Saturday, October 16, 2010

Getting Through - Surviving Mental Illness 2

Context

Marxists used to say that context conditions consciousness, and, to my mind, there is a profundity of insight in that contention.  My consciousness is indeed conditioned by my context - a 52 year old teacher of thirty years experience working as a Resource and Special Needs teacher in an inner city secondary school in Dublin, Ireland.  I spend half my time working with ASD students in small group and 1-1 contexts.  Then I teach foundation Maths and Irish to Sixth Year students - no more than six in any one group.  These students present with varying educational disabilities - dyslexia, dyspraxia, dyscalculia, or even with emotional difficulties (EBD) like ADD, ADHD or ODD.  One has a psychiatric illness, viz., OCD.  The students in our ASD unit are all diagnosed with Asperger's Syndrome and most of them have at least one other disability added to this.  Teaching these boys is both challenging and infinitely interesting because I have a life-long interest in psychology and in trying to understanding and help people.  I also love teaching and meeting people from all walks of life.

Hans Asperger1906 – 1980, the Austrian pediatrician
During this last week I worked with an EBD group of three where I am working on their basic emotional development coupled with an anger management programme which I learned to implement in the past three years in partrnership with the NEPS psychologist.  I also worked with a sixteen year old Asperger's boy who suffers from OCD and who presents with extreme anxiety which is controlled by medication.  All of this requires skills of communication and empathy which I have learned over the years through doing psychotherapy courses and from completing a Graduate Diploma in Special Educational Needs.  However, nothing can substitute for lived expereience and for years of professional interaction with students of all psychological make-ups.  I am also working with one boy who thinks the world is against him - in fact he seems quite paranoid.  Now, I am a teacher with a fairly good background in psychology and psychotherapy, although I am not a qualified therapist.  However, I know enough never to get in over my head and when it is important to refer a student to the school counsellor or other qualified professional.  Real knowledge of any area is knowing where one's own qualifications, knowledge and experience end and where more specialist knowledge begins.  There is nothing as dangerous as working with people who think they have all the answers to life's woes.

Compassion for the Broken and Disintegrated Self:

With these preliminary comments in mind, I now proceed to comment on yet anothyer wonderful article on mental health in The Irish Times Supplement on health, this time by Dr Tony Bates who is founding director of Headstrong The National Centre for Youth Mental Health in Ireland. Headstrong is an independent charity committed to championing the mental health needs of young people and to working with communities to design and implement comprehensive systems of care and support for all young people. Tony’s core professional training is as a clinical psychologist, with a special interest in working with mindfulness-based programmes in mental health settings. He is also a full-time writer and editor of Ireland’s current mental health policy – A Vision for Change.  His short article in this supplement is the essence of compassion, something I'm not surprised at, given that Dr Bates is a psychologist and psychotherapist of such experience and expertise. Here is a flavour of this author's column:

Life has a curious way of breaking our hearts. It is full of violent eruptions of things that seem to come at us from nowhere. An old wound is suddenly reopened; an illness throws everything out of whack; a colleague betrays us; we lose someone we love – moments when suddenly the path we have been on disappears from beneath our feet.
One of the great lessons of life is that, while one may have an ideal picture of how things should be, we have to accept sooner or later that, rather than things being the way they should be, they are usually the way they shouldn’t be. Unless we can accept this about our life, family, organisation and friends, we’re going to have a really hard time.  (Tony Bates: That Crazy Little Thing Called Life )

That's been the experience of most, if not all, of us as we journey through life.  Things break, people get sick, nature intervenes in storms, earthquakes and even tsunamis, pollution occurs, dreadful accidents happen, we age and we die and the cycle continues.  Unless we can accept the distinct possibility of all these things, we certainly will have a hard time. As one of my colleagues puts it: "shit happens!"  How true that statement is.  There is no way it can be gainsaid.

However, it is often at these moments when things go badly wrong that we are offered the opportunity to grow as human beings.  As I have said in the last post - what does not destroy us, strengthens us.  We learn through our mistakes, and by very definition mistakes are a form of evil e.g.,  doing a physical undertaking wrongly, making human error either in mathematical or clerical settings, or even in handling a human interaction badly.  As Dr Bates so succinctly puts it in this superb article:

But it is also true that the moments when things go wrong are also the precise psychological points where we can grow. Even if that hurts, even if it means some of our most cherished illusions about ourselves end up shattered on the floor. Whatever wisdom we mine from the raw material of living comes from facing the episodes of chaos, growing through and being stretched by them.  (Ibid., see the above link!)
Interestingly, he tells us that most of what we accept as normality is in fact a distraction or indeed a fantasy.  I can see clearly what Dr Bates means by this.  We are all prone to set up our own little take on life, our own little perspective on living and to assume that things should be this way or that.  In fact our own little "pictures" of life or living or reality, call it what you like, are just that, "little" - a perspective, often loaded indeed with our own rigid prejudices, biases and blind spots.  In this way, we avoid what Bates calls "the terror of existence."  I can see a lot of the existentialist approach in his writing here.  He reminds me very much of Dr. Irvin Yalom in what he says.

Then the pain of existence in the form of real existential and lived suffering enters our little world through pain, real, dreadful and frightening pain.  Our little vision of things is shattered.  However, many of us seek to protect our closely guarded and long-built-up personal worlds, ordered to our own blinkered vision.  We may protect ourselves by denial, by self-contempt, depression or simply turn against the world in anger.  Each of these options is an effort to keep alive the old stories of continuity, the old patterns of meaning, the old brittle and blinkered vision of things.

Compassion and Kindness Towards Self and Others

Having read much in Buddhism from the Dalai Lama to Thich Nhat Hanh to Wiliiam Johnston and Sogyal Rinpoche, I am not in the least surprised that Tony Bates goes on to mention compassion for the Self.  I have long been of the belief, and I have written it here before, that compassion must start with the Self before it is given to others.  Real compassion begins at home at the very hearth of the fire of the Self!  Let us repeat here Tony Bates's own words:

At first we may feel acutely anxious and unsure how to react. It can take time to make sense of it all and figure out the next step to take. But when we cannot change how we feel, we can choose to relate to it with some degree of kindness. Compassion is perhaps the best place to start when our world gets turned upside down. It is the first step of any growth or recovery process. It enables us to stand firmly in the place we find ourselves; a place that may be painful, but the only ground we can stand on if we want to feel real. (Ibid., see the above link again!)

And compassion is no weak emotion or weak love or soft self-indulgence.  It is, in fact, very objective and very real, essentially accepting of the way things are and is also empowering of the person and a prerequisite to real and deep healing.

To be continued.

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