Well, the concept of supportive challenge from last week didn’t seem to gain much traction! In fact, for the first time in my (short) blogging history there was almost radio silence from readers. I found this interesting and it led me to … reflect! đ This time on the balance required between positivity and negativity.
Previously I have written about the importance of positivity and the importance of relationships and trust. John Gottman brings these two concepts neatly together by focusing on the importance of positive interactions in maintaining trusting relationships, though his magic relationship ratio. He proposes that a ratio of 5:1 positive:negative interactions is required to maintain positive relationships. That means that you need five positive interactions to counteract one negative interaction. Although this concept originated in analysis of marital relationships it has since been shown to be valid in lots of types of relationships, including those in the workplace. Maureen Gaffney, in her book Flourishing, refers to this as the Flourishing Ratio where she proposes that for every burst of irritability, every tense exchange, every negative thought and feeling of disappointment, there has to be five times as many positives.
This is a principle that I now try to bring to all aspects of my life… how I treat my family, how I interact with my colleagues and friends and, probably most importantly, how I talk to myself! I don’t always achieve it but I do find that conflict in relationships is much more easily resolved where there is a sufficient cushion of positivity.
Note the fact that the magic ratio isn’t 5:0. A certain amount of negativity is needed in the world. In fact Maureen Gaffney maintains that appropriate negativity has an important role to play in flourishing. Yet many of us shy away from it.  Sometimes, however, shying away isn’t an option.
With this in mind, I was reminded of a publication which I read a number of years ago in the International Journal of Pharmacy Practice entitled “Who do you think you are? Pharmacists perceptions of their professional identities“. The researchers interviewed 43 pharmacists about how they perceived themselves in the context of their professional identities. It’s an interesting article and could lead to a whole raft of different blogs! But one particular point stood out for me which is related to this topic of the magic relationship ratio. One pharmacist, described their approach to difficult conversations as follows…
“a lot of the time youâre potentially going up to doctors and saying, you know âI disagree with what youâve prescribed hereâ, you have to be able to put that across in a friendly way, without sounding like youâre constantly nagging them, otherwise you donât have a very good relationship with them”
I agree with the idea that if you are must have this type of conversation, you should approach it in a friendly manner. However, as a pharmacist, if every interaction I have with a doctor is focused on telling him/her when they have made an error in prescribing, it’s unlikely to result in a positive relationship, no matter how nicely I phrase it! If I consider the magic relationship ratio, I need to have five positive interactions counteracting that negative one in order to maintain a good relationship. I never considered this when I practiced as a pharmacist. I contacted GP colleagues when there was a problem because a conversation was needed. I handled it as nicely as I could but, to be honest, I rarely, if ever,invested any thought into the importance of balancing those interactions with more separate, positively focused conversations. To be fair, my GP colleagues were always very professional and responded well but I do wonder now if I could have been more mindful of the relationships. With an increasing focus on inter-professional working in our healthcare systems, perhaps it is worth considering how we can achieve the magic relationship ratio across the resultant relationships.
Reflection time
Take a moment to consider your relationships with others. Do you always achieve the 5:1 ratio? Are there times when you’re not able to build up a cushion of positivity to counter the negative interactions? In these cases, is there anything you could you do to get closer to the magic relationship ratio?
Catriona
In the article âWho do you think you are? Pharmacists perceptions of their professional identitiesâ discussion on the medicines advisor ‘type’ refers to hospital pharmacists advising consultants on ’rounds’ and community pharmacists’ advising patients … but omits to refer to community pharmacists advising GPs when they phone to discuss a prescription for a patient they both ‘care’ for – with the objective of improving patient outcomes, risk managing the use of medicines etc etc!
It also strikes me that the ‘educator’ doesn’t surface as a ‘type’ at all in the reference.
I’m wondering if we need to expand our thinking regarding what it is we ‘value’ as a profession?
On the ‘PharmD-for-pharmacists’ degree programme in University of Toronto, pharmacists must undertake 7 compulsory and 4 ‘elective’ (i.e. choose from amongst a range of options) modules during their circa 3 years. One of the 7 compulsory modules is ‘Education theory and methods’.
New perspective perhaps?!