Positive Health Online

The medical conference concerned the fate of a ‘younger disabled’ patient – a formerly healthy young woman who, for reasons no one could figure out, had deteriorated, over the years, into complete physical and mental helplessness. The previous consultant had promised the families of such patients – hopelessly brain damaged in a car crash, survivors of severely damaging meningitis – that the ward would be their home for the rest of their lives. The new consultant, specialist in rheumatology, was determined to discharge them. Our patient’s mother was adamant that she would not care for her daughter at home. Dismissed by the consultant as ‘crazy’, her will still prevailed, and her daughter was found a place in a newly established ‘home’.

She told me two things. One was that she thought her daughter should be looked after by someone whose vocation it was to care for such a person. The fact that it was her daughter who was so damaged did not automatically mean that it became her vocation.

The other was that, as difficult and sad as her own life had turned out to be, she would not have wanted to change places with that consultant. “He is carrying some kind of pain,” she told me, “and cannot bear to work with people he cannot cure.”

Many of the readers of Positive Health PH Online will be healers of one sort or another – our vocation is to make people better. We are used to thinking of success in terms of how much we are able to bring our clients back into good health. When this doesn’t happen, we are likely to feel that we have ‘failed’. Maybe - like that consultant – we are unable to bear the pain of trying to help when we are helpless.

It can be an unfortunate consequence, too, in many of our complementary practices, that in acknowledging the undoubted power available to each of us through managing the way we think and the emotional responses that we experience, we can inadvertently lead the client who succumbs to a health problem to think of him- or herself as having ‘failed’.

It may be that those of us who have always tried to help, to heal, are particularly badly suited to the kind of mind-set – and courage – that is required to be steadfast when, although healing practices may still be helpful, recovery is not an option.

Kleinian psychoanalytic theory refers to a process of internalizing the object of our emotional involvement. Melanie Klein, and the ‘object relations’ school of psychoanalysis would say that the depression which can follow loss is a consequence of having internalized a dying or dead person; carrying that sense of death within ourselves. Depression would make sense also if we experienced that death as a personal failure – “I just wasn’t good enough”. Actually you were good enough, the person had a health problem that was not possible to resolve. That did come from outside. What you did, and tried to do to help is the bit that is about you.

It might sound inhumane, but when we are caring for a person who is not going to get better, like the good life-saver, we need to ‘stay out of the water’. We are not that person, we are not having their experience. If we ‘get in the water’ with them and allow ourselves to ‘feel what they are feeling’, we really are not going to be much use to them. The last thing a sick and dying person needs around them is someone else who is allowing themself to sink into some kind of mire of despair, or sense of failure when they are not getting better. This isn’t about how bad you feel, it is about getting them what they need. Why add to their burdens? They need to be helped to enjoy whatever is available to them to enjoy; they need someone around them who can be creative in the quest for what they may be able to enjoy. They need someone confident and perhaps even aggressive in fighting their corner if they are not being cared for as well as they should. Your success will be in how well you can perform these functions. They also need to be able to express whatever discouragement, fear, or anger they may be feeling – to someone who can really hear them – who can listen to despair without falling into it themselves. To use a profound philosophical expression – ‘shit happens’. It isn’t nice, no one has to pretend it’s anything else, you are angry/sad/frightened, too – sharing these feelings is a way to limit their power. Sharing these feelings is about real love, and real love is what is needed.

Judge your success in terms of how well you have served them, trying to be sure that their needs are met, that they have had what enjoyment is possible, that they have shared what they needed to share, that above all, they have been surrounded by your love.

And when you have done all you can, and their struggle is over, free yourself with the knowledge that you did what you could, with determination and love. Unless that person was terribly selfish, they will want you to remember the good times, remember that you did what you could. When the time comes that you are able to, let them rest in peace – let them go on their journey, as you continue on yours. Grieve, yes. Let the rest go.