Today is our last day at Boole Poole. We travel again today to the cultural center for further interactions with the community and the elders. We had an extra day at Boole Poole last year and that allowed us to do "doctoring" for some of the elders who came over on the boat. I wrote about that in last year's blogs which are still available at www.futurehealth.org. By doctoring, I mean the aboriginal North American version of energy medicine/osteopathy. I suspect that every culture had its own form of energy medicine and hands-own manipulative medicine, though some do not carry these practices in their current repertoire.
Eventually enough people awoke that we could have a discussion on the veranda around breakfast while the rain continued to steadily fall. Our breakfast question was how to bring spirituality into human services. That led us to consider pathology as an organizer. In medicine and psychology, what's wrong with you, the diagnostic category, has become the pivot point around which everything is organized. The assumption is that diagnosis tells you everything you need to know to assist someone. Then relationship comes not to matter because once the diagnosis is made, anyone can apply the treatment. Spirituality becomes unimportant. It is like the steam generated by a locomotive -- pretty to much but not necessary for the operation of the engine. It is a byproduct that can be ignored. How do we change that?
Our conclusion was that we have to listen to the many stories surrounding the person and to grant validity to all those stories. Everyone has a story about how and why they got sick. Often their stories have fused with the stories of the dominant paradigm, such as "I'm sick because I got bad genes and there's nothing I can do about it." Everyone also has a story about how healing is supposed to happen. We have stories that guide us to what to expect when we consult someone who is supposed to help us. My story in seeking a traditional healer is very different from my story in consulting an orthopedic surgeon. I have different expectations for what they will do to me and for me. But, what if I had an expectation that each of them should see the Divine in me and acknowledge it before proceeding with what they do? That seems logical for the traditional healer, but why can't I also expect that from the orthopedic surgeon? Thus, the human services toward which we are striving includes a willingness to meet people where they are and to experience their experience. As a practitioner in a human service, I need to be willing to "be in the story" that's brought to me. I need to "be in the details". I cannot maintain the same level of clinical distance characteristic of the biomedical paradigm. I actually have to be empathic. I actually have to care even if I can't do more than that. Caring and listening are powerful interventions even if nothing else can be done.
This led us to discuss the indoctrination that new professionals receive. Their training and socialization makes them less able to interact with aboriginal people. Some people enjoy formality and distance. Most aboriginal patients do not -- at least not in the same way. I know I want to feel heard. I want to believe that someone cares enough about me to hear all the stories that I feel I need to tell. Perhaps he or she will care enough to elicit some stories from me that I didn't know I had. I need to enter into the stories of my clients enough to share some lived space ("Lebenswelt") with them. That is considered unprofessional in some circles. I am not saying I need to share my ongoing problems with them, though I do use stories about problems I have solved as teaching tales with clients. I think we distance ourselves from clients related to our fear of ambiguity, mystery, and helplessness. The biomedical model purports to give us a certainty that it doesn't deliver. However, if we scrunch our eyes tightly shut, we can pretend that all is as it says it is and that we have certainty. Sometimes we are helpless to do anything and we don't like that either. We are afraid to not know the answer. If I can maintain enough distance, I won't be affected by the vicissitudes of my clients' lives, including when they die. In the biomedical model, I can't afford to care too much. I can't afford to love my patients.
Doctors and patients often come from radically different cultures. Implicit within this is a difference in class and wealth. Managed care in the United States has removed much of the wealth possibility from doctors, but the image remains. In other countries, doctors never had the wealth potential that they had in the capitalist countries. When we come from different cultures, we may have such stereotyped stories about each other that we are incapable of listening or interacting. We interact as if both of us were wearing a mask. Maybe we are!
We agreed that our shared task, and what culture camp accomplishes, is to build bridges with others who are trying to see the world and human services differently. Our current systems do not encourage emotions for and with the clients. We want to change that and to experience the human condition with them and from them. When we do that, we bring spirituality into our practice because that is one aspect of being human -- to reach out to what is greater than us, to contemplate larger powers, to appreciate our small stature in the universe and to be awed by the vastness of all we can perceive.
Culture camp is giving us a shared language for how to move in this direction. It is validating our experience of wanting to hear each other's' stories. By observing each other working in our own context, we learn to more deeply appreciate the human stories and to see the richness of our own. Seeing others' cultures helps us to find our own hidden assumptions, the beliefs and stories generating those beliefs that we don't know we have. We have trouble seeing the stories which surrounded us when we were born as stories. We think of them as ineluctable facts. Seeing others who don't share those most basic stories helps us to recognize our own.
One of the aboriginal elders told us that those who have lost sight of the world as animated and magical need to practice seeing the artifacts and sacred objects as really alive. They need to learn to see the energy around the object instead of the object itself. Compassion is the ears getting bigger and bigger, she said. "Call upon your ancestors," she said, "and hear everything without judging." We talked about the difference between judgment and discernment. I can discern that I don't want to be involved in a particular process or don't want it for myself, without being critical of those who are involved in that process. We heard about the young men from Idaho who come to the Northern Territories to convert the locals to the Church of Latter Day Saints. They are on a mission. They look so out of place in the tropics wearing white shirts and ties. They must always be home at 10pm. "I don't want their religion or to do what they're doing," one man said, "but I don't judge them for doing it. Being in this strange new place must be quite exciting for a sheltered young person from the rural United States."