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)

“we are…making ourselves better heart people,” (Joseph Rael)

A hobby of mine is personal growth and transformation. This is a larger context for human being than a focus on psychiatric treatment or symptoms, although it can include addressing those. During my time at Buchanan Rehabilitation Centre, my goal has been to bring this perspective into our daily work in psychiatric rehabilitation.

What does it mean to be “A True Human Being” or to be Fully Human? What I have found is that it is a funny paradox that involves both acceptance of where someone (or one’s self) is, that people are “ok” (with all their quirks and oddities and problems) and it also involves being on a path of change, growth, self-knowledge and transformation. Every human being is unique and will hit a unique point in their life in which the drive or need to change becomes stronger than past patterns and ego defenses. Rehabilitation is fundamentally holistic – it requires many different approaches and disciplines to support the growth of the True Human Being (by this I mean, again, both for ourselves as health professionals and for clients). That is why a collaborative Multi-Disciplinary Team (MDT) is so important. Each discipline brings a different perspective and dimension to working with human beings and this fosters authentic growth and transformation.  A collaborative MDT is like a healthy human being or ecosystem – comprised of significantly different organs or organisms that all work together in an expression of their unique individuality while simultaneously working together as a collective. Sometimes this is how writers describe the difference between reductionism and holism – that reductionism is about breaking down something large into standard, interchangeable component parts, whereas holism is about something greater than the sum of the component parts. This means that somehow, beyond the biochemistry, trauma history, family dynamics and substance abuse, there is something larger that is both already present and in the process of emerging – the True Human Being.

Ok, I admit that there is a serious paradox here. Is the True Human Being something that is already present in the individual (maybe already ok as it is or maybe just obscured and waiting to be uncovered) or is the True Human Being something that is always in the future – waiting to emerge? As with any paradox about life, the answer is generally both/and rather than either/or. We can look at the relationship or dialectic between Being (already present in the moment) or Becoming (unfolding in the present and into the future). In spiritual terms, this is the dialectic between immanence (already there) and transcendence (something separate that needs to be moved toward). Being is similar to mindfulness, which is a slowing down with awareness of who one is in the moment. Becoming is like what is often called the road or path of growth and transformation, for instance M. Scott Peck’s, The Road Less Traveled. Of course these are artificial distinctions for connected processes, as the mindful act of the Acceptance of Being actually is quite transformative. Joseph Rael (Beautiful Painted Arrow), a Native American spiritual teacher describes this paradox in the following quote:

In each moment that we live there is an opportunity to change ourselves in some way. We shatter what we were in the past, so that in the new moment we can remake ourselves. In a day’s time, we go through many different moments, many different opportunities to re-make ourselves and therefore evolve…What is a road or a path? The road is the metaphor for the head of the family of ideas continually investigating themselves to find out who they are being in every single moment. Because we are changing constantly, we have to be continually investigating ourselves. Otherwise, we lose who we really are. Another meaning for road is the direction or form by which our fears are challenged and the manner in which we face them, (Joseph Rael, Being and Vibration, 57-58).

An earlier column that I wrote on Adam Kahne’s theory of Power & Love in social change brings this back to our work in rehabilitation. Love, in its many forms, is acceptance and support for how someone is in the present – it promotes transformation from the inside. Power is more external change from the outside as it structures and shapes external behaviour. In psychiatric rehabilitation Power takes the form of medications, the Mental Health Act, and behaviour plans. Notice how I use the word transformation for the internal process and change for the external process.

Rather than an either/or, Kahne recommends a both/and approach which promotes a balanced dialectic where through the harmonizing of Love and Power a transformation emerges that is greater than what can be achieved through the application of either principle alone.

Thus, for rehabilitation of the True Human Being, both Power and Love; both External Structure and Internal Transformation; both the work of individuals and the collaboration of groups are necessary.

Let’s return to Joseph Rael and hear what he has to say about “Becoming A True Human Being.” (Word of Caution: this might get a bit spiritual and mystical, which is what is often lost in a reductionistic view of human beings).

The true human is someone who is aware, someone who is, moment by moment, totally and completely merged with life. He is a listener. She is a listener. Out of that capacity of inner and outer listening, comes the capacity of humility. The true listener is no longer defined by desires or attachments. Instead, he or she is sensitized to consciousness, (67).

In the language of nature, working and listening are the same. Working, or listening, means sensitivity, (65).

A true human is a person who knows who he is because he listens to that inner listening-working voice of effort, (68).

Rael introduces the pair of human activities of plowing and playing (which we could take as more examples of being [playing] and becoming [plowing]).

Plowing is a metaphor for this physical way of looking at life…What ideas do we want to cultivate? We study something and then walk it out so that we can plow the fertile field of consciousness and then move forth and plant the seed in that field that we have plowed, which in this case is our bodies. In that way, we plant what we cultivate in the weeks to come and it eventually produces fruit, (68-69).

The metaphor of playing is quite different. Playing means strengthening oneself…making the self what is becoming…Whether we are playing a violin or a guitar, or playing football, tennis or cards, we are, through playing, making ourselves greater heart people, (69).

For the true human, the first thing is to find out how to listen. Listening is different from seeing. Seeing, and the eyes, were created so we could move into things and through things. The ear, on the other hand, was created for the art of giving. One of the attributes of the ear is the give-away; to give into the effort of giving, to give into the effort itself, the effort we can find in the toil of our work in our lives. When we are listening, we are giving. When we are giving of ourselves, we are strengthening the work-listening aspects of ourselves. We are listeners to people’s cosmic needs. First we listen to what needs to be done. But if we start with trying to see what needs to be done we will miss the point and we will not really touch the basic humanity of the situation that is talking to us at that moment in time, (70).

To return back to what all this mystical stuff means for us as health professionals and the clients, we can see a couple things in these quotes. First, to be human is to listen and this is also related to work (work-listening), and this is all related to giving. We must listen with our hearts first, and then see with our minds what needs to be done. This can all be another example of the listening-heart (as holistic transformation) and the seeing-mind (as reductionistic action).  The recent presentation I gave at the Health of Health Professionals conference in Brisbane focused on this aspect of giving as crucial to providing whole person care as well as to supporting the whole person of the professional. When we view work as a gift rather than a time-limited resource or a uni-directional vector, we move from a draining experience to a collaborative and regenerating experience. Lewis Hyde describes the gift experience as:

*         “the gift is not used up in use” (187)

*         “a gift makes a connection…a gift establishes a feeling-bond between two people, while the sale of a commodity leaves no necessary connection” (72)

*         “A gift that has the power to change us awakens a part of the soul” (65)
(Lewis Hyde, The Gift: Creativity and the Artist in the Modern World)

So far, I hope this all can be at least partially translated back to our work in psychiatric rehabilitation. Let’s go ahead and follow Beautiful Painted Arrow a little further, though, even if it might become a greater challenge to bring it back to our work in a psychiatric system. For the most part, I just let the words speak for themselves.

We become human in order to continue listening so that we can continue to verify that we exist, (72).

In the end, the mystery is the infinite void and the mystery of the void is all of us remembering, because, truly speaking, we do not exist, (75).

Sorry, if you follow any mystical line of experience and inquiry you generally end up with strange statements about the void and reality.  Let’s just close with a poem by Rael and then I’ll add an appendix for those of anyone who wants to hear more of Rael’s ideas.

Life is the road of Goodness.
Life is connected to time
as crystalized meanings.
Life purifies itself with heart connection
so it can ascend beyond the heavens as radiating innocence.

(Joseph Rael – Beautiful Painted Arrow)

Appendix: Eighteen Ideas from Joseph Rael

1. Planet Earth is constantly giving life to all things on the earth so that, in the act of giving to us, she shows us all how to serve, to give to her and ourselves.

2. First was the Dream and then the Vision that became the walking, talking, light of the one Great Mystery, which is all of us who are living on the Earth.

3. Taah-Keh (The Big Bang) was created “to initiate action” and from this came the first circle of light. [Taah-Keh refers to a Tiwa myth in which two fawns being pursued by the Old Giantess hide inside the crack in a plow. When the Plowmaker hits the plow with his hammer, the fawns go flying out.]

4. The eyes are channels for the “washing lights” that bring clarity to ideas.

5. The rainbows are hues (vibrations of the rock people) of life on the earth. And the rainbows represent, in metaphor, the breath of the Butterfly of Dream Time, the bridge to eternity.

6. The Earth is the Mother Starship of the Ancient Ones.

7. Resonating energy is simply universal intelligence descending onto its own understanding of the vast greatness of its own greater, inner self.

8. The idea of enteringness created the first form of the face.

9. Water is crystallized light which produces physical light as well as spiritual light. Interestingly, the symbol for water in chemistry is H₂O. In Tiwa, the sound of HO, “Haah-Oo,” means “Little Leaf.” The leaf is the symbol for life.

10. From the first mist of the first cloud comes the idea of birthing as dropping from the biological mother’s womb. And the thread that keeps us connected to our origins was primarily created to help us keep vigilance over what we do and say: right actions/right thoughts.

11. Life on the earth is a living daily experience of inspiring qualities and inner knowing. We find them, these gems of truth, only as we are ready to acknowledge them in our lives.

12. The light is always chasing the shadow and the shadow is always following the light.

13. The breath is the key to all of the mysteries.

14. The breath is the infinite void from which all creativity is first given life, then its purpose.

15. Dream essence of life is what heals life, whereas living life is the visionary part of it.

16. The first visionary who came from the first dream was in the dream state too because he was dreaming his vision. That is, he was the dreamer and the one being dreamed. Consequently, all of life is simply made up of a healing sate that is dreaming itself beyond itself.

17. The eyes are how the Great Mystery sees, how it holds on, moment by moment holds to the gifts of each moment before the next moment appears, bringing with it its own face.

18. The earth is a large stone which is the holder and keeper of all the mysteries that created the life potential here on this earthly home of the People.

Having read these ideas, go outside and sit on a rock that has been heated by the sun. As you sit on the stone, the warmth of the rock will travel through all parts of your body and when the radiant heat from the stone has traveled through all the different parts of your body, the knowledge that lives in what you have just read will be acknowledged and appear in your life. Hereafter, you will get greater clarity on these principles.