A psychological perspective on the inevitability of pain and suffering


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Revd David Nicholson A psychological perspective on the inevitability of pain and suffering, presented at the Holy Living, Holy Dying conference held in Exeter on 2 November 2009

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A psychological perspective on the inevitability of pain and suffering

  1. 1. ‘Holy Living Holy Dying Conference’ Exeter A psychological perspective on the inevitability of pain and suffering Today I want to share with you some of the insights that I have gained through both my work as an Analyst and Methodist Minister. I will therefore be combining both a psychological discipline and a theological perspective. One person who has greatly influenced me is Carl Jung the founder of the school of Analytical Psychology. It was through his writing and my own personal analysis with an analytical psychologist that I was able to give meaning to many aspects of my life and enabled me to reject some of the elements of Christianity and my childhood, giving me a more creative inner and symbolic faith rather than a creedal, handed down one, set in stone by church fathers through the centuries. The result was, so I believe, a more authentic way of living and a faith that resonated with what I experienced within my inner myself. Giving meaning to our lives is so salient to Analytical Psychology. In a few minutes time I will show some clips from Carl Jung’s last interview before he died. To me what Jung raises in his psychology is the question of giving meaning to our lives. As he says: no one wishes to 1
  2. 2. have a meaningless life. Every significant event in our living needs to be understood. For those with a terminal illness the search takes on a vital new dimension. It is what I call an existential moment. It is a time when the present is all consuming and the past and future take on less significance. This is such a time for me personally. Two years ago I would have been writing and giving a very different paper. Having been diagnosed my self with advanced prostate cancer, I hope I write and lecture from the heart and not just from my head. For a few minutes I want to show you part of an interview which Jung gave in his eighty fifth year. Brief explanation and Clip of the Interview During my training as an analyst I was very fortunate to have a supervisor who had met Jung when he came to London to lecture at the Tavistock Clinic. 2
  3. 3. During the course questions and answers, a person in the audience said how pleased they were to be able to call themselves a Jungian Analyst. Apparently, Jung replied ‘There is no such person as a Jungian Analyst; you are who you are, yourself. You can call yourself an analyst for that is what you have become through your training’. Pivotal to Analytical Psychology is what we call the ‘the self’ the core of who we are or if you like, our unique psychological DNA which evolves and develops as we grow in experience. Part of this ‘self’ is our own spiritual self. It is the person who we were born to be: The person who over time will realise his or her full potential. It is the ‘Self’ which over time develops the ego. Not the other way round. The threefold aspects of humankind: Body, Mind and Spirit, have, in my thinking to be an integrated whole. In this context the body is the totality of all our physical being. The mind is our rational and cognitive function and the spirit in analytical psychology is the non material aspects of a living person which can neither be described nor defined. To neglect one of them is to cause an imbalance to a person’s well being. It is unconsciously easy for us as carers representing different disciplines to lose sight of the fact that one of these, the body, mind or spirit, do not come into our professional remit and as a result miss the whole person. 3
  4. 4. So let us now turn to these three aspects of care: The Patient: Throughout this paper I shall be using insights taken from psychoanalytic theory but we need to keep in mind that theory is limited and often provisional and of course has evolved from clinical material taken from patients. Forgive me for stating the obvious by saying the patient should be centre stage. Although I say it is obvious, having worked in the NHS for a number of years I think at times we did loose sight of the fact that we existed primarily for the patient. When my own patients come for treatment I have to remind them that although they may feel overwhelmed by what is happening to them it is only one part of them which is dis-eased. They are still the same person they have always been. Yet they bring with them all the usual feelings that you from your experience will recognise: fear, anxiety, depression, a deep sense of loss and feeling overwhelmed. They experience envy, experiencing others being able to do what they are now unable to do. The basis of such feelings is often anger, an instinctual feeling that is quite difficult to access. They ask the question: ‘why me’? Such a question is very human. 4
  5. 5. Perhaps the most common feeling is being out of control. For those with a terminal illness they find themselves in a very difficult and dark place. It is a place where they have to face their life and death situation. Many of you will know more about this than me. The psychological pain and suffering do not go away. When an individual is passing through their own dark place they can experience loneliness and desolation. The very core of themselves is attacked. Patients deal with their pain in different ways. Some get depressed and immobile, others go into a state of denial and some try to face the reality. All need help to understand what is going on inside them. It is their search for meaning. Of course some do not want to know and we all respect that. But the offer of an accompanying journey should always be on the agenda. Now I have to address why it is so difficult for many people to accept the inevitability of pain and suffering. Pain and suffering are archetypal. They are part of life’s cycle and very few escape them. No one wants to suffer or see people in pain. We live as if it will never happen to us and in some way this is a healthy way of being. But I sometimes wonder if we as a community or individuals cut ourselves off from the reality of pain and suffering and that it can strike at any time. A few weeks ago my wife and I went to the 02 centre in Greenwich. It was a time for people watching! Lots of 5
  6. 6. different cultures: young people searching their Blackberries and mobile phones and a great sense of life was for living now. I suppose I did wonder how real it all was. Were these people connected to the real world, a world of diversity, rich and poor, justice and injustice, health and suffering? How do we cope when pain and suffering strike? Do we have the resources to cope with what is thrown at us? Are we getting so used to living through the glossy magazine image or the next fashion logo that we loose our true selves and the place we have in community? When a person is in need of help my role as an analyst is to help the patient contact the unconscious part of themselves. It is this part of ‘self’ that contains many resources still untapped to help them in their crisis. One of the most powerful symbols of the unconscious is the mythical hero or heroin. We can draw much strength from such images. They can enable us to battle with our feelings of being out of control and give us strength to hold onto our dignity and purposefulness. (As carers you may wish to find out more about how the unconscious gives a balance to the conscious.) Three years ago I spent six weeks living in one of the poorest areas of the world. My time in Tanzania was a life changing experience. Suffering and poverty were always present; hospitals which were fly ridden and dirty; no qualified staff and little in the way of drugs. It was distressing. 6
  7. 7. But my African colleague reminded me that for his people suffering and death were part of their cultural and spiritual cycle. Life and death were not separated. One followed the other and they accepted the inevitability of death and the beyond: Holy living and holy dying. Holy Living, Holy Dying reminds me of a patient who self referred for therapy. She came for her assessment and I soon realised that this was no ordinary person. She was single and 92 years old. She wanted to talk to a male therapist and she wanted to tell her story before she died. Telling their story is another need in patients which can get forgotten or neglected. The carer: You are in the front line of care. You are another human being caring through professional skill for others in great need. But most of us are wounded healers. The wounded healer comes from the myth of Chiron in Greek Mythology: Chiron became a leader and wise elder amongst the centaurs, half man, half horse. Although renowned for his skills and arts as a healer and physician, which had made him patron saint of these vocations, he was unable to treat an incurable wound in his own knee which he had suffered through an arrow. He was, therefore, known as the 7
  8. 8. wounded healer. He lived with the arrow in his knee, a reminder that he always carried the wound with him, thus making him sensitive to the suffering of others. In my experience of the medical profession, those who are most effective are the ones that are aware of their own lack of omnipotence and this can make them empathetic in their caring. Part of the healing process is the attitude seen on the faces of the one who is caring. What the patient sees in the carer will of course cover a whole range of different images and feelings. This moves me onto the most pivotal aspect of care: the relationship between the carer and the patient. The patient and the carer: The psychological dynamic of this relationship contains at its best a reservoir of useful healing properties. Central to my work as an analyst is the how we understand the transference. Transference is not just confined to analytic work it is present in every relationship. The transference is the dynamic between two people and the unconscious feelings it stirs into action. A smile or a frown can trigger memories and feelings from the past usually in connection with a significant person. Putting it simplistically the nurse can become the ideal mother, the doctor the ideal 8
  9. 9. father, the clergyman or woman the ideal spiritual protector. But beware, the idea, has an opposite. When we fail to live up to what they imagine, we can become demoralised and confused. Having a little knowledge of the transference relationship, can help us to feel a greater sense of separation and even well being. Transference is created when two people get to know one another and our counter-transference is finely tuned to help us understand what we are feeling about the patient. In this special relationship there is the capacity for silence. Some of the most meaningful sessions I have had with patients have been where the tolerance of silence created by the patient has been maintained. It is through silence ‘lost for words’ that so much can happen at a deep psychological level. Knowing that someone is there yet no words being spoken, can be a liberating experience. It is in such situations that we cultivate the capacity for ‘holding’ and ‘containing’ the patient in their feelings. I do believe that touch can play an important part in the therapeutic process of healing. In my ministry I have always had a sense that to touch someone, to hold their hand or gently place my hand on their shoulder has been re-assuring, even life affirming. I remember once making a pastoral visit to one of my congregation who had lost her husband. Intuitively when she answered the door I gave her a hug. She told me 9
  10. 10. later that it had meant so much to her. For two or three weeks after the funeral she had had no physical contact with another person. She had felt isolated and had been suffering a sense of loss, in that her physical relationship with her husband had suddenly been cut off. I turn now to the theological perspective of our caring. Perhaps I should change the word ‘theological’ to ‘spiritual’. Speaking of spirituality I am thinking specifically of Christian Spirituality. For those who have a Christian faith it is important to keep in mind, that central to their understanding of what it means to be human, is the life and ministry of Jesus. He is not only the archetypal healer but also sufferer. The cross is a powerful symbol of the recognition that pain and suffering are for most people part of life’s journey. Ann Ulanov in her book The Wisdom of the Psyche comments ‘The real cross is suffering the hard reality that sometimes situations are in fact insoluble’. Our psyche in totality contains both the propensity to embrace light and darkness. The relationship between the two is both a mystery and an opportunity. We are told that we are made in the image of God. Does this mean that God has both light and darkness? Does God have a shadow side? Jung sought to address this kind of question in his paper Answer to Job. Jung argues that if Christianity claims to be a monotheism it becomes unavoidable to assume that opposites are being contained in 10
  11. 11. God. God cannot be all light and divorced from causing suffering, even inflicting it, as in the case of Job. If God has a dark side does this shock or bring hope? It would give meaning to the cry of dereliction of Jesus from the cross ‘My God, my God, why have you forsaken me?’ It would also give us a new dimension to our faith that God is not an interventionist God. There are things beyond his control, which even spring from his creation. He becomes a relational God, someone who is in the pain and suffering with us and that is the hope that most can embrace. David Nicholson Analytical Psychologist and Methodist Minister 11