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Wednesday, May 17, 2017

Haiku on Finally/ No/ Practice/ Pride/ Look

Finally

At last they can start
Finally a beginning
Slightly soggy pitch

Heated arguments
Our world is full of hot air
Finally agreed

He waited for years
Finally his beard sprouted
Then wished it hadn't

No

There is no honour
In killing human beings
Never, anywhere

The classic Noh play
14th century stories
Living tradition

No, sorry, you can't
Do not even think of it
Don't need charity

 Practice

General practice
Never the perfect doctor
Must keep practicing

Dribbled soup again
I should know where my mouth is
Had years of practice

I threw a tantrum
Not quite sure where it landed
Must get more practice

 Pride

Take pride in your stride
Walk off seven deadly sins
Learn humility

Took pride in her home
Worked her fingers to the bone
Keeping things shiny

Lioness and cubs
You see pride in family
Even in nature

Look

Media driven
Need to look at everything
But not see, or change

You look at my face
But don't see my hidden thoughts
Or perhaps you do

Look into my eyes
You are under my control
Now say you love me

Making of a Child Psychiatrist: (76) The General Practitioner (21); Blue Sky Dreaming

On Family
Of course, listening to a wide range of theoretical approaches to working with families at the conference, and at the same time planning to uproot your own growing family and transport it half way round the world, makes you reflect on your own experience of families. Of course, writing about these events many years after they occurred, and with all the accrued experience of an old psychiatrist and family therapist also provokes you into re-evaluating what you did and why, and the impact it may have had on those surrounding you.
At one level to emigrate is easy. You apply for visas, make sure you have up to date passports for everyone, and if possible arrange for accommodation and work for after you arrive; all very logical. But as humans we are feeling entities, and our links with others are crucial to our wellbeing. Our sense of who we are as individuals in the world derives in part from our family history and the place our forebears created for themselves. Much of that information may not necessarily be discussed in detail, or even openly, but in many families you will hear a variant on the phrase: “This is how we do things.” This may simply be a shortened form of “This is how your mother and I have decided we do things.” Or it can be so much more:  “This is how generations of my family have done things, and your mother agrees we should continue those traditions” (or some variant).
You may only find out about such things if you challenge the status quo explicitly or implicitly. An example mentioned much earlier in this book might be my episode of stealing some money simply because I came across it. My father took to me with a leather belt, and I must admit the shock of that had a profound effect. I was only to learn much later that his father had belted him, and my great grandfather had belted my grandfather (and all much more violently than I was ever treated). Apparently that is what fathers did to stop emerging aberrant behaviour. As Jan and I began our own family, I determined I would never resort to violence. And I have not (unless you count the fact that the whole family was to learn Karate to a high standard! But that is as much defensive as offensive, isn’t it?)
I think my parents leaving for Australia when I was 16 led me to appreciate family life in the Hughes family. I saw how respectfully they treated each other, and there never seemed to be much in the way of friction in their partnership. Jan’s parents were gentle people, and I admired that and wanted it for my own future family. I believe Jan and I have achieved that.
But my parents also took Andrea with them. There had always been that seven-year age gap, and ultimately I did not have the opportunity to begin to appreciate her as a person until she had finished University and begun teaching my two boys at St. Nicholas School, coming often to stay at Old Gates. Andrea had rented the top flat at Kingsmead Court from Bobby and Reg, and had a flat mate. She was also close to an aunt of Bobbie’s (through marriage) who had a rented flat at Kingsmead. Andy developed a strong relationship with her, and I was to be ever grateful to Auntie Kate for her love and support of Andrea.
The sad thing is that our own mother missed so much of our lives at the point when both Andrea and I were developing our professional careers. My father also missed out, but for different reasons. As might have been expected he was very lonely as a widower at 50, even though his post Royal Air Force career at the British Aircraft Corporation in Bristol was all-consuming. Very quickly after Eve died, he picked up with a Winifred Moss who, rather strangely, had been a patient of mine at Birchington. She was a divorcee with two daughters, one of whom became a University lecturer, and the adopted daughter a nurse. Ted and Win were married on 27 July 1971 at Margate Registry Office, 13 months after our Eve died.
Winifred was a very anxious woman, with low self-esteem. Rather than taking pride in her parentage, she hated the fact that she had been born a miner’s daughter and worked hard to change her accent and social manners, educating herself to the point of completing a teaching degree, and developing a social circle of friends who played bridge and enjoyed ballet and the opera. She never talked about her family of origin. She was also a very jealous woman and rather quickly eradicated memories of our mother around the Long Ashton house and subsequently in several moves of house (even though Ted kept a small private collection of precious memorabilia in an old suitcase right through to his death at the age of 93).
She also distanced Ted from the May side of the family, and bit by bit alienated the extended Martin side of the family who found her controlling ways intolerable and used to tell and retell stories and laugh behind her back.
Andrea was still financially dependant as a teenager and a university student, and experienced more contact and therefore more frequent difficulties. Being gradually cut off from her father must have been awful. I had less contact with Win, being wrapped up in my practice and family. But both Andy and I became part of the alienation process; we both loathed her ‘la-de-da’ ways and the subtle nastiness.

I am sure I added to Andrea’s woes with the decision to emigrate. Even though I had never really been available as an older brother, perhaps during those years from 1970 through to 1974 I had begun to take on some of that role. And then we left, and Andrea had to deal with losing her emerging closeness to Jan, and her love and care for our two boys. It was to be many years before I really came to appreciate how difficult it must have been for her with virtually no supports, and a rather evil stepmother who would much later cause immense financial problems before she passed away. I am sure I owe my sister an enormous apology for not being aware of these things, but our primary bonds had been broken 9 or so years before when I was 16 and she a 10 year old – ironically when she left with our parents for Australia. The newly developed 1970s bonds were only tenuous. It was not to be until recent years that those bonds have been strengthened, despite the enormous geographic distance between Australia and the UK.

Friday, May 12, 2017

Haiku on Long/ Slip/ Point/ Turn/ Sad

Long

Watching the sunset
Revelling in achievements
Casting long shadows

He had a long face
Some people thought him mournful
Pulling the old hearse

Long and merry life
Surrounded by family
Universal dream

Slip

'Slippy Downs', how cute
No... Aboriginal 'Sippy'
As in 'Place of Birds'

Slipped into dark side
Eyes narrowed and frown deepened
Then an evil grin

Slip sliding away
The essential Paul Simon
Track seven I think

Point

I read your letter
Savouring every word
Yes, I got the point

Mindful exercise
Meditating on a word
The point of haiku

Life's a chain letter
We created to pass on
That is the whole point

Turn

We're in a downturn
Fresh government needs a turn
Creating upturn

Living in Margate
Ethereal landscape art
One J. M. Turner

Wind me up again
So that I can turn you on
Spring into action

Sad

Saddled with sadness
She took her grief out riding
Horse bearing the weight

Good grief, said Charlie
Of course you should cry when sad
It's appropriate

They're sad in Iceland
Seasonally Affected
By the cold and dark

Making of a Child Psychiatrist: (75) The General Practitioner (20); Blue Sky Dreaming

In early 1973, we found out that Jan was pregnant again, with the new baby due in late October. We were, of course, ecstatic and perhaps hoping for a girl. The pregnancy was going well, but Jan and I had not had a break for a long time and, although we were struggling a bit financially, we felt in need of a holiday. We just wanted to go somewhere and have some time together. Bobby and Reg said that they would be very happy to look after the boys for a time, even though they were still quite young with Jonathan a bit older than 5, and Roderick only just 3. We thought that they would be safe with grandparents with whom they had had a lot of contact, and would be unlikely to fret as long as they had each other.
I found a conference that looked quite interesting, and would allow us to defray the costs as professional expenses. Sounding plausible at the time, this was to be the beginning of a way of professional life – finding relevant conferences in exotic destinations around the world and wrapping a holiday around the event and/or a presentation. Part of the rationale was that I was enjoying my part time child psychiatry sessions but, within that, the most exciting aspect was working with families of the referred children, and beginning to have a language to describe what I thought I might be doing, and a range of techniques to use at appropriate moments. I was not a psychotherapist as such, had no idea what a whole conference on psychotherapy might be like, did not want to attend the whole thing anyway because I wanted to spend time with Jan, and assumed there may be some side events and visits for delegates that would make life fun for the two of us. The bonus was that neither of us knew anything about Norway, so sightseeing might be fun. Overall, the event was to be immensely influential in changing the direction of our lives.
The 9th International Congress of Psychotherapy “What is Psychotherapy?” was held in Oslo, Norway June 25-30, 1973. When I had originally come across the conference in the psychiatric journal advertisement, the title had suggested it would be good starting point for a novice trying to do psychotherapy. In fact it ended up being an international window onto a plethora of approaches to working with people struggling with their mental health, and I was to be totally blown away. If I had thought I had begun to understand ways of helping recovery in my psychiatric registrar year at King’s, and rediscovering the joys of working towards understanding and change during my Canterbury days, this conference made me feel like a child in a sweet shop with only 6 pence to spend and an overwhelming choice of delights from which to choose. I had thought my early reading of my two books by Freud and Adler and later a textbook on psychiatry, might have given me a good grounding, but there was so much across the 6 days I just did not understand; the terminology was novel, the ideas complex, and some of it went way over my head.
One of the main Keynotes was an American called Thomas Szasz, from the United States. Of course, as with most of the speakers, I did not recognise his name and was not aware he was at the centre of a storm about the definition and management of mental health problems. His keynote got a mixed reception, and I had not realised that people actually heckled international speakers. There were others whose work eventually became part of my vocabulary and understanding. But generally speaking I was overwhelmed by the ideas, the numerous different forms of psychotherapy, the fact that people had actually written about working with couples, working with families, working with intergenerational families (ie including grandparents and perhaps others), and the arguments about it all.
We fell in with a bunch of happy and somewhat noisy Australians who were about our age. A couple of them presented and, dutifully, we went to hear them speak. Again, there was much I did not understand, but they seemed to know what they were talking about, and the arguments went on way past the end of sessions and back at the hotel. And they just accepted and began to include us in activities. At some stage we went on a fjord boat trip, a wonderfully peaceful event except that fiery and enthusiastic discussions erupted about the speakers the day before.
We had opted to go on a tour to an inpatient clinic doing therapy with families of children with problems. It was a single storey modern purpose built building of wood and glass set in beautiful surrounds; not like Lanthorne House at all. Outside it was chilly, of course, even though it was technically summer. Inside was cosy and warm as with most Norwegian buildings. The openness of families and staff members to talk about their experiences, the bilingual ability of even the children, and the enthusiasm for something vaguely called ‘family therapy’ was impressive. And it suggested possibilities for the future. What if I could become that skilled? What if I could become involved in such an innovative and effective clinical program?
The conference dinner was at the 13th century Akershus Castle near Oslo, and included an historical tour of the royal chambers, mausoleums, and the old prison area with guides who had the usual impeccable English. Like most castles, it was cold, dark and draughty with lots of steps going round and round in the towers. As I remember, we were both grateful to leave the tour a bit early and retire for pre-dinner drinks. I think by the time we got to the dinner, Jan had had enough of being away from home and of listening to people talk about therapy. She had taken several afternoons off to go shopping or to get a nap before dinner. Conferences (as we began to understand over the years) are often a trial of stamina, and while my excitement had buoyed me to attend as much as I possible could, I did have some appreciation of how pregnancy can affect stamina, even if I missed my constant companion.

On the journey home we discussed bits of the conference, and my overall excitement at the prospect of continuing on a steep learning curve in psychotherapy. Somehow our almost instant resonance with the Australian group seemed to be one more piece of the puzzle as to whether we should leave general practice and take up the offer of a job in Adelaide. We talked about what we might gain, but also all that we would lose by leaving family and friends, and the security that had been our place in the Birchington general practice. I was aware that Jan might have much more to lose than I. The excitement of a new job would take me over, but Jan’s would be the shoulders on which the responsibility might land for sustaining our family life and making a new home. There was a slight advantage in the fact we had spent three months in Adelaide 10 years before. And maybe there would be some support from family even though they were mainly in Sydney and Melbourne. Once home, and reunited with our two sons, we spent time talking through the possibilities with Reg and Bobby. They, of course, were very positive even if they had major reservations about their Jan living half way around the world. Ultimately the decision was made, and I wrote a formal letter to Jeff Gerard asking to take up his offer of a job from January 1975. We had about 17 months to get all the arrangements made.