Wednesday, 2 December 2009

Support McCollum!

There's a petition of Facebook to make Paganism a recognised religion in the UK. As far as health care is concerned Paganism is not yet, officially recognised

. . . references to religion and/or faith are taken to include the nine major world faiths: Bahá'í, Buddhism, Christianity, Hinduism, Jainism, Judaism, Islam, Sikhism and Zoroastrianism.

and yet there are a small number of Pagan chaplains working within UK healthcare.

In the US, where religion is taken so deadly seriously, a legal battle has been rattling on tediously for some time. Patrick McCollum is challenging prison policy that refuses to employ a chaplain that isn't Protestant, Catholic, Jewish, Muslim or Native American. Now, Americans United are Cherry Hill Seminary are amongst a growing number of organisations helping Patrick move the case forward.

I recently contacted an American hospital chaplaincy group to ask how many Pagan members they had and received a frankly rude reply:

There are no Pagan chaplains.
Paganism is not a religion.

So I sent a few emails to American friends, who contacted the organisation and Patrick, and everything was wonderfully sorted out within 3 hours.

Religion is such a febrile subject in the US that individuals feel empowered to make policy statements based on their own prejudices - as the chaplaincy organisation, a Federal district judge and fairly disgusting prison staff have. The upside of this is that Americans also take their own individual social responsibilities much more seriously than we do in the UK, and the downside is that Christianity dominates, oppresses other spiritualities and religions in a manner than most people, many Christians amongst them, find repellent.

Circle Sanctuary have set up a site in support of Patrick and this cause. Light a candle, pray, chant, visualise, raise cones of power or whatever you do to send loving vibes to Patrick and to those groups supporting him. It's a full moon tonight - go to town!

Thanks to The Wild Hunt for their ongoing coverage of this and other Pagan matters.

Friday, 27 November 2009

Institutional Evil

This week has been contaminated with more revelations about child abuse by Catholic priests, an abnegation of power by the police and epic arrogance from the Catholic hierarchy

Evidence given to the Chilcot Enquiry about Gulf 2 suggests that world leaders conspired to create war. Not unusual, but still loathsome.

I’ve written before about The Lucifer Effect, Philip Zimbardo’s research on ‘What leads good people to engage in evil actions.’

I propose that in trying to understand how power, abuses of power and personal responsibility – our own and others – weave together, there first has to be a consensus on what reality is. Reality is slippery and feeds into our desires for a peaceful life and personal power. If it is reality that a hospital passes quality assessments and fulfils performance indicators then we can assume that the majority of the staff will be professional, compassionate people. Managers will be doing an excellent job. Patients will be served well. This reality can exist at the same time as a disproportionate number of patients are dying because staff are slovenly and managers don’t care. People who do care feel disempowered to act, are treated with contempt or themselves abused. (Google ‘hospital whistleblower’ for a depressing litany of examples.)

Peter Vardy and Julie Arliss write clearly about this in The Thinkers Guide to Evil

It is almost always easier to identify institutional evil in retrospect. When a person is part of the institution, many things are taken for granted that may later be seen as unacceptable.

The institutional evil of the Third Reich was clear but it was made up of millions of individual Germans who went along with a system many of them must have known was wrong. At the end of the day institutions are made up of individuals and it is individuals who are morally accountable and responsible if they fail to stand up to the evil in which they participate.


When I trained as a nurse there was a rite of passage that happened when, in the second year, you were judged to be responsible enough to carry the keys. A large bunch of metal attached to a huge safety pin was handed over and worn with pride, hanging in but not resting inside of a pocket, so that they made a rhythmic clashing noise as you walked. The keys were, and remain, a symbol of authority in a highly regulated, hierarchical institution. Now, nurses are expected to wear special belts to contain keys so that a ward doesn’t sound like a prison, and still too many nurses wear this emblem as a mark of status. There’s often a link between this behaviour and not wearing a name badge. They are often more institutionalised that the people they should be caring for, secure and settled in an environment they have made their own. Challenge that comfort and you will encounter venom.

It is far easier to keep your head down, secretly despise this behaviour and, 6months later, discover that you are complicit in it. No one is actually physically harmed – not dealing with droplets of blood on the curtains surrounding a bed, or unpleasant toilets, or lying staff doesn’t actually involve physical contact.

Patients move on, or are considered, always, to be exaggerating or malicious in any complaint they dare to make. The only way to get on is to befriend and mollify the person who abuses their power, and often that means joining them in their behaviour. The purpose of the institution, whether that’s a hospital or any other multi-million pound business, is to sustain the institution. Make no mistake.

It’s not possible to avoid harm in this situation. If you don’t speak up the harm continues. If you do speak up you will become subject to harm, and you will cause harm to other individuals. It’s easy to refer to ‘Keep pure your highest ideal; strive ever toward it; let naught stop you or turn you aside.’ But the consequences of that can be dreadful. The consequences of not keeping high ideals can be even worse.

Saturday, 31 October 2009

Happy Samhain!

The cherry tree is dripping with amber; the garden, refreshed after last nights light rain, is ready for the coming of winter; all the bird feeders are full; the outdoor candles, flares and our pumpkin lantern is lit. Some dear friends are coming round in the next hour to share our huge Samhain feast and we've laid a place for all our Beloved Dead. The Ancestral altar is polished and before long our family Ancestors will be joined by those of our friends, and a pomegranete is ready to open to honour Persephone. The house is pristine and I am knackered but very happy.

Later tonight when everyone's gone I'll light our memorial light to welcome all the benevolent dead to our home for Winter, and then I'll renew the boundaries around each doorway, each window for the coming year.

May your Samhain be blessed, your coming year joyful and may peace be welcomed into all our homes.

Happy New Year!

Thursday, 22 October 2009

Interpretive Beings

I’m having to immerse myself in Christian philosophy in order to get some idea of how to approach the philosophy of religion and so I try to attend as many Heythrop College open lectures as I can. What’s becoming clear is that the Christianity people in Heythrop practice is very different from the Christianity I’m used to. They discuss their god in tremendous depth, moving beyond sex and hellfire, beyond sweetness and light, into something far more reflective. They seem to use contemplation of their god as a way of meditating on their lives and way of being in the world. They, too, are distressed by the simplistic nonsense presented by so many of their peers.

I’m going to write the occasional reflection on what I learn from this course as a way of asking myself questions about Paganism and what it means for me to be Pagan. I’ll be using many other peoples' words and ideas and don’t want to pass them off as my own, and I’m also aware of the potential for knee jerk reaction if I say “St Augustine says this . . .” I’m sure St Augustine has said many things which I wouldn’t like, but if he’s said something I feel is useful how do I offer that without some Pagans immediately assuming I’ve become a fundamentalist Southern Baptist, or just rejecting the idea outright?

That’s their trip, I suppose. Too many of us have chosen Paganism because we see it as the best way to show defiance to Christianity.

Today’s lecture was about reading the “Signs of the Times,” observing what the world is communicating and deciding how we respond. The gospels and scriptures guide Christians but I wondered what our equivalents might be. I suppose the closest thing to a holy book we have is the earth itself, the whole nuanced, delicate biosphere. It offers both stability and innovation, the laws of nature can’t be changed but change is the only certainty for the earth and everything dependant on it.

The bible seems to me to be a collection of stories that people can use to justify anything they want, and so it is with out own myths and legends: CuCullain, the Caileach, Demeter and Persephone, Deidre and so on, as well as the more modern myths and legends of our contemporary elders who may in centuries become the Pagan equivalent of Talmudic and biblical characters.

(Did you know, by the way, that there’s an oral Torah?)

Paganism holds tolerance in high esteem for excellent reason, we’re all very aware of how intolerance affects our own lives, but I believe we now need to review what has certainly become a kind of dogma. Tolerance has drifted into relativism: your view of what’s happening in the world and how to deal with it is just fine and my view is just fine and everyone is entitled to their own view, their own truth including, presumably, Stalin. This manner of engaging is very superficial, its lazy acceptance requires no energy and little thoughtfulness, whereas a respectful, authentic meeting takes skill, focus, and will. It accepts the risk that everything might not always be comfortable, and that discomfort is worth it if something more valuable can be gained.

Reframing the problem as seeking understanding rather than truth, is helpful. Where people are certain of the truth we can begin to sense the beginning of a mob mentality. The Truth ™ is easy, and easy to beat other people up with, whereas understanding is collaborative, relational, mutable. How, then, to avoid the retreat into relativism?

“Whatever leads to a better love of God and humanity is a good understanding.”

My own understanding of human behaviour has lead to an increasing dislike of humanity. The sheer historical repetitiveness of it distresses me deeply so that for some years meaning has been difficult to discern, there seems no aspect of life that remains untouched by our individual and corporate stupidity. For me, this has meant retreat and if there were such a thing I’d happily enter a Pagan monastery to do exactly as I do now, but in the dedicated company of others on a similar path. As yet, there’s no room for focused community contemplation within Paganism. I’ve been so desperately moved during visits to monasteries, the rhythm of coming together and moving apart, of steady, mindful movement through the day, and can’t believe that Paganism isn’t capable of something as graceful and disciplined. As yet, however, we are not. As yet, we don't want it badly enough.

So my journey is one of how to make better understanding. “If I understand at all, I understand differently.” And it’s my belief that there are growing numbers of Pagans who want to do this too.

Tuesday, 20 October 2009

Science, Soul, Self

There are some mysteries that we'll never fathom and some that we may just begin to understand. The concept of Soul, of the essential, non-material part of ourselves has intrigued humanity from the dawn of conciousness and various theories, from a basic animating principal to the astral body have been proposed.

Take a look at this on BBCiPlayer for a cutting-edge update of what makes you, you.

This link may be up for a limited period of time so make the best of it!

Monday, 19 October 2009

Time To Take Stock

We are living through a period of history that humanity has never encountered before. The world has opened up to us in incredible ways so that although we may never visit Lhasa we know what the temples at the top of the world look like, what sounds come from them, how the people who live in and around them dress and eat and work. We have some concept of the preciousness of the rainforests and the creatures who live with it, we know that we too live with the rainforests because we understand that climate is partly regulated by them. The horrors of war are revealed where in the past they could be denied or minimized. The realities of child labour, animal experimentation and other abuses, and all other miserable realities have been brought into our living rooms at the same time as miracles of health, travel, personal opportunity, semi-democratized knowledge, and choice have blossomed.

Everything is possible at the same time as we are being told that the world is on the brink of collapse. The places where Paganism has best flourished – the UK and US - have never experienced such freedom and comfort. We no longer depend on the opinions of popes and princes to tell us our place in the world, we’re not conscripted into industrial war machines, death doesn’t have such a consuming affect on our lives and we can chose whichever version of the afterlife best suits our desires.

Modern Pagans look to the past as a source of inspiration but we ignore the flea ridden, half-starved, freezing gloom of an average European family home pre-electricity. Most other religions look to an existence beyond earthly life for good reason, experiencing earthly life as something to endure, their Deity being somewhere other than where they are. Most Pagans who have a concept of Deity understand that Deity to be immanent, present in ourselves and in all things and I believe this is significant for Pagan practice.

All other religions make sense of the world through an understanding of Deity, and so has Paganism. When Crowley, Gardner and Valiente introduced the concept of a female Deity it was beyond radical and had serious material effects. Why do Pagans claim to care so much about the planet? Initially, because we understood the planet to be a manifestation of the Goddess. We’ve absorbed animist spirituality and as well as immanence it gives us the concept of genius loci. So we have some vague thoughts about what and who and how Deity might be.

Animism, a product of belief in immanence, has important effects on our practice. If everything is alive and in relationship then what responsibilities do we have for each other? Do rocks and birds have responsibilities towards us, and if not, what makes us believe we are so unique that only we have responsibilities towards other beings?

It seems to me that there are two things fundamental to justifying our ways of being in the world: the ways in which we understand power, and the narratives we tell ourselves. If we believe the narrative of original sin, or that suffering makes us more like Jesus, or of the gifts that Kali gives us then this will effect how we feel about each other, the world and ourselves. The manner in which we live these beliefs will be affected by our understanding of the use of power.

From the dawn of human consciousness people have been struggling with all of this and I see no need to reinvent the wheel, we can use the structures created by others to gain greater understanding of who we are. Where they don’t fit us then we surely have the intelligence and imagination to create our own. But create them we must. The Unitarians, who also avoid dogma, embrace and live within an ethical code. Are Pagans dressed up Unitarians? If we’re not we need to run to catch up with the rest of the world if we expect to be respected by it.
I have learned two lessons in my life: first, there are no sufficient literary, psychological or historical answers to human tragedy, only moral ones. Second, just as despair can come to one another only from human beings, hope, too, can be given to one only by other human beings.

Elie Wiesel

I’ve entered the stage of what’s been called ‘Post-Paganism’, a moment of awareness that Paganism as it is practiced no longer satisfies or means anything much. Apart from Samhain, I haven’t ritually marked any festival for myself for years though I make a mental nod to calendar dates and natural symbols – the snowdrop, the hawthorn flower – as they appear. My understanding of Deity has changed too, but the genesis and the final cause of my stepping out from Pagan practice is the way that too many Pagans behave.

It doesn’t matter what sacred books we do or don’t refer to, somehow we manage to interpret life to miraculously concur with our personal worldview. So it is that Christians, Muslims, Jews, Pagans, Hindus and everyone else generally conforms to their country’s legislation and social mores. Pagans may ask for time off for religious holidays but this is more a stamp of individuality than a heartfelt yearning for religious obligation, or a passion to be with the Land at a particular point in our joint journey around the sun.

If one of our strengths is our lack of a holy book then a corresponding weakness is that we have no idea what it is that we should be doing or not doing, or why, other than feeling good about ourselves. What began with the weighty “Know Thyself” passing through “ . . . if that which thou seekest thou findest not within thee, then thou wilt never find it without thee” has become pure solipsism. People outside of ourselves exist only as extras in the great, consuming drama of our life. We don’t actually want community at all, other than as some kind of heightened social life.

Protestations of openness, love and honouring as you walk away from a partner into the arms of his friend don’t mean much, neither do Twitters about how strong and beautiful and loved you are as your family flails about in agony. We’ve exchanged Bitchcraft (though this maintains a strong presence) for ethereal non-committal. This isn’t based in a concept of respect for personal choice and trust that we will make good decisions if we are cherished: it seems to me to be fundamental laziness. I’ll light a candle for you as you struggle with your child’s decent into drug addiction but don’t expect much more from me other than affirmation via Facebook. There is no action or event that requires meaningful group introspection or discussion.

I’ve just begun an MA in Philosophy of Religion and whilst I’m amazed at the contortions that scholars have put themselves through over the centuries to anthropomorphise Deity they also have basis' from which to make decisions. This is why Jews and Christians beleive and live as they do, because they have particular understandings of their religions. What might a Pagan theology around voluntary euthanasia be, and why? Non-Pagans might also say ‘Because I wouldn’t allow my dog to suffer like that” but is there a particularly Pagan response? Are we simply romantic, ritualised atheists? Paganism has no morality in the widest sense of the word, our ethics come down to plant trees and save the world by meditating and not watching TV. We would never dream of discussing how many children a Pagan might consider having, even though human population is the single most urgent issue facing the planet, way beyond carbon footprints and coal burning power stations. We have no answers or even suggestions on how to approach the most important issues in human life because it might impinge on someone’s personal choice.

My relationship with Deity, mainly in the form of the Goddess, continues, it’s not that I’ve given up believing that seasons change or that the Ancestors exist; rather, I’ve lost respect for the triviality that masquerades as Paganism and don’t want to associate with it. Like many Pagans, Jews, Muslims and people from other religions, I’m content to simply be in the presence of Mystery rather than wrangle over whether He/She/It is wholly simple or everlasting. But for me, the everyday application of a religious belief has to be greater than doing exactly as you like and justifying it by wearing a cloak.

Thursday, 8 October 2009

Planning Ahead for a Samhain Project

We never get round to it because we’re too young to die, we’ve got nothing to give away, and the kids will be looked after.

I remember reading the horrific story of a mother who’d appointed the bank to be her executor. The children’s social worker had to physically intervene between the banks representatives and a fire to rescue a photo album from the conflagration of the children’s lives. Since the bank was only interested in what was saleable everything else could go to hell.

Despite what some websites will tell you, writing a Will is a complex matter, not something you can – or should – do on a form from a stationer. Samhain seems the very best time a Pagan can consider our own deaths, who we trust (and why we trust them) to see that our Wills are properly executed, and make sure our loved ones don’t have to struggle more than they must.

Will Aid have been going for years and make giving money to a lawyer far more agreeable, since the money you donate goes to charities. Will Aid comes but once a year, sometimes not even that often, so please make use of this great scheme.

Tuesday, 6 October 2009

Towards An Animistic View Of Mental Illness

Please visit this site:

As an animist, my relationship with my spirituality has frequently been positively provoked in discussions with people who function much of the time from within altered (as in altered from the norm) states of consciousness. For example, I spent an amazing night shift packing plastic bottles in a factory (before my nursing days) with a gentle young man, discussing the story of Lot in Genesis (Chapter 19) in which Lot is visited by angels (unknown to him) and insists on offering them hospitality. To this young man, these angels were messengers from God and in his realisation messengers from God came in many different forms, from the casual crossing of paths with a total stranger to the fall of a leaf as you passed a tree. And to him, all experiences were to be welcomed as being potentially such a messenger. In some respects, he was one of mine and I remember that one night, 25 years on,with much fondness. I didn’t see him again, but I did hear three months later that he had been forcibly detained for treatment in the local psychiatric ward.

Tuesday, 15 September 2009

Bread, Salt, Mead and Honey

I’ve just returned from the funeral of Jane, who lived and died in poverty. No one in her circle of friends has any money to spare either and so a local authority funeral was arranged.

Because Jane lived and died in poverty her body spent a month in a hospital morgue while one of the richest countries in the world scrabbled around to find the £753 that it costs to dispose of a human body with studied bareness. Jane was blessed to live in the Royal Borough of Kensington and Chelsea which provided a hearse and dignified undertakers. Had she not lived here, her coffin would have been deposited at the crematorium by van.

The priest allotted for pauper’s funerals could barely speak English and couldn’t find his way – and thus couldn’t lead us - around the funeral service. What he could do, however, was take the opportunity to proselytize and tell us that we would end up in paradise only if we would come unto Jesus. He wasn’t intentionally wicked, just hopeless and the kindest thought I can muster for him is that he will lie in bed tonight and wail with humiliation. He would not be chosen to run an affluent parish but he is good enough, apparently, for the very poor.

I was shocked afterwards to discover that a funeral funded by the State demands a Church of England service, but can see the good intent behind this imposition. A publicly funded funeral is the absolute last resort for people who die alone and without friends or for those of us who have absolutely no income or savings to fall back on: the dignity and solemnity due to royal dead is also afforded to people at the other end of the social scale.

The service can be very beautiful.

Personally I wouldn’t be restless in my grave if it was said over my body, but that’s because I’ve spent a great deal of time thinking about and dealing with death and have my own philosophy on the matter. But it wouldn’t suit my family and friends to sit and listen to Christian liturgy with my very Pagan body on the catafalque, and since I know no one with £1,000+ to spare and haven’t got £1,000 lying about it’s likely that I too will have a state funded funeral. If, as most non-monotheists believe, funerals are for the living rather than the dead then having something that satisfies the bereaved rather than a Church they had nothing much to do with, seems important. Can this be achieved by having a friend read something less formal at some point? It feels token, a deviation allowed by a benevolent dictator.

I could take out a funeral plan and very good many of them are too. Bodies cost money to dispose of and the more we want someone else to do for us, the more we have to pay. The Natural Death Center is absolutely brilliant at helping to empower people who want to do as much as possible for their dead and a DIY funeral is guaranteed to be as meaningful as you like. But you have to plan, and plan now, because bereavement renders you pretty helpless and convention takes over.

What this has brought home to me is that income determines the religious form of a funeral. Whether or not this was the intent of the Church of England, in a multi-cultural society it’s no longer appropriate. So I can take up arms against a sea of Church and State bureaucracy, and by opposing it, go bonkers. More usefully, I can put some serious thought to how my funeral will be funded – with Samhain approaching this seems appropriate. I can beg you to think about, discuss and compose your own funeral as a Samhain project, and thus remove a great deal of weight from the people you love.

And tomorrow, Pete and I will carefully take the hair from Jane’s hair brush that, curiously, she specifically left us for some reason, and burn it with incense, rose petals, honey, salt, mead and bread, to mark her life and death in our own way with our own words.

Thursday, 27 August 2009


Every job these days now seems to require some kind of qualificational (is that a word? It is now!) route into and through it, and the more organized these groups get the more some individuals will want to be recognized as ‘professional’. The professional counseling and psychotherapy association I belong to, the BACP, was created when individual counselors and psychotherapists decided that the public was suffering because counselors and psychotherapists had no accrediting body. They set up the BACP and approached the government to demand that only qualified counselors and psychotherapists be recognized as such. Today, people who are not qualified as anything can still offer their services as counselors. The government, who once took no notice of us, have now decided that they will only recognize psychotherapists and not counselors, which leaves a great many highly qualified counselors potentially out in the cold, and the BACP running about trying to catch up.

At the same time, the BACP created an accrediting scheme that can only be a box ticking exercise since it’s unworkable to have someone present during actual sessions to observe and assess. The BACP’s own research discovered that the greatest number of complaints are made against accredited practitioners.

(please cut and paste, my keyboard has no wriggly line!)

Nevertheless, the larger, more prestigious and higher paying employers of counselors and psychotherapists demand that we be BACP Accredited, not because they understand counseling and psychotherapy or because they want the best people for the job but because they believe that qualifications mean they will be getting a better practitioner and because they want people who are content with jumping through hoops in preference to thinking for themselves.

It’s no bad thing to know that a person has completed and qualified from a particular line of study. Pagans want this too, we don’t want someone calling herself Lady BlueBottle, Hereditary Witch Queen of Atlantis to be involved with, well anything really, but particularly not vulnerable people or representing Paganism. We’re all tired of the fantasy-driven pronouncements of too many Pagans and their incredible claims, and we know that this behaviour is not limited to teenagers. In the non-Pagan world we also know highly qualified and experienced professional people who are untrustworthy. Indeed, the more prestigious their status them easier it is for them to be untrustworthy.

What links these things together, from a growing number of US chaplains demanding access to patient notes and counselors and psychotherapists becoming mesmerized and deskilled by professionalism, to the growing number of very honourable and simple jobs becoming dependent on qualifications is status. Pagans are still struggling to have our status as a bona fide religion recognized, and the starting point for many individual Pagan chaplains in hospitals and prisons was the demand that this corporate status was acknowledged. Those Chaplains who overstep meaningful boundaries by demanding access to patients who haven’t requested it and patient notes, are motivated by the desire to have their personal status recognized.

All of which has nothing to do with accountability. We know that human nature is likely to try and get away with what it can, there’s little can be done about that other than the blunt instrument of punishment, and rather than waiting for behaviour to become criminal it’s probably wise to have an agreed standard of behaviour for different professions. Standardised teaching can achieve something like that and yet . . . when teaching establishments have to fulfill quotas in recruitment and pass rates, which all come down to keeping the institution financially above water it all becomes a bit meaningless. But it does keep the money rolling in.

In the US the Association for Clinical Pastoral Education Inc seems to be the largest representative body for hospital chaplains. They talk about people as ‘Living Human Documents’ and have detailed manuals and standards and an accreditation process and bylaws . . . all the stuff that makes an organization look very proper, professional and acceptable – and gives the organization and its officers high status. This is the group that has encouraged chaplains to demand access to patient notes believing chaplains to have the same status as medical professionals. Presumably, therefore, they believe that doctors have the same status as chaplains.

I’d like chaplains to be accountable to their patients and themselves primarily, then the hospital they work in, then their own Pagan community and then the wider world. But I don’t have a Pagan community, I work entirely on my own and so I’m only officially accountable to the chaplaincy office and the hospital which is perhaps good enough. I would really like a chaplaincy supervision group, Pagan or otherwise - almost entirely the same as my psychotherapy supervision group where I could discus in confidence how things are going. But there isn’t one, there aren’t enough Pagan hospital chaplains to create one and UK chaplaincy groups aren’t organized in this manner.

Long manuals and documents and acronyms do little to protect anyone. Libraries filled with complex and weighty tomes of case law and precedent don’t stop people from breaking the law. What does go some way towards curbing the desire to abuse power is mutual respect and support, keeping organizations small and intimate without becoming incestuous. It can be done. And it’s inevitable that such groups will have lower status and less income.

It’s important to know what the law of the land is and what hospital policy is but this doesn’t stop individuals from working – entirely within the letter of their professional standards – in a callous and burned out manner. (Thank you, Mogg) It is infinitely harder to create, maintain and belong to a small group that actually sees you and hears you, is responsible for and to you than it is to hand over your cash to an organization and perform the tricks they require for advancement which gives you a passport to prestige and greater income.

And of course doing things the hard way requires the patience to explain to the people in suits and the people who have been conditioned to trust anyone with a string of letters after their name, that membership of a professional body is no guarantee of a better service.

Wednesday, 26 August 2009

Status and limitations

Have a look at this article by two medical ethicists clearly declaring that hospital chaplains should not have automatic access to every patient or ever to patient notes. I acknowledged the part of my psyche that objected: “Bah! This is just another way of keeping religion in its lowly place.” But it isn’t. We know that there are individual chaplains who feel the need to impose their religion – they’re likely to perceive it as offering a very important service to vulnerable people. Indeed, we probably know of Pagan friends who found a Christian chaplain at the end of their bed offering their services, and how inappropriate that was. That’s an abuse of power.

I remember being fairly pushy myself when it came to having Paganism recognized in hospitals and I’m grateful for the other Pagan individuals and groups who’ve also made it their responsibility. Wherever there are institutions who have a chaplaincy service and who’re likely to have Pagans amongst them then Paganism should be officially represented on the chaplaincy panel, that’s pretty straightforward. That whole debate is about status, primarily the status of Paganism, but also about the status of chaplaincy.

If this is the case then we need to think hard about what chaplaincy is about and what our role is. Chaplaincy seems to me to be about perceiving a person as unique and as part of their own ‘ecosystem’ – relationships, history, hopes and dreams, fears, desires, abilities, the whole kit and caboodle - rather than simply as their diagnosis, and serving individuals and groups so that they can find meaning and purpose for themselves. I really like this quote

Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping may be the work of the ego, and service the work of the soul.

Chaplains are not part of the medical team. Although spirituality has a role in wellbeing and health this doesn’t mean that chaplains have the same role as doctors, nurses and radiotherapists. This is no threat to our status: we wouldn’t expect doctors, nurses and radiotherapists to be experts in spiritual care. I know that if I read a patients notes I will form a certain set of beliefs and expectations around those written words, it’s why notes are so confidential and the writing of them always under review. ‘Witty’ shorthand such as ‘FLK’ (Funny Looking Kid) is now recognized as reducing the humanity of the individual and being unethical and unacceptable. So it is that the chaplain – and every other person who isn’t directly concerned with the symptoms and cure of the patient – has no need to know anything about them other than what they see in front of them.

I’d say that the strict adherence to limiting who has access to patient notes is a measure of the quality of care patients receive. I know a very ethical, professional complimentary therapist working in a local mental health hospital who is given access to patient notes. She doesn’t take it but it’s not too surprising that the hospital is well known for the number of patients who abscond.

Certainly, doctors have a godlike status. Nurses are, of course, angels. I’m not sure where in the heavenly hierarchy radiographers might fall but as far as pay and conditions are concerned it’s somewhere above ward cleaners and canteen workers. That’s just the way it is, that’s a matter of society deciding that junior doctors and professional football players should be paid more than experienced nurses and firefighters. Chaplains, well we’re strange altogether, with Deity as our employer and the general public feeling both that they respect us and feel weird around us. For me, that’s just a symptom of our liminality and whilst that’s not always the most comfortable place to be it’s also entirely appropriate. This is not to say that chaplains should be content to creep around being thankful to be allowed into a hospital: that’s to get status and role confused.

Paganism should be given the same status as any other religion. Pagan chaplains should be treated with the same respect that other chaplains are offered, and all chaplains should be treated with the same respect as any other member of the healthcare team. But our role is not to tell people what’s best for them. Neither is it to do things at or to a patient. Although chaplains of all faiths have a responsibility to our gods and the culture of our religions we have a greater responsibility to offer something that other people who work in healthcare cannot: we offer love. We are with patients in a unique manner; we bring the empathy of the professional psychotherapist, the communication skills of mediators, and leadership functions of senior staff. We add a thorough, boundaried and flexible knowledge and understanding of our religion and, on top of it all, the wisdom that whatever a persons religion, spirituality or atheism they are equally worthy of our attention.

High status is lovely but the role of the chaplain is not to compete, it is to Be With people who have requested spiritual input. As long as that is facilitated in a quality manner and chaplains of all faiths are treated respectfully what more do we need, and why?

Monday, 24 August 2009

Note Keeping

Because of audits and keeping track of who is where with whom chaplains have to keep some notes. It’s worth remembering the intent of these notes, what they’re not intended for and how they may be used.

The written word has such enormous authority and at the same time can be so ambiguous as to be used and misused by people with very varying purposes.
There’s an art to note keeping, you need to record the fact that you and a particular patient met at a certain date and time and that’s it. There’s a temptation to go into detail and things can begin to unravel quickly, sometimes years after the event.

“X seemed excited today” can be read as “X was sexually aroused.” “X was agitated:” was that generally or specifically around you? Did that agitation have any connection to his behaviour later in the evening, and who did you inform about his agitation? If X goes on to offend or if a clinician or a barrister wants to make a point about X or about your relationship with X or with your way of practicing you can see how your own words can be used to prove something that you did not intend. If we use words that we don’t really know the full meaning of – like ‘manic’ or ‘depressed’ or ‘labile’ – then those words can come back to bite us, used both to prove something about a patient or to demonstrate our own lack of knowledge. You can imagine in a court being asked: “Can you describe what you understand the meaning of ‘manic’ to be? And can you tell the court what your professional qualifications are?”

I get a bit weary when overly anxious people start making noises about the desperate threat of litigation and how we must protect ourselves by messing everyone else about. Personally, as long as the patient, the ward staff and I are happy for something to happen, like taking a patient off the ward, then off we go. It would be so much more safe if we remained in a glass box with audio and videotaping but there are implications for the quality of our relationship. But. The written word supersedes memory in importance. Notes are, not unreasonably, assumed to be an accurate, contemporaneous record of events.

I write notes as if the patient is going to read them which helps me stay focused on what I’m communicating and how it may be read. It’s easy to forget that whilst we are afforded the same respect as other professionals in a clinical setting we are not serving the hospital but the patient. It’s tempting to try and match specialist language or to demonstrate to a putative professional reader that we function at the same level as they do; a paradoxical temptation since the less confident and settled we feel in the role of chaplain the more likely we may be to fall into this style of writing. In the very unlikely event that you’re asked to write anything more than the fact you met then you really should ask for written guidelines about how to write notes for that hospital, then discuss them in depth with the lead chaplain and write those notes under their guidance at the same time as keeping your highest ideal very clear in your own mind.

Perhaps the most fragile and important aspect of the relationship between chaplain and patient is trust and every attempt must be made not to break it. Patient confidentiality should be the basis from which anything is written. If you have a doubt about their safety or the safety of people around them, your notes are not the place to record this in the first instance, you should seek immediate and appropriate support, almost certainly from the lead chaplain. Before you discuss a patient with anyone else it’s an article of faith that you discuss it first with the patient themselves. Saying “I’d like to talk to my boss about this,” creates a space for meaningful communication, you’re demonstrating that you know your limitations, that you’re confident in discussing your limitations with the patient – because it’s not a matter of weakness to know when things are going beyond your remit, quite the opposite. And it models the normality and safety of knowing that we can’t deal with everything on our own, that discussing a difficult matter with someone trustworthy is worthwhile.

When you’ve talked with the lead chaplain and come to a decision, put that in the notes. A patient told me he was going to try to abscond. We talked about why and what this might achieve and so on and still, he declared he was going to try to escape. I didn’t actually believe that this was the case at all, but an expression of despair, a desire for boundaries and attention which would be achieved when I told the staff, which I was obliged to do. But first I told the patient that this was the case (as he knew it was) and that I would have to talk to my boss. I made a verbal contract with the patient that they would not abscond and not make a final decision about absconding until I’d spoken with my boss. Then I asked for an urgent meeting with my boss which primarily served to help me feel better about talking to the ward staff, 15 minutes later. My notes remained very short, about 2 sentences more than normal and limited to absolute fact. Life in hospitals is dramatic and gossipy enough: there’s no need to add to it or get caught up in it.

Confidentiality is entirely breached if you are summonsed by a court, which may happen if your patient does something unlawful or accuses the hospital of something unlawful. In my private psychotherapy practice I simply don’t keep client notes any more which simplifies matters no end and I shred my personal reflections, which are about me rather than clients, around a year after we finish meeting. But hospitals keep notes for a minimum of 5 years and particularly in psychiatric care they can be kept a lot longer and have the potential to be incendiary.

Some of the patients I see are likely to reoffend when they leave hospital and it’s possible that some years into the future I may be asked to give evidence in court. What are my responsibilities? Who am I serving? My answer is that I am serving the cause of truth, that I am not a judge or a jury and that justice will be served by them, not me. The relationships that are co-created with the people I see are delicate, part of the healing process is served by offering and being able to sustain deep trust. If they are then accused of something grave I have to just answer questions as faithfully as I can and put a great deal of trust in the Goddess. I fervently hope it never happens.

Note keeping is a vague subject at the best of times and there are differences between US and UK practice. In the US the Health Insurance and Portability Act appears to cover this minefield. (In an avalanche of impenitrable information, Wikipedia seems to have the best coverage. But my keyboard doesn't have a hash key and the link requires it.)

Here is something less fuzzy for US chaplains that is also of interest to UK chaplains.

Frankly, I have little idea what the Data Protection Act has to say on the matter but believe in keeping it really simple: I keep no chaplaincy notes on my own computer. I used to send my notes by email, but now write them at home, print them out, hand them over to the Chaplaincy Office at my next visit, and keep one copy in a file in a locked filing cabinet. If I know my next visit is going to be longer than a week I’ll write the notes at the end of the day in the hospital itself and take them to the office.

Wherever you practice your chaplaincy notes should be kept separate from the clinical notes. Although spirituality has a proven positive contribution to wellbeing and health, chaplains are not part of the clinical team for excellent reasons. We are not primarily concerned about cure or illness or insurance, it’s not our role to be involved in diagnosis or medication or anything other than the wellbeing of that persons essential being that exists beyond their body or their mind. It’s impossible to capture that relationship on paper and so lets not attempt to. Keep it simple: 'Met with X. Spirituality discussed'

Thursday, 6 August 2009

Missed Sessions

From time to time patients don’t want to come to sessions. At first I used to worry about this and tended to take it personally – what had I done to cause someone not to want to see me? This question remains part of my reflection on missed sessions but I’ve learned that frankly, it’s not all about me!

I don’t subscribe to the theory that there is no such thing as a meaningless occurrence: sometimes a missed meeting is just a missed meeting. And sometimes there is a greater pattern to events. It can be a test, to see if the discussion of returning as much personal authority to a patient as possible has any real meaning; to test that boundary and the boundary of continued relationship. If I am rejected, how will I respond? This has implications too for modelling how rejection might be managed in other relationships.

The therapeutic literature offers different understandings of missed sessions. My own experience suggests that if a client is serious about addressing their distress they will make the effort not to miss sessions. For some clients, therapy is the equivalent for them of buying a new handbag or doing yoga, it’s primarily a statement about who they believe themselves to be and how they want to portray themselves, and when something more interesting than therapy turns up they’ll give up therapy. Some clients are told to go to therapy, very often to gain access to their children or to mime their desire to change, and these clients too are very unlikely to really engage in the relationship. Why should they? They haven’t chosen to, they’ve been ordered to.

When a person finds themselves in an institution where conformity is given high value and behavioural modalities are to the fore they - we, you, I - will seek ways of not conforming at the same time as not being punished for non-conformity. Many of the people I see do this by saying they’re Pagan, which is also a way of demonstrating that the institution cannot fulfil their individual rights. Instead, they manifest me. I’m not part of the medical team and I’m not a mainstream representative. I’m not an employee of the hospital and I don’t have any institutional power. The first question they ask me is if I will do a spell to change their situation. Who can blame them for wanting to know where my boundaries are? I make contractual safety boundaries clear from the beginning “I don’t hurt you, you don’t hurt me,” and very early on in our meetings we talk about the importance of relationship and the uses and abuses of power.

For me, missed sessions can be part of that discourse. One or two missed sessions now and again, well, that’s life. Any apparent pattern can be interesting. A missed session with no reason given is worth talking about, several missed sessions in a row are definitely worth talking about, particularly if this happens around the same time that a client told me something that might result in shame for them, or if they’re also pushing other people away.

Authenticity is central to being Pagan, central to being a properly functioning human being and entirely peripheral to life in an institution. Institutions demand Approved Behaviour rather than authenticity. Just the right amount of crying, but no self-pity; being positive but not manic; sufficient sorrow for past deeds, perhaps even a little panic, but don’t get stuck there. In some US institutions it’s wise to become a very practiced, repenting Christian. For people with anything like psychosis this is terrifically dangerous. Knowing that you will be rewarded if you just consistently appear one way rather than another is very unhealthy. (Which is exactly how we are all expected to behave.) For people who then become dangerous to the people they’ve charmed, this has implications. As a Chaplain I don’t get told and have a positive disinterest in a patients past, but I’d be foolish to ignore the implications of our setting.

There’s an institutional significance to the notion of missed sessions for Chaplains. If a patient doesn’t want to meet with a psychologist or doctor or nutritionist or any other professional it’s too bad, they have to get to the meeting or the meeting comes to them. This is reflected in their notes, a judgement about them and their behaviour is made, formally and informally. If a patient doesn’t want to see the Chaplain, he doesn’t have to, and he doesn’t have to give a reason. This offers religious freedom, protection from religious abuse and is useful in other ways too. But the difference in response between any other professional service and the Chaplaincy service reflects the importance that spirituality – all of them, not just Paganism - is afforded by institutions. That’s not the end of the world. “Professionalism” is the last refuge of many things.

The liminality around the role of chaplains and spirituality offers more space in which to practice, and that’s a double-edged sword. We have to be very clear about our boundaries and behaviours. Once more, I am thrown back on the importance of authenticity: I need to be aware of my own responses. Am I annoyed, interested, bored, upset, sad, glad to be getting off early when a patient doesn’t want to see me? What does that tell me about the relationship, about my role, about my way of being? Once I have that clear-ish, I can bring my authentic self to the relationship. What happens when I say, “I felt dismissed when you wouldn’t meet with me last week. And I still care for you”? Possibilities, sometimes in the form of terrifying chasms, can open up.

Chaplains can offer a model of relationship which is caring, boundaried, deals with power with a clarity and complexity that may never have been encountered before. That’s a heady responsibility and a wonderful opportunity.

pic by Terry Border "Bent Objects"

Thursday, 30 July 2009

Is there a Pagan thealogy of assisted suicide?

All 5 Law Lords agreed that a clarification of the law on assisted suicide is required following by Debbie Purdy’s successful challenge in the House of Lords today. The Director of Public Prosecutions made some very clear and very compassionate statements on the issue taking into account people who will wish to die between now and September when there will be a public consultation. It’s not a change in the law, it’s an understanding that the law is unclear and needs clarity.

Off on a slight tangent my friend Jane in intensive care is in a pitiful state. When we last visited I had a dreadful memory of the Little Brown Dog, a mongrel in 1903 who was passed illegally from vivisector to vivisector and eventually killed, again illegally, in front of a room full of medical students. The suffragists, Louise Lind-af-Hageby, and Leisa K. Schartau, were there too, the only women allowed into the vivisection lab and the only people who objected. Riots occured, statues were erected.

We were with Jane less than 5 minutes when a team of people in scrubs arrived and ‘asked’ us to leave. 4 of those people, all women, none of whom had any ID or name badge, didn’t meet our eyes and seemed entirely disinterested in our existence. The one that spoke to us smiled, but her smile didn’t reach her eyes. Jane, meanwhile . . . well who knows, she can’t speak or move anything apart from her head, and she’s under light sedation so that she doesn’t remove all the lines and tubes. What I felt from her was profound disgust and sorrow. They may be my feelings. Knowing that Jane has consistently discharged herself from hospital whenever she’s been able it’s very hard for both of us to observe the activity of whomever the scrub-clad people might be, and increasingly maddening to watch her other visitors maniacally bounce around talking about getting better and coming home and going on holiday and all the other fantasy.

I know they’re fearful and I’m losing respect for their feelings. Their feelings have always taken precedence over what Jane might want. I don’t know what Jane wants and no one seems very interested in finding out. 7 years ago Jane was given months to live, the will to live through a shocking childhood now seemed to preserve her and I’m sure the medics find her very interesting and a fascinating challenge. I asked what their plan for her might be: “When she comes off the ventilator she’ll be moved to a medical ward.”

No one can see into the future but I think there’s a fairly good chance that Jane will not leave that medical ward and I don’t see what’s been achieved other than the absence of death which will reassert itself in short while, perhaps as soon as Jane becomes able to take some kind of control over the matter herself. She won’t be able to discharge herself now; she’ll not walk again. Is the absence of death a satisfactory result?

I’ve spent some time thinking hard about a theology of a Pagan response to assisted suicide and it seems to me that at the heart of the matter is the use and abuse of power. Jane-the-person disappeared as soon as she was made mute, all of us are projecting our interests on to her. I fear my own loss of power over my own life and death, I fear the clinical interest and the personal disinterest that I saw in the blue-clad ones. I fear that the people I love will not do what I want them to do when I begin to die but will treat the event with terror and denial and in doing so, abuse me.

So I have to relinquish all desire when I visit Jane and visiting has become very difficult. Perhaps the theory is that I will pass through some kind of trial and find resolution after which I will feel relaxed and enlightened. I’ll let you know. But right now I’m watching a woman, mute and paralysed, in a state of terrible physical and emotional distress, and there seems less interest in her as a person than there was in the little brown dog.

Saturday, 25 July 2009

Love without need

I visited intensive care today to see a woman who I’ll call Jane. Jane’s life has been a tragedy from the word go. Born into very unromantic misery, brought up by uncaring people in a harsh environment, working full time aged 9. In Britain in the 20th century. Seeing this person in the street – prison and facial tattoos, staggering about and often incomprehensible – you might cross the road, but like many roaring, frightening people she’s very sensitive and exposed and I feel tearful when I think of the life that was wasted by the adults whose only vaguely gracious act was not to forget to feed her.

This person isn’t Pagan and I don’t visit her in a chaplaincy role, she’s part of our community, she’s appallingly ill and so we visit. I spent about 10 minutes there today and was struck by the strangeness of it all, of every individuals’ need, including my own, being focused through this reclining, semi-conscious lens of a person. The excellent, professional nurses yelled at her in that loving, patronising manner than many nurses have: “Hello darling, I’ll just aspirate your tube.” Her lover, Dan, has miraculously and instantly cleaned up his own problems while he spends as much time as he can at her side. He’s terrified of being left alone. Dan has found status and purpose since Jane has been in hospital. People who would not normally give him the time of day are now treating him kindly and with respect.

What are my reasons for visiting? They’re complex and not fully conscious and I hope that my main impulse is compassion. Jane and I are not intimate friends, there’s a limit to how much time we want to spend in each others company and we don’t have a great deal to talk about beyond having a bit of a laugh. Jane hasn’t got a religious bone in her body but my own needs incline me to offer something that isn’t fear or determinedly, superficially, upbeat. My need to make sense of this situation is as present as anyone else’s, but I hope – I really do hope – that my need is not so desperate that I impose it on Jane.

Jane is dying. She’s not physically alone and there’s a great deal of intense feeling in her room. I wonder, through my own clouded lenses of understanding, about peace. Everyone knows she is dying and no one close to her can bear it, it’s just such an unmanageable, fearful prospect for them. They’ve informed the funeral director, a wake at the pub has been arranged, but these are practical matters, the right and proper actions of responsible friends making forthright plans. There’s a mismatch between what’s being planned and what is being felt. There is no peace in the room.

I stood where Jane and I could make eye contact and spoke quietly to her, saying that she was safe, that she was loved. It’s impossible to know absolutely what is ethical or right or wrong when speaking with someone who can’t speak back, who is in extremis and I would, I believe, feel very desperate if a priest came to me as I lay dying and began imposing his view of the world on me. I know I would want quiet, centred people around me who would not want to hold me back or push me on. But I have a developed personal understanding of how I might approach my own dying and the dying of the people I love, I have a foundation for how I approach the dying of people who know what I do and who deliberately want me present. I have little idea what is right and wrong when I’m with Jane.

What I want to do is to shift the focus of practical support onto Dan, to get him some professional, hospital-based emotional sustenance so that he can begin to reduce his desperate need for Jane not to die. I want to find some impossible compromise with the miraculous, brilliant machines that do more than keep Jane alive, they’re making her body comfortable and safe. And they’re so noisy: the technical mattress and covers hiss, the ventilator whispers, alarms blare.

I want, for my own comfort, to speak to the part of Jane that is not a devastated human being, which is nevertheless intimately joined with every part of her human experience, to remind that most vital part of her that everything is as it should be, that it is safe, that there is nothing to fear. And so on. I want to make it familiar so that I no longer feel helpless.

My husband is so much better at this. He visits more than I do and Jane knows him better. He feels no need to do anything other than hold her hand for 10 minutes a day, to talk about the mundane which is precisely what Jane would wish to talk about most of the time, at the same time as bringing transcendent love with him. In the room he’s not as grounded as I am but he has much more capacity to simply bring Jane love without need. What a journey this is, what learning.

Wednesday, 15 July 2009

For pity's sake, get involved.

ast week the House of Lords rejected an attempt to relax the law on assisted suicide so that people who accompany their loved ones to the Dignitas clinic don’t have to face 14 years in prison. Britain is pretty good at fudging and it may be that this is one of those situations where fudge is uncomfortable but useful. 120 British people have gone to Dignitas so far and not one of the people who went with them has been prosecuted, there’s a tacit understanding between the police, the Crown Prosecution Service and the courts that people who go to the trouble of arranging a Dignitas ending are not likely to be murderers. Lord Faulkner who sponsored the most recent application to the Lords noted that there was a ‘legal no-mans land’ around the subject, which indeed can be dangerous. It means that the police are choosing what they will and won’t prosecute. As it is the situation is being allowed to evolve, the law following public debate rather than public debate being forced to change the law. I foresee a time in the next 5 or so years when an individual is put on trial as a way of testing public opinion. It would be a very blunt, shortsighted move to put the Downes children on trial today when public debate is raging.

A century ago, a policeman would turn up to arrest someone who had attempted suicide. Never mind the circumstances, the law was the law and a person who was actually dying from their attempt would be put in a cell and treated as a criminal. British society, which was fairly universally Christian, eventually found this intolerable and the law was changed so that the suicidal person was viewed as mad rather than bad. But still, suicide was perceived as something that must be prevented at all costs. This remains the case today. I remember babysitting a depressed elderly man who had cut his own throat so extensively that he severed his trachea. He was caught, pounced on, dragged to surgery and spent the rest of his time folded up in a chair. Nurses weren’t there to care for him, we were there to make sure he didn’t attempt to kill himself again.

Chaplains and counselors are very mindful of a clients right to confidentiality, but should the professional believe the client to be at serious risk of suicide we are bound to break that confidentiality. Other times when confidentiality must be broken are when a child is at risk and when a client is planning or admits to terrorism.

I find it absolutely extraordinary that finding ones own life intolerable is judged to be the same as raping a child or blowing up a train full of people. This is solely a religious hangover and it’s worth noting that the 3 most powerful religious leaders led the Lords rejection to a change in the law. Individual religious people may feel that their suffering demonstrates trust in their god but there’s a dangerous madness in the monotheist approach to end of life suffering. Modern hospices were set up by religious people who recognised that palliative care was not, is not, good enough; sadly, religious people don’t contribute anywhere near the sums required to maintain existing hospices, let alone building enough for everyone. When they do, I’ll be more inclined to take their anti-suicide debate seriously.

So the situation we’re left with is delicate. I heard a man tell the story of his dying mother today, in hospital, suffering, exhausted. Her family asked for a meeting with the doctor who said that surgery would extend their mothers life by two weeks. The family said they didn’t want their mother to suffer any more. “You know what you’re saying?” said the doctor, the family nodded and a morphine drip was set up to run rather more quickly than it should have done. Everyone’s heard a similar story. Nothing is said, everyone knows. It seems to me that this is no bad thing when it comes to illegally killing a person in unalterable extremis.

Doctors and nurses hold enormous power over the lives, deaths and suffering of the people in their care and the anti-assisted suicide theory is that they are there to save lives rather than kill people. But they do no harm, which is very different from not killing. It is very harmful to slice someone open or give them drugs that will kill parts of their body, and that’s what we expect surgeons and oncologists to do. When they do kill people as a criminal act they are generally caught, as Beverly Allitt and Harold Shipman were. Shipman is the only British doctor convicted of murdering patients and 23 nurses worldwide have been convicted, so it’s not something that health professionals tend to get up to. Anti-voluntary euthanasia campaigners make a lot of noise about the likelihood of abuse should VE become law, which is a disgraceful insult to the health care professionals and the people who create the safeguards around such a procedure.

It is, of course, probable that abuses of the system will very occasionally occur. Emergency services are allowed to run red lights and exceed the speed limit and very occasionally a pedestrian is killed. Does this mean that the emergency services should wait for a red light to change and tootle along at 30mph? No system is perfect, there will always be an individual who feels above the law but, as with organ transplantation, policy safeguards and transparency will prevent the vast majority of abuse and catch it when it occurs.

Practice already embraces voluntary euthanasia and assisted suicide, precedent is being set, assisted suicide is presented to the Lords every couple of years. Those people who are firm in the knowledge that any positive change in the law will open the door to euthanasia on the grounds of economics seem blind to the fact that it already occurs in catastrophic numbers. If you’re poor you’re much more likely to die miserable, alone or in a crap human storage facility. Private elder and disabled care is already a goldmine and abuse is commonplace.

I haven’t spoken with one Pagan who has a theology around keeping themselves or their loved ones alive in pain. But we haven’t begun to realistically discuss the alternatives. Some of us know about advance directives and that’s about as far as we go. A small number of us will have an idea about hoarding up a store of drugs or leaping from Beachy Head, but these thoughts are hesitant, fearful or more bravura than realistic. We really do need an open debate about the Pagan approach to what will certainly become law within the next 20 years. Judy Harrow began the debate in 1997 ‘Coup de Grace: Neo-Pagan Ethics and Assisted Suicide’ an extended version of which can be found in the Pagan Book of Living and Dying

Take a look here for some different views and opinions.

What is the British Pagan approach to suicide, voluntary euthanasia and assisted suicide? If Boudicca killed herself to avoid dishonour, is suicide OK? In which case, is butchering children and destroying Colchester OK? We need a coherent, intelligent debate based on 2 things: our theology, and what we as individuals are prepared to live with in order to balance our lives as Pagans living in a non-Pagan world. The vast majority of us are recreational Pagans, we take up the cosmetic bits of it and use it when we want some recognition but really we’re like the rest of the country in which we live: culturally Christian and just trying to get on. There’s nothing wrong with that, but it’s not a conscious decision, it’s a default position. That’s just about OK if it helps us make choices about whether to eat meat or not and nowhere near good enough when we know people who are in psychological or physical agony and we have no tools to help; not safe when practice is moving, along with the law, towards voluntary euthanasia and we find ourselves just mooching along with it.


Tuesday, 14 July 2009

Taking ownership of our last great adventure.

Lady Joan Downes and her husband Sir Edward Downes are in the news today for their joint assisted suicide at Dignitas. He was 85, going deaf and blind and she, at 74, had cancer. They’d been married for 54 years. The clerics are rolling out their doleful moaning about how very, very sad and sinister it all is

(please cut and paste this addy, I don't have a hash key!)

I know nothing at all about the Downes’ but my fantasy is that they took their time getting their affairs in order and being with their families, then got on a plane for their next-to-last great adventure. I hope they were with people they loved before going to Dignitas to peacefully, quickly and painlessly die together.

Also today Labour are announcing a vauge ideaish kind of thing about care for the elderly. They’re calling the present system of care ‘a cruel lottery’ which it most certainly is. Unless you are a unspeakably rich with a devotedly loving family you’re very likely to end up sitting in a circle of high backed chairs lining the walls of a room where the telly is permanently on, having been forced to sell your home for the privilege. Which is perhaps better than being maintained, alone in your own home by people who have so little time that they will feed you while you’re on the toilet.

Suicide rates are high in the elderly population. Although people older than 65 years comprise only 13% of the US population in 2000 18% of all suicides are in this age group . . . The elderly generally have a stronger intent to die, plan their suicide more carefully and are more likely to use lethal means of killing themselves than are younger persons.

Many apparently very sophisticated philosophical and clinical treaties have been written about the terrible isolation and psychological pain that leads many people to kill themselves. It is always considered irrational, an aberration of mind, a madness that one can take some kind of pill or psychological treatment for. This is because they are all written by Christians or people acculturated to a Christian society. Most Pagans perceive suicide through a Christian lens too.

But life will end. Usually, the weeks, months or years leading up to death will be filled with misery and pain. Most of us don’t know that because our infirm disappear. It’s all very well for domineering Christians and people who are culturally Christian to insist that voluntary euthanasia can be avoided if only we put more money into palliative and elder care, but beyond wishful thinking is the fact that the very best palliative care often cannot deal with terminal pain; that palliative cocktails are often little more than heavy sedatives, so we can’t tell anyone we’re in pain. Ultimately, it’s the economy, stupid. There are too many elderly people and not enough money to even warehouse them let alone care for them. We voters have no social will to change this state of affairs and it is going to get worse.

Suicide can be an honourable act, as sepuku is, as it was for some periods of Classical Greece and Rome and as it was for the Jews trapped at Masada. It can be a perfectly accepted cultural practice, such as when an elderly person acknowledges that they can’t manage the usual winter river crossing and so stops on the bank, watching their tribe cross to the winter grounds, waiting to die of hypothermia. This has been called quasi-voluntary suicide, the implication being that the youngsters no longer want to care for their elders and so the elder has no choice. I wonder how those tribal people would view our more civilized stockroom approach.

Is there a Pagan theology of suicide? What we have so far seems to’ve come about as a result of our own reactions rather than in considered response to any understanding of Paganism. At the heart of all Pagan practice are two concepts: an immanent Deity, and the implications of our choices.

Deity is part of us rather than some external judge and that immanent part of our Selves cannot be harmed if our corporeal form drops away. If we have a theory of reincarnation – and many of us do not – then how does this affect a proposed journey of the soul? Too many Pagans just echo their dominant culture, somehow suggesting that suicide will mean that the person will just have to go back to the beginning like a naughty child or a sinful follower of a vengeful (but curiously undefined) god. If life is a process of gathering experience then the experience of taking ones own life is simply that.

Ending ones own life certainly can have a devastating impact on those who’re left behind but how much of this is to do with our cultures’ attitude to suicide in the first place? Shock rises from the secrecy and shame surrounding the act, secrecy and shame grows from its illegality. People who kill themselves often leave angry people behind, usually because there are so many pieces left to pick up, and that’s because most suicidal people who start putting their affairs in order are prevented from killing themselves. There’s also a lot of self-righteous gossiping, often in the guise of deep concern, which fuels the anger. A parent who adores their children can find the weight of sorrow greater than their love. They may indeed be psychiatrically ill, and for many depressed people psychiatric services do not help them, it just preserves them in pain. More often, they are alone in their suffering. Life is not perfect.

Many of the people I see in a chaplaincy role are in mental states so enduring and so dreadful that they will never be allowed out of an institution. They will have 50 years or more of living with other enduringly unhappy people, no control over what they eat, when they go to bed, when they wake. Most of them function in barely controlled panic and I’ve been asked a number of times to do a spell that will put them into another world or a picture in a book or back in time so that they can avoid certain behaviours that got them institutionalised. They’re diagnosed as having diminished responsibility – they’re not necessarily bad in the sense that an ordinary criminal is – and they have a life sentence in the absolute meaning of the term. They are in as much pain as the person enduring physical anguish.

Imagine a world where people who were in a permanent state of torment were treated with a compassion that suited them rather than those who have control over them. Imagine if they were given the option – by intelligent people without a budget in mind – to forgo the performance of being a good patient. This alone, paradoxically, might give them the freedom to live as a fully integrated human being for a period of time, something they will never experience on a locked ward, in a locked-down life or a locked-up body.

How much more wonderful would Joan and Edwards final days been if they could have their loved ones around them in their own home and garden, holding hands as they took the drugs that would peacefully and swiftly take away their age, infirmities, fears and pains. What an honour, what a privilege to be with these people in a moment of what could be ecstasy, peace and satisfied completion.

Saturday, 6 June 2009

International Pagan Values Blogging Month!

Over at Crysalis Pax put out the following challenge:

Let us write of the virtues and ethics and morals and values we have found in our Pagan paths, let us share how we carry these precious things forward in our own lives and out into the world.

Join me, in the month of June 2009 in writing about Pagan values.

Go over there to see how it's getting on.

More On Boundaries

The subject of boundaries between divination and chaplaincy is complex and so I sought the opinions of some wise and experienced people.

Holli Emore is the Executive Director of Cherry Hill Seminary.

Isaac Bonewits is a Druid, priest, writer, teacher and the Headmaster of the Real Magic School, psychic, ne'er-do-well and trouble-maker.

Seldiy Bate is a Pagan Priestess and a dangerous old lady.

CS: Hello All, I'm writing a piece about the boundaries between psychotherapy, chaplaincy and divinatory work. Personally I avoid divination on wards like the plague, it feels as wrong as it can get. But you may feel differently. Thoughts?

IB: I don't do health readings much and probably wouldn't in a hospital setting.

I've never been asked to do a reading during a prison visit (have only done a few). It would seem somewhat pointless except for strictly spiritual questions, since the futures of people in prison are pretty frozen until they get out.

HE: I don't always see divination as telling the future or advising a decision. Most of the people I read with gain clarity on their lives, see themselves reflected in the cards, and thus receive value.

SB: I would agree with that.

When I do a "real" Tarot reading, it is exactly that. When I do a commercial Tarot reading (in which we would never discuss health issues anyway, on a regulated service), people just want to know "What's going to happen?" I try my best to explain about Free Will and that the Tarot can point out options, give guidance and show possible outcomes - and that decisions and actions people take affects A future (as opposed to THE future), but most times they will still revert to "What's going to happen?"

CS: Seldiy, you describe perfectly what I've experienced, that despite the theoretical understanding of divination a great many people expect to be told what to do. In these interactions I've found it impossible to get the subtleties of divination across.

SB: It can be a wonderful tool but I think it is best used when the person has some kind of insight themselves. The sort of punters I have on the regulated service are mostly people who don't care what tools you use as long as they can be told "What's going to happen" and because they are paying, they think they own you. They would rather ask ME what someone else feels, thinks or intends to do rather than interact with the person and find out.

But the people who come to it from a different angle - and who possibly have some understanding of divinatory systems, because it is their path, or because they are interested etc - tend to work with me. They don't want to read for themselves, quite rightly, but they need the reader as the catalyst to unlock what's already there. Then it's a good process for both people.

I disagree with Isaac about prisoners being "frozen" though (or their future being frozen). I know what you mean, but their spirit isn't frozen, nor is what they are capable of doing frozen, although of course it is very restricted. I've had a bit of experience with the Jail Guitar Doors project and if anything can bring out motivation, spirit, creativity and ambition, that can. Wow! If the brief had been to do a reading for any of those gals, it would have sparkled.

CS: Seldiy, what's a regulated service? Is this the Fraudulent Medium thing?(!!!)

SB: It's just a phone line thing. All premium rate phone lines (chat, psychic readings etc) in UK are regulated by ICSTIS (now known as PhonePayPlus) and they have a whole stack of rules as to what can or cannot be discussed, as well as regulating the financial implications of such a service. (Which is why these hoaxes about your being unknowingly connected to a twenty six million pounds a minute premium line are a load of rubbish!) All the rules are for everybody's protection and on such a line, I am not allowed to make predictions regarding health, pregnancy and of course, death.

IB: I'm reading a novel called "Houston, We Have a Problema." It's what Phae calls "chick-lit" romance, but I'm reading it because the main character has a psychic she goes to regularly. 2/3 through the story, the psychic, Madam Hortensia, explains to the protagonist that the major thing readers do is give people permission to go with their true feelings.

Naturally, it's when the protagonist stops looking for signs (and stops ignoring the ones she doesn't like) that she makes progress.

Very amusing book and perfect to read between customers. :)

So there it is, some more clarity and understanding. Thanks Holli, Isaac and Seldiy for your help and for permission to share your insights.

Wednesday, 3 June 2009


What boundaries might we draw between spirituality, counselling and chaplaincy? I ask because I’ve just come across a series of leaflets offering ‘Tarot and Counselling’ ‘Spiritual Counselling’ ‘Voicework and Counselling’ and ‘Reiki and Counselling’. I was reminded of one of my teachers on a (post grad) counselling course who was tediously all too eager to talk about out of body experiences or the colour of our auras. She used new age nonsense to make herself feel uniquely qualified in the intangible and would become insufferably smug if anyone questioned the validity of what she was talking about, as if we were all too primitive to appreciate her special knowledge. As a bona fide, old fashioned, not new age Witch I found her abuse of power repellent and wasn’t inauthentic enough to schmooze or massage her ego. Our relationship was not good.

From that experience I learned to keep disciplines separate. When I’m a psychotherapist I’m a psychotherapist and overtly Pagan thoughts don’t really come into it. When I’m doing ritual then I’m not being a psychotherapist. When I’m being a Pagan chaplain I find myself flowing between states; patients need to find their own answers and they also need guidance and debate around Pagan beliefs and behaviours. When we’re in spiritual crisis we don’t need debate we need answers but those answers need to reflect our own way of being in the world. Knowing when to be more one way or the other is a subtle art in which I am by no means expert.

People desire direction, there’s a part of us all that longs to be told what to do and this is where things like tarot come in, they can offer guidance and structure. There’s nothing wrong with doing tarot or reiki or voicework but to attempt to combine it with counselling is unethical. The only thing that goes with counselling is counselling, and the only people who are competent to call themselves counsellors are qualified counsellors. UK trained and qualified counsellors find themselves in an invidious position and it’s why I favour the term psychotherapist for my own work, to distance myself from the very many people with no qualifications or even training who are free to call themselves (and believe themselves to be) counsellors.

The mystery of spirituality confers power on those who say they understand it. Shamanism needs a bit of showmanism but we have to be very clear about why we might choose to use it in our work. It’s one thing to put on a robe for ritual work, quite another to pretend (or actually believe) that we are having a clairvoyant moment which we must share with a vulnerable person who has come to us in need. Whose needs are actually met? Who has the power? As any Pagan knows, names confer power and the names ‘counsellor’ or ‘chaplain’ or ‘clairvoyant’ have enormous power. People respond to these names with trust and a lowering of their daily defenses. When we visit chaplains, counsellors and clairvoyants we do so because we are vulnerable.

I have moments of clairaudience and it’s never been useful to pass on a message from The Beyond ™. Something similar to clairaudience or clairvoyance might be called autheticity. I would propose that being consciously authentic is more important than learning esoteric skills. We don’t have to act on our authentic feelings – it’s seldom productive to scream and run away from a gathering of inauthentic people – but we can acknowledge those feelings and learn from them. The same is true for our work with patients, we can be aware of what we’re feeling, take honest ownership of our feelings rather than attribute them to anything supernatural, and weigh up the pros and cons of sharing the feelings with the patient. If in doubt, don't. Once the relationship is strong and trusting it’s more possible to risk being openly authentic but in a short-term relationship that involves no major crisis there’s little call for it. The relationship is about the needs of the patient over anything else.

It may be tempting, not least because a patient requests it, to do some kind of divination especially when someone is in crisis. Personally, I avoid it like the plague. People can become easily and unnecessarily upset and can hear things that aren’t said. It feels wrong on every level, not least tampering with an individuals power to decide for themselves. In PR terms, in my opinion, it belittles the professional nature of the role of Chaplain, something that is very hard won for Pagans. We are the instrument through which a relationship is made; cards, crystals and pendulums get in the way and act as a distraction. We need to be able to withstand the full force of anxiety, unanswerable questions and fear without diversion.

When a patient wants to do divination for themselves, however, I feel less strongly about it. Personally, I dislike the overt use of paraphernalia, it feels inauthentic to me, but if a person can't make an important decision that must be made urgently, and if they wish to use divination, that's their choice and one that I will witness and, if necessary, help bring a positive interpretation to. We all need something like that distraction when things get intense, but we still must take personal responsibility for the actions that may result from our understanding of it. To say "The cards told me to donate/not donate a kidney," is not taking responsibility.