Last Thoughts from the Clinical Director: Idealism and Cynicism; Endings and Beginnings

I was going to write this column on endings, as that is the obvious choice for the end of my time as Clinical Director at Buchanan Rehabilitation Centre. I was looking at poems about endings and trying to write the column backwards from those poems. It just wasn’t coming together. Endings are times for reflection, assessment and good-byes. I find myself immersed in emotions and logistics of planning an international move. Oftentimes the demand of the logistics leaves little time for emotional processing and the emotions leave little intellectual energy to deal with the logistics. I feel there is so much more that can be done at Buchanan to make it not just an alright place, or an ok place, but to make it a real gem of a service that combines the best of psychiatry, rehabilitation and recovery. Of course, this implies that there are things that we could be doing better and this is what leads me to a discussion of Idealism and Cynicism.

I am an Idealist, I have come to terms with this in my life. It means that I often see how things could be “better,” different, and it can lead me to a dissatisfaction and frustration with “the way things are.” The Greek philosopher, Plato, can be considered an Idealist. His allegory of the cave illustrates this. He describes a person whose only experience of reality is in seeing moving shapes on the cave wall. These shapes are created by light striking objects and casting shadows. There are two implications here. The first is that the person is only seeing an image or representation of reality (the object). The other is that the person could get up and leave the cave, go out into the sun and experience the external real world. Either way, it can be said that the person is not in touch with reality, but just a shadow of it. The spiritual and philosophical concept of “awakening” is relevant here – that the awakened person recognizes the limited or even illusory nature of the reality that we tend to respond to in day-to-day life. It can be said that an Idealist sees the ideal, that which could be, but is not found in mundane reality. Visionaries and transformers are Idealists.

Psychiatrist, Carl Jung, borrowed from Plato’s concept of “archetypes,” these ideal forms that exist outside of the day-to-day realm. These forms exert an unconscious and sometimes conscious influence on the development of the individual. While he listed many different examples of archetypes, the primary one he was interested in is called “The Self,” which is an image or representation of wholeness that works within the individual, who is by nature a small, separate being when compared to larger reality. Jung saw this archetype or force of the Ideal at work in spiritual and artistic creations and experiences in which the individual had some form of healing or renewal in a connection within the self as well as a sense of connection to a larger whole or purpose in the world.

Plato and Jung are Idealists, they view a True Human Being as actually something that is in the process of becoming through a dialogue with the Ideal (or Real). In the last column, I discussed this dilemma about a True Human Being, whether Truth is something in the moment or whether it is something that is gained in the future. I suppose this argument is reduced if we say that a True Human Being is someone who is in an open dialogue with the Ideal (or we could say the Real, or even the Divine if you are spiritually-oriented). In this sense, it is the connection between the Ideal and the individual that is crucial, rather than some present or future state of the individual.

A discussion of Idealism is incomplete without a discussion of Cynicism. There is a Greek school of philosophy called Cynicism, but my own view is that Cynics are Idealists whose dreams and ideals have been frustrated and unrealized. This calls to mind Nietzsche’s saying that man would rather will nothing than not will. Cynics are Idealists who put their energy into tearing down dreams. In a way, you could say that Cynics are the most important part of an organization because they hold a lot of energy, but it is being directed in a destructive rather than a constructive way. A rehabilitated Cynic will bring far more change to an organization than a level-headed Pragmatist. You can always find Idealists, any young person going into health care is generally an Idealist, but most quickly become either Pragmatists or Cynics as they become frustrated and disillusioned with the idea of being able to do the “best” at their jobs.  Really, a healthy and growing organization needs a balance of all 3 types. The Cynics can pull back the extremes of the Idealists, the Idealists can inspire the others, the Pragmatists can be in the middle, working on what is possible in the moment.

These are my thoughts this morning and they link back to my work on my book, Re-humanizing Medicine, which is essentially a guide for maintaining Idealism and rehabilitating Cynicism. How well have I done in my role as Clinical Director? Well, my answer to that changes minute to minute sometimes throughout the day and ranges from extremes to middle ground. I suppose my answer to that question is sometimes Idealistic, sometimes Cynical, and at times Pragmatic.  Perhaps I could have done more or “better,” but I did what I could. Perhaps if I stayed longer and worked harder, it would make a difference, but it is time for me to go. What do I hope will be the outgrowth of my work? I suppose it is related to all this talk about Idealism and Cynicism in some way.

I have had (before the movers so efficiently and swiftly packed up all my things around me) a plaque on the wall with a quote by Howard Thurman, “Ask not what the world needs, but what brings you alive, because what the world needs is people who have come alive.” This is a good definition of Idealism and includes the Jungian concept of Self, that what is ultimately important is in discovering what it is that brings you alive, that enthuses you and fills you with energy. The challenge of the Idealist is in bridging the gap between the Ideal and the mundane world. Most Idealists would agree that this is never completely possible, that it is always a work in progress and always a compromise to some extent.

A successful Idealist, one who can continue to work and create, must come to terms with this dual-natured reality: on the one hand, to be true to the Ideal vision and on the other hand, to accept that the Ideal is unrealizable. Rebecca Solnit, in her book, Hope in the Dark, describes “activists” (who I would say are a kind of Idealist) who work to make the world a better place. She sees activism as a mode of being, a moral responsibility, that is ongoing, and that one engages in regardless of the “state of the world,” or the “chance to succeed.”  She describes the term activist “to mean a particular kind of engagement – and a specific politic:  one that seeks to democratize the world, to share power, to protect difference and complexity, human and otherwise,” (18).  “For a long time, I’ve thought that the purpose of activism and art, or at least of mine, is to make a world in which people are producers of meaning, not consumers, and writing this book I now see how this is connected to the politics of hope and to those revolutionary days that are the days of creation of the world,” (115).  To define an activist or Idealist as a kind of engagement or a mode of being, de-couples it from the outcome. One maintains hope because one has decided to be a hopeful person. One is an activist because they have decided that it is right to work to make the world a better place, regardless of the chance of success. One is an Idealist because they have made the choice to work to bridge the gap between the Ideal and the world.

What does all this have to do with Buchanan and my departure? I have said before that in psychiatric rehabilitation we are in the business of hope. What I hope I have contributed to Buchanan is some of this attitude that we can and should work to bring the Ideal into the actual. This means we can and should work for change and growth in ourselves and for clients. What about endings and new beginnings? Well, those two always seem to go together, don’t they? I’ll have to leave you to work that out for yourself.


The Layers

I have walked through many lives,
some of them my own,
and I am not who I was,
though some principle of being
abides, from which I struggle
not to stray.
When I look behind,
as I am compelled to look
before I can gather strength
to proceed on my journey,
I see the milestones dwindling
toward the horizon
and the slow fires trailing
from the abandoned camp sites
over which scavenger angels
wheel on heavy wings.
Oh, I have made myself a tribe
out of my true affections,
and my tribe is scattered!
How shall the heart be reconciled
to its feast of losses?
In a rising wind
the manic dust of my friends,
those who fell along the way,
bitterly stings my face.
Yet I turn, I turn,
exulting somewhat,
with my will intact to go
wherever I need to go,
and every stone on the road
precious to me.
In my darkest night,
when the moon was covered
and I roamed through wreckage,
a nimbus-clouded voice
directed me:
“Live in the layers,
not on the litter.”
Though I lack the art
to decipher it,
no doubt the next chapter
in my book of transformations
is already written.
I am not done with my changes.

(Stanley Kunitz)



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