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 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
OO onanng trie uarnnesi
cower like an animal, teeth bared, quivering. But of course I did not. People do not. They hang on, nerve and sinew, externally calm, wearing dignity like an armour even when their clothes have been torn away, leaving their bodies exposed and vulnerable. Outsiders sometimes speak of the degradation of prisoners - but I never felt degraded: just hurt, vulnerable and afraid. All this was hard, very hard, but I never lost hope. Even when I was afraid of dying, I believed that I would survive - and I did. So, hard as my experience was, how can I really plumb the depths of the fear of those who know that they are going to die? But at least I have had a taste of fear, and I can offer my hand across the void.
The second major experience as a prisoner that I share with those I care for, is a feeling of loss. It is perhaps impossible for those who have always been in command of their lives and affairs to know what it is like to have the controls suddenly wrenched from their grasp.
It is hard for those who have never known persecution,
And who have never known a Christian,
To believe these tales of Christian persecution.
It is hard for those who live near a Bank
To doubt the security of their money.
It is hard for those who live near a Police Station
To believe in the triumph of violence.
T. S. Eliot from The Rock, ch, VI
Just as it is hard for those who have always slept safely in their beds to understand what it means to lose their liberty, so it is difficult' for those of us whose bodies have always answered our command, to understand what it is to have legs that neither move nor feel or a bladder over which there is no control. In prison I lost my freedom to move at will, to go to the bathroom when I needed, to eat when I was hungry, to read or write. But at least my mind remained alert and my sphincters intact. When I looked between the bars of my cell I longed for the feel of grass under my feet - for the day when I would tou.ch it again. But the dying look out of their window at the cars and know they will never drive again. The sailors smell the sea air and know that they have held the tiller for the last time. That is loss. I cannot fathom it, merely skim the surface.
The Wounded Healer 89
What I do share however, is the loss of that sense of immortality, of invulnerability which is the pride of youth. Once the impossible, the unspeakable has happened, nothing is ever impossible again. Every creak upon the stair is an enemy, every car backfiring a machine gun, every fleeting pain a sign of cancer. But perhaps this loss is no bad thing, for it gives one a shared insecurity, a bond with the old lady who has been mugged, with the girl who was raped, with the man whose constipation turned out to be cancer. One loses the protective belief that car accidents, brain tumours and physical violence are things that happen to other people, and knows that they can happen to one.
As I write this it sounds rather negative and hard but I do not mean it to be so. Happiness grounded in reality is far deeper than that built upon fantasy, and suffering teaches one that happiness can catch a person unawares in the midst of deprivation and desolation. There is a certain stripping away of the externals which makes one more sensitive to joy as well as to sorow. More of this later.
My time in prison then, has enabled me to experience in came propria, as the Latins say, in my own flesh, what it is like to be unutterably alone and afraid of pain and death. In this sense I have been gifted, prepared for my work with the dying. There are, however, other much more common and rather banal experiences which have also helped me enter the world of the terminally ill. I spoke earlier of my fury at the lack of privacy in a gynaecological outpatients clinic and how I felt humiliated at the exposure not of my body but of my neurotic behaviour. We British have, I think, a terror of behaving badly and have somehow been indoctrinated with certain very submissive codes of behaviour in relation to our medical carers. So many people, when I talk to them about dying or about the impending death of those they love, find themselves struggling with tears and almost to a man they apologise for crying and for wasting my time. It is a great joy to be able to give people permission to cry, to be angry, to be sad - to be' what I like to call a paid-up member of the human race.
Psychotherapists in particular pay special attention to providing conditions in which their clients feel 'safe' to be themselves. Carl Rogers, in his book On becoming a Person talks about the 'conditions for growth' in the therapeutic
snaring the lJarKness
The Wounded Healer
91
relationship. The first of these conditions is what he calls Congruence. By this he means that the therapist, be he/she doctor, priest, teacher or parent, should not only be aware of his/her own deepest feelings but should act in keeping with them. By this he means that not only should we acknowledge our feelings to ourselves but we should not hide behind a facade, pretending to be someone we are not. Our clients will only feel safe to be themselves if we are our true selves. I find that behaving in a warm and informal manner with my clients is in itself a powerful therapeutic tool, defusing much of the fear engendered by 'going to the doctor'. The second, condition is that the therapist should exhibit empathy: that he should experience the private world of the client as if it were his own. The third condition for growth is what Rogers called Unconditional Positive Regard. This means in effect that our attitude to our client is without judgement. We leave them space to be angry, to talk of their dark side, safe in the knowledge that nothing they say or do will make us reject them. They are freed from the terror that if they reveal too much of themselves or say 'the wrong thing' the doctor/priest will freeze and become pompous or angry and show them the door.
The fourth and last condition is that we allow the client to experience something of our congruence, our empathy and our unconditional positive -egard. It is no good caring deeply for people and concealing this behind a barrier of icy professional detachment. If people do not know themselves cared for, they will be prey to a thousand fears of being misunderstood or rejected. Having experienced this kind of care myself from priests and other professional carers, I know that the feeling of security arid affirmation engendered is enormously healing. I believe it is one of the most important ways we can experience and mediate Christ's love.
I believe too that it is easier to be open and sensitive to people in this way if we have experienced some of the small fears and humiliations to which they are subject.
A recent severe asthmatic attack gave me a small taste of the terror of those who fight for enough breath to stay alive, and also of the. awful anxiety and indecision of the half-way stage in which one does not know if one is bad enough to call the doctor and if he will think one is a fool for calling him in the middle of the night. Hard too was the experience of the
brisk young doctor who stood at the foot of my bed in the hospital and said, 'I'm sure you'd like to go home' - when I could not face either the prospect of being alone or being a 'burden' on my family and friends.
Enough. Hard as it is to be ill, I find that each episode, when it is over, has been in some sense a gift. It has taught me a little more about myself and about people in general and it has given me another tool with which to practise my art. I like to think that the wounded healer is more sensitive and compassionate than those who are strong and 'whole'.
There is, however, another quite different aspect to the personal experience of suffering which has relevance to the way we function as carers, and that is the way in which suffering can be for us an encounter with the living God. This is a very mysterious business which is not easy to write about for the experience is by no means constant and universal. Clearly, severe personal suffering is for some people a disaster, destroying their faith both in God and in human nature, leaving them permanently damaged and embittered. Others, however, are immeasurably strengthened and transformed as people, becoming filled with a peace and generosity which makes them almost incandescent and a source of strength to those they meet. One such person was Margaret, a lady in her-fifties who spent three months with us at the hospice before she died. The cancer which afflicted her spread to her bones, weakening them so that they fractured and in her last weeks she had fractures of her spine, leg and arms. Unable to turn over in bed or move her hands more than a few inches, she spent her days for others. She arranged presents for all those she loved: a painting of their favourite picnic spot for her husband; an enlarged photograph for me and so on. For a long time she set her heart on going home, but when she realised that this was impossible, she accepted it and turned her gaze outwards, rejoicing in the comings and goings of her family and staff. Immobile, incontinent, in pain, she was a woman supremely in control of herself, giving strength to all who came to her bedside. It would come as no surprise to hear that Margaret was a woman of deep Christian faith who had put her trust in God and was sustained by him. As it happened, however, she had no faith in God or in a life hereafter. Throughout her illness she remained firm in her belief that her death would be the end. Her faith was in love
and in people and that was enough to sustain her in what seemed to be a heroically selfless life.
I tell this story because it is so important that we Christians do not delude ourselves that we have a monopoly on goodness. I have met many generous Christian nurses and doctors but many more equally selfless non-believers. The spirit of God knows no cultural, national or denominational boundaries.
Once again it seems appropriate to write from personal experience of suffering and what it has taught me. This time I write of the intangible, the unknowable: of what I understand as an encounter with God. The experience is one which has changed my life in that it has given me a sort of carnal knowledge, a gut level conviction of an all powerful, loving God. This conviction is, I believe, the greatest gift that I bring to my work, enabling me somehow to sustain those who are afraid and in pain.
My particular encounter with God happened in the context of solitary confinement in prison - but it could just as well have been after a major accident, an illness or bereavement. The essence of the situation was that it was an experience of stripping and of powerlessness, which made me more aware, more open to the presence of God.
It happened like this. After I had been arrested and interrogated by the secret police for treating a wounded revolutionary, I was moved from the torture centre to another prison and placed in solitary confinement. Here, left to my own devices and with the constant harassment of the interrogation behind me I found that, for the first time since my arrest, I had sufficient emotional and intellectual space to manoeuvre, to choose what to do. My immediate inclination was to scream out to God for help, to batter spiritually on the bars of my cage, begging to be released. Surely I who was planning to devote my life to him as a nun, must be specially loved and able to ask his favour? Then a very curious thing suggested itself to me: while I knew that it was quite right and proper that I should besiege heaven with my prayers to be released, an even better way would be to hold out my empty hands to God, not in supplication but in offering. I would say, not 'Please let me out' but, 'Here I am Lord, take me. I trust you, Do with me what you will.' In my powerlessness and captivity there remained to me one freedom: I could abandon myself into the hands of God. Perhaps it was no
J tie Wounded Healer
93
coincidence that I received from a friend a book containing the following poem:
Abandonment
What is an abandonment experience? Is it leaving oneself on God's doorstep, walking into the rest of life, not allowing anxiety, fear,
frustration to enter into one? Is it expecting God to keep one warm,
secure,
and safe,
unharmed? Is that abandonment?
Abandonment has nothing to do with warmth of womb or arms or close clasped hearts.
It is not something done by a child. It is done to him. It cannot be done to an adult. It is done by him. - Abandonment is committed only with and in the maturity of Christ Jesus. It is not just a hanging loose. It is a letting go.
It is a severing of the strings by which one manipulates, controls, administrates the forces in one's life. Abandonment is receiving all things the way one receives a gift with opened hands, an opened heart.
Abandonment to God
is the climactic point in any man's life.
Anon, in Edward Farrell Disciples and other Strangers
So for the next three weeks I struggled to let go the strings of my life, to hand myself over to God. It was not a once and forever dramatic gesture, but a long and terrible struggle, a wrestling with an unseen stranger in the dark hours of the night. The fight had begun some months before in the grounds of a retreat house outside Santiago when I had taken a week apart to pray and discern whether or not I had a vocation to become a nun. It was then that I had conceived the idea of my life as a bank cheque to be made payable to God, the amount and the time of cashing being left to the drawer. It had seemed hard then, as I lay in tears on a pile of autumn leaves and made my 'fiat' but it was in some sense a pious game. Now however, my bluff was being called. I had made my life over to God then, so did I now wish to withdraw that offer? Were there strings attached to my gift, conditions to my loving? Day after day I struggled. Sometimes I snatched the cheque back and tore it in half or threw it to the floor; then at other times, when my tears were spent, I would pick it up and, smoothing the stained paper, Sellotape the torn fragments together and hand it over again. How many times this drama enacted itself I do not know, but there came a day when I no longer wanted to take the cheque back and I was able to make my own the prayer of St Ignatius, 'Grant that I may love thee always, then do with me what thou wilt.'
This abandonment experience of mine of course took place in the rather melodramatic context of a Chilean gaol, but it could equally well have happened in a British hospital, a convent or a suburban house. The act was an interior one, a spiritual manoeuvre taking place within the confines of physical powerlessness. This option for abandonment is available to all who find themselves trapped by circumstance and is the means by which the imprisoned can transcend their bonds. Like a bird in a cage they can choose to exhaust themselves battering their wings against the bars - or they can learn to live within the confines of their prison and find, to their surprise, that they have the strength to sing. Those who are given the courage to accept their situation find that they have far greater reserves of emotional energy than they had realised, for that strength which they had hitherto exhausted in a vain effort to escape is now available to them to adapt to their situation. Helping people accept what is happening to them is an important part of my work with the
/ ne wounded Healer
95
dying and it involves, not, as is commonly thought, a givine up of struggle, but a letting go in order to grow and be free At the beginning of this passage on abandonment I spoke boldly of an encounter with God. It is difficult to speak clearly of this kind of experience. It is not a question of visions or voices, but, like Jacob, one knows that one has wrestled all night with a stranger, and as daylight breaks, emerged limping but somehow blessed.
Living in Unity
97
12
Living in Unity
How good and how pleasant it is, When brothers live in unity!
Ps. 132:1 Grail
Having written at some length of the experience of personal suffering and the manner in which it both humbles and shapes us, I turn to another very important cause of pain in carers: inter-personal conflict. As in the rest of this book, I do not offer clear answers - just a few recollections from someone in the middle of a particular situation: a small hospice for the terminally ill.
The first thing that must be said is that conflict is endemic in communities, and that not only is it a cause of much individual suffering, but it can be very damaging to the work of the group. The next observation is that this conflict is frequently hidden from the casual observer - patients or families cared for in a hospice, retreatants in a guest house or visitors to a monastic community. I have often shared with friends involved in retreat work or other communities the wry humour they feel when visitors exclaim, 'What a marvellous atmosphere - you can feel it as soon as you come in!' One smiles enigmatically and makes no comment, hoping devoutly that the tense voices behind the closed door will remain inaudible and that the scars on one's heart can be concealed just a little longer.
Gerard Manley Hopkins in his poem In the Valley of the Elwy captures that very special feeling of welcome that some houses can evoke in the visitor:
I remember a house where all were good To me,- God knows deserving no such thing: Comforting smell breathed at very entering,
Fetched fresh, as I suppose off some sweet wood. That cordial air made those kind people a hood All over, as a bevy of eggs the mothering wing Will, or mild nights the new morsels of spring: Why, it seemed of course, seemed of right it should.
I have long thought that this poem referred to St Beunos, the massive Jesuit house in the Clwyd valley where Hopkins wrote much of his poetry, and where from time to time I have found refuge when my heart was troubled. He is, however, referring not to his religious community but to some friends in London! On reflection this comes as no surprise because Hopkins was too close to his own community not to be painfully aware of the disharmony behind the welcoming facade.
I write faqade for that is what it is: we present quite unconsciously to the stranger a warmth and welcome which is only one facet of the truth of our community life. We allow them to share, for a time, in our riches of love and companionship, but shield them from the painful forces by which we are being shaped as a group of people. Like the whole of creation, we are groaning in a great travail. God is at work in us, stripping, hollowing, moulding, purifying, in a process which is infinitely painful but without which we would never become a community. I find it rather a joke that I who after twenty years 'vocationitis' found that I was quite unsuited to religious life should end up, after all, in the heart of a community of women. If one believes in a God who 'writes straight with crooked lines', then perhaps the eighteen months I spent as a novice was a formation, not as I had intended, for starting my own monastic community, but for being the medical director of a cancer hospice! Let me share with you my experience of community life, for what it lacks in depth it makes up for in variety!
My first experience of community, like so many Catholic schoolgirls, was a boarding school run by nuns. In the early 1950s Catholics rejoiced in an intellectual security concerning the ways of God which the Second Vatican Council was to explode for ever. The nuns knew with a deep certainty that the religious life was the highest possible way of serving God and that anyone who had a 'vocation - a calling' to become I a nun was especially loved by God.
It should come as no surprise therefore that many of the