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Well Becoming

a blog about being well, becoming well, staying well - and flourishing. Written by a professor and family doctor living between Liverpool, UK and Granada, Spain

Being positive
Sunday, July 31, 2016

For most people, sharing their suffering is just the first step on the way out of the dark woods in which they find themselves.  Let’s now consider the relevance of being positive.


Expressing hope and optimism, and taking a positive approach to a problem, are usually more helpful than expressing doubt and uncertainty.


But we need to be a bit careful how we do this.  


If we are too cheerful too soon, before the other person has had time to tell their story, they may think we just don’t care or understand.  Here’s how Sinéad O’Connor puts it:


I went to the doctor and guess what he told me He said, "Girl, you better try to have fun no matter what you do.  But he's a fool.


 So, don’t rush in too quickly with your hopeful words.


Then we need to think what sort of positive approach is best to take.


I can think of at least four different ways. I may tell Sinéad that I’m an expert and can solve the problem for them; or that we can work on the problem together; or that she has the resources to manage it herself; or that her problem will get easier on its own, given time.  


These approaches all convey hope and optimism, but they are all very different.  We need to tailor them to the understanding of the person we are hoping to help.

For example, an expert approach might be more helpful if Sinéad believed she was suffering from a disease or an illness; but as she sees herself having problems with her relationships, a shared or time-focused approach is more likely to be helpful for her.


So it’s worth finding out how the person we’re hoping to help see things.


In any event, shaping the patient’s story in a more hopeful direction is likely to be valuable.


Talking with Darren, I aim to build on his strengths: his obvious intelligence and his drumming skills. 


And we can see hopeful shaping in this consultation between a doctor and a patient with muscular dystrophy:

P:    It's just quite painful and tiring and depressing.

D:   Yes, yes.

P:    and I've been really cold since I came back, just can't seem   to get warm so it's just very diff-, very depressing. Sorry.

D:   It's not easy to put up with, this, is it? You're obviously somebody, you like to keep very active and getting around the place and doing what you want to do.

P:    I just don't want it to be on top of me, and it feels like it's on top of me.

D: We've got to reverse that, haven't we? We can't get rid of the dystrophy, but you can be on top of it rather than the other way, rather than the other way round somehow.


This is a beautiful example of sensitive, person-centred optimism, which we can all learn from.


Next time – some practical steps to encourage hopefulness.

Like 0        Published at 11:22 AM   Comments (0)

Tears at the heart of things
Sunday, July 24, 2016

Last week I wrote about how difficult it can be to listen to the suffering of other people. I also suggested some ways we can become better at that.  

Here's why this matters: bearing witness to suffering, giving a sense of being understood and accepted, is the first - essential – step towards finding hope.

I’d like to go back a couple of thousand years here, to get some help from the Roman poet Virgil, and his epic poem the Aeneid which describes the travels of Aeneas after the Trojan War.  

Stay with me, this will make sense in a minute!

In the first book of the Aeneid, we find Aeneas as a refugee, driven far from his home by the vicious ravages of the Trojan war. He is in Carthage, gazing at a mural in a temple, which depicts battles of the Trojan War and the deaths of many of his friends and countrymen. He is moved to tears, and offers a rousing tribute to his fallen comrades.

In the middle of this, he says: ‘sunt lacrimae rerum’.  

Yes I know, your Latin is probably a bit rusty, but don’t worry……

These three words - sunt lacrimae rerum - have been translated as either ‘there are tears for things’, or else ‘there are tears of things’.  The first version – tears for things - indicates the burdens we have to bear, the frailty of human existence, the ‘shit life syndrome’ people like Darren (who you met last week) experience. The second version – tears of things- indicates that things feel sorrow for our suffering - that in some sense the universe feels our pain.

But of course it isn’t one or the other. It’s both. Virgil is fully aware of the ambiguity and wishes to us to understand both meanings at the same time. 

So does the Irish poet and scholar Seamus Heaney, who translates the phrase as ‘There are tears at the heart of things.


And this is its richness and power. At that moment when I experience and express compassion for the suffering of the person in the room with me, both senses of sunt lacrimae rerum are simultaneously in play.  They can express pain, distress and suffering, knowing that – from me - they find understanding, compassion and safety. Our meeting place has become, momentarily, a sanctuary.  

Sometimes bearing witness to a person’s suffering in the face of overwhelming life experiences and difficulties, may be all that is possible, or necessary.  


Listening to Darren, behind his angry ranting I hear a lost, lonely, frightened little boy. I want to give him a huge hug and bring him home with me, but I content myself with a friendly smile, a warm handshake, and an agreement to meet again soon.  


What’s your experience of bearing witness to suffering?

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Suffering and Hope
Monday, July 18, 2016

When we’re caring for someone going through difficult experiences in their life, there are two main things we need to do: acknowledge suffering and offer hope

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.




Like 0        Published at 5:32 PM   Comments (0)

Yes country and western music does hold the meaning of life
Tuesday, July 12, 2016

After a long pause, a message from my wife Sue:

I’m listening to Vince Gill- look at us. Also I was checking on the blog and realised there had been a bit of a hiatus in chapters  And realised how the  two probably mirrored life since Chris’ accident 2 years ago.

 But to get back to Vince. To make it easier I’ve cleverly added the words to the blog, well arranged for them to be added.  On the surface it’s a lovely tale of happy ever after.


Look at us after all these years together
Look at us after all that we've been through
Look at us still leaning on each other
If you wanna see how true love should be then just look at us.

Look at you still pretty as a picture
Look at me still crazy over you
Look at us still believing in forever
If you wanna see how true love should be then just look at us.

In a hundred years from now
I know without a doubt
They'll all look back and wonder
How we made it all work out.

Chances are we'll go down in history
When they wanna see
How true love should be
They'll just look at us.

Chances are we'll go down in history

When they wanna see
How true love should be
They'll just look at us.

When they wanna see
How true love should be
They'll just look at us...

But it says more than that.  “After all  that we’ve been through”  No ones’ life is without its ups and downs.  Some much more down than up.  I was on holiday in Crete recently.  Looking at the beautiful Aegean Sea I couldn’t help but think of the refugees who experience it in such a different way. 
Still leaning on each other – that’s what it’s all about. Sometimes one leaning more than the other, and the leant-on wondering if they’ll need a prop to help them not fall over!

 And it’s important that we do recognise when extra props are essential.  Different for everyone.  Maybe friends, medical help, prayer, meditation.  There’s always something however leant on or nearly down we feel. Useful to keep a list of them in your head when time are good so not so much effort to recall when times aren’t so good.  “Here’s one I prepared earlier” we can think to ourselves' ringing a friend to ask for help

  How we made it all work out.  Not just by taking advice from country and western songs although I probably can offer a song for every one of life eventualities.  By working at it.  Doing what’s needed at the time.  Not dismissing the little changes we can make. Since back from my holiday I’ve got involved in MerseyAid, mainly sorting donated clothes for refugees.  And getting Chris not to work too hard is still a work in progress!

So that’s life care of the country scene!

PS  The Dance by Garth Brooks.  Tells us we have to take a chance on life.  Sometimes it works, sometimes it doesn’t.  But you’ll never know till you try.

And now I'm glad I didn't know
The way it all would end the way it all would go
Our lives are better left to chance I could have missed the pain
But I'd have had to miss the dance

Like 0        Published at 5:44 PM   Comments (1)

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