Wednesday, 18 February 2009

Limits to Care

I had the un-nerving experience the other day of meeting with someone who caught my attention more than usual. As you know I have a principal of not wanting to know what patients have done or have had done to them and this particular meeting demonstrated how useful that can be. We were able to meet, person to person, without too much of my anxiety getting in the way.

But the meeting has stayed with me. Where do my responsibilities to the patient begin and end as a Pagan chaplain, and why?

Christian chaplaincy offers a good starting point; they have experience that we don’t. Their theology suggests that they have a duty to visit everyone, perceiving Christ in every individual. Sacrifice is important in Christianity in a way that it isn’t in Paganism which will have an impact on the way in which Christian chaplains are with people who have lived in ways that will be difficult to come to terms with. They have a duty to serve rapists and torturers. I’m not sure that Pagans do.

If we have a concept of the Sacred Feminine beyond something other than a symbol then we have to think about what happens when that sacred feminine is purposefully defiled. If we have a thealogically-based understanding that the abuse of power is wrong then how do we respond when we meet someone who has grotesquely and perhaps over a long period of time abused their power? Do we, like the Christians, hate the sin but love the sinner? Since we don’t have a concept of heaven or hell, of salvation or damnation, but tend towards ideas of the progress of the soul, do we have a duty to ‘save’ anyone, indeed, can anyone be saved? And is there some kind of unspoken trade-off in that dynamic where the more we sacrifice ourselves to save others the more saved we ourselves become?

Paganism doesn’t have a thealogy of forgiveness. Popular writing on the subject encourages us to forgive for our own wellbeing, so that we can feel better, let go move on: forgiveness as self-healing rather than a courageous act to make the whole world a better place. The Shadows of New Age understandings of forgiveness aren’t explored. Forgiveness can certainly be used as a punishment, it raises the forgiver above the person being forgiven, a necessary and useful first movement all round, but a rather manipulative and shady way of doing things if that’s where it ends. Do we ultimately want to meet each other as equals or always remain in top- and underdog positions? Punishment has its place, atonement can be healing and if we deny people the opportunity to atone we can do as much damage as if we were to punish them inappropriately.

Paganism isn’t yet a religion that many of us are born into, it’s a positive personal choice. Whether that choice is made as a rebellion against Christianity (which is no real reason to enter into Paganism, but one that many people take) or whether it genuinely feels like a homecoming it’s not something that you casually decide to do. We research it, even if that means reading just one terrible book and almost all of those books, no matter how dreadful, will discuss personal responsibility. So Pagans know that we can’t go all post-modern about life, that although there may be good reasons for people to behave poorly the buck needs to stop somewhere.

Patients can learn from other people on the wards and the nature of institutions is that power is at the forefront of everyones behaviour. Paganism can be seen as the obvious way to get what you want which makes it an apparently simple choice for people who like to get what they want.

Anecdotal evidence suggests that some people discover they’re Pagan soon after going to prison. The need to be seen as an individual; the need to be seen at all; the need to be different; the need to exert their difference may all feed this epiphany. My own experience suggests that being seen to be Pagan can be a way of demanding special treatment. In every case I’d say that every person should be given special treatment, it’s what our institutions tell us they’ll deliver, personalised care tailored for the individual. In almost every case, the Pagan patients I’ve met know very well that this is a load of nonsense; they’re very clear-sighted about abuses of power and rebel against cant.

In the lemniscate of complexity in people’s circumstances and motivations, and in our own, where do we find guidelines for ourselves around who we will and won’t deal with, safety considerations aside?

Personally, I don’t want anything to do with child or elder abusers or rapists. We all do things in moments of madness but rape and torture doesn’t come into that category. In the unlikely event of a Pagan vivisectionist ever finding themselves in hospital I wouldn’t want anything to do with them either. Child and elder abusers, rapists and vivisectionists have purposefully and for personal gain turned off their natural ethics and I dare say they can all give excellent reasons for doing so. I don’t agree with them. Since I hold strong opinions on the matter I’m unlikely to be of any use to them.

This is where my principal of not knowing can be both a help and a hindrance. Life being what it is I’m bound to find myself face to face with a deeply distressed child abuser, someone like Mary Bell who killed her first child when she was 11 having (inevitably) experienced abuse herself and didn’t leave prison until she was an adult. What happens then?

Who knows? My answers today may not be my answers of tomorrow. Looking outward for enlightenment has limited effect, we have to look inward, to our own resources and weaknesses, goodness and evil, light and dark, complexities that can be almost impossible to manage. Because, despite what the majority of druid and witchcraft authors may tell us, we all have within us the capacity to murder, rape, abuse and torture. When we deny our own dark we become as unbalanced as those who deny their light.

So I don’t have any definite and easy wisdom to pass on, other than, perhaps, to follow the Charge myself, to constantly seek answers inside and of myself as well as seeking for useful external help to guide my knowledge.

Wednesday, 11 February 2009

Serving Two Masters

Matt 6:24 "No one can serve two masters; for a slave will either hate the one and love the other, or be devoted to the one and despise the other. You cannot serve God and wealth.

Putting to one side the business about slaves Matthew has a point. Institutions, particularly caring institutions like hospitals, are notorious for their numbing effects where everything would work very well if only the ‘service user’ would go away. There’re a myriad of issues here: why people are attracted to caring in the first place, what purposes caring institutions actually fulfil, the deep seated (even if rebelled against) needs for leadership, control, hierarchy, personal responsibility and accountability, and who we are accountable to.

The first analysis is straightforward. As a chaplain I am accountable first and foremost to the Goddess, one percentage point above the person I’m visiting, and the institution comes somewhere further down the line. In my opinion, when this is not the case this is what can happen.

Mrs Waller and her husband Richard, 35, claim they contacted the hospital on several occasion but were refused permission to bring their daughter back in and instead referred to a child psychologist who told them 'not to worry'. She became so thin she could not walk on her own and was found dead in bed on December 2, 2005 - two weeks after leaving the hospital. She weighed less than four stone.

The parents hoped that the hospital would do something and felt powerless to act. The psychologist knew best. The nurse who rang to tell the parents not to come in took no responsibility and wasn’t expected to. No one felt responsible for anything and a child needlessly died. Now an inquest has begun and various policies will be tiddled with . . . you know the story, we heard it as soon as we became aware of the media and we’ll continue to hear it for as long as we live. A terrible inversion of purpose occurs again and again, the intent of the job is actually to tick boxes, fulfil policy and protect oneself and ones employer not just from litigation but also from adverse publicity. And yet anyone who’s ever spent more than a couple of days near a hospital knows that abuses of power, unkindness and thoughtless behaviours (as well as good practice) are fairly standard. Don’t pretend it’s not so! The very basis of institutions is the wielding of power.

I used to work in a psychiatric hospital in the 1950s. After having studied philosophy, I wanted to see what madness was: I was free to move from the patients to the attendants, for I had no precise role. It was the time of the blooming of neurosurgery, the beginning of psychopharmology, the reign of the traditional institution. At first I accepted things as necessary, but then after three months (I am slow-minded!), I asked, "What is the necessity of these things?" After three years I left the job and went to Sweden in great personal discomfort and started to write a history of these practices [Madness and Civilization]. It was perceived as a psychiatricide, but it was a description from history. You know the difference between a real science and a pseudoscience? A real science recognizes and accepts its own history without feeling attacked. When you tell a psychiatrist his mental institution came from the lazar house, he becomes infuriated.
Truth, Power, Self: An Interview with Michel Foucault - October 25th, 1982.

From: Martin, L.H. et al (1988) Technologies of the Self: A Seminar with Michel Foucault. London: Tavistock. pp.9-15.

(Practices have changed in hospitals, psychiatry and even in prisons yet their basis’ remains the same, it cannot help but do so: if they were to change they couldn’t continue to exist. In turn those practices are founded on basic human impulses, including yours and mine, which also remain the same. The classic demonstration of this is the Stanford Experiment

where a group of students were randomly allocated 'prisoner' and 'guard' roles. You can guess the rest. I've often wondered how life would be if our police, prison guards and traffic wardens uniforms were a light pink and they had to wear flower wreaths rather than caps.)

So. I am personally responsible for not reporting the abuses of power I may witness, from terminally disinterested staff to 4 large adults piling on top of a frail childs body. If I was to report everything I’ve seen in the decades I’ve been involved in hospitals I’d be admitted to psychiatric care myself. I don’t report everything because weighing up the benefits and detriments of doing so I’ve concluded that more often than not it will cause more trouble than it’s actually worth. I take responsibility for that which means not only that I trust I will stand in court and admit my failure if needs be, but also try to remain alert to the likelihood that I am losing interest in giving a damn.

I have the luxury of not being a member of staff employed by an institution and so am less institutionalised. As a visiting chaplain I’m very clear that beyond answering to managers or following policies I’m ultimately answerable to the Goddess. For me, the Charge is the first written source I look to for guidance, stressing freedom, love and balance and particularly personal responsibility.

Let there be beauty and strength,
power and compassion,
honour and humility,
mirth and reverence within you.
And you who seek to know me,
know that the seeking and yearning
will avail you not,
unless you know the Mystery:
for if that which you seek,
you find not within yourself,
you will never find it without.

But it's not always easy to be certain who benefits from my seeking for balance . . . my life is easier all round if I ignore bad practice on the ground that nothing will be done in any case, or that staff will learn not to trust me and so make access to patients less straightforward, or that patients may use me to manipulate a situation. We just try to do the genuine best we can. Knowing what's genuine is harder than it seems.

Image of Hekate by Robin M. Weare, 1995.