The language of compassion

We are all pioneers of a sort - rough frontiersmen and women. The so-called helping professions are at the beginning of an exciting journey that attempts to explore and enlarge human awareness and establish new disciplines - echoing some of the experiences of sixteenth-century physics. It is a fresh form of alchemy. There is the same sense of arrant nonsense and profound wisdom jostling side by side - often very difficult to tell which is which.
David Brandon (1941-2001)

Here's a vignette from a (very helpful) training exercise at a Buddhist Chaplaincy (Kalyana Mitra) study day, intended to develop competencies required for the chaplaincy task:

'Helen grew up in a small market town, trained as a teacher, and started a family. She had always been used to walking in the countryside as a way of ensuring that her career and family life didn't become too stressful for her.

Following the birth of her second child, however, Helen began to experience some unusual phenomena related to her walks in the country. She started seeing patterns in that nature which she hadn't perceived before; believed certain trees were speaking to her, and felt herself and her two children being drawn towards the lake.

These experiences reached such a pitch that she became very unwell; there were concerns about the safety of the children, and Helen was referred to the crisis resolution team.

Helen has no particular religious faith, but her spirituality is very much linked with her love of nature, and her love of children, especially her own children.'

To encourage reflection and discussion, the exercise poses the following question:

How can the chaplaincy service assist Helen to continue with a spiritual journey without aspects of it leading her on a path which might endanger her and her children?

For me, this vignette is characteristic of the 'mental health' mindset: it proceeds from genteel, middle class professional inferences (assumptions) about class, aspiration and lifestyle; it travels smoothly and without hesitation or doubt towards a further set of description of Helen's experiences. These seem to be a further set of inferences, couched in language that is at once tentative and non-attributable (the authorship is vague) and, at the same time, both authoritative and vaguely threatening.

Such language, it seems to me, is carefully crafted to combine a dual purpose: to convey a message of well-informed concern and benevolence on the one hand; on the other to imply a perilous or dangerous situation, a potentially malignant state of mind, a pressing need for urgent for intervention, and a presumptive right to do so. The language, at first reading, seems to be sympathetic, even empathic, full of well-judged concern: the language of compassion.

I also detect an unchallengeable conviction of the rightness of the view expressed; and an implied warning along these lines: "you would do well to consider that it might be imprudent, reckless even, not to accept this assessment of the situation, not to align your own opinion with this reasonable paradigm. Specifically would you want to risk the possibility of, and take responsibility for, serious harm to defenceless children at the hands of a hopelessly deluded mother?" None of this is stated so bluntly, of course.

How is this murderous intent, and the need to forestall an insane crime, implied in a few lines of anonymous reportage?

"Helen grew up in a small market town, trained as a teacher, and started a family". Helen, the writer seems to imply, is of archetypally wholesome and uncomplicated rural provenance, of modest intellectual capacity and ambition, heterosexual, and defined at least in part by her wish to become a mother within a conventional nuclear family. So far, so unexceptional; the sort of person, perhaps, who has known her family doctor since childhood, and whose parents live in the same town and happily babysit their grandchildren when invited.

"She has always been used to walking in the countryside as a way of making sure that her career and her family life didn't become too stressful for her." Note that reference to her "always" being used to country walks emphasises her rural origins, although presumably she has only "always" used these walks "as a way of making sure that her career and family life didn't become too stressful for her" since she had a career, and had a family.

One might imagine that Helen herself had volunteered this information about stress-management, but there is no evidence of this; indeed, none of the information about Helen is corroborated by actual statements she made, included in her own words. They might as well have been from third parties, or even made up. But the overall effect is to show concern for Helen, as a likeable young woman who organised her leisure responsibly, so as to maintain her personal and professional equilibrium: an example of good-housekeeping in every sense of the word.

Note that nothing is said or hinted at that might detract from or cast a shadow over the image offered the reader. No harbinger of a future sinister turn-for-the-worse. No hint at childhood trauma or a troubled adolescence; no problematic relationships; no major illnesses or accidents; no thwarted ambitions, no hidden fears, no repressed compulsions. There is an unsullied innocence about Helen, she is a clean slate. When she becomes "very unwell" we can derive some satisfaction from knowing that, because her life is otherwise so naturally wholesome, it should be possible to restore her quickly to health, to the bosom of her family, to the status quo ante of woodland walks, children busy in her classroom, primroses in a glass on the breakfast table.

After the birth of her second child, Helen "began to experience some unusual phenomena". It's at this point that the account begins to change style, and the clue is in the phrase given, which - rather than use Helen's own language to describe her experience, distances her experience from the narrative with the phrase "some unusual phenomena". The phrase is deliberately obscure and all-encompassing, and - if interrogated - could be (and almost always would be) re-expressed in terms that were incomprehensible to a layman: words such as "ideas of reference", "autochthonous delusions", or "thought insertion". These are psychiatric terms understandable to mental health professionals, but usually quite mysterious to lay-people.

Three examples are offered to give some substance to the unusual phenomena Helen is said to have experienced. First, "she started seeing patterns in nature which she hadn't seen before". Seeing new patterns in anything is not of itself problematic; indeed the opposite could be true, it might be a kind of awakening, a broadening and deepening of awareness. So what casts a shadow over it? Maybe it's the next phenomonen to be catalogued: Helen "believed that certain trees were speaking to her". We don't know whether Helen volunteered this as, "I believe that certain trees are speaking to me", or whether she used some other form of words.

It would be interesting, for example, to know whether she said that the trees spoke singly, in audible words, or together; and to hear from her what they said, in what tone or quality of voice. Did they utter cautions or commands, give advice or commentary, or offer reassurances? Did she recognise the voices in which they spoke? Or was Helen's use of "speaking to" a poetic metaphor? None of this seems to matter to whoever spoke with Helen; or if it did, Helen's possible meaning has been subordinated to the need to build a case against Helen's meaning, and in favour of a psychiatric diagnosis, within which meaning can be disregarded or set aside.

"And (Helen) felt herself and her two children being drawn towards the lake." It's a rhetorical device to combine three sentences or ideas to build emphasis, and this device seems to be used here to good, deliberately chilling, if understated, effect. Again, one would hope to find her own words on the page. Perhaps she said, "It would have been really nice to take the kids by the the lake, it was so pretty there with the trees and everything"; "I wanted to bring my kids down to the lake, I can't explain why really, but it seemed sort of important that I took them"; She might have said something like, "The way the trees seemed to lead down to the water, it was like an invitation, they were sort of pointing the way, and I thought of the girls, and that maybe the trees wanted us all to go down there together, where we could be peaceful and safe, and nothing bad could touch us...."

But one doesn't find this kind of personal statement in mental health reports, because it's too ambivalent, too open to interpretation, too full of idiosyncratic and contingent meaning, to close to the grain of human experience, in all its fury and its mire.