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... e we avoided this potentially positive side of the equation and repressed any spiritual connections of the experience of having a psychiatric illness? Sullivan proposes that we typically fear the discussion of the symbolic and mythic dimensions of the experience because it might encourage the person to become preoccupied with their inner life and consequently precipitate a relapse. But as he adds a person returning from such a journey with profound psychic experiences do not feel completely resolved until they have had the opportunity to put their experiences into words or art; to tell their stories.
A person can emerge from a psychiatric episode with a belief like 'Suffering is a punishment for something I did wrong', 'If I tried harder to be good, I could get well' or 'There must be some reason God has chosen me to suffer' (Lindgren & Course 1995) These belief systems provide a meaning to an illness whether we like them or not. I am sure you have come across such expressions from consumers. So what do we do with it? Firstly we assume that because of the religious belief this person has a very low self esteem and so the religion is a negative thing and perhaps even the cause.
As workers it would often be avoided, and the discussion repressed or the belief of the person dismissed as invalid. How did this help the consumer resolve the huge existential question? It didn't, but gave the consumer the idea not to talk to you about such matters anymore, and merely reinforced the belief that suffering was a way of life and no one was going to help understand it differently. It probably goes without saying that the ability to perform the role of spiritual facilitator following the psychic journey of the soul requires certain skills and attitudes. Thirty-seven percent of consumers in one study who were interested in issues of spirituality said they did not want to discuss spirituality with their support workers. The reasons for this were to do with being misunderstood and the worker having a different belief system.
But without some means of discussion and communication, how can consumers begin the explore the implications of their beliefs and be able to identify experiences which are perhaps harmful if there is no forum to do so? It has been suggested that what consumers would like is a 'soul mate' who may be a friend, counselor or clergy person who is available and open to discuss these issues. Community implications of the separation of madness and spirituality People with a mental illness are often aligned with the ills of modern society. They have become the scapegoats for when things go wrong.
Newspaper headlines are a testament to how we look for madness as the reason for mass murders, murder suicides, genocide, extreme cruelty. Did the person responsible have schizophrenia is often the first question asked by journalists? What was the reason they did this terrible act? So then all people with a mental illness become associated with violence, unpredictable and cruel behavior. They have then by default become the scapegoats for the human acts which cannot be logically explained and which go wrong.
The scapegoat is an ancient image, originally an image of healing the community. In Jungian terms it is a form of denying the shadow the part of ourselves we do not want to know about, the repressed anger, hatred, the impulses which call into question our validity to be called human. Hebrew religious tradition had a scapegoat ritual which ensured the ongoing health, safety and spiritual well being of the whole community. At the festival of Yom Kippur the priest would choose a goat and all the negative elements of the community, the sin, disease, violence, psychic sufferings were all placed on the head of the goat.
The goat was then sent out into the dessert, away from the community and the community now being rid of its ills was once again whole. In the modern context this ritual has continued as individuals or groups, seen as the cause of the communities ills have been ostracized in this manner, sent away, put away, allowed to live in cardboard boxes, given no resources to develop or gain any status of value, out of sight and out of mind. However the ancient ritual had another dimension which has been overlooked. The dessert was symbolic of renewal.
It was the place of spiritual renewal for prophets, it was the place the Hebrew people developed an identity, and while it was a lonely and threatening place, it was associated with the learning the depths of the soul. So the goat was sent to the place of spiritual renewal. And as long as the people knew the goat was in the dessert, their own healing was assured. The goat was not forgotten. The healing was reliant on the community remembering the goat in the dessert, the goat was bearing their ills and because the goat was there, they were free of their own potential destructive elements. Madness is not just about a definition in a clinical textbook.
In order for me to be considered sane, I am aware than someone else has been called insane. And in order for that insane person to have the potential of recovery from her / his insanity, then I must also have the potential to embody the qualities of insanity. This isn't just about dualism or cosmic balance, but about the continuum of life along which we move and change. The goat in the dessert is not different from the community.
It is a symbol of one aspect of the community. R. D. Laing criticized the placing of all the responsibility on the consumer to make their realities understandable to others.
He said 'Both what you say and how I listen contribute to how close or far apart we are' (Miller). The person diagnosed with schizophrenia or bipolar disorder or obsessive compulsive disorder, is representative of an aspect of the community of which we are all a part. The problem with the modern scapegoat and definitions of clinical diagnoses is that the scapegoat is profoundly alienated from the community, not only in ritual but in belief. We assume the scapegoat represents his / her own problems and that they have nothing to do with me. And in so doing not only have we cut off those people labelled with the mental illness, but we have cut off any potential of healing the community as a whole. We have denied our part of the scapegoat and we have denied them and we have castrated ourselves from hope and healing.
People with a mental illness, in the dessert, on the collective boundaries and the isolation and disintegration of their madness, carry within them a part of the spiritual health of the community. And this we have negated, the goat is at risk of dying from disconnection and for this we have suffered a great loss (Bellingham, Cohen, Jones & Spaniol, 1989). Symbols and their expression in psychosocial rehabilitation I believe that symbols are an important means of enabling the spiritual expression and development of people who have experienced a mental illness. There is a fantastic story of the closure of the psychiatric hospital in Trieste Italy. When the hospital was closing the whole community was involved in the preparation of it. The inpatients at the time decided on a symbol of their life being taken out into the community.
Over time a story had developed among the patients around the large draft horse which worked for the hospital laundry. Each day the horse would leave the hospital laden with linen to be cleaned. This horse became a symbol of their freedom. So on the day that the hospital closed a parade was planned and the inpatients made a huge replica of the horse. Inside the horse was placed letters and poems of the inpatients expressing their hopes and dreams. Then as they pushed down the wire cages surrounding the hospital precincts, the patients pulled the horse out of the hospital grounds and into the streets of the community.
You can still see the horse today in Trieste. When I started working at the Mission, there were some critics who felt that some parts of the programs such as art, craft, woodwork, music, drama and the association with the church were not really about rehabilitation. We were also meeting well meaning workers from other services referring participants who felt that learning to cook and budget was more important than art. This was perhaps why Cathy Harper and I presented a discussion at the Mental Health Conference on 'There is more to life than learning to cook'. To me the devaluing of the creative and overtly spiritual aspects of programs was just another way of discounting the need for spirituality as an integral part of rehabilitation and negating the spiritual contribution that people with a mental illness make to the whole community. What I have spoken about today has not been about programs or models of service delivery but about something more fundamental, attitude and belief.
Why are we here at this conference? Why do we work in this field? How do we really view people who have been through the experience of a mental illness? Yes we may believe in their under utilised potential. Yes we may consider the quality of the relationship with them as of prime importance. But if at the end of the day we are doing this simply because they need to receive what we can offer, then I feel we have missed the point, and I fear that one day history will merely label us with a more sophisticated form of paternalism.
Alan Pinches a journalist and mental health consumer activities concludes an inspiring article with these words; 'With a breakdown, there is often a disintegration of personality and confusion in the thinking processes, in the early stages. All the ingredients of identity, meaning and purpose go back into the melting-pot, and a longer 'ferment's tage follows. In a long process much information and experiential learning grow into a new understanding of life. This understanding is often of a more fundamental nature: 'I am human and I have unconditional worth'... Over time, a new synthesis can develop in us, a sense of true self can build up, wisdom can grow, and perhaps a realisation that the world's priorities need not necessarily be ours. That we can be ourselves and pleased and proud at that.
The seeker is then likely to justify his or her life's quest with the argument that spiritual work is just as valid as any other form of work or vocation, and that society and the planet needs its thinkers, dreamers, poets, artists, writers and seers of visions' (Pinches 1996). For me, perhaps more than any other time, when the value of what we do and who we are is indicated by the dollar sign on a balance sheet, I think we need seers of visions, people who have journeyed into the depths and we need to hear what they have to say. Reference List Bellingham, R. , Cohen, B. Jones, T. & Spaniol, L. (1989). Connectedness: Some skills for spiritual health. American Journal of Health Promotion 4 (1).
pp. 18 - 31. Cooper, E. (1992). To be rooted. The Journal of the California Alliance of the Mentally Ill 3 (4).
p. 15 - 16. Elkins, D. N. (1995). Psychotherapy and spirituality: Toward a theory of the soul. Journal of Humanistic Psychology 35 (2). pp. 78 - 98.
Kirk, R. (1992). The next voice you hear: Other pathways on a spiritual journey. The Journal of the California Alliance of the Mentally Ill 3 (4). p. 33 - 34. Maitland, S. (1997).
Whisper who dares: On psychiatry's simplistic approaches to the hearing of voices. Open Mind 84. p. 10 - 11. Miller, J. S. (1990). Mental illness and spiritual crisis: Implications for psychiatric rehabilitation.
Psychosocial Rehabilitation Journal 14 (2). pp. 29 - 47. Lindgren, K. N. & Course, R. D. (1995). Spirituality and serious mental illness: A two-part study.
Psychosocial Rehabilitation Journal 18 (3). Pp. 93 - 111. Perera, S. B. The Scapegoat Complex: Toward a Mythology of Shadow and Guilt. Inner City Books Toronto.
Pinches, A. (1996). Spirituality: the missing link in psychiatry. New Paradigm November 1996. pp. 8 - 11. Smith, W. J. (1994).
The role of mental health in spiritual growth. Journal of Religion in Disability and Rehabilitation 1 (2). pp. 27 - 40. Sullivan, W. P. (1993). 'It helps me to be a whole person': The role of spirituality among the mentally challenged. Psychosocial Rehabilitation Journal 16 (3).
pp. 125 - 134. Watson, K. W. (1994). Spiritual emergency: Concepts and implications for psychotherapy. Journal of Humanistic Psychology 34 (2). Pp. 22 - 45.
York, R. L. (1992). Something discarded. The Journal of the California Alliance of the Mentally Ill 3 (4). pp. 3 - 6.
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