A Liberal Conscience

I was going to begin this blog by observing that there had ben two major tragedies in the world this week. Then I thought about that sentence again. What I meant, of course, was that there were two major news stories that caught my attention-which is not the same thing. No doubt there were many tragedies this week throughout the world. People dying prematurely, babies born with birth defects from environmental toxins, young children being sexually abuesd. The list of “small” tragedies is long and no doubt each personal story is as important to that family as the ones that make headline news. Having made that caveat, I want to focus on two stories that made the news last week.

One was a fire in a psychiatric hospital in a village outside Moscow. 38 patients died here. The other story was of the fire in a clothing factory in Bangladesh where 370 people died. The second story was much talked about and written about. (It even came up in the Quaker meeting I attended this morning.) Looking at those events on Google was telling. The Bangladesh fire attracted 9,368 rested articles, mentions etc whilst the Russian fire got 1,191 similar mentions. That’s a ratio of nearly 8:1 in favour of the Bangladesh fire.

Are we saying that a dead Bangladeshi is eight times more important than a dead Russian? Or that simply being a poor Bangladeshi clothing worker makes you eight times more needy than being a Russian psychiatric patient? From the news coverage this would seem to be the case.

We are used to worrying about the cost of our clothes  in England and the West. In the same way that Fair Trade coffee etc has become fashionable, so it is fashionable to worry about buying cheap tee shirts and the like. We are expected to boycott Primark and similar stores for exploiting their Third world labour so that the company can make more profit. And continue to provide jobs for around 27,000 people in the process. (One suspects that the people who worry about cheap tee shirts are those who can afford to not buy them.)

Details about the psychiatric hospital are harder to find. I could find no reference to its name, how many patients live there, how many staff are employed or any details about the place beyond its location. I heard nothing about this event discussed on “Any Questions” or “Any Answers”. Twitter was busy with it with comments like “Another reason to hate Walmart” . And “How can Primark bosses not sign the Bangladesh Fire agreement?”  As I write this tweets are still being posted about this fire. Search Twitter for the Russian fire and the difference is striking. Most of the tweets are simply relaying news of the event with little moral comment-except for  for one noting “This is what happens when Governments neglect funding for its disadvantaged…”

My sympathies lie with all who died in these fires, their families, their friends. Sadly one doubts this will be the last fires to happen. Equally one knows which subsequent event will stir the chattering classes to wring their hands in distress.

The Late Quartet Cont’d

Last week I wrote about the film from which this image is taken-The Late Quartet.I picked up on the theme of the tension between a life that is tightly scripted (Daniel) and one that is lived less rigidly scripted (Robert). In the film both men add immeasurably to to the richness of the Quartet and its music. Indeed it is the tension between these two men that produces much of the music’s beauty and excitement. So long as Paul is also present, this tension is held and channelled creatively.

It is interesting to read the two accounts of succession of the son from his father in both Freud and in Winnicott. In simplistic terms Freud’s view is that the only way in which the son will inherit the kingship is by killing the father. For Winnicott, the way is gentler. At an agreed time the Father stands down and gives the son his blessing and the crown. This tension is seen at a societal level in politics, monarchy and corporations. Who will take over power and how? Is it more satisfying to kill for power or to have it handed to one?

There has  been talk today of how much time nurses are having to spend on paperwork that takes them away from the clinical area. Whenever I teach Post Registration nurses I am always struck by their high levels of paranoid anxiety. The fantasy is “If I don’t do X,Y and Z my manager will punish me.” Whether this is factually true is not as important as the fantasy itself. The feeling is that they are not managed by people who are sympathetic and supportive but are driven by managers who are in their turn driven. Far from motivating lazy staff to meet high standards this mindset means that the rule becomes “What gets measured gets delivered”. Thus if paperwork is measured, then the paperwork gets done.

How do these two themes run togther-harassed nurses and two different musicians playing styles? It seems to me they both epitomise the difficulty of holding two different ways of Being in creative tension. Rather like Cain and Abel. Can both brother’s contribution be acceptable or must one kill off the other?

I find a similar tension in  the faith community. My early choice of Christian belief was an attempt at Fundamentalism- this choice echoes Jung’s maxim that there is no illness that is not, at heart, a failed attempt at a cure. Fundamentalism was my attempt at a cure for uncertainty, anxiety and lack of direction. (I both was and was not a good fundamentalist!) Thirty years later and I am slowly trying to find my back to some kind of spirituality that works with me-rather than whipping me like a slave driver. This quote sums things up well “God is in the world, or nowhere, creating continually in us and around us. The creative principle is everywhere, in animate and so-called inanimate matter, in  the ether, water, earth, human hearts. But this creation is a creative process, and ” the process is itself the actuality” since no sooner than you arrive you start on a fresh journey…”

I find that most encouraging since the work of creation necessarily holds both Structure and Chaos; Light and Dark; Life and Death; Paperwork and Nursing. T.S.Eliot put it this way “We shall not cease from exploration, and the end of all  our exploring will be to arrive where we started and know the place for the first time.”

The Late Quartet

We recently watched the film “The Late Quartet” about a String Quartet faced with the loss of their key player, Peter Mitchell due to Parkinson’s disease. It is about what happens when, as Eliot wrote, “Things fall apart. The centre cannot hold.” The film explores the ways in which the Quartet responds to Peter, the group’s father figure, leaving the group. All the characters act out in their own particular ways, expressing feelings they have long repressed in the interest of the Quartet.

And I could quite properly leave my blog at this point, commenting on what happens when the centre cannot hold. Whether that centre is a person or an organisation of some kind. Nearly all my patients are struggling with a centre that has not held them properly over the years. My role is to become a holding centre who they can take in as a good object. A kind of fostering arrangement.

However the aspect of this film that I wanted to write about was the tension between two of the other players-Robert and Daniel. Daniel plays First violin and Robert Second. Both are complementary and vital to the Quartet, Both have very different personalities. Robert is overweight and mildly chaotic. He enjoys living in the moment. Daniel, by contrast, is strictly controlled. Music is played following the score. He is tightly controlled in all his Being. Musically he and Robert complement each other in a creative tension that works as long as there is a Centre to which they can both relate.

The Quartet have often played Beethoven’s Late Quartet’s to high acclaim. Always they have followed the score which is carefully annotated to guide the individual players in their performing of the piece. Robert longs to do without the score for one performance, arguing that this would bring a richness and aliveness to their playing. He is over ruled by Daniel who insists that they follow the score as they have always done. (Both men have a point.) Daniel’s concern is that playing without a score leaves them open to mistakes and errors which would make it harder for the other members of the Quartet to respond. “Yes!” cries Robert, “That’s my point. We would have to go with each mistake, correcting our playing to incorporate those elements. And to find a way to keep true to the music we’re playing.” Daniel will have none of it until Peter’s leaving becomes a reality for the group. Finally the Quartet play the music from memory and risk whatever comes. (The scene where one by one the musicians close their scores is exciting and moving. As is the music that follows.)

This same tension gets played out in much of my life-personally and professionally. One of my team was once asked to describe the management style of the three team leaders. “There’s Mary. For her it is always ‘We work inside the box. That way we are safe’. Then there’s Clare. For her it’s ‘We’ll work mostly in the box. Sometimes we’ll go outside of it.But, mostly, we stay in the box’.Then there’s Terry.” A long pause as she looks at me.”With Terry it’s  more a case of ‘Box? What box? Oh! That box… we’ll worry about that later!’”I take that as a great compliment but am aware of the difficulties that way of Being can cause. If I have people around me who can work with me and provide me with a holding framework, I thrive. so do they. Those in my team who enjoyed my “Box? What box?” enjoyed working with me for the freedom I gave them. Others found me impossible and left.

To be continued…

The King’s Speech

I recently watched this film again- The king’s Speech-and was, as before, very moved by it. i also remember seeing a comment that “It’s nothing to do with speech” which puzzled me. On seeing the film again the comment made sense. Talking is not the King’s problem. We see him reading a story to his children and talking comfortably with his wife. All without any stammer .His problems arise when talking with-or being spoken at- his family. His father and older brother both bully him-using his speech impediment as a a weapon. He finds it impossible to answer them, so oppressed does he feel by them.

Jung commented that there is no illness that is not a failed attempt at a cure. This comes to  mind the more I see patients and the more I teach on Mental Health issues. In the case of George V1 his stammer kept him from telling his birth family what he thought of them-presumably he feared  his own words so” chose” not to be able to speak them. At a conference a speaker was talking about a young woman who he was working with in the context of family therapy. She heard voices and was deemed the mad member of her family. The therapist mused with us about the role of this girl for her family. He invited her to reflect on which voice she wanted to hear. Her reply was to the effect that the voices in her head were far better to listen to than the voices of her family. A good example of an “illness” serving as an attempt at a cure.I have several patients who have come to see me with for help with their anger. When we sit down and begin to talk what so often emerges is that anger is a defence against being vulnerable. “If people fear me, then nobody will try to hurt me.” is the message they give themselves. And this works admirably. Nobody comes near them!

The King’s speech served a similar purpose. If he denied having a voice, nobody could make any demands on him. This is shown brilliantly in the film in the King’s relationship with Lionel Logue, his speech therapist. The King insists on being called “Your Majesty” and wants to refer to Lionel Logue as “Dr.Logue” ( a title he lays no claim to have.) This serves to keep the King from any acknowledgement of need or vulnerability or intimacy. The relationship with his therapist is strictly about his speech-and nothing else. His problem is purely mechanical with no ” meaning” attached to it. The genius of Lionel’s work is his insistence on first name terms and intimacy. He allows the King to become Bertie- thus allowing him access to the ordinary parts of himself  which “His Majesty” wants to deny.

Jung also wrote “There is no coming to consciousness without pain.” This is writ large in the film where the King has to face the pain of being human and thereby having to understand the source of his stammer. Coming to consciousness is painful. Remaining unconscious is dangerous! (I often hear people talking about their fear of going into therapy. “I don’t want to know what might be lurking in the bottom of my psyche” is a regular comment. My own response has always been to want to know what might be lurking in my psyche. If i know what is there, I can make some choices about it. Not knowing what is inside me is far more frightening than knowing it. If King George had not chosen to work with his speech impediment, his life would have been much the poorer. As would the life of his country, who needed a strong King to see them through World War Two.)

My final thought was the title of the film “The King’s Speech”. Finding his voice not only enriched the King’s speech. It gave words to all of him. With a voice all the parts of him that had been silenced were released. Which is scary. Because now not only did he have a voice to read bedtime stories, he also had a voice with which to be angry. Or contemptuous. Or needy. Or uncertain. He had a voice with which to be human. An awful responsibilty.

 

Easter Eggs 2

I don’t usually write two blogs on the same day. Writing one weekly usually takes enough effort, But I have the time at the moment and I don’t think Easter Eggs 1 makes too much sense on its own. In “Eggs 1″ I wrote about a sermon I listened to on Easter Sunday. the core message was that Kinder eggs represented Christianity better than an ordinary one because the former eggs always had a gift inside them whilst ordinary Easter eggs were empty. From there I suggested that Easter could be understood in psychological terms as well as religious ones. In this blog I want to take that idea on further and then go off at tangent to think about cave paintings and the Easter tomb- improbable though that link may seem!

When the preacher spoke about the empty Easter eggs I found myself making an association to the walls of the tomb where Jesus was buried. My association was to cave paintings. The walls of Jesus’ tomb would have made a good surface for some cave paintings. 

The exact meaning of these paintings is unknown but the consensus seems to be that they wee some form of communication-although quite what was being communicated is unclear. Were the scenes depicted simply a primitive piece of graffiti? Were they linked to some kind of myth ritual? Or were they an expression of creativity? Or a combination of all these? Whatever they are, they are a moving and awesome record of the lives of our ancestors.

In my fantasy I wanted to use the walls of the Jerusalem tomb as a canvass for current  wall paintings. I envisaged people painting their current concerns. Homelessness. Abuse. Violence.Depression. Along with Joy and Fun and Dancing and Celebration. I wanted it to be this particular tomb because the story has it that Jesus rose from the dead and, ultimately, ascended to Heaven where, we are told, he sits at the right hand of God the Father. From which position he will judge the living and the dead. It seems to me that these fantasised cave paintings should also be taken up to Heaven and given a place of value and exaltation.It seems to me that the woman who has to have an abortion is celebrated and her mourning validated. That the young man with a violent and abusive father should have his struggle with his anger celebrated. The woman who hears voices that often denigrate her should have a place ” on High”. Along with all those who daily live their lives trying to be as alive as they can. These are the wall paintings I want painted on the walls of Jesus’ tomb. Because these are the daily lives that surrounded him and which deserve to be celebrated.

In her novel, The God of Small Things, Arundhati Roy writes “And the air was full of Thoughts and Things to Say. But at times like these, only the Small Things are ever said. Big Things lurk unsaid inside” I want these cave paintings to celebrate all those Small Things-and, of course, all the Big Things lurking unsaid.

 

 

 

Empty Easter Eggs 1

I went to church on Easter Sunday. I think the preacher had been told to make his sermon child friendly. His visual aids were several different Easter Eggs. He tried to make some sort of spiritual point about each of them. (I shall now view Cadbury’s Creme Eggs in a different light!) His main point was to take a Kinder Surprise egg and an ordinary one. He tried to show that an ordinary egg was not a good illustration of spirituality because it was empty. The Kinder egg, however, was a better one because it always contained a surprise. This he suggested was a picture of Christianity. It always holds a surprise inside itself. (I’m not too sure about this picture of religion but…)

Despite myself I was struck by his two images. I was, however, more struck by the “empty” egg and its possibilities. (At this point I am going to get “religious”-or perhaps”spiritual” is a better word.)

I found myself conflating two ideas from this sermon. Or perhaps three. One was the idea of emptiness. Specifically the emptiness of an Easter egg. This reminded me of the empty tomb of the Easter story, which we are told signifies Jesus’ resurrection from the dead and his eventual ascension to heaven. (All of which find echoes in psychological language.) I then played with what might have been painted on the walls of the tomb. (Hence the picture of cave paintings.) Finally I had an idea of these images “rising” with Christ into some new life, having been redeemed. (Again I think all these words have a resonance beyond their specifically Christian context.) Hopefully I will make my point in the rest of this piece-and probably in another one as well.

The Christian meaning given to the Easter event is that Christ’s death and  resurrection are a means- the means?- by which our sins are forgiven and we are able to be at one with God and ourselves. Implicit also in the narrative and subsequent commentaries is the idea that we can choose whether or not to accept this offer. If we do, the story goes, our lives will be richer. We will be made whole. If we choose not accept the offer, then we risk losing out on many levels. (And depending on how cruel one’s God is, this loss extends through all our temporal life and into eternity where we will have plenty of time to regret our choices. Or to delight that we made the “right” choice.)

At this point I want to suggest some obvious emotional parallels here. Many individuals and communities know what it is to have suffered at other’s hands-and feet. And guns. And machetes. And assorted other methods of abuse, both physical and psychological.  The image of a man  hung, naked and helpless on a cross is one graphic way to encapsulate suffering.

In psychological terms Easter seems to suggest that we have choices. That, with help, suffering can become a spur to wholeness. That trauma, whilst not to be forgotten, can be used creatively. Most of my patients come to me because they want to find a way to make sense of their past. And to try to find a more healthful future for themselves. Their past hurts and abuses are not forgotten. Nor ignored. They bring these pasts into every session one way and another. And part of the work is to try to redeem these pasts. to detoxify them. which seems to me to be one way to understand the Easter story. It is a detoxification narrative.

I  bought some Easter eggs yesterday. I used the self service check out and was surprised to have an alert come on the screen. I wondered what was in this egg that needed me to be approved by a member of staff. (The alert was triggered by my having bought an Easter egg which contained alcohol. Specifically some chocolates that had a small amount of Bailey’s liqueur in them. I assume that the actual alcohol content was so minimal as to be almost non existent.)

I mention this to highlight what seems to have become a feature of life these days. The ubiquitous Risk Assessment. Three cornered flap jacks are now banned because a child was hurt when one was thrown at him in a food fight in a school canteen. (All sorts of questions come to mid here. Where were the teachers? Why were these kids having a food fight? who won?) We hear of conker fights being banned because of a risk that someone might get hurt if one breaks. (I always thought that breaking one’s opponent’s conker was the point of the game!)

I teach psychiatric nursing and nurses and was in clinical practice for twenty years before that. I have seen the rise of the Risk Assessment mind set. It now dominates the thinking of most all the nurses and students I meet. I recently did a role play exercise with a group of mental health  nursing students. I was working with a student who was playing a patient who was hearing voices. In the course of our conversation I responded to the feelings he was sharing  with me. I commented on his feelings of shame and exclusion. “You sound as though you feel like a leper”. “Yes” he said, “that’s just how i feel.” I finished the role play and asked the class for their thoughts. One student put his hand up “Terry. You called him a  leper. Aren’t you worried that he’ll report you?” I was lost as to how to reply. When did using a simile in counselling become a reportable offence? Or any kind of offence? And what had this student seen and heard that he could worry about my use of language? (I use a lot of “language” in my lectures. This was the first time a student had ben bothered my choice of words.)

The psychoanalyst Jo Berke says of Risk “To be at risk is to be alive. At any moment the consequence of being alive entails sudden unforeseen changes which may enhance or endanger health”  (Berke 2003) Arthur Ransome’s more often quoted quip “Better drowned than duffers. If not duffers won’t drown.” has the same idea.

A year ago i had a bad cycling accident ( entirely my own fault!) in which i broke my wrist in four places and  also my hip. Getting back on my bike has been a long, slow process. The physical side was relatively easy involving exercises, work from an excellent physio and a determination to get my body back in shape. The fear was much harder to overcome. Every time i went round a corner, saw a pothole or felt a bump, my mind and body took me straight back to my crash. My instinct was to pull on my brakes as hard as possible and get off and walk.  One session with a hypnotherapist and a trauma workshop has me back riding. (I still get more anxious than pre crash but at least I can manage this anxiety.)

My point is that it is surprisingly easy – and logical- to want to avoid risk. Having had a very bad fall, nobody would blame me for giving up cycling and taking up dominoes. Or golf. Or something relatively safe. But I would know that i was not making a choice. My choice was being made for me. By fear. By anxiety. By loss of confidence. My world would have shrunk.  Fortunately, I have enough good objects inside to provide me with the resources to get back to Life.

No doubt Tesco want to prevent me from a future of alcohol abuse by putting a warning on their Easter egg. My student who was concerned that he might be  reported for risking a vivid image. But where does this lead us? To clinical work that is insipid and “safe”. To patients being failed because nurses have internalised a  highly critical censor. 

I am aware, also, of writing this blog in what we call Holy Week. The story of the crucifixion, however we understand it, seems to me to be at the very least a story about Risk.