Jim Collins Paradox

[Lenora Rademacher]

Imaginefacing down the reality of years in prison, torture, potentially seeing friends killed, and still being able to have the faith that you will overcome your obstacles. It really does seem like a paradoxical thing.

Optimists are great at running short sprints when their goals are in sight, pessimists barely even start their race, but those who apply the Stockdale Paradox will have the legs to run the entire marathon.

On one of my many trips in and out of the bathroom, a family member asked if we needed to call a plumber. I scoffed at the notion. I was going to fix the toilet all by myself. (Yes, sometimes I act like a stubborn 4-year-old exerting my independence.)

Later that night, I took my dog for a hike. I listened to a podcast interview with Jim Collins. Jim did not disappoint. He dropped value bomb after value bomb and reminded me of the Stockdale Paradox. Jim describes the paradox this way:

So as I move into the second half of my leadership journey, I want to maintain my unwavering faith, but I need to get better at confronting the brutal facts. And when I do confront the brutal facts, I need to get better at not coming off as harsh and judgmental. (Man, developing as a leader sure is a long journey. . .)

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Introduction: The incidence of obesity, a condition characterized by systemic chronic inflammation, has reached pandemic proportions and is a poor prognostic factor in many pathologic states. However, its role on immune parameters has been diverse and at times contradictory. We have previously demonstrated that obesity can result in what has been called the "obesity paradox" which results in increased T cell exhaustion, but also greater efficacy of immune checkpoint blockade in cancer treatment.

Methods: The role of obesity, particularly in the context of aging, has not been robustly explored using preclinical models. We therefore evaluated how age impacts the immune environment on T cell development and function using diet-induced obese (DIO) mice.

Results: We observed that DIO mice initially displayed greater thymopoiesis but then developed greater thymic involution over time compared to their lean counterparts. Both aging and obesity resulted in increased T cell memory conversion combined with increased expression of T cell exhaustion markers and Treg expansion. This increased T cell immunosuppression with age then resulted in a loss of anti-tumor efficacy by immune checkpoint inhibitors (ICIs) in older DIO mice compared to the younger DIO counterparts.

Discussion: These results suggest that both aging and obesity contribute to T cell dysfunction resulting in increased thymic involution. This combined with increased T cell exhaustion and immunosuppressive parameters affects immunotherapy efficacy reducing the advantage of obesity in cancer immunotherapy responses.

In 1965, Admiral Jim Stockdale's plane was shot down in North Vietnam and he was a POW until 1973. Tortured over 20 times in that span, he was without prisoner rights, a release date, nor certainty that he would see his family again. The Admiral faced his enemy valiantly, using a razor and stool to disfigure himself so he couldn't be used as TV propaganda for the Vietnamese's alleged well treated POWs. He instituted rules that helped deal with the system of torture, such as after 'x' minutes, a soldier can give certain information, which gave each POW milestones for survival while being tortured. He rallied his troops, creating an elaborate communication system of taps to lessen the effects of isolation. On his 3rd anniversary of his plane being shot down, the POWs tapped out "We love you" using mops while cleaning the central yard (Collins, 2001). The question is simple: how did he survive?

Fist I want to start with admiration for my clients and the clients of my colleagues who have survived. They have withstood traumatic events, painful histories and loneliness (the latter being the worst part). Yet the resiliency and mental toughness to pursue therapy, group work and community within their lives is inspiring. Many clients have had to face the brutal consequences of their addiction, then doing everything in their power to find sobriety and connection. There is something in the human spirit that might try to give up, but the inclination towards survival and thriving is so strong that we know there is a seed. And a seed means there can be life.

So how did Stockdale survive? In an interview with Jim Collins (2001), the Admiral was asked who didn't survive. "That's easy," he said." "The optimists. The ones who said, 'We're going to be out by Christmas.' Then Christmas would come and go. Then they'd say 'We're going to be out by Easter.' And Easter would come and go. 'We're going to be out by Thanksgiving.' It would come and go. Then they'd die of a broken heart." Isn't optimism good? Aren't we suppose to have hope? Yes. But the Admiral had a sense of reality. The optimists had faith, but were in denial of the reality of their situation, i.e. the brutal facts. This ignoring and minimizing comes out in depression, anxiety and a shut down of part of our nervous system (Katehakis, 2016). It can lead to despair. Thus, when applied, the Stockdale Paradox means facing the brutal facts of your situation, no matter what they are, and retaining faith that you will prevail at the end, no matter the circumstances.

This psychological duality (Collins, 2001) is hard to tolerate. How does one hold parallel the facts of childhood sexual abuse and believing that peace, joy and love will come? How does one hold the insecurity of unemployment with knowledge that one will land a job? How does one face the struggle of parenting a difficult child while loving him/her through it with unwavering faith that the child will heal? These are complex questions with no simple answer. But I have learned a lot from my 4 year old daughter and the TV cartoon Daniel Tiger. He has a saying, "Sometimes we have two feelings at the same time and that's ok." In childlike surrender, have you given yourself permission to cry and be angry? Have you felt hurt and allowed the peace and hope to surface after the tears? There is something deeply fulfilling in tolerating paradoxes in life.

In the therapy office, it seems that most clients arrive knowing the brutal facts. This is not the rule, but a trend I see. So I'd like to help foster the theological virtue of faith and hope. Jesus introduces several paradoxes in the Gospels. One is "For whoever desires to save his life will lose it, but whoever loses his life for My sake will find it" (Mt. 16:25). Surrendering what we want 'fixed' in our life is so hard, but the antidote to control. There is a Jesuit form of prayer with the acronym ARRR. This stands for Accept, Receive, Relate and Respond. In the practical, it means to accept the feeling/desire/situation at hand, receive it into your heart, relate it to God (tell Him about it), and allow Him to respond through the silence or scripture or imagery the Holy Spirit wants to spark in one's soul. Jesus will answer, but the opened door or the finding might be different than what we are looking for.

On the human formation side, hope has a psychological component. First one needs to have a goal. With this goal in mind, one must have a plan B to accomplish that goal, or a plan C, D or E. This is in case plan A doesn't work. Third, one must have agency (Brown, 2013). A secular term indeed, however Jesus wants us to have confidence in ourselves, that we can attain all things through Him and with Him. Through this belief in oneself, the goal will be attained, through unwavering faith even if the brutal facts are dark and overwhelming. Admiral Jim had a goal of reuniting with his family. He went through several means to accomplish that plan and he believed in the God given capabilities with which he was gifted to carry out that plan. You have what it takes to heal and God will continue to unveil layers of your heart to 'accept the things you cannot change and the courage to change the things you can.'

For as long as I can remember, I have felt that my heart condition was a paradox in my life, an inconvenient reality that did not match my body or spirit. A dancer since the age of two, I have spent most of my life on a stage asking for attention, yet wanting the scars of my surgeries never to be noticed. I wanted to stand out during every performance while always hoping that no one noticed when I fatigued quicker than my fellow dancers, or that my coloring was fading to pale by the end of a piece. When I was told by my primary cardiologist that I needed to be safe in choosing activities and hobbies, I proceeded to join the track team in middle school, always hiding the monitor I was forced to wear as a compromise made with my very frustrated cardiologist.

When I made the decision to enter my first Miss America competition two years ago, I knew that the scars along my chest would be on full display and that there has never been a Miss America with such a degree of visible imperfections. While I believe that most judges would not knowingly hold this against me, I also know that my body is sometimes not pleasant to view; I represent chronic illness, I represent less than perfection, I represent mortality.

I won the first competition I entered and a few months later competed in Miss West Virginia 2017, placing second runner up. Nine months later I competed and won the Miss Elkins 2018 competition, giving me yet another run at the Miss West Virginia title. In June 2018 I was named Miss West Virginia 2018 wearing a white gown featuring a very deeply plunging neckline, fully displaying, if not framing, my sternotomy scars.

Madeline Collins was diagnosed with tetralogy of Fallot at birth. She graduated from West Virginia University summa cum laude with a degree in Child Development and Family Studies. She is employed as a performer and dancer with the Walt Disney World Corporation in Orlando, Florida. Madeline is a very active volunteer with the Children's Miracle Network and Give Kids the World Village located in Orlando. In Fall 2019, Madeline will begin graduate school at Columbia University in New York City, after her year of service at Miss West Virginia 2018 is over, and after competing for the title of Miss America 2019 in September 2018.

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