Radical Honesty and Social Change: An Experiment in Dialogue, Deliberation and Action

It can be useful to use science-oriented and brain-oriented metaphors to investigate we-space practice, as these metaphors are accessible to a larger segment of progressive culture vs. Thought processes and ideas including, information, knowledge, meaning, and creativity can be described in terms of connections relationships or associations.

What is connected can be as small as a neuron or as large as a paradigm; and we can use this framing to speak about individual thought and collective thought at various scales. Experience is about firing. Learning and development are about wiring. In terms of AQAL theory, states involve firing and stages involve wiring. Both firing and wiring are about associations between things nodes, ideas, neurons, etc. Discussions of shadow usually focus on problematic obstructions that are the result of painful or traumatic experiences that the mind resists revisiting.

One could not function if one had to process the massive amounts of sensory information available at every moment; and the massive set of possible connections that the mind might make among that information and between that information and memory. Some of the filtering is related to shadow processes, which may have had an adaptive function in the past but now is maladaptive to a thriving life. Also, information can be filtered to reduce complexity, for example, when first learning to drive a car one can not coordinate conversation and tuning the radio which focusing on driving, but after mastery one no longer needs to filter these externalities and desires out.

At a deeper level we could say that certain types of filtering are built into cognition and even genetics, for example, humans can only perceive certain frequencies of light and sound. Because occlusions and filters can be diminished or removed, and detrimental ideas can be inhibited, there is the important potential for un-learning.

Growth cognitive, emotional, and spiritual thus involves both learning and unlearning. Most models of development, such as Hierarchical Complexity Theory and subject-object theory, involve creating higher level meta-connections that transcend and include. Processes of reflection and witnessing also involve the growth of such meta-level processes. In contrast, some aspects of development involve unlearning and the removal of either connections e.

These relate to modes of letting go, freeing of awareness, allowing what is, and the opening of perception and compassion that are referred to in our descriptions of contemplative and we-space practices. Collective intelligence and collective consciousness are common goals of we-space practice. In studying collective-intelligence and collective: When a group of interacting people shares a worldview, an idea, a goal, an emotion, or a state of consciousness, synergistic amplification is possible. More connections are made available to each and to all. Resonance—the amplification or multiplication of affects in interacting systems that are tuned to or sensitive to the same frequency—is a phenomenon applicable to all systems holons —physical, chemical, biological, social, noetic, etc.

Participation points to full involvement, complete interconnection, and minimal restriction in the flow of information. Full participation means not only that all are sharing their perspectives with all, but that all are open to and curious about the perspectives of all i.

Full participation implies the establishment of stable networks of empathy and ongoing exchange and feedback. Full participation thus supports the phenomena of resonance and synergy. In The Wisdom of Crowds , Surowiecki gives four preconditions of collective intelligence i. In the work on group creativity there are indications that similar principles apply to small and medium sized groups as well.

Though resonance speaks to something shared among participants, diversity is also important in collective intelligence and in we-space work in general. The whole usually benefits when individuals have a wide range of perspectives, experiences, and skills. Clearly, creativity is enhanced through greater degrees of freedom and greater readily-available fields of possibility. Research indicates that creativity in groups is harmed by social inhibitions and cognitive interference and is supported by social and cognitive forms of stimulation and support such as accountability and incubation; Paulus, Too much diversity, or certain types of diversity, can diminish the coherence that supports synergy—so there are design tradeoffs involved in balancing diversity vs.

In designing group processes, the question of what should be diverse or divergent, and what should be similar or resonant, will depend on goals of a process and the developmental or interior depth participants are capable of. Individuals can differ in terms of expertise; temperament and styles personality, social, and learning ; gender, class, and cultural identity; and ego development, to name just some of the dimensions.

In general, individuals with higher levels of ego development can ignore surface-level differences and resonate on deeper levels, allowing them to work on dilemmas and tensions that arise from even deeper levels. The amount of time available and the type of facilitation are also important factors in establishing a container that can hold the dissonance and higher levels of energy and chaos that can arise from difference and conflict.

Most of the we-space processes mentioned in this paper value creative or generative outcomes, and we can draw from the literature on creativity. Much has been written on intuition, creativity, and insight, that could be applied to we-space practices see Dunbar, ; Meyers, ; Gilovich, ; Gadwell, All of the theories point to the unconscious and non-rational mind as the source of insight. Creative insights are birthed through processes that can be both fragile and incendiary.

Insights in gestation can be lost through premature application of analysis which can shatter or critique which can smother. Research on creativity and intuition shows that the suspension of judgment, as suggested by Bohm, is a critical element Sternberg, ; Paulus, Basseches notes that creativity is achieved by not resolving contradiction, but by exercising the capacity to remain open and maintain conflicting alternatives , p xii.

Thus processes need to balance intuition vs. We-space practice requires deep participation within spaces of deep interiority. Collective intelligence and collective consciousness are intermediate goals for we-space practice, but what about the final goals? We-space practices include more than meditation practices and more than collective somatic practices because of the added element of dialogue.

Thus, what is unique about we-space-practice in this context relates to the meaning-making aspects of being human together. I will suggest, following Roy , that the most important goal of we-space-practices is the generation of insight. The term insight is related to creativity and intuition, but includes an emphasis on depth that I am exploring in this paper. Though I will claim that insight generation is the primary goal, there are many other valid goals for we space practices.

I list them below, including in most items a relationship to insight generation. The goal in Bohm Dialogue is insight into the nature of thought processes, including cultural or collective shadow, and the creation of more coherent thought. As was mentioned, Bohm Dialogues are not debates, therapy groups, social gatherings, or conflict resolution sessions—the goal is the transformation of thought and belief patterns within individuals and groups.

For U-Process, the goal is to generate insights that lead to action-reflection cycles. Insight can be understood in two complimentary yet very different ways. The first uses an additive or integrative model. This model is used in group brainstorming, visioning, and problem solving work. Many ideas are put on the table and the insights are the new configurations or pathways that emerge from creative thought and synergy. In contrast, we will emphasize an ablative eliminative model for insight. In this sense insight involves the revelation of that which was hidden, suppressed, or occluded—the removal of barriers and the untying of knots.

In this sense insight and thus we-space practice is closely tied to shadow work. We-space-dialogues are about the playful even if sometimes painful generation of ideas and insights. The deeper the interior space, the greater the potential for radical ideas and profound insights. In our definition insights do not come simply from additive or gestalt combinations of ideas, nor from creatively brainstormed ideas. They come from the lifting of a veil of ignorance from a concealed, suppressed or denied truth.

My relationship with that person was mostly a projection of my relationship with my dad. I was just able to let go of my assumptions enough to really get what you were saying. These are examples of personal-level disclosures, but group-level insights are also possible, in which what is revealed relates to more universal themes.

I just got a deep sense of how connected I am to everyone in this room. We have to generate our entire storehouse of meaning—Oh no! In a sense there is nothing truly new to discover within the depths of wisdom, but so much to be recovered. We-space practice is oriented toward insight, which in turn is based to the ablation or integration of so-called shadow material. We can draw from this, but the insights we are after in we-space practices involve the ablation of collective shadow, not individual personal shadow though personal transformation can happen as a side-effect of a group session.

What do we mean, then, by shadow and collective shadow? I will start with individual shadow and extend this concept to collective shadow. As mentioned above, thoughts and beliefs can be thought of in terms of connections. Through various processes, including painful experiences and cultural conditioning, some ideas and some pathways become occluded. I will use the word occlusion to stand for the many metaphors that can be used for shadow or the dynamic it creates, including: Related words used in psychotherapy include: Related processes and outcomes include: Similarly, the absenting of shadow material might be described in terms of revealing, untying, healing, unblocking, deactivating, purifying, deconstructing, unlearning, re-integration, liberation, emancipation, transformation, transmutation, etc.

Bhaskar uses the term demi-real to stand for all thought-forms that do not correspond well with reality, and shadow is one aspect of the demi-real. This barrage of terms and metaphors attributes to the scope of what we mean by shadow, and attests to the complexity and breadth of the topic, yet there is a single basic notion underlying it all.

In most theories of shadow, it is believed that the occlusions hide things that would bring psychological pain if they were to arise or re-arise in consciousness. These parts of our being are disowned and split off from the self-system or ego—one can deny the hidden truth or the distorted action even as it stares one in the face. Material can be actively projected onto objects in the external world.

Though pushing aspects of the self into shadow may constitute a successful adaptive strategy for avoiding pain at one point in life, usually shadow material is seen as something to be undone, healed, and reintegrated on the path of realizing full human potential. The defenses, pathologies, and lacuna of shadow can also hinder mature ego development. In addition, under conditions of stress or complexity, shadow can cause one to show up embodying a regressed stage of development. Due to its active nature, much human energy and potential gets bound up in the maintenance of shadow patterns.

When and as shadow is freed up and made transparent when the implicit is made explicit not only are the occluded ideas or aspects of self revealed, but they are suddenly made available to make new connections throughout the mind, in a flood of reorganization, unlearning, insight, and freed up energy. New modes of perception may also be freed up, deepening the quality of awareness.

Reorganization happens quite naturally and this has important implications. First, it supports our notion that insight is mostly about the ablative processes of unlearning or habit-breaking. Therapeutic, reflective, and critical forms of dialogue and personal process usually bear fruit only through substantial motivation and skillful means. But it often appears that once the knot is untied or the dam is broken, what follows is an automatic flow of new information, energy, and possibility which, again through effort, must be integrated into the life-world.

The methods and theories for doing shadow work are many and outside the scope of this paper and largely outside of my field of practical expertise. Shadow work can take on both rigorous and mundane forms. One of the main principles in shadow work is presenting the mind with something—a fact, an idea, a person, a set of feelings, a conundrum, etc. This was alluded to above in discussing self-distanciation and dissonance.

Contemplative dialogue practice is not usually understood as a place for serious personal shadow work, but participants are invited to work their personal edges. Accessing spaces of collective deep interiority is not so much a process of permanent healing or ablation of personal shadow material like cutting through a thicket to reach a goal , as it is of creating temporary environments that support participants in bracketing rendering unimportant, semi-transparent, or non-hindering those elements of their personal shadow that might disrupt the process or prohibit them from fully participating.

What is most important is that the group as a whole functions at a particular level for the duration of the process. Through group process structures and agreements, individuals can be supported to bring the best of themselves to a gathering, orienting to the benefit of the whole. And, lest all the talk of dissonance make shadow work or insight generation sound too arduous, it can also look and feel very much like play, which often assumes risk taking, learning through splendid failure, and the excitement of the challenge.

One of the main benefits of group work is the diversity of perspectives and skills that are made available. Diversity increases the possibilities that new ideas or challenging dilemmas will lead to insight. Above we discussed how full participation supports resonance and synergy. In his World Work Mindell notes how creating safe space for mainstream groups usually amounts to unsafe or oppressive space for marginalized groups.

Feelings of insecurity and threat are often intermediate goal states in such processes. In such situations one might invoke the concept of courage rather than that of safety. Related themes arise in the context of ensemble improvisational dance. Above we noted how shadow can be thought of in terms of occlusions or inhibitions among various types of connections. As Wilber notes Wilber, , building on Koestler , the important elements of collective social holons are the relationships between them—the connections, structures, and modes of communication among members.

The structural and emergent properties of collectives are very different than that of individuals, and one must be careful of using principles and metaphors appropriate to the first to describe the second see the Appendix on metaphysics. As noted by Schwartz we can describe collectives two ways: Thus we can talk about the developmental level, intelligence, compassion, or beliefs, of a collective as an aggregated over its members average, center of gravity, ideal max potential, etc.

At the level of the single collective object one can attribute properties and patterns such as diversity, language games, clusters, family systems, roles, norms, power dynamics, stratification, etc. Whatever might emerge at a higher level from individuals in a group would not have properties such as compassion, intelligence, or creativity in the way that they exist for humans. At the individual level shadow is about what cannot be thought about consciously, while at the group or social holon level, shadow is simply what is not talked about or communicated, explicitly represented, or enacted.

To ablate collective shadow is to speak or demonstrate or represent in some way a truth or apparent truth not previously consciously known to oneself and the rest of the group or the majority. Note however that we are focusing on revealed intuitive insight, not intellectualizing analysis not that these are mutually exclusive categories. But understanding and doing collective shadow work seems of the utmost importance in addressing contemporary social issues. Though it is one of the few models that brings shadow work into traditional cultural and organizational contexts, it is a fairly analytical process which does not include an invitation into deep interior space, and is thus a bit outside of our frame though this lack does make it more accessible to certain audiences.

In the integral theory community discussions of development are sometimes confusing around the downward movements into evolutionarily prior earlier, pre-human capacities vs. Lower level functions are available to us from birth, though accessing or experiencing them is often occluded or repressed and they, like all capacities, can be refined with practice. Such freeings can open up spaces of open awareness, senses of unity, connection, and vitality that are closely linked with our, one could say pristine, animal nature.

Development, on the other hand, as usually understood, is a process of accumulation and complexification. Each developmental change operates upon lower level capacities through differentiation to create wider fields of nuance, or through integration to create higher gestalts of unity. In integral theory individuals attain capacities to take additional types of perspectives with each succeeding developmental level. In spiritual discourse we speak of the deeper authentic Self, which seems to point metaphorically down towards elimination, and the higher, more conscious, or future Self, which points more upward Soul points down, Spirit points up.

In our model, surrendering is the downward and ablative move into experiencing parts of the self that are primitive or in shadow, and witnessing is more of an upward move that turns subject experience in to object reflective awareness. Disentangling the upwards vs. As mentioned, upwards is more about developmental or evolutionarily later phases, and downwards about earlier phases. As a type of awareness it operates upon something and is thus developmental in nature. But, as mentioned above, what the witness is aware of is often lower level functionality.

But in many contemplative practices the discursive mind is silenced, and what one is aware of is the animal-level or one could say the infant child-level consciousness prior to language and free of the layers of distraction and occlusion usually present in the mind. Thus non-duality is more about the journey down than the journey up. Again, the journey down is eliminative.

Though there are various interpretations of non-duality, one meaning is to perceive reality without the usual sense of duality. The experience of duality is largely an outcome of the language function of mind or how we use it. Again, this accesses evolutionarily lower level capacities. Thus there are several ways that the lower and higher interplay. Development beyond this requires personal motivation, unusual experiences, or life stressors that propel one to build higher level skills and capacities. Accessing and rebuilding lower level occluded capacities does not usually happen by itself or easily—doing so requires higher level capacities such as reflective awareness and self-understanding.

As Roy puts it:. Only the post-conventional mind can begin to deconstruct all these implicit biases and blind spots. When we are ready to begin again, from that place we interpret as origin…something curious happens. We find we will need to become more and more sophisticated, cognitively, to sufficiently de-couple ourselves from all those conditioned patterns in order to witness them as objects in awareness. We find that we need to create higher and higher levels of abstractions and meta-abstractions to get at the deeper and deeper kernels of reality.

The spiritual or developmental journey is sometimes described with an upward metaphorical arc, and sometimes described with a downward arc of emptying and letting go—the above describes how both metaphors are apt. The downward arc is, in part, an arc of embodiment. Intuitions arise primordially as felt-sense before they bubble up into symbolic thought Brown, Anther important relationship between the lower and higher arcs of development is that shadow material, specifically pathologies related to lower developmental levels, can both hinder and distort the development of higher levels As described in Wilber, This leads to the widely acknowledged injunctions that shadow work and embodiment should be a prerequisite and companion to meditation and other practices aimed at boosting developmental levels or producing advanced state experiences.

This supports our ablative model of development, shadow-work, and insight. Both critical realism, through its dialectic turn, and integral theory, through its inclusion of shadow work, highlight the eliminative movements within human liberation—freedom from cultural conditioning, oppressive forces, illusion, pathology, ego, etc. As noted above, both the upward and downward arcs are important. First, the downward arc is the elimination of shadow and the demi-real, and points toward the unleashing of human potential that was bound up in internal conflict and incoherence.

But for the vast majority, deep liberation and spiritual attainment are not naturally occurring processes, but require the additive and upward motivational forces of human development, a path that does not come naturally or easily to most, and must be supported and nurtured using skillful means. To ignore developmental principles is to take on an overly Romantic view of human nature. Second, the downward arc releases new insights, information, perspectives, and questions that call to be upwardly integrated, usually in trans-rational ways.

In the standard AQAL interpretation, morality develops along a separate developmental lines—vs. These lines are assumed to influence each other but their relationship is underspecified indeed it must be quite complex. However, spiritual, ego, and social-emotional skill development are all aspects of what we might be called Wisdom Skills, which combine cognitive post-rational development and heart-based capacities related to compassion, empathy, care, and feelings of mutuality and union.

We can use our upward vs. I propose that the heart-based aspect of development is ablative downward toward embodiment. Through the negation or transmutation of shadow material there can be an opening to an underlying or primal sense of unity and oceanic love that has been occluded through conditioning, but is available to the infant and at the mammalian levels of human being.

However, as described above, the upward developmental arc is usually needed in tandem with the ablative side, both to produce the motivation and skillful means to navigate the deep dive, and also in how the insights and new capacities that are uncovered are integrated, interpreted, and put to use. This helps explain the reason why late stage ego development seems to lead to profound commitments to compassion and service across ever wider extensions of time and space.

To experience others with empathy is to know our common humanity. This is the level of human emotional and embodied experience that all have in common; despite any differences in beliefs or values. The experiences of anger, frustration, joy, creative expression, jealousy, fear of otherness, maternal care, gluttony, awe, curiosity, etc. To feel deep oneness with another or all humans is to be in touch with that within oneself that is shared in common with them.

Still deeper involutionary revelation creates a sense of commonality, unity, and care for animals the Mammalian Self , and then for all life forms Biotic Self. In contrast to the realm of emotion and embodiment, where all humans share the basic ingredients of experience, in the realm of beliefs and abstract ideas people can diverge radically, sometimes with little hope of reconciliation or unity Rosenberg, There is no guarantee that one can fully understand, never mind agree with, a belief of idea of another for example, the other may have been socialized in another culture; or may have spent a lifetime studying in a field one is ignorant of.

The types of messes humanity has gotten itself into global warming, economic inequality, obesity, market collapses, high rates of depression, etc. In contemplative dialogue we access these insights through processes that support the dance of many ideas, grounded in a deep interiority, surrender, and openness. This is in part because, as described above, insights lie in those deeper downward aspects of human being that we have in common—where realities, in a sense, converge; while rationally constructed ideas and symbolic abstractions move into spaces where individuals tend to naturally diverge.

Here we can reiterate that, though some descriptions of we-space practices focus on meta, compassion, and service for example, Insight Meditation , we are proposing that these things, while being important preconditions and outcomes, are not as central to defining we-space practice as insight generation. Within this model an insight is a realization about love or unity that emerges when we roam the spaces of experience and possibility made available when shadow is negated. In this section I propose a specific layered model for the downward involutionary arc and the middle-out process of development that has already been hinted at above.

Different sources of shadow are associated with each phase of evolution as recapitulated in development: Related to each layer are truths that can be pressed into the demi-real of shadow through denial, resistance, pathology, etc.

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Liberation and insight for each layer involves revealing what was occluded at that layer. Here I will present one that is simpler that that used by Roy. Knowing the layer of shadow that a group is struggling with or producing insight from can inform process design and leadership decisions; and can help we-space practice groups auto-reflect and self-regulate to deepen insight. The proposed model has similarities. The evo-devo model covers similar ground and produces many similar principles as the Spectrum of Consciousness model and more recent models of Ego-development and Spiral Dynamics and it takes all of these as important influences.

Often the differences are a matter of emphasis rather than disagreement. The evo-devo model grounds in a different explanatory narratives and sometimes leads to different conclusions that the Spectrum model. It is important to distinguish between awareness as vs. The categories illustrated above are rough sketches that could should be refined and further researched. Of course, any such categorization scheme will be limited due to overlapping categories and the generally imprecise nature of describing complex life conditions using a linear sequence of classes.

An existential crisis awaits the practitioner at each layer. A significant amount of what is hidden remains so because a truth revealed would threaten the self one is identified with. According to Roy, an exploration into the lower involutionary levels of self animal and matter is necessary to allow for an authentic participation, in the deepest sense, with the world around us.

She explains that it is the collective shadow of a deep disconnection with these aspects of our nature that has lead to the environmental and ecological disasters humans have perpetrated on the planet. Humanity as a whole, and most individuals in Modern society enacts conflicting agendas—we want to change behaviors and improve things yet our actions are at odds with those voices an immunity to change.

These sorts of binds point inevitably to shadow material. The involutionary layers are aspects of the subject or self, and the developmental levels indicate what has become object. Thinner lines represent emerging awareness and heavier lines represent fuller awareness.

We in Western cultures at least are naturally socialized to a conventional developmental level of behavior and cognition. At this level one has some capacity to reflect on and expose shadow material at the concrete sociocultural level of involution. And this also seems to follow a middle-out path. This map can help describe the shadow-work aspects of group processes. What does it look and feel like for a group to gain awareness and see through the occlusions at each of these layers?

I will sketch out some possibilities below in an approximate order of accessibility, from easier to more challenging, in a rough developmental sequence. Each developmental step illustrates the involutionary layers that can be seen or seen through, and the type of shadow work that might be most appropriate there. The descriptions make the simplifying assumption that most or all in a group are operating at the same level, which is often not the case, so the descriptions are rather schematic.

The Middle-out relationship between involutionary layers and developmental levels. Pre-conventional level —any group work is difficul t. At this level the individual, or the group on average, does not have awareness of the Adult Self or any other layers. There is barely sufficient intelligence or cohesion to do any type of group or collaborative activity. Group processes may involve a fair degree of blaming, defensiveness, projection, posturing, or non-participation. They can be used to describe a momentary state or a more established stage. Conventional level —stable social collaboration.

With Adult Self concrete socio-cultural self awareness established, participants in a group activity can maintain basic levels of respect, composure, and awareness of the group context. Outbursts or actions that dominate group space, or withdrawals from group relationship, are possible at this level but are done from choice rather than impulse. As is described in various developmental theories, dialogue at the conventional level contains a fair amount of right vs. A reachable goal for participants at this level might be to let go of posturing and personal story, gross defenses and neuroses, to create a basic level of trust and congruence of intent.

It is not uncommon for participants in Conventional and Modernist groups to at least occasionally drop into reactive or regressive pre-conventional, child-like modes of being, We are all vulnerable to such occasions, each having our own emotional or limbic trigger points. This is the level of awareness assumed or hoped for in most group processes including brainstorming, organizational meetings, citizen dialogues, group therapy, meditation retreats, etc.

They have a post-conventional freedom to think independently, and they make good faith efforts to minimize personal and cultural bias as they engage. They are good listeners, logical and creative thinkers, somewhat in touch with their feelings, and can take the perspectives of others. Participants can reflect upon the quality of information and information sources, and the logical validity of claims. At this level one begins to gain awareness of the shadows of the Socio-Cultural Self, but insights are attached to specific ideas, cultures, or situations as opposed to a phenomenon in general.

It appears that, at least in western cultured, the fuller emergence of the rational mind creates two effects that work against collective deep interiority and must be worked out at higher levels: Pluralist level or post-modern level — interest in and early capacity for we-space practices. We-space practices, as we have defined them as contemplative dialogue, begin to have relevance at this level.

Participants can share curiosity about and deep inner exploration of, not only specific culturally biased content as they do in the Modernist Level , but about the very nature of such systemic bias; observing how it arises inside one and within group contexts. Insights about shadow related to the Mammalian Self may begin here also, as embodied practice leads to increased in-the-moment awareness of how instinct and emotion arise. Because participants are not acting predominantly from the Socio-Cultural Self, interactions can be said to be impersonal or transpersonal.

Yet deep feelings of compassion, connection, caring, and appreciation can and usually do arise. Vision Logic level or second tier or integral level — full capacity for we-space practices. It contains the maturation of shadow-awareness begun in the Pluralist level, and begins exploration into the layers of the Biotic self and the Material Self. They are enacted so minimally that they do not influence the flow. When these things do arise, there is no or little embarrassment or judgment—everyone understands that we are human and animals and the dialogue moves on without skipping a beat.

Ideas and concepts are at play, not in competition. With the other involutionary levels seen through, deep insight at the levels of the Biotic self and Material Self are increasingly possible. Post-Vision-Logic level — the future of we-space practices. Roy points to the possibility of post-dialogical participation at this level. It is probably exceedingly rare in Western society to encounter group practice in which the participants have reached a mature level of awareness at the levels of the Biotic Self and Material Self though it is likely that many individuals within the integral community have a post-vision-logic center of gravity, this does not translate directly into group work at that level.

In group work these levels and layers can be used to monitor depth and presence. Facilitators may want to assess both the range and average for the group; and track how the interactions and verbalizations that arise track up and down levels or layers , through periods of relative deepening and periods of relative chaos and challenge. Because many of the disclosures are at odds with established ego-defenses, each deepening step can bring a new phase of chaos and disequilibrium for individuals or the group.

The model can also be used to assess the depth attained at the bottom of a U-Process. Presumably, deeper level processes produce more profound insights and emergent actions. Martin Keogh, a movement teacher in the contact improvisation community writes: This is also a wonderful description of the openness, fluidity, trust, and panoramic simplicity-within-complexity that describe successful we-space practices. In this paper I have described we-space practices, and the causal spaces of deep interiority that they aim for, from embodied and phenomenological perspectives.

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I have also tried to put them in context with related practices in ensemble somatics, meditation, and dialogue-and-deliberation processes, to help us gain more clarity about what is unique about we-space practices, and to situate these other domains in a way that allows we-space practitioners to draw more from what the other domains can contribute. I have proposed that the core purpose of we-space practice is the collective generation of insight; that insight is primarily about ablation and shadow work; and that what is of deepest interest are insights that pertain to collective shadow, including insights about broad cultural and even species-level shadow material.

It can be used as a diagnostic tool assessing the states and types of content arising in a group practice, and as a guide for the most appropriate fulcrum points for process structures and interventions. I have not given much about practical methods and formats here, except to outline how Bohm Dialogue works. There are many methods, practiced and not yet discovered, for brining a group from everyday consciousness into deep listening, coherence, and luminosity. My hope is that this paper will nudge us a bit further toward a type of clarity that will both accelerate the inquiry into we-space practices and, in taking a non-metaphysical tact, allow us to share what we learn with communities of theory and practice outside the integral community—and to better learn from them in the exchange.

What I have not covered in any detail are the practical questions in designing we-space practice groups and activities. A practical manual for process design might answer the following important questions:. Of course, the answers to all of these questions will vary based on the we-space practice context and underlying theory. All of the pioneers mentioned in my overview of contemporary we-space practice projects are working hard at the leading edge of these questions, and many do have partial answers to some of these design questions. Integral Politics as Process.

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Integral Review , 6 3 , Through a combination of knowledge and skills gained from a range of theoretical and experiential sources, expert nurses also provide holistic care. Experts are thought to eventually develop the ability to intuitively know what to do and to quickly recognize critical aspects of the situation. In fact, several studies have found that length of professional experience is often unrelated and even negatively related to performance measures and outcomes. In a review of the literature on expertise in nursing, Ericsson and colleagues 65 found that focusing on challenging, less-frequent situations would reveal individual performance differences on tasks that require speed and flexibility, such as that experienced during a code or an adverse event.

Superior performance was associated with extensive training and immediate feedback about outcomes, which can be obtained through continual training, simulation, and processes such as root-cause analysis following an adverse event. Therefore, efforts to improve performance benefited from continual monitoring, planning, and retrospective evaluation. Intuition is the instant understanding of knowledge without evidence of sensible thought.

When intuition is used, one filters information initially triggered by the imagination, leading to the integration of all knowledge and information to problem solve. A review of research and rhetoric involving intuition by King and Appleton 62 found that all nurses, including students, used intuition i. The challenge for nurses was that rigid adherence to checklists, guidelines, and standardized documentation, 62 ignored the benefits of intuition.

This view was furthered by Rew and Barrow 68 , 74 in their reviews of the literature, where they found that intuition was imperative to complex decisionmaking, 68 difficult to measure and assess in a quantitative manner, and was not linked to physiologic measures. Intuition is a way of explaining professional expertise. Shaw 80 equates intuition with direct perception. Direct perception is dependent upon being able to detect complex patterns and relationships that one has learned through experience are important.

Recognizing these patterns and relationships generally occurs rapidly and is complex, making it difficult to articulate or describe. Perceptual skills, like those of the expert nurse, are essential to recognizing current and changing clinical conditions. Perception requires attentiveness and the development of a sense of what is salient. Otherwise, if nursing and medicine were exact sciences, or consisted only of techne, then a 1: Before research should be used in practice, it must be evaluated.

There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking and good clinical judgment. Sometimes the research findings are mixed or even conflicting. As such, the validity, reliability, and generalizability of available research are fundamental to evaluating whether evidence can be applied in practice. To do so, clinicians must select the best scientific evidence relevant to particular patients—a complex process that involves intuition to apply the evidence.

Critical thinking is required for evaluating the best available scientific evidence for the treatment and care of a particular patient. Good clinical judgment is required to select the most relevant research evidence. To evolve to this level of judgment, additional education beyond clinical preparation if often required.

For many years now, randomized controlled trials RCTs have often been considered the best standard for evaluating clinical practice. Yet, unless the common threats to the validity e. Relevant patient populations may be excluded, such as women, children, minorities, the elderly, and patients with multiple chronic illnesses. The dropout rate of the trial may confound the results. And it is easier to get positive results published than it is to get negative results published. Thus, RCTs are generalizable i.

In instances such as these, clinicians need to also consider applied research using prospective or retrospective populations with case control to guide decisionmaking, yet this too requires critical thinking and good clinical judgment. In clinical practice, the particular is examined in relation to the established generalizations of science.

With readily available summaries of scientific evidence e. Might it not be expendable, since it is likely to be out of date given the current scientific evidence? But this assumption is a false opposition and false choice because without a deep background understanding, the clinician does not know how to best find and evaluate scientific evidence for the particular case in hand.

The concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals. This implies that evidence-based practice, indicative of expertise in practice, appropriately applies evidence to the specific situations and unique needs of patients. Conceptually, evidence used in practice advances clinical knowledge, and that knowledge supports independent clinical decisions in the best interest of the patient.

Nurses who want to improve the quality and safety of care can do so though improving the consistency of data and information interpretation inherent in evidence-based practice. Initially, before evidence-based practice can begin, there needs to be an accurate clinical judgment of patient responses and needs. Nonetheless, there is wide variation in the ability of nurses to accurately interpret patient responses 92 and their risks.

Attaining accurate and consistent interpretations of patient data and information is difficult because each piece can have different meanings, and interpretations are influenced by previous experiences. Once a problem has been identified, using a process that utilizes critical thinking to recognize the problem, the clinician then searches for and evaluates the research evidence and evaluates potential discrepancies.

Yet many nurses do not perceive that they have the education, tools, or resources to use evidence appropriately in practice. In many clinical situations, there may be no clear guidelines and few or even no relevant clinical trials to guide decisionmaking. In these cases, the latest basic science about cellular and genomic functioning may be the most relevant science, or by default, guestimation.

Consequently, good patient care requires more than a straightforward, unequivocal application of scientific evidence. The clinician must be able to draw on a good understanding of basic sciences, as well as guidelines derived from aggregated data and information from research investigations. But scientific, formal, discipline-specific knowledge are not sufficient for good clinical practice, whether the discipline be law, medicine, nursing, teaching, or social work. Practice communities like individual practitioners may also be mistaken, as is illustrated by variability in practice styles and practice outcomes across hospitals and regions in the United States.

This variability in practice is why practitioners must learn to critically evaluate their practice and continually improve their practice over time. The goal is to create a living self-improving tradition. Within health care, students, scientists, and practitioners are challenged to learn and use different modes of thinking when they are conflated under one term or rubric, using the best-suited thinking strategies for taking into consideration the purposes and the ends of the reasoning. Learning to be an effective, safe nurse or physician requires not only technical expertise, but also the ability to form helping relationships and engage in practical ethical and clinical reasoning.

The notions of good clinical practice must include the relevant significance and the human concerns involved in decisionmaking in particular situations, centered on clinical grasp and clinical forethought. We have much to learn in comparing the pedagogies of formation across the professions, such as is being done currently by the Carnegie Foundation for the Advancement of Teaching. To capture the full range of crucial dimensions in professional education, we developed the idea of a three-fold apprenticeship: This framework has allowed the investigators to describe tensions and shortfalls as well as strengths of widespread teaching practices, especially at articulation points among these dimensions of professional training.

Research has demonstrated that these three apprenticeships are taught best when they are integrated so that the intellectual training includes skilled know-how, clinical judgment, and ethical comportment. With that as well, I enjoyed the class just because I do have clinical experience in my background and I enjoyed it because it took those practical applications and the knowledge from pathophysiology and pharmacology, and all the other classes, and it tied it into the actual aspects of like what is going to happen at work.

For example, I work in the emergency room and question: Why am I doing this procedure for this particular patient? Clinical experience is good, but not everybody has it. The three apprenticeships are equally relevant and intertwined. In the Carnegie National Study of Nursing Education and the companion study on medical education as well as in cross-professional comparisons, teaching that gives an integrated access to professional practice is being examined. Once the three apprenticeships are separated, it is difficult to reintegrate them. The investigators are encouraged by teaching strategies that integrate the latest scientific knowledge and relevant clinical evidence with clinical reasoning about particular patients in unfolding rather than static cases, while keeping the patient and family experience and concerns relevant to clinical concerns and reasoning.

Clinical judgment or phronesis is required to evaluate and integrate techne and scientific evidence. Effectiveness depends upon mutual influence between patient and practitioner, student and learner. This is another way in which clinical knowledge is dialogical and socially distributed. The following articulation of practical reasoning in nursing illustrates the social, dialogical nature of clinical reasoning and addresses the centrality of perception and understanding to good clinical reasoning, judgment and intervention. Clinical grasp describes clinical inquiry in action.

Clinical grasp begins with perception and includes problem identification and clinical judgment across time about the particular transitions of particular patients. Four aspects of clinical grasp, which are described in the following paragraphs, include 1 making qualitative distinctions, 2 engaging in detective work, 3 recognizing changing relevance, and 4 developing clinical knowledge in specific patient populations. Qualitative distinctions refer to those distinctions that can be made only in a particular contextual or historical situation. The context and sequence of events are essential for making qualitative distinctions; therefore, the clinician must pay attention to transitions in the situation and judgment.

Many qualitative distinctions can be made only by observing differences through touch, sound, or sight, such as the qualities of a wound, skin turgor, color, capillary refill, or the engagement and energy level of the patient. Another example is assessing whether the patient was more fatigued after ambulating to the bathroom or from lack of sleep. Clinical situations are open ended and underdetermined. Modus operandi thinking requires keeping track of what has been tried and what has or has not worked with the patient.

In this kind of reasoning-in-transition, gains and losses of understanding are noticed and adjustments in the problem approach are made. For example, one student noted that an unusual dosage of a heart medication was being given to a patient who did not have heart disease. The student first asked her teacher about the unusually high dosage. The teacher, in turn, asked the student whether she had asked the nurse or the patient about the dosage. When the student asked the patient, the student found that the medication was being given for tremors and that the patient and the doctor had titrated the dosage for control of the tremors.

The meanings of signs and symptoms are changed by sequencing and history. The direction, implication, and consequences for the changes alter the relevance of the particular facts in the situation. The changing relevance entailed in a patient transitioning from primarily curative care to primarily palliative care is a dramatic example, where symptoms literally take on new meanings and require new treatments.

Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population. The comparisons between many specific patients create a matrix of comparisons for clinicians, as well as a tacit, background set of expectations that create population- and patient-specific detective work if a patient does not meet the usual, predictable transitions in recovery.

Over time, the clinician develops a deep background understanding that allows for expert diagnostic and interventions skills. Clinical forethought is intertwined with clinical grasp, but it is much more deliberate and even routinized than clinical grasp. Clinical forethought is a pervasive habit of thought and action in nursing practice, and also in medicine, as clinicians think about disease and recovery trajectories and the implications of these changes for treatment. Clinical forethought plays a role in clinical grasp because it structures the practical logic of clinicians. At least four habits of thought and action are evident in what we are calling clinical forethought: Future think is the broadest category of this logic of practice.

Anticipating likely immediate futures helps the clinician make good plans and decisions about preparing the environment so that responding rapidly to changes in the patient is possible. Without a sense of salience about anticipated signs and symptoms and preparing the environment, essential clinical judgments and timely interventions would be impossible in the typically fast pace of acute and intensive patient care. Whether in a fast-paced care environment or a slower-paced rehabilitation setting, thinking and acting with anticipated futures guide clinical thinking and judgment.

Future think captures the way judgment is suspended in a predictive net of anticipation and preparing oneself and the environment for a range of potential events. Clinical forethought involves much local specific knowledge about who is a good resource and how to marshal support services and equipment for particular patients. Examples of preparing for specific patient populations are pervasive, such as anticipating the need for a pacemaker during surgery and having the equipment assembled ready for use to save essential time.

This aspect of clinical forethought is central to knowing the particular patient, family, or community. This vital clinical knowledge needs to be communicated to other caregivers and across care borders. Clinical teaching could be improved by enriching curricula with narrative examples from actual practice, and by helping students recognize commonly occurring clinical situations in the simulation and clinical setting. For example, if a patient is hemodynamically unstable, then managing life-sustaining physiologic functions will be a main orienting goal.

If the patient is agitated and uncomfortable, then attending to comfort needs in relation to hemodynamics will be a priority. Providing comfort measures turns out to be a central background practice for making clinical judgments and contains within it much judgment and experiential learning. When clinical teaching is too removed from typical contingencies and strong clinical situations in practice, students will lack practice in active thinking-in-action in ambiguous clinical situations.

In the following example, an anonymous student recounted her experiences of meeting a patient:. Kim was my first instructor and my patient that she assigned me to—I walked into the room and he had every tube imaginable. And so I was a little overwhelmed. She asked what tubes here have you seen? Well, I know peripheral lines. The site, check the site. He had a feeding tube. I had done feeding tubes but that was like a long time ago in my LPN experiences schooling. He had a [nasogastric] tube, and knew pretty much about that and I think at the time it was clamped.

So there were no issues with the suction or whatever. He had a Foley catheter. He had a feeding tube, a chest tube. As noted earlier, a central characteristic of a practice discipline is that a self-improving practice requires ongoing experiential learning. One way nurse educators can enhance clinical inquiry is by increasing pedagogies of experiential learning.

Current pedagogies for experiential learning in nursing include extensive preclinical study, care planning, and shared postclinical debriefings where students share their experiential learning with their classmates. Experiential learning requires open learning climates where students can discuss and examine transitions in understanding, including their false starts, or their misconceptions in actual clinical situations. Nursing educators typically develop open and interactive clinical learning communities, so that students seem committed to helping their classmates learn from their experiences that may have been difficult or even unsafe.

One anonymous nurse educator described how students extend their experiential learning to their classmates during a postclinical conference:. So for example, the patient had difficulty breathing and the student wanted to give the meds instead of addressing the difficulty of breathing. But she shared that. One of the keys to becoming an expert practitioner lies in how the person holds past experiential learning and background habitual skills and practices.

This is a skill of foregrounding attention accurately and effectively in response to the nature of situational demands. Bourdieu 29 calls the recognition of the situation central to practical reasoning. If nothing is routinized as a habitual response pattern, then practitioners will not function effectively in emergencies. Unexpected occurrences may be overlooked. However, if expectations are held rigidly, then subtle changes from the usual will be missed, and habitual, rote responses will inappropriately rule.

The clinician must be flexible in shifting between what is in background and foreground. This is accomplished by staying curious and open. Assessment and validation are required. In rapidly moving clinical situations, perceptual grasp is the starting point for clarification, confirmation, and action. Having the clinician say out loud how he or she is understanding the situation gives an opportunity for confirmation and disconfirmation from other clinicians present. For example, when the background rhythm of a cardiac monitor changes, the nurse notices, and what had been background tacit awareness becomes the foreground of attention.

A hallmark of expertise is the ability to notice the unexpected. Tacit expectations for patient trajectories form that enable the nurse to notice subtle failed expectations and pay attention to early signs of unexpected changes in the patient's condition. Clinical expectations gained from caring for similar patient populations form a tacit clinical forethought that enable the experienced clinician to notice missed expectations. Alterations from implicit or explicit expectations set the stage for experiential learning, depending on the openness of the learner.

Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. This section of the paper was condensed and paraphrased from Benner, Hooper-Kyriakidis, and Stannard. Turn recording back on. National Center for Biotechnology Information , U. Show details Hughes RG, editor.

Chapter 6 Clinical Reasoning, Decisionmaking, and Action: Background This chapter examines multiple thinking strategies that are needed for high-quality clinical practice. Critical Thinking Nursing education has emphasized critical thinking as an essential nursing skill for more than 50 years. Scheffer and Rubenfeld 5 expanded on the APA definition for nurses through a consensus process, resulting in the following definition: Course work or ethical experiences should provide the graduate with the knowledge and skills to: Use nursing and other appropriate theories and models, and an appropriate ethical framework;.

Evaluate nursing care outcomes through the acquisition of data and the questioning of inconsistencies, allowing for the revision of actions and goals;. Critical Reflection, Critical Reasoning, and Judgment Critical reflection requires that the thinker examine the underlying assumptions and radically question or doubt the validity of arguments, assertions, and even facts of the case. Techne and Phronesis Distinctions between the mere scientific making of things and practice was first explored by Aristotle as distinctions between techne and phronesis. Thinking Critically Being able to think critically enables nurses to meet the needs of patients within their context and considering their preferences; meet the needs of patients within the context of uncertainty; consider alternatives, resulting in higher-quality care; 33 and think reflectively, rather than simply accepting statements and performing tasks without significant understanding and evaluation.

As Dunne notes, A practice is not just a surface on which one can display instant virtuosity. MacIntyre points out the links between the ongoing development and improvement of practice traditions and the institutions that house them: Experience One of the hallmark studies in nursing providing keen insight into understanding the influence of experience was a qualitative study of adult, pediatric, and neonatal intensive care unit ICU nurses, where the nurses were clustered into advanced beginner, intermediate, and expert level of practice categories.

Gadamer, in a late life interview, highlighted the open-endedness and ongoing nature of experiential learning in the following interview response: Intuition and Perception Intuition is the instant understanding of knowledge without evidence of sensible thought. Evaluating Evidence Before research should be used in practice, it must be evaluated. Evidence-Based Practice The concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals.

When Evidence Is Missing In many clinical situations, there may be no clear guidelines and few or even no relevant clinical trials to guide decisionmaking. The Three Apprenticeships of Professional Education We have much to learn in comparing the pedagogies of formation across the professions, such as is being done currently by the Carnegie Foundation for the Advancement of Teaching. Making Qualitative Distinctions Qualitative distinctions refer to those distinctions that can be made only in a particular contextual or historical situation.

Recognizing Changing Clinical Relevance The meanings of signs and symptoms are changed by sequencing and history. Developing Clinical Knowledge in Specific Patient Populations Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population. Clinical Forethought Clinical forethought is intertwined with clinical grasp, but it is much more deliberate and even routinized than clinical grasp.

Future think Future think is the broadest category of this logic of practice. Anticipation of crises, risks, and vulnerabilities for particular patients This aspect of clinical forethought is central to knowing the particular patient, family, or community.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

In the following example, an anonymous student recounted her experiences of meeting a patient: One anonymous nurse educator described how students extend their experiential learning to their classmates during a postclinical conference: Seeing the unexpected One of the keys to becoming an expert practitioner lies in how the person holds past experiential learning and background habitual skills and practices. Conclusion Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment.

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