Look out for the outliers

Seeing the good qualities in others lifts them, benefits us, and makes the world better.

Roger Bretherton

Roger Bretherton is Associate Professor of Psychology, at the University of Lincoln. He is a UK accredited Clinical Psychologist.

A office worker wearing headphones looks out of a hectic and loud office space around which people are moving

Nick Jones/Midjourney.ai

I was talking to someone the other day. She is a website developer and she’s just changed jobs. She is not a loud person, but anyone who meets her knows she is a person of quality, of depth and presence. She emanates a humble confidence. In her old job, she worked in a quiet, fairly sedate, office where she was given the space and the time to bring all her creativity to bear on whatever brief she was given. She was known and appreciated.

But her new job – the job she started last week – is a bit different. Her new colleagues are loud and outspoken. Silence is unknown in their office. They like to work to a soundtrack. The drum and bass keep thumping, and the banter never stops flowing. She’s finding it hard to fit in with her new team. And things weren’t made any easier when, after a few days, her new boss took her aside for a pep talk.

What was the problem? She was ‘too quiet’.

It hurt to hear that. It broke my heart to think that anyone could be so blind. How shortsighted do you have to be, to view the grace and peace someone carries as a problem to be solved? In a world of distressing noise and clamour, she is precisely the kind of person every office needs to temper the insanity.

I’m not worried about her. She’s bright and innovative. She’ll work it out. Either her new boss will see sense, or she’ll leave. And if she does, the queue of employers looking for someone just like her stretches round the block. She’ll be okay.

But it got me thinking about the kind of psychology I study. In my research, she would be called an outlier. One of those people in a team or a family who don’t quite fit in. Not because they are weird or awkward, but because they possess some positive quality the rest of the gang don’t have. They are the creative exuberant in a team who prefer doing things by the book. The hilarious joker in a pack who like to take things seriously. The conscientious worker trying to get on with the job in an office that would rather play now and work later. The kind one in a family of cutthroat competitors.

At the top of the list of reasons for wanting to leave work are the words: I am not appreciated.

The thing is we all have a unique contribution to make to the world, a one-off fingerprint of strengths and abilities never to be repeated in anyone else. In research these have been called Signature Strengths, the unique combination of positive qualities that make you you. And the weird thing is that we don’t have to try that hard to be them. If you are naturally kind, or wise, or grateful, or disciplined you won’t be able to stop yourself being that way. They come effortlessly to us. And if someone tries to stop us being the loving thoughtful faithful person we know ourselves to be, it is like losing a limb. If we find ourselves in a context where the most beautiful things about us are unwelcome – like my friend the website developer – it is like being rejected, right to the core.

But here’s the cool thing. If we can live by our Signature Strengths – if we can wake up each morning and ask the question, how can I use my unique positive qualities in a new way today? – it leads to remarkable improvements in wellbeing. Multiple studies have shown that those who live like this, thinking about how they can bring what is best in them to the opportunities and obstacles of each day, report increased happiness in living. Not only that, but they also show reduced anxiety, stress and depression. It turns out being good is good for us. Who knew.

That’s not the whole story though. To really be our best, we need other people to spot these strengths in us. If they don’t, we feel confined, unable to be ourselves in some way. When I ask people what it is like not to be able to bring their best qualities to the people around them, they come up with some pretty dark images. It is lonely, isolating, a desert, a fog, a prison, like being trapped in a cage. And when researchers ask people why they consider leaving their current job, their answers often reflect something like this. Work-life balance and salary are no doubt important, but often, at the top of the list of reasons for wanting to leave work are the words: I am not appreciated. Something good we wanted to give has not been received. We feel unseen.

So that’s why I say: look out for the outliers. Who is it in your family, your workplace, your neighbourhood, who goes underappreciated? Who do you know who has something good to give, but needs some help to give it? Because if we can learn to see those invisible beautiful qualities in the people around us, we not only give them the joy of being known, we also invite more light and flavour into the world. Life becomes a little less grey.

I just hope my friend’s new boss can learn this while he still has the chance. It is tough for her to feel so misunderstood, but it’s worse for him. She can move on, but he has to remain in an office deprived of the humble compassion she would have brought to it. It’s a question worth asking. What gift of beauty and goodness are we excluding from the world because we failed to see past the packaging?

Article

Ageing

Care

Change

Death & life

20 September 2024

6 min read

A Tolkien poem helps a nurse understand the ravages of dementia

'Not all who wander are lost.'

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

An elderly woman wearing headphone looks up and to the side with a big smile.

Playlist for Life

Not all who wander are lost.

Often written on a care home wall, on an inspirational poster, these words are usually set against a forest background, or compass, for added effect. They have also been used as the title of a conference paper discussing so-called smart trackers for people with dementia, whilst, Not all who wander need be lost is the title of a concise guide to navigating the heartbreaking challenges when a loved one is diagnosed with Alzheimer’s disease or other dementia.

As a care home nurse for more than ten years, I have seen residents wander - not lost but “walking with purpose”, as it is sometimes known in the caring community. “Nobody gets up and walks without a reason,” says Suzanne Mumford, Care UK's Head of Nursing, Care and Dementia; perhaps they are easing pain, or boredom, or looking for something that they can’t describe. I remember residents exploring, enquiring into self-made mysteries solvable only by themselves, examining everything from door handles to another resident’s buttons, even escaping with surprising speed. Walking with them, often in silence, can bring a sense of relief, comfort and companionship.

What I didn’t know was that this is a quotation from a poem by JRR Tolkien, published in The Fellowship of the Ring seventy years ago. The actual line is - “Not all those who wander are lost”.

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.

From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be blade that was broken,
The crownless again shall be king.”

We first hear this poem in Chapter Ten of Book One, as Frodo reads it in the postscript of a letter from Gandalf. As I read it, the imagery of being lost, withered, frost-bitten, in darkness, burned and broken, speaks something, in poetic picture language, of the ravages of dementia, the harrowing losses, the valley of tears. It brings to mind residents unaware of familiar objects or surroundings, looking straight through loved ones without a flicker of recognition, losing also language, continence, mobility and the ability to swallow.

The TV presenter Fiona Philips recalled an agonising decline in her mother as she succumbed to Alzheimer’s, describing how, in the final stages, her mother “spent whole chunks of time just sitting and staring ahead, only able to give out a series of sounds”. Fiona herself now lives with dementia. “'It’s devastated my family and it’s the biggest health and social care challenge we face as a country,” she says.

I once interviewed retired doctor Jennifer Bute, who lives with dementia. She talked of time travel (perceiving herself as living in a time from her past); disorientation to place and person; frightening hallucinations when old memories are seemingly ‘unlocked’; and ‘emotional unzipping’ when agitation and anxiety increase, often in the late afternoon or evening in something poorly understood as a symptom, known as ‘sundowning’.

Yet there is something more to this poem – each of the pains has a promise – not all who wander are lost; the old that is strong does not wither; and, most poignantly, deep roots are not touched by the frost. In dementia, it is true that deep roots are untouched, that an enduring aspect of a person’s identity never truly withers, though it may be mostly unseen. Something remains. Oliver Sacks the famous neurologist emphasised that, even in the late stages of Alzheimer’s, the person is still ‘alive inside’ (the inspiring documentary with this title is recommended). In stunning real-life stories, he has shown how music appears to ‘call back the self’, awakening moods, memories and thoughts that had seemingly been lost. He refers to music’s extraordinary ‘neural robustness’ and describes one man, unable to tie his tie or find his way to the stage, yet able to perform a perfect piano solo. In one life-affirming, must-watch, tear-jerking video, gospel music was shown to enliven, calm, focus and engage a man simply known as Henry.

Watch Henry

Singing can “provide islands of arousal and awareness like nothing else can”, according to Alicia Clair, Professor of Music Therapy. I’ve seen singing bring the person into the present for a passing moment, illuminating a face that seemed far away. One otherwise-silent lady completed the chorus of ‘Daisy, Daisy’ before descending into dementia again. Others have laughed, clapped, danced, embraced and even shed a silent tear during music therapy sessions, when music elicits memory. Doll therapy meanwhile has sometimes restored and revealed a sense of nurture, purpose, care and pride, with residents feeding their new friend before accepting their own food, folding its clothes and taking care of it cradled in their arms. Though it divides opinion, a doll can preserve dignity if it de-escalates agitation or engagement in physical or verbal abuse; a sense of dignity also comes from the person being able momentarily to give care rather than receive it.

“From the ashes a fire shall be woken, A light from the shadows shall spring; Renewed shall be blade that was broken,” continues Tolkien's poem, and, though not the original intention, these powerful images of renewal and restoration paint a picture of something known as “paradoxical lucidity”, or unexpected cognitive lucidity and communication in some patients with severe dementia, especially around the time of death (though sometimes long before).

Anecdotes are recorded of “unexpected, spontaneous, meaningful, and relevant communication or connectedness in a patient who is assumed to have permanently lost the capacity for coherent verbal or behavioral interaction due to a progressive and pathophysiologic dementing process”. Some scientists are seeing them as a paradigm shift in the understanding and perhaps even treatment of dementia. I will never forget when a woman in the late stages of dementia, with little spoken language, was brought back to the nursing home weeks after hospital admission; she had been perilously ill. With bright eyes, she took my arm and, as if the mist had cleared for a moment, spoke warmest words of thanks to me for helping her on the day she collapsed. In another fleeting and irreproducible moment, a lady wished me happy birthday, before continuing her silent walk around the home. Witnessing such an event is ethically and emotionally transformative.

The concept of remaining ‘alive inside’ even when abilities, language and memory are eroded by dementia is taken to the next level in Christianity, which teaches that life continues even after death itself. The Bible speaks of new life beyond the grave; the fire shall be woken, a light shall spring. And there will be a crown (and the gold will glitter). The Crown of Life is referred to, being bestowed upon "those who persevere under trials." Dementia is one of life’s severest trials; a cross to bear. In the 1912 hymn “The Old Rugged Cross”, another cross is spoken of, being the cross of Christ at his crucifixion. Clinging to that cross, living out a Christian life, the hymnwriter wrote of “exchanging the cross for a crown” at life’s end. After ashes, hope awaits the Christian.

Playlist for Life is a charity encouraging people to create playlists for people living with dementia.

Playlist for Life