Jack and the Beanstalk . A risk Assessment story.

This is a coming of age story. About a young boy discovering his capacity to be potent. To make  a difference. But to do this there is Risk. Any sensible person would have done a risk Assessment and decided to stay in the comfort zone. One old cow. One market place. One purse of money. One knacker’s yard. Deal done. Not Jack. He sells the cow for some beans. How stupid is that? (His mother makes her feelings known very clearly. She is, of course, a Sensible Adult.)

Jack is unrepentant. He plants his beans to see what will happen. Nothing much. That’s the trouble with Taking a Risk. One is never sure of the outcome. Cinderella couldn’t guarantee her Prince. Dick Whittington his streets of gold. Aladdin his lamp.  That’s just the Way Things Are. No Risk. No Gain. (And, of course, no Pain.)

We are in the country of Kiergaard and his Leap of Faith. Of Pascal’s Wager. Both should be seen as a Bad Influence. Suggesting that taking a leap of Faith is a worthy practice. (But, surely, the whole Christmas story is about Leaps of Faith .Mary and Joseph; the Shepherds; the Magi ; God. All involved in one lemming like leap. How unwise. Look how all that ended.)

So, Jack and a handful of beans. What to do? Obvious. Plant them. Bury them. Take a chance that they will find favourable conditions and grow. (That’s also the story of therapy. Create favourable conditions for growth and see what emerges. It is of course the story of any conception .Create the right conditions and see what grows. Even if the result is not what we were expecting)

The beans having been planted, something breaks the surface. A small shoot at first. Then it keeps on going. And growing. And growing until its’  tops are out of sight. What to do now? Fence it in and invite the public to come and see it. Charge an entrance fee. That would solve their money problems. Hire  an accountant to give them the best return on their money. Jack has a different idea. (He always will have.) He climbs the beanstalk. To who knows where or what. Life or Death. Heaven or Hell. Angels or Giants. Poverty or Riches. Or all these.)

We know what happens. A golden goose. A magical harp. Oh. And a giant.That ‘s just the way things are. Music and money. But also giants and danger. Giants who resent having their things stolen.  The giant comes down. The tree is felled. No more giant. Everyone lives happily after. Except the giant. That’s another part of these stories. They accept that not everything is fair all the time for  everyone. The giant loses out. Jack’s happiness is gained at a cost to someone else. That’s unfair. But this is not a cosy morality play. It’s about the harshness of things.

Bettelheim puts it like this“The unrealistic nature of these tales (which narrow-minded rationalists object to) is an important device, because it makes obvious that the fairy tales’ concern is not useful information about the external world, but the inner process taking place in an individual.”

That works for me! I know my generosity is tempered by my meanness. My kindness by my cruelty. My wealth by my poverty. That’s what makes me human.

Breaking up with God- the cracks appear

 

I heard myself today saying out loud to someone “I don’t believe in God”. Nothing particularly odd in that remark. Many, many people say the same every day. But for me it was an important statement. An acknowledgement  of where I am today and have been for quite a long while. (I love the cartoon by the Naked Pastor at the head of this blog. It sums up my experience.)

Let me give some of my religious history. I’ll begin with St.Paul. In his letter to the church in Philippi he sets out his Jewish pedigree. “… if anyone else thinks he has reasons to have confidence in the flesh, I have more: circumcised on the eighth day, of the people of Israel, of the tribe of Benjamin,a Hebrew of Hebrews; in regard to the law, a Pharisee; as for zeal, persecuting the church; as for legalistic righteousness, faultless.” (Phil 3:5 NIV)

Let me add my own religious CV. Born and raised an Anglican. Baptised and Confirmed. “Saved” at a Billy Graham Rally. Destined for the Priesthood (C of E) Read Theology and English at college. Taught R.E. Eventually joined a fundamentalist christian community (Or commune. Or cult. Depending on your point of view.) Here we had all things in common and met for prayers twice daily. (Trying to chant metrical psalms at 6:30 in the morning is overrated as an activity!)

I can add to that list that I have preached, prayed,prophesied. Spoken in tongues,fasted and cast out demons. I’ve also struggled to strip down a car engine,  milk cows and plant potatoes. Quite impressive, I think. I can trump many of my christian friends with that list. All they do is go to church on a Sunday and, possibly, once mid-week. Milksop christianity!

For many years I was a true believer. Quiet times, prayer meetings, long Sunday services. Very little conversation with my inner self .This conversation began when I went into therapy and had a space in which to Think. I worked out how much my religious beliefs were a defence against anxiety. It didn’t matter what happened to me, I could trust that it was all in God’s plan for me. Many highly disturbed psychiatric patients prefer being in a locked ward. The boundaries are very firm and very clear. The  patient feels very contained. I look back on my experience of Christian fundamentalism as serving a similar  purpose. It gave me clear and firm boundaries. A sense of containment. (Prayer as an anti-psychotic?)

So, therapy. I began here to articulate my reservations about Christianity. Or the version of it I had encountered. Like so many before me, I struggled with  the reality of suffering. All the standard objections rang true. If God is Benevolent, why does he let some people have utterly miserable lives? If he is omnipotent, why does he not intervene more often? And if none of these attributes are true, what right does he have to call himself God?  There are  limits to how much one can change the established definition of a word. Surely the word “God” has to have some definable limits. (Although three years of theology at college taught me that, like Alice, “words mean what I want them to mean. So God is Wholly Other, Holy Other, Numinous, Ground and source of my Being, Beingfulness, Spirit, Energy, Divine Energy. the list is endless! But for now  I’ll assume that most people’s idea of God is roughly the one they see in the Bible.)

So, I began to ask questions about my own beliefs. The clincher was working in an acute psychiatric admission ward in South London. I met some lovely people (the staff were pretty good as well!) There were alcoholics, drug users, manic-depressives, schizophrenics etc. Standard fare for this kind of place. And I liked them-mostly! I looked at their histories and found nothing in my religious vocabulary that could mean anything to them. If Wendy was manic, she loved me, hated me, feared me, wanted to have sex with me-all within the space of a minute. If John had been drinking he could be violent, abusive, obnoxious. A real pain! But when Wendy was well, she was charming. When John was sober he was witty and fun. Both these two used their illness to defend against loss, sadness, anxiety, depression , fear. They needed a hug. A nurse who liked them and did not judge them. A ward they could come to for sanctuary. Good medication. (All of which we did our best to provide.) Jesus was not the Answer here. But if Jesus was not an answer here, where on earth or anywhere else could he be of use? Thus began the questions.

 

 

 

On falling off bikes

One of my patients who reads my blogs was asking about my piece on Identity. I had spoken of how pleased I am to be back on a bike. That being a cyclist is an important part of my identity. And I suppose I draw a distinction between being somebody who can ride a bike and somebody who enjoys all the challenges of riding.Which includes coming back from an injury. My last accident has taken me about two years to recover from psychologically. I am now back to 90% of my emotional fitness. There are times when I have to manage my anxiety very actively. If I am going down a steep hill I use my brakes more now than before my crash. But I never could simply put my feet on the handlebars and allow the bike to take me down a 1 in 3 slope.So not much has really changed. My patient’s question took me by surprise because I don’t see cycling as inherently dangerous. I have been riding for 20 years, Ten of those riding into south London twice a day.

I began trying to get to work by car and discovered how pointless it was. I sat in a traffic jam from Woolwich to Camberwell, listening to the time checks come and go on the radio and fuming at everyone and everything. When I arrived at work I had to spend another fifteen minutes driving around trying to find a parking space. I dumped the car and brought a motorbike. A small 125. I have never in my life ridden a motorbike. I had to ask a friend to ride it home for me, so little did I know. I spent some time over a weekend learning the basics. How to start. Stop. Change gear. that was it! My first proper ride was on a Monday morning riding from Woolwich to Camberwell at six in the morning. Then coming back again at three in the afternoon. This lasted until the next Friday evening. I was almost home when the car in front of me stopped unexpectedly. So did I. Via his boot! (I think I broke my collar-bone in the crash.) I sold the motor bike that weekend and soon after brought a push bike. A very useful mountain bike- a Rockhopper Comp. Thereafter I cycled into work for nearly ten years along with a posse of other riders all dodging through the traffic and swearing loudly at our common enemy the motorist. On the whole it was fun. (Perhaps a small part of the pleasure was the adrenaline rush of choosing the best route through the traffic. Of gauging if it was safe to jump these lights or not. Of trying to shave off two minutes from my previous ride time.)

That is a brief history of my cycling career. Every cyclist will recognise it. Any non cyclist will wonder if we are all quite mad-as I  think my patent did. The best answer I could give him on the day of his question was “I don’t want my world to be circumscribed by fear. I do not want my world to shrink because I had a cycling accident.” I still think that is a good answer. There are many things that worry me. Computers worry me. Getting lost in strange cities worries me. The way that nursing is practiced worries me. Our blame culture worries me. But cycling? I’m King of the Road!!

 

Mad words 1

I have been thinking about madness this week. (Not entirely surprising when one works in Higher Education). More specifically about mad words; mad language. There was an amusing exchange on the Mental Health Nursing Facebook page. A student nurse asked about what euphemisms staff used when at work.  Some suggestions were PRN (As Required medication) becomes a euphemism for “You’re driving me mad. Have a pill-and be quiet”. “Setting boundaries” is shorthand for “Do as we say.” Whilst “Encouragement given”  should be read as “All but forced at gunpoint…”  Everyone in the system understands these phrases and their unspoken meaning. It is a shared madness.  Each place has its own, local equivalent. Religion is another area that abounds with mad words-particularly the fundamentalist wings,  where behaviour and attitudes that are abusive are condoned on the basis of a spurious reading of a particular holy book. (And it is all too often men who hold all the power. We make the correct interpretation of the holy writ. We enforce these interpretations on those whom we make voiceless. Women, children and animals. The cleverest trick of all is to brand as heretics or similar all who try to disagree. Then we can legitimately silence them in any way that we can justify.)

In the field of mental health a similar his dynamic is often cobserved. The Critical Psychiatry Network is one such organisation . (www.critpsynet.freeuk.com/criticalpsychiatry) as is Mad in America (www.madinamerica.com). Both these groups-and many similar-argue that we medicalise “ordinary” distress. That the mental health system imposes its meaning on people’s expression of need, sadness, misery, loss and fear. Rather trying to reach a shared understanding of someone’s behaviour, psychiatry labels it as illness and treats it – mostly with drugs. The parallels between this and religion are disturbing. (I have recently been watching “Spooks” where mad language abounds-particularly with politicians. Presumably Newspeak is the ultimate mad language which would delight Humpty Dumpty.)

The Critical Psychiatrist, David Cooper, wrote “I am not saying that there is a radical need to go mad but that madness is one desperate expression of a radical need for… change’ (The Language of Madness 1960)

The link is to Lucky’s speech in Waiting for Godot, a play I have been fortunate enough to see three times. It was played twice as tragedy, once as near farce. The director’s view  of course, shapes any understanding of Lucky’s speech. Is he simply a clown coming out with empty syllables? Is he mad-manic, with clang associations and flight of ideas? Is he a Holy Fool whom we ignore at our peril? Or is he all three and more beside? Our answer will be shaped by our “inner director”. I have always delighted in this speech since being introduced to “Godot” in my Sixth form. It is probably one of the texts that has shaped my clinical practice and how I teach. I have an “internal director” who thinks Clowns, Jesters and all Holy Fools should be given the highest honours society can give them. But that would, of course, be to silence them and destroy them.

Stranger in a Strange Land-Confessions of a Conference Goer

 

I recently attended a counselling conference. It was the first one I had been to as a counsellor- I usually go to conferences in my role as a nurse and /or university lecturer. I also have a confession to make about conferences-or at least the one’s I’ve attend. I do not like them very much! I spend my time getting lost on campus. (I have an awful sense of direction. If a conference is due to begin at 9:00 a.m. I make sure I leave at 30 minutes to get to the main venue. Despite the assurance that “The main conference venue is only 5 minutes walk from our well appointed halls of residence.” It never is in my experience!)

The other aspect of conferences that I find difficult is the “networking”-another skill I seem not to possess. I watch other delegates going to complete strangers and, within minutes, exchanging business cards and a promise to “write something” for their new journal. Or promising a chapter for their new book. “Nothing too much. It needs to be between 5 and 10,000 words.” I’m normally the chap sitting in a corner with his coffee wondering what I’m doing here. (The answer, of course, is that it seems like a good idea at the time.) Eventually I manage to make the effort and move in on a conversation going on around me. I stand on the edge for a minute or two, gently making a space for myself. Then just as I’m about to open my mouth to say something someone more important than me appears and is welcomed like a long lost relative. I go back to my coffee or wander over to the bookstand pretending to be interested in buying yet another book to add to my “must read” pile.

As you will see, I went to my most recent conference with huge misgivings. Although I had made a mental note to try and talk to someone new this time. Registration was at 9:00 a.m. on the Saturday morning so I arrived at 7:00 p.m., on Friday evening. The hall of residence was empty and I had planned a lonely evening eating a solitary meal and going to bed early. (And wondering why on earth I hadn’t caught a much later train and arrived at 11:00 p.m. having had dinner at home.)

I had booked dinner for 8:00 and went to the campus restaurant in good time. I sat at a table wondering what happened next. Was it self-service or waitress service? After a few minutes a waitress came over

“Are you with the conference?”

“Yes”

“What is your room number?

“101” (An inauspicious start I thought.)

“You’re a bit early. The others haven’t arrived yet. You’re all on that table over there.”

I went back to my room and came back a quarter of an hour later. And found a dozen people sat waiting for we stragglers. I sat down expecting to listen to other people catching up on the gossip since they had last met. To my surprise the person sat next to me turned and introduced herself and several of her colleagues. Asked me my name and in turn introduced me to them. This lasted throughout the meal, people automatically involving me in the conversation. The meal finished and I expected to go back to my room. This again was “hijacked”.

“We’re going to the bar now, Terry. Will you join us?”

How could I refuse?

This openness and generosity was the hallmark of the conference.  I was going to write “even though I was an outsider” I was made welcome. But that would be unfair and inaccurate. Although I was a visitor and the conference was part of the university’s M.A. course, I have rarely felt so at home.  At every turn people made me welcome and invited me in.

It might also be worth noting that the conference was at Keele University, home of Rogerian counselling. (I had not realises this when I applied.) My own training is psychodynamic. The gap between Freud and Carl Rogers being a large one! (I was giving a paper about my work on Narnia, written from an analytic perspective. But that is another story.

I’ve spent much of this week thinking about that conference. I didn’t learn much new theoretical material. I’ve been involved in counselling and mental health for more than twenty years and am thoroughly immersed in the psychoanalytic tradition. Yet the grace with which this conference met left me left me feeling very humbled.  My analytic colleagues could learn much from this Person Centred tradition. What is passed off as “boundaries” in some analytic circles can often feel cold and persecutory. An interpretation delivered with gentleness can be empowering. An analytic interpretation delivered from the dizzy heights of the analytic chair can leave one feeling humiliated and demolished.

Similarly in too much psychiatric work, nurses use “keeping boundaries” as an excuse to avoid risking a real meeting with their patients.  Too many nurses fear meeting with patients, particularly those who are psychotic. Often because they have no capacity to bear madness. Either their own or their patients. (Menzies seminal work on Containing anxiety in Institutions still speaks to today’s clinical work.)

The Keele conferencees taught me much about risking meeting someone with a very different worldview to their own. (But who took the bigger risk in this meeting is a moot point. Enough to say that I’m already planning to go back next year. If they’ll have me!)