76
Sharing the Darkness
think one could say that Joy was 'healed5. She was healed of the anger and the bitterness, the selfishness and the discontent with her very cruel situation. Not only was she healed, but she grew, spiritually and humanly, in a way which amazed us all. I have no doubt that this was the work of God. True, some of us were the channels of this healing, for surely he has no hands but ours. The work though, was his.
Her father, who had found her illness terribly difficult, was able to say of her death, 'It was so beautiful' - and indeed it was. The growth of the spirit is perhaps the most beautiful revelation of God's love that we are privileged to see, and like all beginings of life, it is about the secret emergence of something new and vulnerable in the darkness. In the presence of such mystery one can only bow down in awe.
r; j
10
Out of the Depths
Out of the depths have I cried unto thee, 0 Lord. Lord, hear my voice: let thine ears be attentive to the voice of my supplications. If thou, Lord, shouldest mark iniquities, 0 Lord, who shall stand? (Ps. 130; 1-3 AV)
In July 1987, with only half this book written, I became depressed and quite unable to write. I found it particularly hard since I had set aside the quiet summer months to complete the work, and there I was with time in hand but deserted by my muse. Eventually, in September, I forced myself to begin again and this is what I wrote:
This has been for me a grey, grey summer and my heart has drifted disconsolately like an empty tender loosed from its moorings. Unable to write for a month, because of exhaustion, I have been tossed high on the crest of the wave and pitched into troughs of despair so deep there seemed no escape, the walls black, glossy, impossible to scale. Then, just as my heart had shipped so much sadness it must certainly founder, the tide receded leaving it beached, but intact upon the shore. It is now the Tuesday after the summer Bank Holiday and I sit once more at my desk overlooking Plymouth Sound. The sea is shrouded in a thick cloud of mist and the quiet morning disturbed only by the occasional wail of sirens. A few left over holiday makers make their desultory way along the Hoe while the rest of the world returns to work. As I watch, the mist lifts to reveal the pleasure cruisers riding quietly at anchor. It is the first of September and another Autumn has begun.
Is it right, I wonder, for me to write about my own experience of darkness? Would it not be better to write dispassionately about the problems of stress and depression in carers in
tliete ~
general, outlining the causes and suggesting a few remedies such as counselling, support groups, regular exercise, relaxation and a healthy diet? Oh, that would be safer all right. Then I would be seen as a calm knowledgeable professional, fully in control of my life and job, and people would say, 'Isn't she marvellous? So strong and capable.'
But it is my experience that people are hungry for personal testimony; they want to know how you do it: how you keep slim, handle your guilt about the Third World or cope with anxiety, depression or insomnia. As the years go by and I become in some ways more confident about myself as a person I have become more of a 'stripper' and I have come to understand that, paradoxically, in my weakness lies my great strength. Whereas years ago I thundered eloquently from platform and pulpit about the needs of the Third World, I now sit and talk more gently of the yawning gulf between my ideals and the actual realities of how I live my life. I have learned to laugh at myself in public and share my weaknesses with others so that they may be encouraged, rather than impressed.
More than anything I have learned that we are all frail people, vulnerable and wounded: it is just that some of us are more clever at concealing it than others! And of course the great joke is that it is OK to be frail and wounded because that is the way the Almighty transcendent God made people. The world is not divided into the strong who care and the weak who are cared for. We must each in turn care and be cared for, not just because it is good for us, but because that is the way things are. The hardest thing for those of us who are professional carers is to admit that we are in need, peel off our sweaty socks and let someone' else wash our dirty blistered feet. And when at last we have given in and have allowed someone to care for us, perhaps there is a certain inertia which makes us want to cling to the role of patient, reluctant to take up the task of serving once more. It is easy to forget that so much caring, so much serving is done by people who are weary and in some way not quite whole. Because we want our carers to be strong and invulnerable, we project on to them qualities which in fact they do not have. But again, perhaps that is the way things are because that is the way people are and we must learn to be strong for those who need us most urgently and relax and lower our
^ hi-
guard with those who are able to accept our weakness and to cherish us.
Let me tell you a little of how it is for me. I am the youngest child of a shy artistic English gentlewoman who did not much care for children, and an ambitious clever Australian Air Force officer who from childhood carried all before him. Now, at fifty, with both my parents long since dead, I piece together the fragments of information about them and our life together so that I may understand the woman I am today. The jigsaw is as yet incomplete, but there emerges a picture of conflicting gifts: of a powerful creativity only partially fulfilled in caring for the sick; and a terrible urge to succeed, to be better than other people, to climb every mountain, that has driven me far in my profession but leaves me still restless and hungry for more. Perhaps because I am a religious person, I understand this hunger in part as a longing for God and I am aware of the tension between the contemplative and apostolic sides of my spirit: a tension that is highly creative but easily thrown out of balance if one or another is denied its needs. These personality traits are no doubt bound up in my Irish ancestry: a Celtic temperament with its highs and lows, lyrical strands and a deep earthy pragmatism. Anyway, wherever it all comes from, I am subject to conflicting drives and wild changes in mood which vary from a feeling that I can conquer the world to a.despair in which I have fantasies of ending my life. I have from time to time sought psychiatric help in the belief that I was suffering from a depressive illness but I am assured that it is no more than a deep mood swing and that much of it is under my own control. If what I experience then, is part of the human condition and perhaps particularly common in people who, for whatever reason, drive themselves very hard, then it is worth talking about it rather than pretending it does not happen.
What seems to happen to me is that when I am high I misjudge my capacity for work and other endeavours and take on more things than I have strength for. This folly is compounded by the fact that my fertile imagination dreams up a dozen different schemes of research, broadcasting, education or expanding and improving the care for the dying, and I then set about convincing people that I propose to implement them. Were I not also extremely articulate, this would probably not matter and I would be laughed into
uw ^jriuTing trie uutmusss
submission by my colleagues: but when I am on form I can convince almost anyone of the virtue and viability of my ideas! Thus it is that, like Ogden Nash, I find myself praying:
Dear Lord, observe this bended knee, This visage meek and humble, And heed this confidential plea, Voiced in reverent mumble.
I ask no miracles nor stunts, No heavenly radiogram; I only beg for once, just once, To not be in a jam.
One little moment thy servant craves Of being his own master; One placid vale beneath the waves Of duty and disaster.
Let me not bite more off the cob Than I have teeth to chew; Please let me finish just one job Before the next is due.
from Prayer at the End of a Rope
This spring was another of those occasions when I bit off more than I could chew: lectures at home, lectures abroad, some broadcasting, a film about the hospice and the first half of this book. And it was not as if I did not complete the course: oh, I made it to the finishing line all right, straining at the tape, and the crowds went wild and cheered as I lay, gasping, on the cinders. But then the crowds went home for tea and there was I, alone and shivering with a mouth full of cinders and my heart wrung out like a discarded towel.
It always takes me a long time to accept the connection between the overspending of emotional energy and the depression that follows. If it hit me the next day, perhaps I would learn my lesson, but it does not happen that way. While I am in the middle of it all I ride high and think I am coping beautifully - but then things start to go wrong and I panic. The first thing that goes wrong is my sleep. Instead of waking around half-past six or seven, I wake at five and then four, three and two. My mind races and my guts churn and I know I am done for. The commitments of the next few
Out oj the Depths 81
months rise up in serried rows to mock me and I am mortally afraid. 'Now you've done it,' the voices say. 'You'll make a fool of yourself and no one will ever respect you again. You'll lose your job and what'll you do then?' On and on it goes and the panic rises like gall in my throat. I force myself out of bed and go into the kitchen. The city is dark. All the world is asleep but me. No one else has insomnia like mine, grief like my grief. There is no one I can talk to. I am totally alone. No one loves me. I am a total failure. On and on it goes. I wallow in a sea of guilt, misery and despair.
When one complains about insomnia, people often make banal remarks like, 'Just lie there and relax, it will do you as much good.' Or, 'Why don't you get up and write some letters, or read a book or paint a picture?' It is hard to explain that in the depths of such despair, one is in no state to write letters except desperate self-pitying angry ones to a priest or counsellor, I have two possible choices: I can read a medical textbook or I can pray. Mostly I pray, clutching a mug of cocoa and huddled in sweaters and rugs gazing through my tears at the flickering light of a candle. Sometimes even that is impossible and I read the Psalms of the Divine Office, trying to feel some bond with the monks and nuns who also pray at this unearthly hour. Perhaps it is no coincidence that the^ Psalms of Matins, now boringly called 'The Office of Readings', are so often the sad, angry Psalms of a people trapped by oppression or by circumstance:
My God, my God, why have you forsaken me? You are far from my pleas and the cry of my distress. My God, I call by day and you give no reply; I call by night and I find no peace.
Ps. 21:1-2 Grail
I am fascinated by the number of these psalms of entreaty: perhaps my experience is a much more common human phenomenon than I had realised, but people do not talk about it for fear of what others may think. However that may be, their words echo so clearly my own feelings of loneliness and despair that I can easily make them my own.
I find the same sense of bond with the poet priest Gerard Manley Hopkins when I read Carrion Comfort or another of his poems of desolation, like this sonnet which begins:
I wake and feel the fell of dark, not day,
What hours, O what black hours we have spent
This night! What sights you, heart, saw; ways you went!
And more must, in yet longer lights delay . . .
I find Hopkins difficult to fathom and I do not claim to plumb the depths of this poem, but rather to say that this kind of verse resonates with me when things are black. Curiously enough, it was another of his poems of desolation which helped me begin the ascent out of my most recent pit of despair. I have known Carrion Comfort since my schooldays and loved the imagery of the wrestling with God, but this time it was the first few lines that struck a chord in me, for I realised that I had given up my attempts to overcome depression and was, like Hopkins, tempted to 'feast' upon my despair:
Not, I'll not, carrion comfort, Despair, not feast on thee; Not untwist - slack they may be - these last strands of man In me or, most weary, cry / can no more, I can; Can something, hope, wish day come, not choose not to be. But ah, but O thou terrible, why wouldst thou rude on me Thy wring - world right foot rock? lay a lionlimb against me?
With darksome devouring eyes my bruised bones? and fan,
0 in turns of tempest, me heaped there; me frantic to avoid thee and flee?
Why that my chaff might fly; my grain lie, sheer and clear.
Nay in all that toil, that coil, since (seems) I kissed the rod. Hand rather, my heart lo! lapped strength, stole joy, would laugh, cheer.
Cheer whom though? the hero whose heaven handling flung me, foot trod.
Me? or me that fought him? O which one? is it each one?
That night, that year Of now done darkness I wretch lay wrestling with (my God!)
my God.
Gerard Manley Hopkins Carrion Comfort
When one is very low - or at any rate, when I am very low,
1 search desperately for someone to pull me out. I talk about
uut oj the Depths
83
it to those who support me and I long for some antidepressant pill which will work a miracle and restore me to good spirits and high energy. The really hard thing to accept is that while other people can support me and hold my hand in the darkness, it is / who must make the effort to struggle towards the mouth of the cave. It is I who must make the decision not to feast upon my despair, to tighten up the weary slackened sinews of resolve and determine to hope that day will come. It is hard, very hard, but possible. (Remember that I write of a deep mood swing, not a depressive illness.) This time I listened in a dull fury to the psychiatrist who said, 'Do you take any exercise? Why don't you buy a bicycle or take up swimming! I'm sure you'd be able to sleep better if you were physically exhausted.' I wanted to scream at him and say: 'You don't understand - the sea is too cold, the pool's too small, I'm too exhausted. The hills are too steep to ride a bike - and anyway I hate going out alone.' But this time I was too weary to argue and sullenly acquiesced. Then £rj7£<*te I went home, and, hating him and myself and all the world/ Uf dug out my bathing suit and went to swim in the open air pool.
It was cold - freezing, but I suddenly noticed that the sun was bright and the water shining and the Sound was full of . sailing boats skimming past like a flock of birds, their multicoloured wings gloriously filled by the light evening wind. I sat for a while and watched them and without my noticing it hope crept into my heart again. I have swum every day for three weeks now, struggling out of bed and down the steps to the sea. It is perishing cold, but oh, so beautiful and each tyt day I feel a little stronger and my limbs move more freely. I /w^cT^w had forgotten the view of the harbour and its ships that one gets from the raft anchored off the swimming jetty and I have bbV Ltf/t learned to enjoy the fleeting, undemanding companionship of b&ti-^ the other early morning bathers. It remains to be seen if I have the strength to brave the cold all year round: but for the moment it is enough that I am strong and well again and that I sleep,
What is the meaning, the deeper spiritual meaning, of this kind of experience? Does it have meaning at all? Perhaps, like all life, it has whatever meaning you can wrest out of it, whatever lessons you can learn. I think I can draw two major truths from my own experience of depression, exhaustion,
burnout, whatever it should be called. The first is the lesson of humility. I have to learn and re-learn that I do not have the strength to do all the things I want to do. I cannot hold down a demanding full-time job, fill every spare moment with lecturing, writing and broadcasting and expect to survive. I am only human and I have very human needs. I need time to myself, I need to pray, to play, to read, to be with friends, to have fun. If I am always away or exhausted or working, how can I enter into a healthy relaxed relationship with people. And if I do not cherish my friendships, how can I expect to keep them? Again and again we religious people forget that we are only human and that we have just the same needs as the people we care for. If we are too proud or too stupid or too disorganised to take time out and care for ourselves who will? And if we fall apart, then who will care for those who depend upon us? Do we not owe it to those we serve to accept our limitations and cherish our minds and bodies so that we will be available to serve them a little longer? I have learned to be very wary of the famous prayer of St Ignatius:
Lord Jesus, teach me to be generous, To give and not to count the cost, to fight and not to heed the wounds, To work and not to seek for rest, Save in the knowledge that we do your most holy will.
Is it really the will of God that we should deny our humanity and work ourselves into the ground? I suspect not. I am not talking about times of disaster or emergency - then surely we are all called to push ourselves to the limits of endurance. No - I am talking of routine day to day caring for the sick, the handicapped or the otherwise disadvantaged. If we are to be engaged in this work for a substantial number of years then we must take time out, each day, each week and each year. We must take days off and holidays, like the rest of men and women because, however dedicated, we remain just that: ordinary men and women.
I say this with some passion because there is a tendency for those on the outside to think that people in the caring professions are somehow different, more dedicated and without ordinary human needs. There is a curious disparity
between the voices that say 'I do think the work you do is wonderful. I don't know how you do it: I certainly couldn't' and the voices (paradoxically the same!) that keep a watchdog eye on salaries, sick pay and holidays, lest they get out of hand. The world longs for its Mother Teresa figures because they can put them safely on a pedestal and admire them -but it feels quite differently about nurses (who do the same work) belonging to a trade union and protesting about their salaries! In the past six years I and the nurses with whom I work have cared for nearly one thousand patients in a cramped ten-bed hospice. We are, I believe, by any standards, a devoted group of carers, but we have seen too often the threadbare scratchy behaviour of those who are overstretched not to know that our time out is a vital part of serving. Knowing one's needs is integral to the humility of the carer.
11
The Wounded Healer
And there was one that wrestled with him until daybreak who, seeing that he could not master him, struck him in the socket of his hip, and Jacob's hip was dislocated as he wrestled with him. (Gen. 32:26)
Perhaps the most exasperating, yet at the same time the most exciting thing about the gospels is the richness of their paradox. Do you want to save your life, we are asked? Do you want to live happily ever after? Well then, you must lose it first. Unless you take up your cross you can never be happy. And, speaking of the cross, we must not forget that the cross in Jesus' day meant ignominious death - not just a spiritual symbol of a hard time. Jesus' whole life in fact was a paradox: the barefoot Messiah who was more at home with the outcast then the establishment, the Saviour who himself became a victim of the oppressors - and in his dying, completed his mission. Really, when you think about it, it is very hard to take. St Paul sums up our difficulty when he speaks to his bemused disciples of the folly of the gospel:
And so, while the Jews demand miracles and the Greeks look for wisdom, here are we preaching a crucified Christ; to the Jews an obstacle they cannot get over, to the pagans madness, but to those who have been called, whether they are Jews or Greeks, a Christ who is the power and the wisdom of God. For God's foolishness is wiser than human wisdom, and God's weakness is stronger than human strength. (1 Cor. 1:22-25)
The spiritual life too abounds in paradox. Just as we think we have understood something, it is turned upside down for J us; the mat is pulled out from under our feet and we are left
The Wounded Healer 87
sitting on the floor muttering 'but I thought you said . . .'. Learning to live with paradox is an essential part of humility, of bowing down in baffled awe before a mysterious incomprehensible God. Thus, having written at length about the importance of accepting our limitations and taking care of ourselves in order to survive as carers, I have now to admit that every time I am forced by circumstances or my own stupidity to enter into darkness and suffering I emerge battered, but richer. As the nineteenth-century philosopher Adalbert Stifter wrote, 'Pain is a Holy Angel which shows treasure to man which otherwise remains forever hidden.'
What is it about pain and suffering that make them the instrument or the occasion of revelation, the gift of a loving God? We are back again in Eckhart country - in the territory of the faithful God who frequently lets his friends fall sick, not because he is angry with them but precisely so that they may be purified, may learn to rest upon him alone.
There are two aspects of the experience of personal suffering which I see as relevant to Christian caring and which I wish to explore, The first is the rather pragmatic issue of empathy, of entering into a world of the client; and the second is that much more mysterious business exemplified in the Bible by Jacob's struggle with the angel: the encounter with the living God.
People often ask me if my experience of prison has helped to prepare me for my work with the dying. The answer, of course, is yes, for any major experience of powerlessness must give one some insight, however limited, into the feelings of those facing death. What do I recall of my own experience that can help me understand my patients? What does the prisoner of conscience in a Latin American gaol have in common with the cancer patient? I think my strongest memory is offear: the fear of pain, of helplessness, of brutality, of humiliation, of death. It was a fear that possessed me like a demon, present day and night, lurking like an animal in the shadows. It invaded my very being, rising in the throat like gall, choking like a hand around the jugular. It attacked the knees turning them to jelly so that I could barely walk -and yet did. It attacked the mind, paralysing thought, clouding my vision like the blindfold so that all landmarks disappeared and I was irrevocably disoriented and alone. It was a fear that made me want to scream out in agony, to