Reflecting on the losing of humanity…

Thank the good Lord for Friday. It has been another long hard week.

Regular readers and friends will know that I earn a living by working as a mental health social worker- for around 20 years now. Or to be honest, these days I do not do a lot of social work (although I still practice as a Mental Health Officer)- I do this other thing called ‘management’.  Some days I am not sure how much longer I can do it.

What has allowed me to survive so long working within a large bureaucratic institution has been two things- firstly the need to provide for my family, and secondly the hope that I might be able to genuinely make a difference to the lives of the people I work with. In management, it is possible to fulfil the first, but the second- well the evidence is not as strong.

Being in contact with people in the extremes of distress and crisis on a daily basis does something to you. It is impossible to stay as emotionally engaged as we do when we first begin these encounters. The best of my colleagues hold on to their compassion however- we nurture it by making it shape our language, our small talk and the way we treat everyone we come across. We have learnt that kindness in the small things, despite terrible external circumstances, can indeed make a difference.

And sometimes that is the only thing we have to offer.

Images by Fred Kleinberg

In the course of my work, I come across people who have done terrible things. People who others would say have lost all sense of humanity.

People who have harmed children, or killed and dismembered people.

Others who have locked themselves away (or been locked away) and have lost or forgotten almost all basic skills of human interaction.

Perhaps most striking is watching people slowly destroyed by addiction. To see them in the later stages of this- near to death- and wonder what incredible life force keeps a person alive when skin is bright jaundice-yellow and all organs are playing discords.

Sometimes it seems that almost all that makes us human is gone.

Almost- but not all.

Because in all of these people, despite their brokenness, what is left- what is most visible, is… their humanity.

Unhidden, undefended, right on the surface like an open flesh wound.

And should we lose sight of this, the danger is that it is not their humanity that will be at risk- but rather our own.

I wrote this in response to a recent event…

Deep in the soup and the stew of him

In the ooze and glisten of his grey matter

Some synapses spark and flicker

Sending out electro-chemical dots and dashes

.

And he- wired almost to breaking point

Is all strung out

Senses dulled

But deadly receptive

.

So bone becomes knuckle

Muscles turn to gristle

And poisoned sinew moves like a snake

Ready to strike

.

Later some said he was evil

That some dark thing was in him

Others called him mad

A flesh machine gone wrong

.

Still others bayed for his blood

-as if enough had not been spilt already

They want eyes put out for the eyes he closed

And every broken tooth smashed in return

.

Me, I stand over a stain in an old carpet

Through which something human has fallen

And feel a little of myself

Drain away

Hope for recovery…

I spent an afternoon meeting with some people who came together to discuss the establishment of a Recovery Network for people who have experienced mental ill health in Argyll.

The Recovery movement is one of the most exciting things to happen within the mental health world for years. It is a grass roots movement, turning the power relationships in psychiatry upside down. It’s persuasive idea is that we need to stop doing what we are doing, because it is not working- rather we need to equip, empower and inspire people towards control of their own choices and decisions towards building real and meaningful lives.

I was reminded again yesterday of the word HOPE.

Because recovery does not depend on the presence or absence of illness- for most people mental health ebbs and flows. For some of us, this ebbing and flowing can be more severe.

But recovery very much depends on the presence or absence of HOPE.

And where hope is being raised, it makes visible to me a kind of humanity that make clear that we are beautiful creatures, made a little lower than the angels.

But let us make no mistake- hope is a dangerous and scary word. It contains all possibilities, but also the danger of disaster and failure. It is something that we need to hold on to firmly but tenderly, like a bottle of nitro-glycerine.

And we need to acknowledge that for many, there is a recovery journey that begins first in daring to use the word again…

Here is a little more Foy Vance-

If theres one thing that I know
It is the 2 shades of hope
One the enlightening soul
And the other is more like a hangman’s rope
Well it’s true you may reap what you sow
But not that despair is the all time low
Baby, hope deals the hardest blows

There was once someone I loved
Whose heart overflowed his cup
And his shoes got covered in blood
Oh but he never knew cos he only looked up
Well he was in trouble and so
Had known pain more than most I know
Yet it was hope that dealt the hardest blows

And the girl that holds the hand
Of her somewhat distant man
Though she did everything she can
Still his heart set sail for distant lands
And she wonders sometimes if he knows
How she feels like a trampled rose
Baby, hope deals the hardest blows

Well some people think their sin
Caused the cancer thats eating into them
And the only way that they can win
Is by the healing of somebody’s hands on their skin and praying
But when the cancer does not go
Baby, hope dealt the hardest blows

And now all these truths are so
With foundations below them
They were dug out in a winter’s cold
When the world stole our young and preyed on the old, well
Hope deals in the hardest blows
Yet I cannot help myself but hope

I guess that’s why love hurts
And heartache stings
And despair is never worse
Than the despair that death brings
But hope deals the hardest blows, dear
The hardest
Hope deals the hardest blows

Making recovery real…

To Oban today to a Scottish Recovery Network conference on the promotion of ‘recovery’ as a concept and driver for mental health services, and more importantly, for those of us who experience mental ill health.

It snowed, and so we were a bit worried about the drive, but in the end Audrey, Victoria and I got there and back with no trouble.

The challenge and critique brought to services by the change of thinking and shifts in power required to move towards a recovery based system (rather than an illness based system) has been the stuff of my working life for a while now. I have found that it has had the capacity to reignite my passion for the work that I do.

I have spoken about recovery before- here and here, but for those who have not come across the concept before, here is the definition from the SRN website-

“Recovery is being able to live a meaningful and satisfying life, as defined by each person, in the presence or absence of symptoms. It is about having control over and input into your own life. Each individual’s recovery, like his or her experience of the mental health problems or illness, is a unique and deeply personal process.”

It is about trying to stop expecting people to fit into hierarchical burearocratic structures, but rather shifting power from the institution to the individual. It is about creating opportunities for people to rediscover hope, and to re imagine what a fuller life might look like.

You could say that it is about the redemption business- the Jesus business. And where he is, I want to be near.

But lest you think that I am doing that familiar paid helper thing, and dividing the world into us (the professionals) and you (the recipients of our expertise) then let me confess that I too am in a process of recovery.

Or should I say sometimes I am.

Because we were asked today to consider what might contribute to our own ‘wellness’, and people gave the usual answers- love, relationships, long walks in the country, meaningful activity, meditation and rich ruby wine… But I was led once again to reflect on my own mercurial sense of wellbeing, and how fragile it was at times.

Because sometimes it seems as though I am merely a victim to unfolding circumstance. Things happen, and I have little control over them, nor my emotional reaction to them. Of course, this is not true. There are lots of things I do, or avoid doing that make me who I am.

It is perhaps more like one of those slow unfolding accidents, that give you chance to react and minimise the inevitable impact- which is nonetheless still painful and shocking.

Of course there is such blessing in this journey of mine too- and I am so grateful that I do not walk alone.

So by way of celebrating these continuing outbreaks of redemption, almost in spite of my own ability to miss them- I offer you this lovely poem by Gerard Manley Hopkins-

As kingfishers catch fire, dragonflies draw flame;
As tumbled over rim in roundy wells
Stones ring; like each tucked string tells, each hung bell’s
Bow swung finds tongue to fling out broad its name;
Each mortal thing does one thing and the same:
Deals out that being indoors each one dwells;
Selves—goes itself; myself it speaks and spells,
Crying What I do is me: for that I came.
I say more: the just man justices;
Keeps grace: that keeps all his goings graces;
Acts in God’s eye what in God’s eye he is—
Christ—for Christ plays in ten thousand places,
Lovely in limbs, and lovely in eyes not his
To the Father through the features of men’s faces.

Asylums, churches, and the retreat of the institution…

I was in Lochgilphead today, with a series of meetings- including one at Argyll and Bute hospital. The building dates from 1862, and is one of the very few Victorian ‘lunatic asylums’ still in use today.

Lovely old building it might be, but it is a total anachronism. Built to house hundreds of patients from all over this area, only a handful of the original wards are still open, whilst the cost of maintaining the structure eats away at resources desperately needed by community services more fitted to present day understanding of treatment and support of people experiencing mental ill health. It is hoped that a new purpose built facility will (hopefully) replace it soon…

It stopped raining today, and I decided to take the camera into the woods at lunchtime.

I walked into a forest that until recently was managed by a woodland project run by patients from the hospital. The project has lost it’s funding now, as patient numbers have dwindled, and as segregated projects like this are now regarded as a potential obstacle to recovery, as they are not supportive of integration back into the community.

It was lovely though…

The subject I was chewing on as I walked, was the huge change that this areas has seen. The hospital was built as a means of providing what was regarded as much needed humane treatment of ‘lunatics’ and ‘idiots’. These very terms are now insulting and offensive, but at the time the hospital was progressive, impressive and planned to ‘scientific’ principles.

Even the trees I walked in were planted as a means of sheltering (or perhaps hiding) the hospital.

Evidence of the attempts to use the forest as a resource were everywhere- the notices describing different trees, the carvings, the rough wooden tables- and this…

I think it was built to make the best of a view, but in effect, it stands as a temporary monument to a rather meaningless industry.

A bridge into nowhere.

The people that made it are no longer in the hospital. I hope and pray their lives are rich and meaningful, and that the time spent working in these woods is a happy memory. But the fact is, such forms of occupational therapy are no longer part of common psychiatric practice.

And I thought of that other late Victorian institution that I am so familiar with- the modern protestant church. The buildings that were the places of the Protestant institutions still adorn all of our towns and cities- many are lovely too. Most of them are just as empty as this old hospital.

The parallels are pretty obvious. What both offered was good- perhaps even the best of what was possible in their day. They were raised with such energy and optimism. They changed the landscape of their times.

But as time passed, the rituals and routines that they followed became less and less in tune with the wider world. In some case, it was even toxic- what started off as an enclave of hope, became a backwater, where lives stagnated. Escaping such situations can be so very hard…

And what industry there is continued to look towards the institution. It was contained within the stone walls and the boundary fences.

And bridges were built to nowhere.

There will be a new hospital soon, which will not be perfect- there will be more compromises, more challenges- but we hope that the focus will shift to outside these old stone walls and into our homes and houses- where real lives are situated.

I kind of hope the same for church…

Mental illness and spirituality…

I had a good chat with our friend Kathryn tonight about spirituality and mental health problems.

Kathryn has been studying with ICC in Glasgow and has a passion for working with people who have problems with mental illness. To this end, with her husband Bobby she has been running a furniture recycling/reallocating project- in her spare time that is, as well as her day job!

She also has this idea for a kind of friendship group where people who have mental health problems (and lets face it, this is many of us at some point in our lives.) This has formed part of her studies, and tonight was a chance for us to talk through some of this stuff- which was great, not just because it was good to see Kathryn again, but also because this subject kind of beats in my heart.

The bias that I feel Jesus had towards the poor and broken, and the hope that we feel for a new way of being- categorised by grace, and radical inclusion, according to the rules of the New Kingdom- these things are all in there for me.

As part of her project, Kathryn asked me to consider some questions- which I found surprisingly hard to answer given that this is an area of constant reflection. In particular she was interested in how church might provide help and assistance to people experiencing mental ill health.

Here are some of the things that I was chewing on-

I want to suggest that all of us are potential sufferers of mental ill health- including many people within church. We too easily start with an ‘I’m OK, you are not OK’ way of thinking- which leads us to believe that we have the answers to other people’s problems. Perhaps in part, we might actually be part of the cause!

We often fail to acknowledge MH difficulties amongst people within church- the stigma is as strong, if not stronger, against mental ill health within church as without- because we add assumptions about spiritual weakness to all the other negative assessments.

Another assumption we tend to make is that our job as Christians is primarily to bring people inside the club by making them realise that they are outside. Our job then easily becomes to invite people into our buildings, and hope they will then become like us. The support available within church for people who have MH problems has often been far from perfect, and very poorly integrated with other community resources.

Christian groups/churches seeking to support and provide care for people experiencing mental ill health easily fall into lots of traps. I would include some of these-
The evangelical trap- Our real (covert) motivation is to convert. Most folk see this coming and run a mile. Some may indeed convert- repeatedly. The difficulty is that conversion does not make the illness go away, and we may find ourselves being dishonest and conditional in the way we offer love and support.
The therapy trap- Christians tend to do bad therapy. Bad therapy often does more damage. It is easy to inadvertently be the ‘expert’ and then let people down when we fail to deliver.
The dependency trap- Sustaining relationships with people who have experienced real damage can be extremely hard. If people find something that is helpful and supportive, it can easily become a full stop. The dependency that begins can be an impossible burden for those running groups also, leading to broken promises and further alienation and rejection.

My strong feeling is that Christians ought to be attracted to failure, rather than being seduced by success.  I also believe that Jesus calls us to the poor in spirit.

But I am not sure that he calls us to ‘rescue’ people- rather that he asks us to practice a form of radical inclusion.

I think too that all streams of ‘therapy’ have a thing at the heart of them- for CBT it is about therapeutic allegiance, for person centred counselling it is ‘unconditional positive regard’ and for psychoanalysis it is ‘transferance’. All these seem to me to carry something of Jesus about then- they are related to LOVE. They are in some senses a Christian heresy.

I wonder whether we might yet work out how better to understand the relationship between Spirituality and mental health problems? Is this something that Emerging Church might yet do better?

To accept that our fallability is not a sign of individual weakness, or spiritual corruption, or demonisation. It is just part of who we are.

Part of what it is to be human. Even extra-human.

Jonathan Miller on life, and psychiatry…

Jonathan Miller said this-

I hold all contemporary psychiatric approaches – all ‘mental health’ methods – as basically flawed because they search for solutions along medical-technical lines. But solutions forwhat? For life! But life is not a problem to be solved. Life is something to be lived, as intelligently, as competently, as well as we can, day in and day out. Life is something we must endure. There is no solution for it.

Miller J [Ed] Ch 15. Objections to Psychiatry: Dialogue with Thomas Szasz States of Mind:
Conversations with Psychological Investigators London: British Broadcasting Corporation 1983, p.290, Quoted in this really good article, ‘The mythical self, we make ourselves up as we speak’- here.

Amen Jonathan. Amen.

‘Road to recovery’, and ‘spiritual capital’….

BEWARE- this is quite a long post, but please bear with me dear readers, as I think it deals with rather important stuff… but then I would say that, wouldn’t I?

recovery

Powerful image from here.

I love it when you come across something unexpected that reeks of the Kingdom of God…

I spent all day yesterday at a development day and Annual General Meeting for the Cowal Council on Alcohol and Drugs. I am one of the volunteer directors of this company, who provide counselling and support for people with addictions in this area. I am proud to be part of the organisation, which like all such voluntary sector small companies has had some challenging times.

At present, I think it is a good healthy place to work, and brings genuine help to people who suffer from addiction to drugs and alcohol in our area. Our area (the west of Scotland) has seen too many lives cut short and families devastated by addiction. But there are many people who we are not able to help- and the purpose of yesterday was to try to consider how we might set our agenda for next year to do better.

I was part of a discussion yesterday about the concept of ‘recovery’.

Recovery is a word that I am very familiar with from the point of view of mental health services- in this context, it is life giving and hope enhancing. Check out the Rethink website, or the Scottish Recovery Network site. I seriously think that any Christians interested in seeing the words of of Isaiah 61 made real in our time should become familiar with what is happening in the area of Recovery- a lot of the sites are full of personal stories that make you weep. Chains are breaking, and we people of faith ought to celebrate and support as much as we can.

Until recently I was not aware of how much the concepts of recovery are starting to cross over into the the field of addiction.

This is an excerpt from a recent Scottish Government document called ‘The road to recovery‘, which specifically addresses addiction to drugs-

81. What do we mean by recovery? We mean a process through which an individual is enabled to move on from their problem drug use, towards a drug-free life as an active and contributing member of society. Furthermore, it incorporates the principle that recovery is most effective when service users’ needs and aspirations are placed at the centre of their care and treatment. In short, an aspirational, person-centred process.

82. In practice, recovery will mean different things at different times to each individual person with problem drug use. Above all, people aspiring to milestones in recovery must have the confidence that they can achieve their personal goals. For an individual, ‘the road to recovery’ might mean developing the skills to prevent relapse into further illegal drug taking, rebuilding broken relationships or forging new ones, actively engaging in meaningful activities and taking steps to build a home and provide for themselves and their families. Milestones could be as simple as gaining weight, re-establishing relationships with friends, or building self-esteem. What is key is that recovery is sustained.

83. Recovery as an achievable goal is a concept pioneered in recent years with great success in the field of mental health. The Scottish Recovery Network has been raising awareness of the fact that people can and do recover from even the most serious and long-term mental ill-health. 32

84. The strength of the recovery principle is that it can bring about a shift in thinking – a change in attitude both by service providers and by the individual with the drug problem. There is no right or wrong way to recover. Recovery is about helping an individual achieve their full potential – with the ultimate goal being what is important to the individual, rather than the means by which it is achieved.

‘Recovery’ is essentially a collection of grass roots movements growing out dissatisfaction by users of services who are sick of being ‘done to‘ by professionals, and are looking to break free- not only from the specific difficulties affecting their lives, but also from the industry and economy generated by medical, social and political attempt to ‘cure’ them. The fact that recovery is now forming a part of government documents is both a triumph and a threat. It is a threat because there is a real danger that the word becomes just a word. It stops to carry any passion, or any hope…

But back to our discussion yesterday.

One of the things evident to anyone seeking to discuss the possibility of recovery with people who have been forced beyond the edges of society by addiction, mental illness or stigma and discrimination, is that there can be no recovery without mental wellbeing, and there can be no mental wellbeing without real opportunities to build friendships, find meaningful activities and participate in our towns and communities as both recipients and a contributors.

I have blogged several times about the idea of Kanyini, and how the loss of identity, purpose and spirituality amongst Aboriginal people has led to a loss of their very selves. Anyone who has spent any time amongst people with addictions (who have may also have lost everything) will resonate with Kanyini. Bob Randall speaks movingly of how his own people have fallen into addiction, isolation and mental illness…

There was a discussion yesterday about how we might be able to encourage these things in our organisation, and more importantly, our community-

  1. Recovery capital- how do we give power and control back to people who use our services, and provide change opportunities, not ‘slots for treatment’?
  2. Social capital- how do people find meaningful social connections, from a position where trust and opportunities have all but disappeared?
  3. Spiritual capital- this gave some pause for thought, so more on this one below!

What is ‘Spiritual capital’? I suppose this rather depends on your definition of spirituality- but lets not get into that just now. In this context, I think Spiritual capital refers to MEANING. The meaning on life, the meaning of love, the meaning of small stuff, and the biggest stuff.

Most of us do not need to dig into this too much- we have no time, and the scaffolding around our lives- jobs, marriages, mortgages, etc- means that we are insulated from the biggest questions. But people who have none of this scaffolding and have reached the end of all their coping, even the bottom of the bottle- these people have a whole different place to look at spirituality from.

Interestingly, the discussion in one of the other groups seemed to get into RELIGION. There are some Christian organisations involved in addictions work. Some of them use high octane charismatic deliverance kind of stuff- which to be honest, I kind of find slightly disturbing. But then again, if it is meaningful and helpful to people involved, great. My fear is that one addiction is replaced by another on, called GOD- and this can indeed be a dangerous addiction for some…

But I wonder if Spiritual capital can be seen more commonly in encouraging people to consider things relating to the heart of who we are, rather than the material stuff that we surround ourselves with…

And in this, I think people who have suffered addiction, or experienced mental health problems, have much to teach the rest of us…

As for me, it started me thinking about a writing project, and I had a great conversation about the possibility of a ‘recovery cafe’ with my mate Ali…

Scottish Mental health Arts and Film Festival 2009

Scottish Mental Health Arts & Film Festival 2009

For those of you in Scotland- check this out!

It brings a whole range of the arts to bear on one of the biggest social justice issues of our times- that of the effect on people of mental illness, and more particularly, our societal response to this.

This is what they are about-

CHALLENGE PERCEPTIONS:
What mental health means, stigma and recovery, inequalities in mental health, exploring our history of mental health.

MAKE CONNECTIONS:
Connecting the community, public, arts, academic and voluntary organisations.

DEVELOP AUDIENCES:
Reach those who are often missed by traditional means of engagement.

PROVIDE ENCOURAGEMENT:
Encourage participation in the creative process by those who have experienced mental health issues, but also the wider community as a well-being initiative.

PROMOTE CREATIVITY:
Creating great art and events.

more about “Media“, posted with vodpod

Miranda Epstein- cartoons about recovery

merinda_epstein_sanity_fair

Following on from my earlier post about mental illness stereotypes and the Mental Health Machine, I thought I would post some more of Miranda Epstein’s wonderful cartoons. Check out her site here.

I think they speak for themselves.

(Click to enlarge)

Mental illness- challenging the stereotypes.

1mad

Everyone at work is discussing the first episode of a BBC TV programme at the moment called ‘How mad are you?’

You can check this out on the BBCiplayer on this link

Now I must confess to being someone who loathes reality TV programmes- although I did watch Taransay one (Castaway?) which kicked the whole genre off in the UK. I am a sucker for anything filmed on a small Hebridean island.

However, the idea of this one caught my interest even before I watched it. 10 people in a castle. 5 of them have diagnosed mental illnesses, the other 5 are (wait for it) ‘normal’. They all get to perform lots of tasks and batteries of tests from psychiatrists, who then have to declare who they think is mad, and who is sane.

Anything that challenges the prejudices and stereotypes about mental ill health that still prevail is great as far as I am concerned- particularly if in the process the power relationships get reversed, and the black arts of psychiatry get placed in the hot seat…

I should confess to a bias here- I have worked as a Mental Health Social worker, then as a therapist, and now as a mental health manager. I was drawn to work in this area because my faith lit in me a desire to make a difference- to seek brokenness and try to bring healing. I have been inside the Mental Health system in the UK for most of my working life- and have discovered that it can be a very frustrating and at times an infuriating experience.

At its worst the psychiatric system in this country tends to suck in people at the most vulnerable time of their lives. The next part of their experience is often about LOSS.

Loss of freedom and choice.escher_about-institution

Loss of opportunity

Loss of relationships

Loss of employment

Loss of identity

Loss of motivation

Loss of hope

Loss of self esteem

…and once these things are gone, it becomes very difficult to transcend the circumstances you find yourself in. It becomes almost impossible to escape.

Sure, the system also GIVES people things. It offers a kind of sanctuary- either the physical safety of a ward or care environment, or a more emotional/psychological kind of security given by the label- ‘depressed’, ‘schizophrenic’, ‘manic depressive’. It also offers a whole new role- that of a ‘sick’ person, who needs help from the ‘experts’ who can treat them with medication or therapy- people who can take the messy chaos of their humanity and squeeze it through a scientific colander and filter out all the bits that are not helpful. (If only huh? I think we could all do with this process about once a week…)

And all these things too become like prison bars.

There are some encouraging signs though. Some people who have carried mental health labels are starting to take back the power. This can be best seen in the ‘recovery’ movement. Check out this article on the Re-think website, or The Scottish Recovery Network site.

Recovery thinking perhaps grew out of the hearing voices network, who dared to suggest that just because people heard voices, this did not make them less human- it did not make them mad. Many people even questioned the very nature of psychiatric diagnosis- suggesting (not for the first time) that schizophrenia was nothing more than a reaction to trauma- both trauma outside the system, then more trauma within it.

The voices from the recovery movement are mostly those who have been through the system, and managed to come out the other side. They have often found themselves in conflict with the powers within system- because they speak a different language, and do not conform. Some of their rhetoric is seen as (and perhaps actually IS) downright dangerous. They no longer are interested in talking about ‘cures’ to ‘illness’- rather they seek the right to choose their own path, and their own solutions to life crises.

merinda_epstein_the_consumer

(Cartoon from here)

That is not to say people do not need help. We are surrounded by people who are damaged and vulnerable. But many of us in the system, and many others who are subject to it, are convinced it needs to change. And the ideological challenge brought to us by the Recovery movement is like light in darkness.

And so as a Christian, I reckon that this is a flavour well worth seasoning.