I’m going to explore these two themes in a series of
posts over the next few weeks.
Let's start with acknowledging suffering.
Suffering
may be expressed in the poetry of Gerard Manley Hopkins: No worst, there is
none. Pitched past pitch of grief/More pangs will, schooled at forepangs,
wilder ring […..] O the mind, mind has mountains; cliffs of fall/ Frightful,
sheer, no-man-fathomed.
Or in the paintings of Francis
Bacon – currently on exhibition in Tate Liverpool - portraying his subjects ‘enclosed in the wretched glass capsule of the human
individual’.
Or in the expression of collective
suffering when (as WB Yeats puts it) ‘Things
fall apart; the centre cannot hold; Mere anarchy is loosed upon the world’: be it the continuing effects of the Iraq war
or the migration forced by political turmoil in Syria and Libya.
Or in the bristling, frustrated
anguish of 19 year old Darren, piercings through lip, nose and eyebrows,
scarring up both arms, who tells me about parental separation, fostering and
sexual abuse, bullying in school; and how booze keeps him from feeling too much
but leads to fights with friends, nightclub doorman and police. His only
comfort is beating the hell out of his drum kit in the middle of the night. He doesn’t think he’ll live much longer, and I
fear he may be right.
The first thing we need to do is to listen. In the words of the British psychoanalyst Wilfred Bion, we should be listening ‘without memory or desire’: when we listen with memory, we are intent on making the speaker part of an old agenda; when we listen with desire we are intent on making them part of a new one.
To
listen purely, to just listen, is the most valuable thing. But
it is also the most difficult thing. I don’t know about you, but I often find
it exhausting, debilitating, to give my full attention to the suffering of
others.
We often find ways to
protect ourselves – to distance ourselves - from the full emotional impact of
what our patients are trying to tell us. A bit of me doesn’t want to hear what
Darren is telling me – it’s too raw, too real, too painful.
But we can do better.
Ronald Epstein recommends
that we turn toward suffering:
actively seek to recognise it, become curious about the person’s experience,
and intentionally become more present and engaged.
What help me to turn toward
suffering are daily mindfulness meditation, my weekly 5k parkruns, and being
able to discuss knotty problems with my wise wife Sue.
What helps you turn
toward suffering?
Next time - the first steps in offering hope.
Dear Chris
ReplyDeleteThank you for this. As a GP my ideal is to offer this level of listening to my patients. As a human being trying to see 40 patients per day, I become too exhausted. I suspect many, including policy makers, don't see such pure listening as part of the GP role. How to remain a GP, but offer the kind of care to my patients that you describe? Kind regards, Ros Johnston
Hi Ros,
DeleteAbsolutely - the urgent and greatest challenge for our profession? Might be a cop out, but for me - one element has been getting better at listening to ( allowing myself to listen to) my own suffering. So I can then listen to others ... ? I know I really struggle to listen to particular stories that are too close to one of my own at the mo. I also talk with patients about doing the same...giving themselves 'space'/permission to acknowledge their own suffering ( when they feel like they are all used up with other peoples' suffering?).
But we do also need to change the 'system' we work in too!
Come the revolution...?!
Bye for now
Joanne ( also a gp)