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 | The Tidal Model: The Maori Context | |||
 | Jacquie Kidd Director Hineira Health Ltd, Hamilton, New Zealand
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Te Ahuahu te maunga Omapere te wai Te Uri Taniwha te tangata Ko Nga Puhi toku iwi Ko Te Uri Taniwha raua ko Ngati Hineira oku hapu Ko Parawhenua toku marae Ko Jacquie Kidd toku ingoa He neehi ahau, i te Ao Wairangi No reira, tena koutou, tena koutou, tena koutou.
| Te Ahuahu is my mountain Omapere is my lake Te Uri Taniwha is my ancestor My tribe is Nga Puhi Te Uri Taniwha and Ngati Hineira are my sub-tribes Parawhenua is my ancestral home My name is Jacquie Kidd I am a mental health nurse And so I give you all greetings, once, twice, thrice.
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He aha te mea nui te Ao? He tangata, he tangata, he tangata. This whakatauki, or proverb, is central to being Maori as I understand it. It translates to: What is the most important thing in the world? It is people, it is people, it is people. Before I can begin to discuss the application of the tidal model to a Maori context, that context should be explored. It is important to state at the outset that being Maori is both a collective and a highly individual experience. The collectivity is represented in our creation mythology, in the concepts created through our language – although there are many dialectical variations, and in the recognition we have with and for each other. This recognition is sometimes an overt search for connection; “where are you from?” “Who are your family?” Sometimes simply a smile or a raise of the chin acknowledges the kinship of being Maori. Individuality is represented by the varied way that individuals go about the business of ‘being’ Maori. An ancient culture, we have been colonized in many different ways; forcibly by the British throughout the 1800s and early 1900s, coercively by laws and politics, benevolently by intermarriage, and now voluntarily (it seems) by the American culture. Being Maori can, therefore, take many forms. Notwithstanding these later influences, each iwi (tribe) had their own kawa (lore, protocols) and dialect, so that even in pre-European times the experience of being Maori would differ between regions. My experience of being Maori is influenced by early intermarriage, assimilation through all levels of my education, and moving away from the region where our iwi belong. So, my words here are those of an individual, writing as an individual but sharing some common beliefs with whanau (family), hapu (wider family group), iwi (tribe) and the Maori nation. Some Maori who read this will debate my perspective, and in that debate is a celebration because while we are exploring who and what are Maori, the powerful voice of colonization is hushed. The Maori word for spirituality is wairua. Literally translated, wairua means two waters. This immediately creates an affinity with the Tidal Model metaphor of water, with images of the duality of water being life giving and life threatening, calming and violent, supportive and overwhelming, peaceful and powerful. The chaotic nature of water with its mysterious nature and elemental power reflects the consistent mobility of life and the unknown nature of the forces that impact on us. My conceptualization of the Tidal Model is that it models a way of being with people that is grounded in spirituality. Spirituality for Maori contains the essence of all that is important in life. Water holds a central place in Maori spirituality, which is evidenced by the mihi (greeting) shared when Maori meet. The mihi makes specific reference to the body of water that is sacred to that person. For me, reference to “my” lake, Omapere, offers not only a landmark so that people will be able to identify my home, but also an acknowledgment of my source of spirituality. Going home to cleanse in one’s spiritual waters is akin to the symbolism of returning to the womb and being reborn. In using water for its core philosophical metaphor, the Tidal Model offers a model of care that fits with the use of water for healing and cleansing, and for guiding us towards new beginnings or at least refreshed continuation of the journey. While water can be a powerful metaphor, it is also grounded in reality. In addition to returning to home waters for cleansing and renewal, water is used for symbolic cleansing of a person, article or place. Then there is the healing power of walking beside a river or beach, the healthful properties of drinking water, and the physical relief of floating in deep water. Water is a central theme to spiritual and physical life for Maori, and therefore Tidal Model is a comfortable match in symbolic and metaphorical terms. In a practical sense, the Tidal Model views mental health problems as “problems of living”, and as such acknowledges the importance of human connections. The humanity of this approach reflects the Maori focus on family. Family is, however, much more than a nuclear group. Family is whanau, hapu and iwi. Family begins with tupuna (ancestors) many generations removed, and includes all the cousins, aunties, uncles, nieces and nephews that were generated by those ancestors. As Maori, one is a part of a whole. Standing alone is not perceived as being healthy or complete. The nursing implications of working with people who hold this worldview about whanau (family) are far reaching. Issues of consent, privacy and confidentiality are revisited. In a whanau who continue with traditional ways, the person with the identified mental health issue may not be the person who consents to treatment. The person who consents may be an older person, perhaps a kaumatua (elder man) or kuia (elder woman). The whanau may refer to this person as “auntie” or “uncle”, and it can be very confusing for the care team to have this person hold so much power while often seeming very innocuous, even shy. The Tidal Model offers a way to be with the whanau in their “mental health” experience. Without defining the human system within which the person exists, the Tidal Model validates the structure of the whanau and appreciates the variations that occur. The tupuna (ancestors) who figure so prominently in the Maori world also occupy a key position in the concept of mental illness for Maori. By maintaining an open door between this world and the last, by keeping the past alive and relevant, and by taking an active part in the lives of many Maori, tupuna can look like symptoms of psychosis to western eyes. The Tidal Model requires that carers ask the person what their illness and their symptoms mean to them. Thus, the Tidal Model affords Maori a real chance to describe the difference between distressing symptoms and the comfort or challenge of tupuna involvement in everyday life. By locating the person at the center of their experience, previously marginalised beliefs and events can be drawn into the healing experience. My experience of Maori in the “mental health system” is that a great deal of energy can be expended by the care team in an effort to align the person’s progress with a pre-determined idea of wellness. This often results in the loss of the individual person as they say “I don’t know how to be the way you want me to be. Show me, save me”. The Tidal Model actively promotes the use of healthcare professionals as involved helpers who engage in mutual discussion to determine the course of healing, thus endorsing the person as they work towards the image of wellness that is culturally real for them. My experience of using the Tidal Model in my practice has not been extensive, as I had only about 12 months in practice after I “discovered” it, and before I moved into the education sector. But my use of it nonetheless been practical and satisfying for me as the nurse, but more importantly for the people in care I encountered during that year. My purpose in writing this is to express the ease with which the Tidal Model fits with my worldview as a Maori nurse, and the comfort and delight people expressed when I introduced them to care the Tidal Model way. It is my hope that the Tidal Model will continue to grow and evolve as people, both in the water and reaching out to them, use, critique and use again. He aha te mea nui te Ao? He tangata, he tangata, he tangata. What is the most important thing in the world? It is people, it is people, it is people. Arohanui Much love Jacquie Kidd
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