Theory

Theory (cont'd)

Learning is experiencing. Everything else is just information.

Albert Einstein

Many of us spend much of our lives trying to control our circumstances. However, life has a way of just 'going along' regardless. We try to control friends, family, our bodies and even our minds.

We try to shape people and things and even ourselves into some kind of 'ideal'. Some of us actually believe that we succeed in doing this. However, many people - often in old age - admit how futile an exercise it was. Life goes on regardless of our efforts. We have wasted precious time that could have been spent 'learning from Reality'.¹

We like to think that our lives follow rules and stay within certain boundaries. However, Reality suggests that things are much more chaotic than ordered. Indeed, we talk about people 'mentally disordered', implying that such a thing as mental order might exist, or even be the norm.

Reality tells us that none of us know what is likely to happen next. We simply pretend or hope that we do. The idea that life might have its own agenda is simply too frightening. Our belief in the idea of mental 'order' might even be crazier than the accepted notion of 'mental disorder'.

What does this have to do with mental health? We only really find out exactly how people became 'mentally ill', and the sense they made of it, and how they recovered, after the event. People look back on their experiences.

From those reflections they learn something about what has happened. They learn from the Reality of their experience. Reflection is a wonderful tool - it is the mirror of experience. Experience is, of course, the mother of all teachers.

In trying to help people who are encountering mental distress, whatever it is called, we need to be careful that we do not devote all our energies to trying to control their experience.. We need to allow people some time to learn from Reality, so that they can become wiser about what has happened to them.

By sharing something of the experience of mental illness, we might be able to share some of that wisdom too. When we ask people who have been to the farther reaches of human nature - like Sally Clay - what kind of a nurse was really helpful, the answer often is - 'someone who didn't try to control me completely...someone who let me own my experience'.

People who are in mental distress need support. Ideally, they need someone who can meet their needs without entirely sacrificing themselves in the process.

Lifesavers recognise when someone is drowning and execute swift and efficient rescue, without risking drowning themselves in the process. They 'get involved' with the person; they 'share the experience of drowning'; but by keeping themselves in balance, they do not risk going down with the person they seek to rescue.

This may be a useful analogy for the kind of 'caring with' necessary for people in great mental distress. We need to get involved with people, sharing something of their experience, showing that we are not afraid to get 'into the swim' with them. However, we need to maintain our balance, or else we all risk 'going under'.

Learning how to get involved without risking our own emotional or spiritual safety doesn't come easily. It is not something that can be learned from books or videos. Certainly, it is not a lesson that can be learned from reading a short guidance manual. It has to be learned from practice.

However, knowing how difficult it might be to acquire such a human skill, may be the first step towards acquiring it. If we can do nothing else, we can remind you how difficult - and possible lengthy - the process of learning how to stay in balance, might be.

As Sally Clay said, we all need to share our experiences, and learn from one another. Whether you call that clinical supervision or 'just talking' is immaterial.

The important thing to remember is that we need to keep on learning from one another's experience - learning from reality. We also need to learn how to balance the 'ordinary me' that might risk drowning, and the 'professional me' who might be frightened to get into the water, in the first place.

The Tidal Model emphasises an appreciation of the fluid nature of human experience, if not of life in general. "All is flow" as Epictetus said. Many models of human functioning try to 'freeze-frame' experience, assuming that human experience can, in some way, be stable.

Some models even deceive us into assuming that people are like rocks when the nearest analogy to the human state is water. In the Tidal Model we have used water as the core metaphor for both the lived experience of the person who becomes the psychiatric 'patient', and the care system that attempts to mould itself around the person's need for nursing.

The water metaphor is apposite for a number of reasons.

	The ebb and flow of our lives is reflected in the way we breathe in and out, like waves lapping at the shore
	All human life emerged from the ocean
	All of us emerged from the waters of our mother's wombs
	Water is used, universally, as a metaphor for cleansing of the spirit.
	Water evokes the concept of drowning, used frequently by people who are overwhelmed by their experiences.
	The power of water is not easy to contain. We can scoop water from the sea, but we cannot scoop out a whole ocean
	The only way we can cope with the power of water, is to learn how to live with its forces - we learn how to swim in water, or we build boats that float on the waves. Ultimately - however - the power of water is unpredictable.

In talking about the 'ocean of experience' we acknowledge the spiritual journey that underpins life, and which is writ large in the experience of mental illness or madness, as people like Sally Clay would describe it. Of course not all people describe their distress in spiritual terms. However, we have yet to meet someone who was mentally distressed and who was not seeking meaning - trying to find, as Hilda Peplau said," the truth about themselves and their lives".

The developmental journey made by people as they move through various stages in their lives, is a journey of exploration and discovery. It yields not only the opportunity to discover new lands, but also carries many risks: metaphorical storms, as well as the risk of running aground, or of the ship sinking. The seaworthiness of the ship may be an apposite metaphor for the person's health status or constitution. Clearly, the extent to which we are able to journey across our ocean of experience is dependent on the physical body on which we roll out the narrative of our human lives.

However, when people experience a disruption of their sea-journey, they may - like Coleridge's Ancient Mariner, become becalmed at sea. Depression often has just such a becalming effect. Or, they may be thrown violently on to the rocks. Psychosis often appears like the experience of shipwreck. Either way, a signal emerges that something special needs to be done - crisis care - and, if this is to be ultimately successful, needs to be followed up with a range of interventions - from simply keeping the person afloat (community support) to deep sea-diving (exploring the submerged causes of the crisis).
This is hardly a new perspective on the human condition, but it is a different perspective on some age-old understandings. However, our discoveries of how people function, psychologically and socially, has tended to get in the way of our appreciation of what it might, ultimately, all mean – in human terms. Dickens acknowledged the tidal nature of life and death, through his character - Mr Peggotty, who said: "People can't die along the coast, except when the tide's pretty nigh out. They can't be born, unless its pretty nigh in.- not properly born, till flood. He's a going out with the tide."
A similar understanding is found in much eastern thought, where the breath – the life force or prana – heralds life with each inhalation, and death with each exhalation. People, are therefore, poised, constantly on the tidal cusps of life and death.
Most famously, at least within the Western canon, Shakespeare summed up the fundamental assumptions of the Tidal Model in Julius Caesar:
	"There is a tide in the affairs of men, Which, taken at the flood, leads on to fortune; Omitted, all the voyage of their life Is bound in shallows and miseries. On such a full sea are we now afloat, And we must take the current when it serves Or lose our ventures."

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