One of the main tenets of Professor Onora O’Neill’s arguments around the theme of trust is that we must aim to have more trust in the trustworthy but not in the untrustworthy. She says, “I aim positively to try not to trust the untrustworthy.”
Which brings around the questions. Who can you trust? Who do you trust? And then by extension, Who can trust you? Who does trust you?
All of us exist in different circles. At the centre is the Circle of Control. Sometimes when I talk to dentists and their teams they say that they feel they have little control over their lives, I can understand those feelings but they are not correct. We have control on where our focus is from moment to moment. We choose and can control our reactions to events and to others. We control where and how we spend our time and energy. We control how we turn up every day. We also control how trustworthy we are.
The next circle is The Circle of Influence. In here are the things that concern you and that you are able to Influence. When we look at this closely many of the things that cause us concern are beyond our control and influence.
Finally the outer circle is the Circle of Concern. In here lie all the things that concern you in your work and life, including health, family, finances, the general economy and so on. Everything inside the circle matters to you, everything outside the circle is of no concern to you.
The lesson around the circles is to “Focus on what you can control and don’t waste energy on the things that you cannot.” To take a topical theme, it is very unlikely that any of us can control the outcome of the UK’s proposed Brexit deal - yet many are losing sleep, getting anxious, losing friends and letting it dominate their thinking.
To return to trust. Dentists often say they feel they have lost trust in successive governments, in the GDC and, increasingly, their colleagues. They will often give me evidence of things that have happened where their trust has been “betrayed” by an associate, a principal or an employee. When a patient makes a complaint we feel our trust has been betrayed in some shape or form and it hurts, of course it does.
Often when we analyse the situation we find that the relationship had not been founded on trust, that there was not complete transparency between the parties. In the past when deference was given to professionals there occurred “blind trust” which now, quite rightly, plays little role in our lives.
Unfortunately too many of our relationships have to be with the slab like nature of organisations, where trust is replaced by unintelligent accountability. This is based on managerial concepts of controlling performance by setting targets for individuals and institutions. Success, or not, is measured by whether targets are attained.
For the majority of dental team members, gaining trust with patients and each other is built in gradual stages. The speed depends upon the individuals involved. Bud Ham described the stages involved as a five-step process, Acquaintance, Rapport, Mutual Acceptance, Mutual Respect and Intimacy. The requirements for each stage are “Others’ Conscious Attention, “Friendliness”, “Shared History”, “Disclosed Beliefs” but for the final stage we need to take the risk of sharing “Secrets”.
Most teaching on good communication is “sales based” and stops at “Rapport”. I think it’s only just starting and would suggest that if our relationships are to be trustworthy they must, as Bud says, get closer to the Risk of Intimacy; emotional, mental or spiritual intimacy.
To return to Trust and to wrap things up.