In Pursuit of Chiropractic Ethics -- Part IV: Happy Talk

Dr. X, his head in his hands, groaned. He had used his rent money for an expensive advertising campaign that he really believed would work. He had visualized success so clearly. He didn't understand why it only bought in one prospect. He knew that if he kept a positive attitude, everything would be all right. He had to cheer himself up, put a smile on his face, a tie on his neck, because he had to give a free exam to that one patient. He knew if he kept his enthusiasm up, he could sell that patient $2,000 worth of treatment.

Dr. X is using happy talk. Happy talk is part of American business culture that has become an essential flavor of chiropractic culture. Think and grow rich. Happy talk is what we say to ourselves in our internal dialogue. It is positive affirmation and imagery. It is also what we say to those around us with positive words, confidence, and optimism.

Our profession's culture involves much positive thinking. We believe our success in chiropractic depends on our attitude and philosophy. The corollary is we believe that without an enthusiastic, positive attitude we cannot succeed, because we believe we cause success through our attitude. Therefore, all actions and problems must be subsumed under the correct (i.e., positive, enthusiastic) attitude.

My strongest personal experience with using positive affirmation and imagery came 16 years ago when my seven-year-old son suffered stage IV metastatic Wilm's tumor. In addition to standard protocol surgery, radiation, and chemotherapy, we employed many types of positive mental/emotional/spiritual techniques. My son's complete healing was called a miracle by his oncologist. It was so notable he was on television. When he was 15-years-old, he was told he had made medical history.

When my son was sick I learned that it is always our individual responsibility to do everything we can do to effect the desired outcome of a situation. One of the most important things is doing our best with our minds and emotions.

However, when we attribute causation in the outside world solely to what any of us can do within our minds and emotions, we are wrong. The causation of what happens in the world is much more complex and mysterious than what any of us can do within our minds and emotions.

Through the years, I have been close both to positive uses and to abuses of these techniques. People often go overboard with them, while trying to effect what they want in the world. They cross an invisible line. They're coping through fairy-tale fantasy they can control. It becomes a hindrance to their ability to deal with reality.

Gary Goldstick says in Business Rx: How to Get in the Black and Stay There, "If the executive is secure, he can more easily afford to seek rational explanation and take in real-world data. ...The more insecure he is, the more he may withdraw into himself. Within his own mind, he can then build a safe place, a refuge from the storm."

He notes that the psychologist, Bruno Bettelheim, explains in The Uses of Enchantment, how very young people learn to help themselves to feel secure through fairy tales. The positive stories and images from fairy tales include believing in benevolent powers, help in time of need, in magical intervention, in monsters vanquished, in rewards for being brave and daring, in a safe place, and a happy ending.

"Fantasy can be an enormous comfort to the executive under stress and can become addictive. His problems seem overwhelming, and if he can convince himself that there are no problems, or that the problems can be solved by magical intervention, he doesn't have to do anything different.

"He can't solve the business's problems, so he tells himself that there are no problems to solve. To keep that fantasy alive, he must shut down some of his thinking process. He cannot allow input or he must distort input that challenges his underlying belief. ..."¹

Goldstick goes on to say, "The mind's ability to reshape reality to fit beliefs is a phenomenal talent. What people tell themselves, no matter how distorted the perception, can be powerful enough to override all evidence to the contrary. ... The perceived distortion is compounded by the fact that people act on their faulty perceptions."²

In a way, what we believe about success in chiropractic depending on attitude and philosophy is true. The doctor's self-confidence, drive, and optimism are definitely necessary to set the tone for everyone and increase probabilities of success. However, when the method of happy talk is being abused, doctors do not see reality clearly. Often we're pushed onto a slippery slope of questionable ethics because the chiropractic group ethos rigidly requires an enthusiastic attitude must be had at all times.

Instead of making a clinical decision about what the particular new patient really needs, Dr. X was planning to sell the patient with enthusiasm. This hurts us with the public. They want a doctor who they can trust to tell them what's medically necessary, and they get a salesman.

Happy talk abuse causes us to base business decisions on unrealistic optimism. We can't consider the negative, so we have no alternate plans. Then we find ourselves in financial binds, which push us into unethical behavior.

Happy talk distracts us. Our heads, far from our feet, are absorbed in clouds of a fantasy land. We lose footing in reality and slide down a slippery slope of loose ethics.

References

1. Goldstick G: Business Rx: How to Get in the Black and Stay There. John Wiley, pp 52, 1988.

    

2. Ibid., pp 59.