Monday 23 March 2009

Magic on Wards

‘Will you do spells for me?” is the first question most patients ask me and the answer is always no, for two reasons.

1. Doing spells for the purpose of exerting power over someone or something else on behalf of someone who’s mentally ill has obvious ethical problems.

2. Simply satisfying the superficial desire to exert power doesn’t engage with the feelings that give rise to the desire. Exploring those feelings, though a long and perhaps difficult process, will be more fruitful than waving wands about.

Another good reason, perhaps the best, is that if magic is about changing consciousness at will, and if mentally ill people have trouble with their consciousness in the first place, then we need to be alert to the potential for making life much worse for already distressed people. Moral principles aside, this is dreadful PR for ourselves as individuals and as representatives of a minority religion.

To leave a distressed person with nothing from a visit can also be harmful and it’s almost always possible to offer small ritualised acts that can satisfy their need for ‘magic’ without turning the volume up on their distress. Many patients feel that they’re at risk somehow, from another patient, from a member of staff, from an unknown source and while paranoia may be a manifestation of their illness it’s also very real for them. What’s lacking in many health care environments is empathy, of attempting to acknowledge and understand someone else’s experience,

The classic definition of pain is "what the patient says it is, and it's as bad as the patient says it is." (Margo McCaffery 1968) and this is not a bad place to begin when considering empathy as a Chaplain. If the patient says that someone is trying to kill him never mind if it’s a delusion or manipulation or psychosis or any other diagnosis, whether the patient is ‘testing’ you or whatever phrase is used to distance ‘us’ from ‘them’. The patient wants you to hear something about them. I’ve found that the more I authentically hear a patient the better relationship we have, and since all the psychotherapeutic research demonstrates that the model a psychotherapist or counsellor or psychiatrist uses is of far less importance than the relationship between them and the person they’re working with, that seems a good place to start. Take the experience of the patient seriously. Do not dismiss it.

This is not to say that you have to run to the police to say that a nurse is slowly poisoning a patient or to believe that the ward turns into a Bruegal vision as soon as you leave. But we do need to understand that this is the experience of the person who is telling us about it, and to consider how this must be for them.

So what can be done to help this person feel safer, to satisfy their need for help from you, without doing anything that will feed their illness?

Simply listening and taking a person seriously is a spectacularly good first move. Being any patient in a hospital you become your diagnosis. Being a mentally ill patient you are obviously not to be taken seriously: the fact that you believe what you believe is why you’re mentally ill in the first place. As a chaplain, never mind all that. Be With this distressed person. Take them at face value. Start your relationship from a place of mutual respect.

If the patient feels under threat offer a Lorica invocation, a prayer that acts as protection, named after Roman armour. Here’s the Babylonian original

Shamash before me
Behind me Sin
Nergal at my right,
Ninil at my left.

St Patrick’s breastplate was just one of many early Celtic protection prayers. The simple act of listening may be enough to allay the patient’s fears, they may simply feel less mad and therefore less in danger. If being heard isn’t enough suggest that you can perform a protection invocation for them. Hold your hand above their head, then at their feet, then to their left and right, in front of and behind them and say something along the lines of

Let there be peace above you,
Peace below you,
Peace to your right
And peace to your left.
Let there be peace in front of you
And peace behind you.
Peace surrounds you,
So mote it be.

Depending on the patient and how much they genuinely know about Paganism it may be worth describing a pentagram above their head and so on but bear in mind that the pentagram is a widely misunderstood symbol, and it may be offering them something they don’t want or understand.

That’s about the sum of magic I’ve done for patients, and even then only a small minority.

Ritual is another matter and I’ll address that later.

No comments: