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.

Sportives Endings

Let me begin this blog with what may sound rather pretentious. Not the quote, which is lovely. But my choosing to attach it to a series of thoughts about cycling. “If stories come to you, care for them. And learn to give the away where they are needed.  Sometimes a person needs a story more than food to stay alive.” (Barry Lopez in Crow and Weasel) One my memories of my early childhood was writing stories. I didn’t write them for anyone. I just liked writing them. I still do. That’s probably another reason for becoming a nurse and a counsellor. I get to hear people’s stories. Or, more precisely, people choose to tell me their stories. Together we give them shape and structure and see where they fit with all the other stories. I think that’s why I chose psychoanalytic work. It holds that stories have meanings that go beyond their immediate telling. So I recently missed an appointment with one of my patients. They came to their next session with a story about a bad manager.(One does not have to be Freud to see the link!) So, this short series of stories about my Sportive is ended. All I’m doing now is reflecting on the associations it triggered for me. Associations which I hope others have enjoyed and will reflect on in their turn, so the story goes on.

As I have mentioned, I recently had an episode of depression. It was short-lived and unpleasant. But even when I was in it, I found myself observing myself. And noticing my symptoms. Knowing that I would eventually write about it in some shape or form. That way I could take something from the experience. And give something back. Otherwise I would feel as though I had missed an opportunity. A sort of psychic recycling!

So, to return to my Sportive. The final instalment is about endings. When we got back to the finish almost everyone  had gone. We crossed the official Finish and were handed a bottle of tepid water by a bored official who had not just ridden 100 miles. Where was the band? The Marching girls? “Land of Hope and Glory” blaring from the speakers? Eliot remarked “This is the way the world ends. Not with a bang but a whimper.” So it was for us. When I worked in a Therapeutic Community, we always had a Goodbye tea when someone left. It was a way of making sure they didn’t end on a whimper. The community could say goodbye. “Good luck for your future. Well done for staying the course. We hope you’ve learned enough to keep going.” When I left I cried for two weeks afterwards. I’ve never had such a difficult leaving. (One of the gifts I was given was a hug from a male patient. He had been a rent boy from 12 years of age. Became a male prostitute. Had done drugs and been in prison. He was a lovely man who found my work with him very healing. At my party he came and hugged me. I shall treasure that hug all my life. It gave so much.)

I digress! My point was about how we mark endings. In psychiatry it all too often is  “Hello Michael. We’ve had a ward round and the doctor thinks you’re well enough to go home now.” Not exactly a planned discharge! The least we could do would be to give them a Certificate of Survival.”This is certify that xxxxx has successfully survived xxxxx in xxxxx ward. Signed. The Staff.” Crossing the finish line I did get a certificate. I shall put it on my C.V. for any future job interviews.

Thus ends my blog on cycling.There’s a 75 mile ride coming up locally. Very hilly. Very hard. But with lots of food stops manned by cyclists. 75 miles. That’s better than 100 miles. I wonder…

And whilst I think, here’s a fun song about riding all kinds of machines.

What is Truth?

I hesitate to try to write a blog with such a huge title. Endless books have been written on the topic. Let alone all the blogs, pub discussions and wars that have occurred as a consequence of this question.  I want to think about truth in a clinical setting rather than a religious or philosophical one-although I may stray in to these areas. I want to link two things that came up this weekend.The first was that a friend tweeted me warning me not to watch a particular film because it suggested that truth was relative.The second was a mini sermon from somebody at church giving his view of the “real” story of the Feeding of the 5000. I don’t have a particular view about this story. But his suggestion that this is simply a story about the value of good organisation left me unmoved. (It felt like all the magic had been taken out of the story. What was left were the dead facts.Neatly laid out. But nonetheless dead.) But I confess to being one who happily believes that somewhere in a hidden valley somewhere unicorns exist. And that dwarves, elves, fairies etc probably did live here-albeit a very long time ago. In a kinder age where they were appreciated and valued. So whilst I don’t know what happened to the 5000 I want to see the story as being about more than good organisation.

The film my friend was warning me about was one in which a number of witnesses give differing accounts of an accident they have seen. The problem seems to be that they all saw something different. They were all telling their truth. The word true -and its derivatives- has some interesting roots. It carries with it the idea of a truce. That there is an agreement between the story told and the facts. It also has connections with hard; strong; firm. All a long way from our contemporary Post modern understanding. In clinical work one tries to find a balance between “facts” and “telling”. One searches for meaning as much as facts. (Which is the problem with the current trial of several celebrities on charges of sexual harassment and abuse more that 30 years ago.How do the victims prove their case? How do the men charged prove their innocence?)  In counselling, we try to make a truce between hard facts-something happened. And soft facts-I don’t know why it happened.

I have had a number of patients who have come with problems with Anger. Their stories are similar in one regard. They always explode when they feel their partner is trying to belittle them. (Their partner seems to be doing something different. Trying to stop their partner from drinking too much. Or spending too much time out with his friends at the cost of family life. Or simply telling him that dinner is ready.) The “truth” differs depending on who is telling the story. Sometimes one has to stand back from a story and think about the details. Could this have happened in the time frame the patient is suggesting? Is it physically possible that the event could have happened as described? As a counsellor my task is not to find the Truth, the Whole Truth and nothing but the Truth. My task is to try to understand meaning. What does it mean that my patient tells me they are an innocent victim of domestic violence? What might it mean when I am told that my patient had an affair because his wife had got fat? Truth and meaning are not always the same thing. Which can make the work difficult at times. Counselling is not a law court where guilt and innocence are sought. As a counsellor I try to understand what it is my patient is conveying when they tell me a story. Rather like the Feeding of the 5000. There is no single meaning to the story. It may be a miracle-pure and simple. God did something astounding that day. Or it might be a story about good organisational skills. Or some other meaning. The danger comes when an orthodoxy imposes a given meaning to a story. (And orthodoxies can be internal as much as external!)

Tall Tales 2

This is a continuation of my piece last week about the way in which we use stories. I told the story of the very different way in which my wife and I use stories. Both ways are “true” but reflect the different emphasis we place on facts. My family saw stories in the same way as ancient bards saw them-as a way of conveying an inner truth. My wife’s family uses stories to illustrate an external truth- such as Boyle’s law or something similar. I suggested that we had needed to learn to hear each other’s stories and not dismiss them because they did not fit our particular schema.

As both a psychiatric nurse and a counsellor I hear lots of stories. I hear from my psychiatric patients that the IRA are out to kill them. Or that they are controlling the events they are seeing on the television news. The patient who believed this was deeply troubled by her belief. She saw herself as being personally responsible for the deaths she was watching.

Another patient whom I see for counselling was badly treated by her mother as a child. Her father apparently did not intervene to stop the abuse. One consequence of this is that my patient has a chequered history with men. Her story is that she must be a very wicked person to be so deservedly punished. Another patient comes and tells me about their difficulties in a rather detached tone of voice-as if describing someone else’s  life. Yet when associating to a dream, their responses were much more affective. Some real feelings began to emerge.

What links each of these people is their use of stories to illustrate their truths. My work is to listen to the stories. To hear them, value them and help my patients think about the ways in which these stories are used. So my psychotic patient was expressing both her horror at what she was seeing. Her own horror at her own history. And, perhaps, an awareness of her own capacity for violence. Or a fear of her belief in her capacity for murder and hatred. (“Tread softly, for you tread on my dreams.”)

My patient who sees herself as wicked is, in part, using a story to protect herself from confronting the way in which her parents treated her. Easier to believe that I am wicked than to have to face the knowledge of my parent’s cruelty. This knowledge raises too many difficult questions. Similarly my ” detached” patient tells stories in a remote, sardonic way which protects them from the knowledge of their emotional emptiness. (“We are the hollow men. We are the stuffed men.”)

My work, with my patients, is to honour the stories. And to help them find new ones which tell a new story. Not to rewrite their histories, which would be dishonest. But to find stories which reflect a new truth which is true because they are renewed. And need a different story.

Tall

I discovered some time ago that my wife and I use stories in quite different ways and to serve rather different ends. For my wife and her family the main purpose of a story is to convey facts. If one of her family begins a story with “Do you remember last Tuesday when we went for a trip to the National Trust gardens in  Kent?” they had better be very confident of the facts of their story. Otherwise it will be swiftly “deconstructed”. “No. It wasn’t last tuesday, it was last Wednesday. I know that because last Tuesday we had our boiler repaired and I had to stay home all day”. “And,” someone else will chime in, “it wasn’t Kent because they had floods and we couldn’t get there.” “That’s right, ” somebody else will say ” it was last Wednesday and it was English Heritage because the National Trust property didn’t open on Wednesday.” As you can imagine in my wife’s family one learned to get one’s facts correct before risking a story!

By contrast my family used stories in a different way. The “facts” always served  secondary purpose. nobody particularly minded which day a given event took place. Nor even where. Stories were to illustrate someone’s character. Or how V.W.’s were less reliable  than Ford. The whole infrastructure of “facts” were less important than the point they were being used to make. These two different mind sets took us both a long time to get used to. I accused my wife’s family of needless pedantry whilst she accused mine of a wilful disregard for the facts!

We are, of course, both right. And both wrong. As a counsellor and a lecturer I hear many stories from my patients and my students. I remember my early days as  a lecturer talking to a class of thirty students about schizophrenia. After about ten minutes a student put up their hand and asked “Terry. Do you think schizophrenia is caused by demon possession?” I was very unsure what to say. I had a view which did not include demons. Yet I did not want to crush my student. We both had stories about the origins of schizophrenia. My task was to allow him to explore and tell his story. And to value his experience whilst finding a way of suggesting that demonic possession was not the most helpful model to use in clinical practice.

C.S. Lewis in his novel “Out of the Silent Planet” has one of the characters, Ransom, comment “It even occurred to me that the distinction between history and mythology might be  itself meaningless outside the Earth.” In my counselling work “”facts” are, of course important. Did my patient hit her husband? Was my patient drunk and was he arrested by the police? Did my patient steal from Asda? These are facts and they are important to the work. But the more important questions then follow. “Why did you hit your husband?” “Why did you get so drunk?”  “Why did you steal from the supermarket?” The back story-and a  particular kind of truth-then begin to emerge. History and mythology can join hands and support each other rather being in competition.

This distinction between history and mythology opens up many areas for discussion. That will be my next blog.