Thoughts from the Clinical Director: Change

I tend to be somewhat philosophical and the more change and stress I am under, the more philosophical I become. Sometimes at night when I don’t know what to do, I lay on my back on my back stairs and look at the stars. Tonight there are patchy, fast moving clouds concealing and revealing the stars. Moby has a song called “We Are All Made of Stars.” The refrain is “people they come together, people they fall apart, no one can stop us now, because we are all made of stars.”

Scientists think we are literally made up of stars – that is that at the time of the Big Bang, there was only hydrogen and helium and these elements made up the first stars. Eventually when these stars died and exploded, they created heavier and heavier elements, such as some of the medium weight elements like carbon, oxygen and nitrogen, and these are the elements that we are physically comprised of.

We are going through a lot of change at BRC in the upcoming months, personally the most relevant change to me is my final day on 24/10/13. We are looking for locums to fill in for the clinical work and will be having interviews for the permanent position in the upcoming weeks and will keep you updated as we have more information. There is also the change of our psychologist leaving, our nurse educator having left as of today, and our other consultant leaving in February. That is a lot of change in the clinical team and it is likely to have some ripple effects in how stable BRC feels.

There is actually something called the Book of Changes, as the I Ching is sometimes translated. This is an ancient Chinese text that dates back to between the second and third millenium BCE. This book is all about studying change. It states that “When change is necessary, there are two mistakes to be avoided. One lies in excessive haste and ruthlessness, which bring disaster. The other lies in excessive hesitation and conservatism, which are also dangerous.”

Psychiatrist, Carl Jung, in his foreword to this book discusses the role of chance and synchronicity that influence how changes play out. No matter how well change is planned for, there will be unforeseen chance events. This makes managing change as much an art as a science.

Here are some more quotes from the Book of Changes, maybe they apply to BRC.

Everything is in motion: therefore if one perseveres there is a prospect of great success, in spite of existing danger. When it is man’s fate to undertake such new beginnnings, everything is still unformed, dark. Hence he must hold back, because any premature move might bring disaster. Likewise, it is very important not to remain alone; in order to overcome the chaos he needs helpers…In order to find one’s place in the infinity of being, one must be able both to separate and to unite…If a person encounters a hindrance at the beginning of an enterprise, he must not try to force advance but must pause and take thought. However, nothing should put him off his course; he must persevere and constantly keep the goal in sight.

I know that the goal at BRC is always to provide supportive care to clients in order to promote mental health, recovery and rehabilitation.

The I Ching discusses three kinds of change: non-change, cyclic change and linear change. Non-change is the fixed background that makes change possible. (At BRC this is the continual goal of supporting rehabilitation; for staring at the sky, it is the, relatively, fixed and unchanging background of stars). Cyclic change is the recurrent change of the organic world, or we can see cycles in the history of psychology, such as between nature/nurture and biology/psychology. (At BRC when changes are proposed I often hear, “we used to do it that way;” with the sky, it is the cycles of clouds covering and uncovering the same stars). Linear change is a form of progress and this creates a specific history for a given place or person. This is another level of viewing cycles of change, that when sequenced together they lead to a progress toward a certain goal. (While there are cycles of change at BRC, there is also a continual adjustment to the changing needs of the clients and the changing philosophy of the DHB. While there are similarities of current change to past methods, we are continually at a unique point in time in which we are striving to bring about the right elements at the right time to support change and growth for clients. For the sky, the interplay of cyclical change against the background of the non-changing sky creates unique moments and configurations which will not happen again, but which create a kind of linear, beautiful movie).

I’m not sure how much the I Ching can help us during this current change, but maybe these concepts can help to put the current anxiety and change into a larger context. The Greek philosopher, Heraclitus, wrote that “There is nothing permanent except change.” I do know that having a larger context in which to view change can lead to greater acceptance of the change in the moment as well as to allow one to work effectively in the current moment rather than resisting the reality of the present.

The Promise of the Inner World

If you take away all a person knows,

you are left with the mouth of a fish

gulping water as fast as it can. If you

take away a person’s coverings, you are

left with the naked freedom of a star.

If you take away all a person has done,

you are left with a soul eager to build.

And if you take away what a person has

saved, you are left with a life that

has to live now.

Stripped of too many thoughts, we

grow wise as stone. Stripped of too

many accomplishments, we grow

possible like the sun. And stripped

of what we hoard, we grow immediate.

So taking away is not just about loss.

Like it or not, we are forced, again

and again, to the nakedness of freedom,

to the eagerness that wants to build its

way out of nothing, and to the poverty

of time that has to live now. If blessed,

we wake, one more time, gulping

our way into tomorrow.

(Mark Nepo, from Reduced to Joy)

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