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Sunday
May072017

Book review: the Outrun by Amy Liptrot January 2016

The Outrun is a book about recovery.  It charts Amy’s journey from the rock bottom of self destructive alcoholism and shows there is a way, if tortuous and difficult, to gradually, and slowly heal.  Why review this book?  Why now?

I think this is an important book.  I don't think it is always great literature, though many reviewers would agree with me, but the issues she tackles, and the honesty and transparency of her recovery process are relevant, to me, and judging from the highlighting in the kindle version, many other people.

Amy describes her childhood in Orkney, growing up on a farm close to Scara Brae, with parents who combined hope for a new life with mental illness and evangelic Christianity. From her teenage years she strives for excitement and escape, drinking increasingly heavily.  This pattern continues when she moves to London, where she finds herself in a bubble of drinking, drugs, successive failed jobs, and endless moves, frustrated flat mates, and eventually ending up in a tiny lonely bedsit. After many dangerous and humiliating experiences she decides to enter rehab, a three-month detoxification process.

Newly sober, she returns home to Orkney, and gets a job with the RSPB, tracking corncrakes.  Through this link she is able to spend a winter on the tiny island of Papa Westray (“Papay”), living in a pink cottage, baking bread, walking, and immersing herself in the Island culture, environment and wildlife, connected to the wider world through a variable internet cable.

She becomes fascinated by the world around her, by the stars, by the ships that pass, the wildlife and the birds that nest around Papay’s rocky shores, and how the islands small community survives and thrives.  The chapters become increasingly circular as she weaves together her experiences in Orkney, in London, in rehab, and in Papa Westray, searching for meaning, striving to make sense of why all this happened, and drawing in the healing power of the island and nature.  For me this book is very much about someone trying to find themselves, moving from a gaping, painful hole, to a sense of who they are, and who they are in the world.

I resonate with much of this book.  I have lived in or visited all the places in the book, including Papa Westray, which is a very special island.  I have not been an alcoholic, but I have been in love with one, attended AA meetings and addressed my own needs through Al Anon.  I have experienced that sense of searching, a need for continual movement, which runs through the book. 

One reader described the books’ style as “relentless”.  We are treated to her thoughts, and more thoughts, moving between topics and time, linked by sometimes over-worked metaphors. There is no dialogue and other characters are often sketchy, possibly to protect them.  This is a book about her process, her thinking, and her sense making.  It may not be yours.  Throughout the book there are moments that will stay in your mind, where she captures the utter degradation of her addiction, or the absolute wonder and beauty of the night sky, the sea, or cliffs that surround her. Or you may enjoy the highly informative tangents that make up much of the second part of the book. 

I started by saying this is an important book, and I believe it is because it contains hope. It shows recovery is possible, and she articulates brilliantly how opening herself to the natural world, observing, becoming curious, attuning to tides and seasons helps this process, and helps her to know who she is.  The book  certainly has its flaws, but I would recommend it.

Friday
Jan062017

Book review: Being Mortal: Illness, Medicine and What Matters in the End by Atul Gawande 2015

This book stopped me in my tracks.  It is a closely argued, passionate, moving and powerful book, addressing uncomfortable issues that affect all of us.

 Dr Gawande starts with looking at ageing, and how old age is a relatively new phenomena.   It is only in the last 50 years that large numbers of people in western societies have started living into their 80’s and beyond.   I remember learning about the age pyramid:  lots of children at the bottom and then tailing off to just a very few people at the top.  But in western societies we no longer have a pyramid, because people don’t die young very much any more, so we have something approaching a rectangle.

This change is happening across the world, as societies become more wealthy.  Gawande reflects on the role of the extended family, which it is easy to idolise as a perfect solution: and how this is really dependent on there being very few old people to look after and revere.  But this system is challenged when there are lots of old people, and proportionately fewer children to look after them.

Medical advances mean that we now expect to be cured of any life threatening disease.  He points out that this is relatively new (certainly in western society) but documents how pervasive this belief is. This ability to keep ourselves alive means that the majority of us are living far longer than before, and expect to live full and independent lives.  Our mortality and the effects of ageing therefore catch us unawares.

The central section of the book considers how we can retain meaning in our lives when we get to the stage where we need assistance and care.  Through a series of case studies he describes ways that individuals have set out to provide alternatives to institutionalised nursing and “old peoples homes”.  Conventional institutions are great at keeping people alive, but what for?  He looks at approaches that have allowed people to stay in their own homes, providing support on an outreach basis, that have brought institutions (and their residents) to life by bringing in birds, animals and children, and nursing care that has stood convention on its head by allowing residents to lock their doors, have their own kitchens, and go for solitary walks when they wish to (or even have sex).  I found this section fascinating, inspiring at what a few individuals could do, and the challenge to the dominance of keeping people safe rather than happy.  As all the examples are from the US I was intrigued to know whether these initiatives were also happening in the UK.  His enthusiasm for understanding older people is infectious, and I found myself wondering what I needed to learn to be more useful to this ever increasing group of people.  Which of course, will, at some stage, include me.

He then addresses the issue of mortality itself, and the tendency, in the US at least, to avoid talking about a person’s imminent death. His stories describe people continuing with complex medical interventions, even if they had little chance of success, and in actually shortened people’s lives rather than extended them.  Many years ago I remember being shocked that surgeons had amputated my grandmothers leg as she lay dying in hospital. Fortunately she wasn’t aware of it, but I wondered why.  Why could she not be allowed to live her last few days in relative peace?  

He contrasts the medical approach (including his own) with that of the hospice teams, who aren’t afraid to talk about death, but instead talk about life. 

What do you most need right now?

 What do you fear most? 

What is important to you, and what would make a good day for you?” 

His stories show how this approach helps to relieve people’s fears, to focus on what is most important to them, achieve what they absolutely need to  (e.g. attending a wedding) and give them space to die.  Interestingly, he cites statistics that show that people choosing a hospice approach rather than further medical intervention often live longer, quite possibly because they have taken back control of their lives, and crucially, worked within their reality of what is possible at that moment, for that day.

The final chapter describes his own father’s aging and death and his struggles with this, as the notions of mortality move from the beautifully written stories about other people to the deeply personal.  This transition took me on a similar and uncomfortable journey.  Reading the initial chapters about aging, and retaining dignity and choice helped me to understand some of the issues around my father’s situation, and seemed very positive, and also reasonably distant and manageable.  The final chapter however reminds us that death will come for all of us, to those we love most in the world, to ourselves, and it may not come when we want it to. 

The book ends on a sombre note, but it is also deeply alive.  More than anything this is a book encouraging us to ask questions, to find out what is important to people and to find ways to support them, and above all to remember that we are human.  And being human involves being born, living a finite life, and then dying, and all parts are important.

 

Saturday
Jul022016

Making sense of loss and grief

 

 

Just at the moment, many of us are in a state of pronounced grief.  We have embarked on a massive change, and any change brings loss.  Even those who welcomed the referendum result will still be adjusting to change and the prospect of living in a very different world.

From a therapeutic point of view, thinking about Kubler Ross’s ideas of how we work through grief is helpful.  The diagram shows it as a wave, but it isn’t a linear process, and  it is often shown with stages in different orders, but the important point is that all stages are necessary.  And they take time.

When we are faced with loss, whether unexpected, or anticipated, as when terminally ill loved one dies, there is always an element of shock and denial.  To feel a mix of feelings, or none at all is entirely normal.  As the confusion and denial passes, we start to feel angry, and this anger is important.  People who can get angry and express these feelings when faced with bereavement often process their grief more effectively.  When we find it hard to get angry or turn this anger internally, we may well get stuck longer with unprocessed grief.

The important thing about depression after loss is that it is normal.  It is our wholly human response as we feel great sadness.  The colour goes out of our world, our energy diminishes, and we lose interest in our surroundings for a while as we process the feelings inside.  It isn’t a permanent state, even if it can feel endless. These feelings will pass.

 Much of our work at Solace is about helping people to find some meaning in the losses and trauma they have experienced, to help people tell their story, and to re-emerge as human beings who have suffered greatly, experiences unimaginable losses and who can, accepting all this, live their lives fully.  Over a week on from the referendum, many of us still find it hard to talk about very much else.  This bargaining phase is all about trying to make some sense of it all.

 Acceptance in the case of the referendum result will mean different things to different people.  For some, it means literally accepting the result and getting down to making a success of where we are. Theresa May appears to be doing this!  For others it may well mean finding new energy to stopping Brexit happening (such as the recent growth in the Lib Dems and the Green Party).

 This blog isn’t about politics, but is intended to be helpful in understanding how we might be feeling, and to put our feelings into the context of a very natural process.  A process that we experience every time we lose somebody,  or make a major change in our lives, planned or unplanned.

Saturday
Jun252016

The challenge of uncertainty

The result of the EU referendum, whichever way you voted, or didn't vote, has been a shock, and a massive change to the world as we know it.  My own reaction was one of distress and mourning, for stability and security, for shared values, and for the belief I hold dearly, that we are always better together than apart.  My fears and grief were deepened by the SNPs inevitable call for a second devolution referendum, and the very real likelihood that this time, they will succeed.

 So what to do? Emigrate to Canada?  Move to Scotland?  Wear a big badge saying “it wasn’t me” or maybe, start talking to people to find out what this is all about.

 In the shock of Friday I found myself wondering:

“what is this challenging me to be?”

And this was a helpful question to ask myself. 

I felt first and foremost I needed to be grown up, to be reassuring, to communicate my own feelings and fears and to listen to others.  At first I needed to hear others’ fears and grief, and then as I became stronger, I was ready to sit with people who had voted leave, to hear why they believed this was the right option.  Hearing well thought out arguments for this decision helped, even if I didn't fully agree with them.

So what actions should I take?  In times of uncertainty our core values come to the fore.  What really matters to you?

I am passionate about our environment, so thinking about how I support the protection of our natural world once we leave the EU is of paramount importance.   I also believe in dialogue and understanding, and finding a peaceful, positive path through situations.  Other people may see trying to ensure that the Conservative party has a leader of integrity as a top priority.  Still others focus on reaching out to neighbours, friends and colleagues from other European countries to show that they are still valued and welcome. 

What would it be for you?

If nothing else, this referendum has shown that what we do matters.  Our actions have consequences, and this one will have consequences, good or bad, for many generations to come.

Monday
Jun202016

Why I love working with a sand tray

Isn’t that just for kids? 

Well, yes, sand tray therapy works brilliantly with kids.  It was developed as a form of therapy, by amongst others, Virginia Axline, who wrote the landmark childrens’ therapy book “Dibs: in search of self”.

And it also works really well with many adults.

 

What is a sand tray?  And what is sand tray therapy?

A sand tray is a rectangular shallow box, with fine sand in, that feels pleasant to run your fingers through.  Alongside the tray are objects, a whole range of different sorts of objects that you can choose to represent the issue that you are exploring, and to explore your own personal world.  My collection of objects includes stones, feathers, shells, domestic and wild animals, monsters, dinosaurs and heroes, a clock, a bell, mirrors, ribbons, and many strange and wonderful items that are not easily summarised and described.

To work with the sand tray, I invite the client to choose items that appeal to them in some way and place them as they wish in the tray.   It may be to create a specific scene to explore an issue, or a broader representation of your world right now.   The edge of the tray provides a safe boundary in which to contain the work, which can make difficult issues much more manageable.   I have used sand trays to explore support systems, to recognise strengths, to explore relationship issues and illuminate internal conflicts and feelings.

I value using sand trays in my work, and in my own therapy (the tray above is one of mine) because they always show something new.  They allow us to connect with our unconscious, and to follow our intuition in choosing items and placing them, and noticing how they relate to each other.  It isn’t a thinking exercise, and there is no right and wrong: whatever appears is there to help us.  I am often impacted by the emotion that can be expressed in the sand tray, as we suddenly see part of ourselves, and make that connection.

Sand trays are particularly good when words seem to be failing to reach what the issue is all about.  By bringing in intuition and touch, and the scope to physically move things around, to build, bury, remove and replace items we can open up new insights that words might never uncover.  And as we explore an issue at arms length, with our hands, and recognise the resources we can release stuck situations and gain new choices.

My sand tray is always available to use: some of my clients love it, some never use it.  The choice is yours!