadership and frontline staff. You will learn a framework to create a sustainable culture of well-being in your healthcare organization.

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