Do no harm

19/12/2017

The best of intentions. How often we do things with good motives and yet, in spite of that, our actions have unintended consequences. It’s often because we haven’t known or understood the wider implications of what, where, when, how or with-for whom we do something. We may, for instance, offer support to a specific person, team or group…only to discover that a different person, team or group perceives that intervention as partisan, favourit-ist or creating unfair advantage.

Here’s an extreme. A friend was delivering aid to a poverty-stricken village in Sudan when he was stopped at gunpoint by militia from a neighbouring village. He was forced to the ground with rifle barrel pressed hard against the back of his head whilst the group relieved him of the vehicle and relief supplies. It turns out the group and its community were envious and resentful that they were being effectively ignored whilst supplies were being provided to a different village.

Or here’s a less extreme example. I spoke with an emotional intelligence (EI) specialist this week about using psychological mentoring, coaching and tools to raise awareness and insight, with a risk that some clients may use it in weaponised form to manipulate colleagues or customers. It points to a real need to pay attention to wider systemic, cultural, ethical, political and longer-term considerations when seeking to do the right thing – a principle known as ‘primum non nocere’.

If you’re a leader, coach, OD or trainer, here are some questions for critical reflection: When have you acted in good faith to resolve one issue, only to discover that your interventions have inadvertently incentivised, precipitated or exacerbated another? How do you manage the tension of never fully knowing or understanding the potential implications of everything – and yet still taking meaningful stances, decisions and actions? What is your best advice on ‘do no harm’?

110 Comments

Barbara Pando-Behnke, MA, MSOD, ACC

19/12/2017 12:24:38 pm

This is an excellent post. As a coach one can encourage clients with questions to identify stakeholders and also consider how particular actions to impact them in different ways.

Nick Wright

19/12/2017 12:34:46 pm

Thanks Barbara. Yes, I think that can be a useful and important approach...although I have encountered some coaches who disagree, saying that wider stakeholder interests should only be discussed and taken into account if the client raises them him or herself. What do you think?

David Harrell

19/12/2017 12:49:20 pm

Without O.D. experience and knowledge, many times, the best of intensions go left wanting.

Nick Wright

19/12/2017 12:50:57 pm

Hi David. Do you have any examples from experience that you could share, e.g.where, in your view, OD experience and knowledge have made a net positive difference?

Robyn Cantrell, MBA

19/12/2017 06:22:38 pm

Interesting article. This resonated with me as I am investigating a consultant business for small businesses. There exists a hypocratic oath for MBA's whose tenets I agree with and have signed. Now the rubber meets the road. If I were to work with an organization, assisting with processes and business improvements, what else do I need to look at in order not to bring unintended negative consequences? Stated another way, how deeply do I need to look at an organization? Thanks for the post!

Nick Wright

19/12/2017 06:35:56 pm

Thanks Robyn and thanks for such an open and honest response. I wasn't aware there is a hypocratic oath for MBAs - fascinating! I Googled it and found this: http://mbaoath.org/take-the-oath/

It contains some great principles; e.g. 'I will protect the human rights and dignity of all people affected by my enterprise, and I will oppose discrimination and exploitation; I will protect the right of future generations to advance their standard of living and enjoy a healthy planet.'

I think the questions you posed are interesting and important. You may find these related short pieces - and some of the responses to them - interesting? http://www.nick-wright.com/blog/bubbles; http://www.nick-wright.com/blog/systems; http://www.nick-wright.com/blog/spotlight

Marita Jane Laxa

20/12/2017 09:57:10 am

Great article, Nick. I've experienced this in my personal life. Having honest and good intentions for one while it will impacts negatively for another, can certainly make one feel like life is unfair. Then you ask yourself, why even bother in the first place?

Nick Wright

20/12/2017 10:00:56 am

Thanks for such an honest personal response, Marita. Yes, life can sometimes feel perplexing and disheartening, especially if we set out to do a good thing and, unexpectedly, it all appears to go wrong!

Mark Molitor

20/12/2017 10:01:42 am

Another thought provoking post Nick-Thanks!

On the issue of 'managing the tension,' I think being clear on what you own and, even moreso, what you don't, is critical.

On 'best advice': to the best of your ability hold true to the intention to do no harm-build your capacity to see the system (s), hold multiple perspectives, and be choiceful-but avoid the trap of expecting to always get it right (exercise self-compassion).

Nick Wright

20/12/2017 10:05:38 am

Thanks Mark - and well said. Yes, it's important to manage the boundaries. There is a risk that we may step so far into another's shoes that we inadvertently step out of our own. Trying to keep the bigger picture in view, including the picture that a client and his or her culture and context hold for themselves, is so important. Self-compassion: critical. Learning to forgive ourselves and others is one of the key things that enables us to learn, grow and keep moving forward.

Richard Simpson

20/12/2017 11:39:33 am

Great post, Nick. I was reminded of the proverb - 'the road to hell is paved with good intentions.' I can't say I'm anywhere near perfect in the 'do no harm' stakes but I am aware that if I introduce my coaching clients to techniques they can use to, say, better manage relationships, that they use those insights responsibly and with generosity and kindness. But how would I know? I guess the answer to that is in understanding the client in the first place and making a judgement about their capacity for inflicting pain on others!

Nick Wright

20/12/2017 03:52:13 pm

Thanks Richard. 'Making a judgement about their capacity for inflicting pain on others' raises such interesting and important questions. I meet so many coaches who, in my view, appear to dodge the ethical bullet by claiming 'neutrality' and asserting that it is not their role to set or influence the client's agenda.

At the worst extreme, I try to imagine Adolf Hitler asking me to provide him with coaching support that would enable him to be more effective in reaching his goals as leader of Nazi Germany. At such extremes, we can see ethical concerns and need for boundaries drawn in sharp relief. But what about in more ordinary cases..?

I think this is often a very fuzzy area in coaching, the assumption being that the role of a coach - as enabling clients to achieve their goals - is, in essence, values-free. I wonder how far we should consider it legitimate, as coaches, to challenge or raise the client's awareness of the ethical implications of their choices...

Ian Henderson

20/12/2017 03:52:51 pm

It's the law of unintended consequence I guess Nick. My Mum once told me not to expect too much out of life so I wouldn't be disappointed. Positive intent but negative impact.

Nick Wright

20/12/2017 03:55:24 pm

Hi Ian. What a great - and sad - example of a paradoxical intervention. It reminded me of a client I worked with who said her parents never placed any expectations on her at school so that she wouldn't feel pressured by them. As a teenager, it left her with the feeling that they didn't care whether she succeeded or not. Again, 'positive intent but negative impact'.

Tara Parker

21/12/2017 09:55:44 am

The example you give here is a great one, Nick, not just in terms of intent of the message but the reception of the intent. There is a need to be mindful of what we say to others despite how thoughtful we may be.

Nick Wright

21/12/2017 09:56:46 am

Thanks Tara. I think it's something about listening and hearing to what is important for the other person or group, rather than assuming what they may want or need..?

Tara Parker

21/12/2017 09:57:32 am

Nick, this article is well-timed. I coach adult learners in higher education. As I get to know my student I will ask key questions to get get to know them and obtain an understanding of their direction in terms of school. I have been surprised by the number of students who pursue an education at the direction of their inner circle, i.e. family, friends, and co-workers. The advice received is typically well-intended as a means of protecting the adult learner but tends to be an anchor to the adult learner who would rather be pursuing an area of passion and interest versus "job security" and a high pay position. I often remind my students that while their inner circle may have good intentions they may not be well-thought out intentions. Your post provokes me to think more about my well-intended comments and how they truly impact others.

Nick Wright

21/12/2017 10:05:09 am

Thanks Tara. I really like the honesty and willingness to reflect in your response. Your final comment reminded me of an occupational psychologist who once challenged me on my OD approach. She said, 'You pose penetrating questions, insights and reflections that can deconstruct a client's paradigms, assumptions, beliefs etc. In doing so, you may inadvertently dismantle the structures that provide the client with security and meaning in the world and, thereby, leave them anxious and floundering.' Good intentions; unintended consequences.

E.G.Sebastian - CPC, CSL

22/12/2017 08:48:00 am

Tough one, Nick - yes, I've been several times in that type of situation (thinking I was guiding client in the right direction, and backfiring)... Advice? Hmm... I guess before jumping into agreeing with a client's "epiphany" or "a'ha moment," probe a little more, and make sure that that path of action is the best one to take...

Nick Wright

22/12/2017 09:01:27 am

Thanks E.G. and thank you for such an honest response. I really like your advice and find that wise and useful: '...before jumping into agreeing with a client's epiphany or aha moment, probe a little more...'

We can be seduced into supporting a client's choices - sometimes because we are so relieved they have reached a solution! - without having explored some of the wider implications, e.g. for other people, wider team/org/community etc.

A tricky part is whether the client is interested and willing to 'go there'. It begs questions about how far the coach shapes the coaching agenda - and what a coach's ethical responsibilities are in relation to a client's choices.

Nandita Mehta

22/12/2017 09:02:34 am

What is your best advice on ‘do no harm’?
People believe in law of Gravity, then if they believe in law of attraction and understand "what you give, comes around", I guess they will do no harm and understand a bigger and whole picture.

Nick Wright

22/12/2017 09:04:45 am

Hi Nandita. Thanks for the note. Do you mean that, if a person acknowledges there are consequences to their actions, including potentially for themselves, they are more likely (and motivated) to take a bigger picture into account..?

Nandita Mehta

23/12/2017 08:23:49 pm

Yes Nick.

Nick Wright

23/12/2017 08:24:09 pm

Sara Pearson MSc

22/12/2017 09:18:09 am

Hi Nick, this is indeed a profound and significant question and poses real ethical consideration. On one hand you could say its better to do nothing than something because of the uncertainty of the outcome and yet risks are integral to business growth and sustainability. Saying that, we should never over-estimate our capacity to do ‘good’ nor should we under-estimate our capacity to do harm.
My general philosophy and best advice is never act / make decisions based on good intentions as these can cause greater harm than the good that’s initially intended. Listen and learn from others and from mistakes. Always try to keep true to your values and yourself whilst respecting others. Act with integrity and authenticity at all times, accepting that your solution is not always the best one and never forget that the whole is greater than the sum of its parts.

Nick Wright

22/12/2017 09:24:07 am

Thanks Sara. I found your comment, 'never over-estimate our capacity to do good ... or under-estimate our capacity to do harm' thought-provoking.

I'm intrigued by your comment, 'never act/make decisions based on good intentions' - can you say more? Do you mean something like, 'never act/make decisions based solely on our own perspectives and agendas - even if well-intended'?

You may find this related short piece and some of the comments posted in response to it interesting: http://www.nick-wright.com/blog/bubbles

Sara Pearson MSc

22/12/2017 12:25:37 pm

Hi Nick, on your first comment, I am pleased you found it thought provoking as it did with me when I was first taught this very early on in my nursing career. It has certainly stood the test of time from my perspective.

On the second note, yes is the answer, but I would go even further and say that whatever is in your mind, hold on to this pending further investigation, enquiry. This will facilitate a better understanding of the outcome of the action whilst also taking into account the wider perspective / impact. ‘To err is human..’ we all make mistakes but this action should help to minimise significant risk.

We all know the quote by John Lydgate, ‘You can please some of the people all of the time, you can please all of the people some of the time, but you can’t please all of the people all of the time’..sometimes you just have to accept the fact and not beat yourself up about it... but unequivocally learn from it.

Nick Wright

22/12/2017 12:40:24 pm

Hi Sara. You reminded me of action research. Act in the light and love that is available to us, observe what happens with an open mind and heart, learn with humility from what happens, step out with courage again.

Sara Pearson MSc

22/12/2017 02:04:58 pm

Exactly! thanks for that.

Nick Wright

22/12/2017 02:05:20 pm

Jeff Nelson

23/12/2017 08:18:42 pm

It's okay to include values into your training and coaching content. Love, kindness, integrity, developing one’s talents to add value, making a difference in lives of others ...

Nick Wright

23/12/2017 08:22:22 pm

Hi Jeff. I believe we always bring values into our training and coaching content - sometimes implicitly rather than explicitly and sometimes without realising it. If we are explicit and authentic about our values, at least it opens them up to support or challenge within a group.I like the values you have listed!

Rhiannon Rees

24/12/2017 12:33:41 am

Best advice is to have the ‘intention’ to ‘do no harm’ and position this with clients from the very beginning. Not always perfect, definitely solid though!!

Nick Wright

24/12/2017 12:34:52 am

Hi Rhiannon. I'm curious: do you have any examples you could share of you, 'position this with clients from the very beginning'?

Terri Hase

24/12/2017 12:35:58 am

I feel like 'do no harm' is a distinctly different thing from what is initially outlined here.

Anything I bring to a coaching relationship 'can' cause harm. Water, if used as a weapon makes a mighty fine one, but it's not designed for that, nor used for that in the greatest sense. How I respond when something lovely gets perverted into another use is very different from taking responsibility to do nothing that I believe (or know) will cause harm. The origin of 'do no harm' is designed to make practitioners mindful of situations where doing something, or anything, will likely produce more harm than good. This is to say, sometimes do nothing, even if 'something' could be done.

In the first case, I must allow others to take their measure of responsibility for how something sees its next application or iteration. I must also evaluate my gut to see if I feel that the 'whatever it is' feels safe in their hands - accessing the latter definition in my evaluation.

Nick Wright

24/12/2017 12:40:20 am

Hi Terri. Thanks for sharing such thoughtful reflections. In relation to 'do no harm' in the first example I cited here, you may find this paper interesting? http://badael.org/wp-content/uploads/2014/12/DNH_Options-for-Aid-in-Conflict.pdf

Richard Simpson

24/12/2017 10:45:18 am

Wow, Nick. This Post has certainly created some interesting comments. If I may be permitted another comment, during the course of the discussion I was reminded of something I read in my other profession - Public Relations. A young British practitioner had been working in the Far East and, with her unconscious British world view, began to advise her Asian counterparts on the art of PR. I read it horrified at her lack of cultural empathy evidenced by her complete lack of understanding of why her Asian colleagues did their work in a way which was quite alien to her. They saw the Westerner as wiser and more worldly than themselves and began to adopt her advice, excited that the bars on the cage of their own worldview were being bent and broken. I feared for their jobs, worried that the cultural dissonance they would create by adopting British methods out of context would rebound on them - creating harm. Your own blogs on your experiences in The Philippines show a sensitivity to cultural norms which were sadly lacking in the inexperienced British PR person. So for me, Do No Harm is something about being aware of other perspectives and of systemic complexity. In the Coach's worldview, a problem may easily be reduced to a linear cause and effect. In the Client's situation, solving the problem so directly could have untold unintended consequences. At the end of the day, we are not there to solve the Client's problems or impose our own world view on her. Do No Harm is a useful heuristic for any Coach to take consciously into a Coaching Relationship.

Nick Wright

24/12/2017 01:41:12 pm

Hi Richard. Thanks for sharing such insightful reflections. I find the cross-cultural dimension so interesting.

On the one hand, we need to be sensitive to the client's cultural environment and context and, on the other hand (...if we assume only 2 hands...), coming from a different culture and context can help us usefully to challenge assumptions, paradigms etc.

I think it's something about how we handle these dynamics sensitively when contracting and working with clients, bearing in mind that even contracting itself can be tricky and nuanced when working cross-culturally!

I have made some big mistakes when working cross-culturally in Asia. I too fall into the linear cause-and-effect pattern from time to time. Although sometimes bemusing and frustrating for all concerned at the time, I try to learn from them where I can.

Jakob Panduro

24/12/2017 01:25:44 pm

I’d just “freestyling” over some questions there maybe could be useful. It could be asked after the client have the “a’ha moment” so we don’t end there, but go a little further
It’s just for inspiration:
How can your “decision” effect your surroundings?
What does you head tell you about your decision?
What does your gut tell you about your decision?
What does your heart tell you about your decision?

Nick Wright

24/12/2017 01:30:15 pm

Hi Jakob. I think those a good questions. We could also reframe them and use them experientially and experimentally, e.g. by inviting the client to imagine other people or stakeholders in their wider 'system', to create the 'system' in the room by using a separate chair for each person or stakeholder, then to sit in each chair in turn and respond to your final 3 questions from each seat as if that person or stakeholder. Alternatively, we could invite the client to explore the possibility of holding similar conversations with the actual people and other stakeholders directly.

Anita Evans

25/12/2017 11:21:47 pm

Best advice: stop controlling. Ask questions, and listen. Our clients know whats best for them; it is our job to give them the space to figure it out without advice. Space mean there is nothing... where they can create their world in our listening. And lastly, context, context, context... once we have asked what is important for them to accomplish and make sure they are clear and simple about it; then our job is to keep them focused on what they told us important to them and hold them accountable to accomplish it. Ani. :)

Nick Wright

25/12/2017 11:24:41 pm

Hi Ani. I can see how what you are describing is important in coaching practice. Can you say a bit more about how that helps to ensure 'do no harm', e.g. perhaps vis a vis 'context, context, context'?

Derek Rowe

25/12/2017 11:26:08 pm

I find the serenity prayer works wonders.

Nick Wright

25/12/2017 11:27:18 pm

Hi Derek. Do you have any examples of how the serenity prayer has enabled you to 'do no harm' as a trainer?

Ron Bayless

29/12/2017 03:03:23 pm

One of the (many?) problem(s) with "do no harm" is that "harm" is subjective. If one of the purposes of training is to assist others in learning to do what they can't do, the mechanics of that transition will necessarily prove uncomfortable, even harmful, to some.

Nick Wright

29/12/2017 03:05:47 pm

Hi Ron. 'Harm is subjective'. I think that's an interesting point.

Lovely Kumar

30/12/2017 10:51:10 pm

This is extremely interesting. Looking forward to perspectives on "do no harm".

Nick Wright

30/12/2017 10:51:48 pm

Thanks Lovely. I would be very interested to hear your perspectives too!

Yolande Conradie

31/12/2017 02:18:00 pm

Teaching someone to bake bread to sustain themselves or as a way to earn a living is good. If they bake bread, and eat too much of it, become obese and unhealthy...would it have been better not to teach them to bake? Was it really “harm” to teach them?
You have the responsibility not to impart half-truths, unfounded theories, opinions and assumptions as “knowledge.” Any person who teaches and/or trains has a massive responsibility to work with the hearts and minds of others in a responsible way, but the learner or student is also responsible for how he/she uses his/her knowledge.

Nick Wright

31/12/2017 02:19:17 pm

Hi Yolande. What a fascinating and thought-provoking illustration!

Sangeeta Shahane

1/1/2018 10:21:32 pm

'Do no harm' is pretty subjective. As a trainer I teach the participants the skill of managing conflicts by becoming assertive, especially those who I find to be passive or submissive. Many a times towards the end of the workshop I notice that they become aggressive. The training pushes them to cross the thin line between aggression and assertion.

Nick Wright

1/1/2018 10:22:58 pm

Hi Sangeeta. What an interesting example. Are you saying that, in training people to be more assertive, there is a risk that some may become more aggressive?

Bruce Bennett

2/1/2018 05:56:16 pm

In my research, I've come up with a concept I call Positive Harm™. It occurs when great training creates high expectations for change (positive) but nothing changes when employees return to their job. The results are individual cynicism, organizational resistance, and leadership inaction (harm) - exactly the opposite reasons most organizations invest in training. The better the training, the greater the harm when organizations are not prepared to support change. The key to identifying and eliminating Positive Harm™ is understanding what happens after training as employees try to use their new skills.

Nick Wright

2/1/2018 06:05:42 pm

Hi Bruce. Thanks for sharing such an interesting idea. It's as if the 'harm' is created by dynamics in the wider system or culture - and perhaps how and with whom the training was contracted at the outset - rather than in the training per se?

Nancy Boudreaux

3/1/2018 01:41:12 pm

As a former "passive" employee myself, I noticed that when trying to change my own behavior pattern, I had to go to the other extreme (aggressive) before I could find a balance in the middle. I've seen this in others, too.

Nick Wright

3/1/2018 01:42:57 pm

Hi Nancy. Thanks for such an honest response. I'm intrigued. What do you think it was about going to the other extreme that enabled you to find a 'balance in the middle'?

Mike Barnes

4/1/2018 09:26:53 pm

I think you're over-thinking this issue Nick (with respect) There's always going to be room for misinterpretation or a rogue element of some sort. From a coaches perspective, do the best you can, with what you have for who you're helping. It's just life...

Nick Wright

4/1/2018 09:36:28 pm

Hi Mike. Maybe...maybe not. Stretching the boundaries of our thinking, testing our assumptions and exposing ourselves to new experiences is at the heart of critical reflective practice - as coaches and as a profession. At the same time, we need to be careful to avoid becoming paralysed by over-thinking...which may be what you're driving at! :)

Anne McFarland

7/1/2018 02:34:48 pm

I wonder if the phrase is perhaps a bit impractical. Is it possible, in any activity, to do absolutely "no" harm?

Nick Wright

7/1/2018 02:36:56 pm

Hi Anne. I'm curious. Could you share an example in principle or from experience to illustrate the dilemma you are alluding to here..?

Jean Eva Thumm, LMFT, CPC, BCC

7/1/2018 05:46:00 pm

As coaches we need to understand not only the strengths of our clients, but also their struggles and the impediments they must overcome. We can begin by getting a wider picture of their family and social groups. Although coaching is generally goal-oriented, we need to have a wider grasp of the individual's environment. We CAN do this assessment as we work on another level to outline goals and objectives.

Nick Wright

7/1/2018 05:50:00 pm

Hi Jean. Yes - I think that's why exploring 'realities' is so important and useful. Sometimes, for instance, the strengths a client could draw on lay not in themselves per se but in the environment or in others around them. I think this is where coaching as increasing resourcefulness and developing critical reflective practice can be so valuable. It's also the domain in which some of the most important ethical considerations arise too.

Michael Taylor

7/1/2018 07:31:51 pm

Hi Nick, would a more realistic objective be to minimise harm rather than ‘do no harm’? Coaching generally will involve some degree of change for the client which results in a level of pain or ‘harm’. Through exploring the above mentioned strengths, weaknesses, building trust, shared values and others we can form an environment where change, failure and success are all accepted equally with a view to personal and professional growth beyond that of which they would have achieved without our support. I believe the work achieved in building a sound platform before engaging in coaching allows for the minimisation of harm and more openness and acceptance of any change.

Nick Wright

7/1/2018 07:37:56 pm

Hi Michael. I think that's an interesting question. I guess 'do no harm' is, in one sense, about 'don't make worse', either for the client or for others by implication. The discomfort associated with change could be painful but not necessarily harmful in the sense of causing actual damage?

Damian Gauntlett

10/1/2018 11:05:28 am

Hi Nick. This is a really powerful query for me as I don't always feel employers appreciate the power of a more empowered workforce through effective L&D interventions. Go back a few years... following a coaching intervention an employer lost an employee I was working with - they decided to pursue their lifelong dream. The employer questioned me on the role I played in this. Conversations took place and eventually all sides were very happy. My reason for reliving this is that I now include in contact conversations the reality that empowered staff will behave in new ways; as such be prepared for this. The good news is that this 'conversation' has never been negative. It has also lead to more business which is always a good thing :)

Nick Wright

10/1/2018 11:11:12 am

Thanks Damian. Yes, I think that's a good and important point. When we work with an individual on, say, their personal and professional development, if successful it will have an impact on their relationships and work in the wider systems and culture of which they are a part.

This impact can be experienced by others as disruptive and, at the extremes 'harmful' - even if that is not the intention of the person or the L&D practitioner. As you say, this is a good and important reason to involve others in the system at contracting stages (where this is possible and appropriate) or, at least, the enable the person to consider the wider system/culture, what their new beliefs/behaviour/ways of working could evoke and how ethically and authentically to handle that well.

Craig McFadyen

18/1/2018 09:11:29 pm

Thanks, Nick, a great thinking post. I have always believed that as trainers we have a certain power and responsibility to always do right and well by others. We hold in our hands the ability (and I know because I have seen it many times) to change peoples lives by what we do. Therefore if you are lazy, uncaring or indifferent in this role you will do more harm than good. We also must realise we have no control over outside forces and how they choose to react, all we can do is lead by example.

Nick Wright

18/1/2018 09:12:53 pm

Thanks for your encouraging feedback, Craig. It's good to hear you take the ethical-influencing aspects of your training seriously.

Franz Villa

19/1/2018 10:15:31 am

While understanding the relevance of our actions as training professionals is all well and good, aiming to positively impact as many people as possible will probably be the best that any of us can do. "Do no harm" is impossible, but "Do as little harm as possible while doing as much good as possible", is probably more realistic. As famously written by poet John Lydgate, "You can please some of the people all of the time, you can please all of the people some of the time, but you can't please all of the people all of the time." Anne McFarland, "no", Newtons 3rd Law.

Nick Wright

19/1/2018 10:19:15 am

Hi Franz. Your quotation from Lydgate reminded me of a satirical version I saw on Twitter last week: 'You can't please all the people all the time, but all the people could try to please me all the time. I'd be OK with that.' ;)

Steve Schuster

21/1/2018 04:53:15 pm

“Do No Harm” https://youtu.be/Mbz6GJx6a4o

Nick Wright

21/1/2018 04:53:40 pm

Interesting! Thanks Steve.

Todd Walters

22/1/2018 08:41:38 am

Thought provoking piece. Reminds me not to lose focus on understanding the bigger picture to what I'm doing and to consider the wider implications by looking at things from different perspectives.

Nick Wright

22/1/2018 08:44:14 am

Thanks Todd. Me too. You may find this related short piece interesting? http://www.nick-wright.com/blog/micro-macro

Adam Bostock

22/1/2018 09:27:13 pm

Hi Nick. That's a great topic, and I'm pleased you have raised it. It does seem that despite genuine good intentions we can "make some people happy some of the time", but "we can't make everyone happy all of the time" :-) As initiators of decisions/actions we'll make our lives better if we learn to cope with that; but we can also make more people happier if we learn how to reduce the negative impacts. Often it's down to poor communication, and forgetting that communication is a two-way process. If we had all the facts and all the individual opinions before a decision is made then this might make things better. This might allow more win-win decisions (but admittedly, sometimes it's hard to make win-win decisions).

Perhaps flatter hierarchies and more democratic transparent processes are the answer. At a technical level this might be leveraged with a good intranet and an AI system...

Nick Wright

22/1/2018 09:30:18 pm

Thanks Adam. Yes, awareness and communication are so important. Although we can rarely have the full picture, we can try to be open to and curious about wider possibilities and dimensions wherever possible.

Kathy Cocchio

26/1/2018 11:22:33 am

Thank you for promoting authentic practitioner reflection. I would extend the mantra of "do no harm" to educational practice from K-higher education. Imagine the learning paths that would be illuminated by care-fueled learning experiences!

Nick Wright

26/1/2018 11:24:46 am

Thanks Kathy. What is K-higher education? I'd be interested to hear more about what you envision 'care-fueled learning experiences' to look and feel like!

Dasaradhi Koganti

26/1/2018 11:25:49 am

Life is an echo....it comes back.....all depends on how do we prepare for the session keeping the emotional needs of the trainee.....cause the other day we are going to be trainees...we have to be extremely careful while understanding the training needs and and supporting them through training....thank you for the share Nick....worth reading...

Nick Wright

26/1/2018 11:28:37 am

Thanks Dasaradhi. Your comment reminded me of what some people refer to as the golden rule in Jesus' teaching in the Bible: 'Do to others what you would have them do to you.'

Dr.Chandrashekhar Ranade

1/2/2018 10:10:03 am

I prefer to use the term ' Safe ' practices since ' Do no harm ' has a negative connotation . You can please many people but not all . I consider it a welcome feedback when I get a so called ' negative ' response to my well intentioned interventions .

Nick Wright

1/2/2018 10:13:44 am

Hi Chandrashekhar. I think that's a really interesting comment about the connotations that 'do no harm' may hold for some people. Interestingly, 'safe' holds negative connotations for some people too, e.g. vis a vis the debate in Western universities about 'safe spaces' vs 'free speech'. I like your approach to welcoming feedback. If we invite feedback, we are more likely to be in a good psychological state to receive it that if it is offered uninvited...and it means the other may feel more willing and able to be honest too.

Steve T

5/2/2018 11:21:07 am

I like the blog. It would be interesting to look at the Do No Harm framework and see what might carry over into the coaching/OD field of work.

For example, an analysis of context - what do we have here - a complicated or simple situation/ dangerous or safe/ open or hidden. What are the connectors - what exists connecting the client to the change they are seeking? Dividers - what is preventing or are barriers to the client achieving the change they seek? How do they work with each? How do they make them feel?

DNH as some of the contributors suggest can be more about mitigation than prevention. After all, people would be using it in turbulent contexts, often in open conflict and war. The question for the NGO is if I step into this arena- do I know what I’m doing? Who is who? What is really going on?

Perhaps that is another thought for a coach - you are stepping into the persons ‘arena'? You do not need to know what is going on of course but you do want to help the client see what is going on in their ‘arena’.

Nick Wright

5/2/2018 11:23:26 am

Thanks Steve. Lots of profound insights and ideas...as usual! Your final comments resonate well with another short piece I posted last week: http://www.nick-wright.com/blog/state-of-interdependence, especially the final question at the end of that piece. Let me know what you think?

Jan Chambers

5/2/2018 06:18:51 pm

I'm not sure you ever can cover all the bases. It reminds me of the health warning that is often issued at the beginning of some TV and radio programmes that some listeners/viewers may find aspects of the programme disturbing. And then the programme is followed by various links for people who may have been affected by the programme. I often think there are plenty of disturbing aspects in programmes that have no warnings. Who's to say what anyone might find disturbing because we have no way of knowing what someone has experienced prior to the programme's transmission or our L & D session. Not sure if that adds much to the party!

Nick Wright

5/2/2018 06:24:41 pm

Hi Jan. I think that's an interesting angle. Do you think we should add health warnings to our L&D programmes and follow-up opportunities afterwards? It could make the programmes feel a lot more edgy! :)

Having said that, I have been on some training programmes that some participants found difficult to deal with emotionally, e.g. on child protection in conflict zones.

In my early L&D career, I was challenged by a supervisor on my tendency to deconstruct ideas in the room without always enabling people to reconstruct new ideas - with the risk that it could leave them feeling floundering, confused or debilitated. It was a good health warning..!

Jan Chambers

6/2/2018 05:32:41 pm

I actually believe that the best L & D should always challenge the participants' ideas and beliefs, not in a 'playing devil's advocate' way but in genuinely challenging whatever is current practice. Of course it does rather depend on the focus of the L & D. If the purpose of the session is to learn how to operate a piece of machinery challenge probably isn't what you're looking for but if it's about how and why the machionary might be used then challenge should be what you're looking for. After all as a learner you don't have to agree with the teacher. The best sessions I ever attended as a learner were characterised by the feeling that I came away with more questions than answers and was stimulated to find those answers.

Nick Wright

6/2/2018 05:33:54 pm

Hi Jan. Well said.

Maria Luisa Gay

5/2/2018 06:25:25 pm

This is really interesting and reflection I have all the time in many contexts both personal and professional. Like the proverbial well-intentioned road leading to the bad place. From my standpoint, trying to use the most neutral language possible in the exchange of information is a good start. The second, is something I heard from Daniel Pink and that was to encourage a self-talk so rather than "I can do this" or "You can do this" ask yourself or ask your trainee "Can you do this?" and let a self-dialogue lead you down a path where the resources needed start to emerge organically.

Nick Wright

5/2/2018 06:27:50 pm

Thanks Maria. Yes, I can imagine how encouraging and supporting self-dialogue in the way you describe can be useful. It can be useful, too, to engage and support similar dialogue in teams, groups and communities. It raises awareness and enables people to find their own focus, way of approaching an issue, conversational pace etc.

Dr. Terrence E. Maltbia

8/2/2018 07:13:21 pm

Great graphic!

Nick Wright

8/2/2018 07:13:57 pm

Thanks Terrence. I found it on Google images.

Andrea Sheehy

16/3/2018 10:28:33 am

Hi Nick.
I'm a great believer in rupture and repair. People can often show there is a problem by being openly hostile or critical or by less direct means. There are many ways we can draw this to their attention and explore their experience of the rupture. Repair is crucial in our work and I guess empathy, accepting responsibility and non defensivness (not always easy, I know) is as good a start as any.

Nick Wright

16/3/2018 10:34:24 am

Hi Andrea. I guess a 'do no harm' -related question could arise in terms of the implications of what we or the client consider as an appropriate means to 'repair'? What if, for instance, the apparent repair inadventently has harmful impacts for the client and/or others..?

Andrea Sheehy

16/3/2018 03:24:12 pm

I see rupture and repair as a part of the debate. We are all fallible. None of us are perfect and we all make mistakes. We are all going to miss our clients or others at some point and repairing this in a theraputic setting can lead to greater insights into how we were missed in childhood. There is, of course some risk in everything we do and so I like this translation from the Hippocratic Oath.

“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”

Nick Wright

16/3/2018 03:27:01 pm

Hi Andrea. That sounds like an authentic and wise approach. It points too, for me, to the critical importance of high quality supervision. It's often hard to see and make sense of these experiences on our own.

Andrea Sheehy

18/3/2018 01:22:12 pm

Absolutely.
There are of course also a few in the therapy field, therapists, supervisors, professional bodies who are as capable as the next person of using what they know for the dark side (as I have called it) although I think I prefer your "weaponised form". Sadly not much is done about this, there aren't that many training organisations these days that are prepared screen or seem to penalise "weaponsied" therapists. What I mean is it would be possible for a person to complete a psychotherapy syllabus without actually gaining any real insights into their issues and I wonder if that person would actually be effective as a therapist or would they end up doing more harm than good.

Nick Wright

18/3/2018 01:24:24 pm

Wow, Andrea - that opens up so many wider issues in the profession!!

Mark Redwood

18/3/2018 10:34:25 pm

I think this depends on your ethical stance... As in do you take a consequentialist approach... The moral worth of your actions depends on the amount of good it creates... Or do you take a Kantian deontological approach... Your moral worth is based on your intentions...

Because the dictum to do no harm is impossible from a therapeutic perspective... For therapy to work we must accept that it may harm... Because if it has no potential to harm... It has no potential to help either...

Which then takes us to responsibility... Because if I take a consequentialist approach then I am responsible for the outcomes... And then you must ask at what point does that responsibility end? Even for things we could not predict? From a Kantian perspective my responsibility is limited to the intention of my actions... That is the person I am helping is responsible for how they use the therapy... I am responsible for working to the best of my ability...

Nick Wright

18/3/2018 10:36:09 pm

Thanks Mark. Interesting reflections.

Curtis DeLeon

18/3/2018 10:37:39 pm

...Just to add to all that have been already said , because of our therapeutic blind spots and personal and professional limitations, together with our unconscious bias, prejudices and unresolved conflicts, I suspect we will at times falter even unknowingly and as such I imagine all the more reason supervision s so crucial.

Nick Wright

18/3/2018 10:38:13 pm

Hi Curtis. I agree - and well said.

Paul Feiger, LMFT

18/3/2018 10:40:14 pm

Great question. IMO, it is always the best policy to just ask questions of the client(s). By that I mean have no agenda going in, have no solution based on your assessment of the "problem." It seems to me we often attempt to dx the problem prior to really getting to know the clients. We experience resistance and rejection because we make it all about us and our solutions rather than about the client. All people behave in ways they have found useful in the past. The problem seems to come from when those chosen (consciously or unconsciously) behaviors arn't working any longer. Only respectful questions will do no harm and elicit the causes.

Nick Wright

18/3/2018 10:43:53 pm

Thanks Paul. I think that's a good point about trying to fix things and the risks that often entails. At the same time, if only questions could be so neutral..?! And is having 'no agenda' always the best way of to avoid harm..?

Mary Jane Hurley Brant

19/3/2018 09:51:41 am

Thanks for sharing your thoughts, Nick. When I've erred and my client speaks to me about it I accept his or her feedback. "Let's talk about it" is my first response. Once, years ago, a client was upset that I encouraged her child to spread her wings (child was 20) and live her dream of moving to a big city and working in the theater. Her mother was furious with me. I anticipated it. I asked the mother in. "Let's talk about it. If you are satisfied with the session, you pay for the therapeutic hour. If you are not, the session is on-the-house. The mother not only wrote the check, she entered therapy. Mother and daughter are closer than ever. Sometimes we just have trust that our instincts are good.

Nick Wright

19/3/2018 10:05:57 am

Thanks Mary. It sounds like the situation you described had a happy outcome. It illustrates well how our work with clients touches on wider systems and cultures (e.g. family), often out of our (and, sometimes, the client's) awareness. I think 'encouraged the child to spread her wings' touches on all sorts of issues and tensions in therapy and coaching arenas. How far should we explicitly support a client's course of action, even if it is the client who chooses it? This is also an area of increasing focus and concern for professional indemnity insurance providers in the UK..!

Ella Risi

19/3/2018 10:06:52 am

There is something about this question that bothers me. I see myself as one part of a clients life. I tend to work on the principal that I hold the therapy and keep myself accountable for who and how I am in that hour. The clients life and choices is not my responsibility.

Nick Wright

19/3/2018 10:10:14 am

Hi Ella. Yes, that is a common principle in therapy and coaching fields. In practice, however, I don't think we can draw such hard or clear lines between what we do with the client and what the client chooses to do. We invariably exert influence, e.g. through the nature and quality of the relationship itself as well as through any questions, reflections etc. that we may pose to the client. That makes issues of respective responsibility more blurry and complex.

Kevin Burns

19/3/2018 03:55:52 pm

Harm is part of life and part of healing, if only to open and clean the wounds. So I think 'do no harm' is a fantasy, and probably a dangerous one. Making mistakes that will hurt the client is inevitable, however much I try to avoid them and as Winnicott says, necessary to separation and individuation anyway. We can't be perfect and nor should we attempt to be.

Your question seems to suggest that perfect knowledge of the therapeutic relationship is desirable and possible. I think that went out 40-50 years ago when countertransference and then enactment were recognised not as obstacles but as aspects of the work. I imagine it's different with coaching.

I wouldn't seek to provoke a client deliberately, but my mistakes are often the greatest gifts, giving me the opportunity to engage with a client's anger and acknowledge my equal humanity with them in a way that is otherwise difficult or impossible.

Nick Wright

19/3/2018 04:04:54 pm

Thanks for your stimulating comments, Kevin. I don't believe that perfect knowledge of a therapeutic (or coaching) relationship is possible...and I recognise that working with transference and countertransference can be useful. I like your comment, 'not as obstacles but as aspects.' At the same time, I am aware that our work with clients doesn't take place in a cultural, systemic or contextual vacuum. What we do with a client will have impacts in the client's wider arena. How far do - or should - we take those wider implications into account? I think that's an important question ethically and practically.

Do no harm

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