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Health?

I am now some five or six weeks post surgery and am feeling better. (I overtook another pedestrian on the hill into town recently. Granted he was around 80 years old and using a Zimmer frame. But it was progress!) I’m finding this stage of my recovery very frustrating. Part of me is saying “Come on. You’ve had six weeks of lounging around being ill. Enough is enough. Get back to work. Do something constructive. Get to the gym. Go for a ride.” And another part warns “This is typical you. It is impossible for you to be less than 100% of anything. Take it easy and you will be back on your bike etc. Rush it and you’ll set things back by who knows how long?” I’m trying to listen to this part of me – externalized in my wife! But my nature is to be restless. I need to feel that I have achieved something each day. Even when I was in hospital, the moment I was told it was ok to do some gentle exercise, I learned how to disconnect my monitors and simply told a passing nurse “I’m going for a walk.” It probably did me no harm but unless somebody had sedated me, I was going out. I had to in order to prove I was still alive -and not merely physically. I remember thinking when I got home that I had spent two weeks behind enemy lines, trying to survive.  Somehow my illness and recovering from it became a battle for my soul. My sense of who I was and how I did things became identified with that ability to go out for a walk on my terms. It became a statement that said “OK. My body has had a huge shock. Fine. Now get on with life.”

Michael Eigen, in his book “The Psychoanalytic Mystic”,  comments “Nothing one goes through in a deep way is wasted.” I hope he’s right. I hope that I can incorporate my experience into my sense of Me-ness in a way that also accords with the WHO definition of Health. Otherwise I shall have wasted something that should be important. My heart damage was a shock. It was / is something that I have gone through deeply. The next stages are going to prove interesting. How I find a meaning / shape /purpose to the experience.

Watch this space…

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Reflective Practice, The Inner World, The unconscious, Ways of Being

Still me

My apologies for another blog about me. It’s one of the problems of having a major trauma. One becomes too self-absorbed. Thee is a whole world going on outside my front door. Tsunamis, Hurricanes, Famine, Massacres and the like. And what do I choose to write about? Me. Again. In my poor defence I am not planning to write about my symptoms or my body. Not explicitly, anyway!

I saw the film “Still Alice” yesterday. It is about an American psychologist who develops early onset dementia in her 40’s. The film is about how she and her family cope with this. It is also about identity. What does it mean to say that, despite so much loss, Alice is still Alice despite her profound dementia? It is an uncomfortable film and not recommend for the emotionally faint hearted.

I was left thinking about my own recent history. One moment I’m well. 24 hours later I emerge from major heart surgery having been given 24 hours to live if I do not act now and agree to surgery. (I agreed to surgery!) I’m now left with a slight feeling of anxiety. The clock can strike 13 and call into question everything. If the impossible can happen once, why can’t it happen again? At the moment I am very conscious of my body. I am aware of constantly mo noticing my heart rate. Is this a symptom of something major or simply what I might reasonably expect given what happened? A month ago I did not view my body in this way. If I wanted to go to the gym, off I went. If I fancied a long country walk with the dogs, we did just that. But now I think carefully about these activities .Do I have the stamina? What will it cost me? How long will I need to recover? Hopefully most of these anxieties will disappear and I will regain my previous relationship with my body.But until then my mind and my body are both on high alert for any changes.

The point I’m trying to make, I think, is about identity. For me the impossible has happened. I nearly died and had very little advance warning. If it can happen once, what is to stop it happening again? (I gather that it is unlikely to recur.) I am now someone who has gone through a life changing experience. But I’m not sure about the nature of those changes. I look and sound much the same as I did five weeks ago. B ut I suspect that my view of the world will never be quite the same again.I am a slightly different person now. The question is, who?

 
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Counselling, Psychoanalysis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Faith and History

I listened to a lecture at the Quakers on Sunday. It was given by one of the Meeting who had been a theologian at Oxford university. She took the idea of the Jesus of history and the Christ of Faith .She asked how much we actually, factually, know about Jesus. She pointed out that the gospels were written around A.D.60 at the earliest and were probably based on the early church’s preaching. She added that St.Paul who was writing much earlier mentions very little in the way of facts about Jesus. Her conclusion was that there probably was someone like Jesus living at about the right time to be the man described in the gospels .She saw him as a particularly radical Rabbi.

The arguments supporting or challenging this view have filled the shelves of libraries since Jesus’ day. I have neither the skill or the time to expound them here. Nor, in truth, am I too much interested in them these days.(I have family members who will rehearse the arguments eloquently and passionately.) What surprised me was my reaction to this lecture. I was left feeling that the baby had been thrown out with the bathwater. The arguments were not new to me. I no longer hold myself an Evangelical let alone a fundamentalist. I see myself as a counsellor and therapist who is interested in his patient’s inner world-however they choose to express their understanding of that world. (I am of the opinion that theology and psychotherapy share a good number of ideas-albeit expressed in different language. I spent much of my first therapy wrestling with this material.)

Psychotherapy talks of internal objects and object relations.Charles Rycroft in his Critical dictionary of psychoanalysis describes an object thus:

“That towards which action or desire is directed; that which the subject requires in order to achieve instinctual satisfaction… in psychoanalytical writings, objects are nearly always persons, parts of persons or symbols of one or the other” An object is an intellectual / emotional representation of something or someone important to the patent.” In clinical work one never challenges the existence of an object. There is no point. We try to understand how a person’s objects shape – or have shaped- their life. Put simplistically, a parent who is always critical will be internalised as a crippling voice that tells its “owner” that they are useless. A parent who is always angry will, in all likelihood, produce an angry child who finds intimacy and vulnerability difficult. In the religious sphere one meets people who have internalised a helpful Jesus. One to whom they can turn when in need. Others have internalised a Jesus who resembles a slave driver. (In each case the Jesus who has been internalised is an extension of the original relationship with the parent.)

I suggested that one never challenges the existence of an internal object. We explore the role the object serves. Here, I think,is my discomfort about Sunday’s talk. Its purpose seemed to be to destroy an object by presenting the “facts”. Better, I think,  to  have explored people’s relationship with the object we call Godchrist-enthroned-orthodox-witness

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Borderline States, Madness, Psychosis, Reflective Practice, Religion, The Inner World, Ways of Being

The past is myself

I want to move on from my experiences in Papworth. Too many more blogs on this topic will become self-indulgent. So, I want to  move on. But I also want to make some links between the Papworth blogs and new material. So, my tenuous link is in the title of this blog. “The past is myself.” My heart problems and their treatments now form part of my narrative of self and must be incorporated into my experience to shape how I think of myself in the future. The link I want to make is with ISIS destroying the Assyrian  sculptures in Nimrud. I have heard conflicting accounts of what is actually happening in Nimrud. One commentator suggested that what are being destroyed are plaster copies of the original art works. (ISIS having long ago sold off the real ones on the black market to fund their work.) In one sense  it doesn’t matter. The original work has been removed-stolen or destroyed. ISIS appear to be telling the world that they are the dominant group in this area and only Islam may be honoured. This feels like the work of an extraordinarily insecure group of people. (Islam began as Assyria was finishing around 605 -610 A.D. Assyria was a major power from around 2,500 B.C.)  Watching ISIS destroy these artefacts reminds me of a child who by shutting his eyes, wants to pretend the rest of the world does not exist .ISIS seem to be doing the same. By destroying some Assyrian works of art, they can pretend it never existed.

I see something similar in my counselling room. A patient will come in and tell me that their childhood was idyllic. And will launch into a series of illustrative anecdotes to confirm this view. Alongside the story of this wonderful childhood there are often stories of a number of failed relationships. A shrug of the shoulders asks “What more can a person like me expect?” The work is to unravel the stories of childhood. This process can feel as brutal as ISIS’ destruction. One treads gently and allows different memories to emerge -which can be painful . “Tread softly for you tread on my dreams” wrote Yeats. Healing comes when a true story of my patient’s life can be told. One which does not shrink from some of the darker aspects but which also acknowledges that the people involved tried their best, given all things.

Denying the past will not change it. ISIS can destroy as many statues as it chooses. Assyria will still have existed and made its contribution to the world-as has Islam. ISIS would do better to learn from history rather than destroy it. But to do that means changing one’s current story to make room for other facts. Unlike many of my patients, ISIS seems unwilling to do this. Fortunately my patents don’t come to me driving bulldozers and wearing rifles.
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Counselling, Mindfullness, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, Ways of Being

Soul and body

It’s been interesting doing some reading about recovery from major surgery. The literature I’ve read consistently talks of the value of pre and post operative psychological support – not always possible!) Other helpful factors are a sense of optimism about life in general and in particular, an optimism about the outcome of surgery. A religious world view is also a plus. Other factors include the list we now hear regularly. A happy and supportive marriage. A strong social network. Good physical health. Enough money etc. All in line with Maslow’s work. Papworth scores badly on some of these indicators. They offered no emotional support to either me or my wife. I don’t expect a busy admission ward to run a daily support group for patients and their family. I do think that somebody taking 10 minutes a day to sit with me and ask “How are you?” is not asking too much. Similarly I think that 10 minutes spent with my wife, offering her a space to talk would have been very helpful.  (I came across one study that suggested good psychological support reduced admission time by two days. That’s a lot of time saved and a lot of discomfort avoided. When I raised this with a senior nurse the response was “We’d love to. But we’re just so busy.” Menzies work in the 1960’s made a clear analysis of the reasons for this busyness in hospitals. She saw it as defensive. If I am so busy doing my nursing duties, then I have no time to face my own mortality. If my day is spent measuring urine output, checking BP and heart monitors etc, I give myself no room to feel about my patients. Nor to become attached to them. To worry about them . To care about them.If I am the aortic division in bed 3, I am not a whole person. If I am only a surgical problem, I have no past, present or future. I am not a real human being with whom nurses have to engage.

Cardiac surgery in particular challenges all of me. Breaking my leg is inconvenient but it does not challenge my whole existence. Cardiac surgery-along with other major trauma- goes right to the heart! It threatens my whole being.The heart is so much more than another muscle. It sits at the centre of my being and governs all other systems. It also stands for my inner life. How do I see myself? Who am I ? What is at the heart of me?

And that is my gripe with my experience of thoracic services-brilliant though they were at their work. It is also my complaint about far too much NHS care. It forgets to see me as body and soul. My body is more than just a collection of organs. it also houses what I’m going to call my soul. That bit of me that makes me who I am. It is every bit as crucial as my body systems. But seems to be the forgotten part.Embodied soul

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Counselling, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Uncategorized, Ways of Being

Why?

This is the last of my musings on suffering. Unsurprisingly I have nothing new or radical to add. We watched a documentary last night about two homeless families in London. Both consisted of several children being raised by a single mum. It charted their journey from a succession of temporary hostels through to relatively happy endings in suitable accommodation. It was harrowing.These families spent two years frequently being moved  around London boroughs for no apparent reason-except that an even more needy family was taking precedent over them for the accommodation. The overwhelming sense was “How can this be in 2015 in our capital city?” That highlights my thinking about suffering. It becomes destructive when it seems so random. Why should a previously bright granny deteriorate into a dense dementia? Why should this child be born with an obscure genetic illness? (If God plays dice, it seems to me that he uses genes as dice.)

As a therapist my work is to create a shared meaning with my patient. (I’m told that a great sculptor sees their task as liberating the form already implicit in the granite. So Rodin freed David to become the awesome sculpture that we see today. He did not create him. Which gives some interesting room to play with the Creation stories in Genesis.) It’s an analogy I like . Yes, if somebody comes to me for Anger Management I have a theoretical framework into which to place them. There are certain familiar patterns that I now expect to see. But I am always wary of making my patient fit my theory. My task is to walk with them and draw a map of their life, noting how many areas will be marked “There be Dragons.” Little by little we can go into these  lands and demythologise them. Certainly there were monsters there when you were young. But let’s see what that monster looks like now. The monster of old was monstrous but is now a monster of memory who can be managed. (Which is why I so like Process theology with its God who walks with me as against a fat controller who only coordinates journeys.)

So, back to suffering. My major criticism of my experience of Papworth hospital is the lack of care given to us. Or the lack of time to help us create a story to guide us. The physical care was excellent but one was left feeling that the staff could have managed us more efficiently if we had been in comas. I have no idea what story will emerge of my own experience of illness. It will be shaped by many factors from my inner and outer world. And, no doubt this story has to incorporate the new and unforeseen material. But then , that’s the pleasure of stories. They change and grow with us.9172115

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Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

It’s not fair

I continue to be intrigued by the fairness argument. Not particularly at a personal level-although my episode does seem unfair. But more by our wish to see the world as fair in the first place. I’ve just re-read the first account of Creation in Genesis. There is a simplicity to it. A sense of order and purpose with each part making an overall picture of the Universe. It is an ordered place. Then in chapter three we get the story of how Adam and Eve choose knowledge that they seem ill equipped to deal with. The rest, as they say, is history. The first murder occurs and everything falls apart. This seems a high price to pay for knowledge except that it has been worked out so many times over the centuries. Knowledge is power. And each leap in knowledge adds more power to a group somewhere. (What would the world look like to us if we never sought knowledge?)

I am very aware as I write this of being in a position of great privilege. I live in a house I love. I have a garden that complements the house. This is situated  in a small enclave of privilege in a town that is comfortable. I am sitting in my study writing on my computer with my one or two questions sitting in my mind but none of them are life threatening questions. I am not a refugee in a camp in the middle of a desert .I have not had my wife and children blown up by a missile sent from another continent. I am not likely to be arrested and tortured by the ruling elite because they dislike something I have written. ( I have no idea what I would do in any of these situations and, frankly, hope to never find out.) It is unfair that due to a succession of accidents I am where I am.

Which brings me back to my central question about why suffering occurs. The origins of “fair” are in the idea of  something beautiful to the eye. Thus the idea of morality being attractive.(And the opposite. Unfairness is also displeasing to the eye.) Justice is also connected to fairness in the sense of an item of clothing being a just or a good fit. So a just person is one who is appropriately dressed in clothes that fit. Justice is supposed to be a good fit.

So, going on from here we have to face a world where many things do not fit well. Teenagers are murdered and dismembered. Classrooms full of students are gunned down “because I don’t like Mondays.” Where is the fitness in all of this? And why does so much of the world seem determined to keep its neighbours badly dressed?

In some ways having an omnipotent God in charge is simpler. “I don’t understand His purpose for my life, but I trust that there is one.” (In my fundamentalist days  we called it The Cross. ” I don’t understand why this is happening to me but I believe it is for my own good. My sinful self is being crucified so that I may better serve God.” I now find that a most ill fitting argument but it still sells well.

The other option is that  everything is for the best in this the best of all possible worlds. Which works until I look out from my refugee camp somewhere and see how other “best worlds” are out there to which I don’t have access.

The other options take as much time and energy to explore. I haven’t come anywhere near offering an answer .Maybe, to quote my chaplain colleague, the only answer is there is no answer. In which case, why bother? Just accept that Life is Not Fair. It’s simple. It fits all cases. But… it feels unsatisfactory to me. A kind of off the peg fit. Not made to measure.

 

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