Seeking kinship in the thick of fire and poison

"Nobody can meddle with fire or poison without being affected in some vulnerable spot; for the true physician does not stand outside his work but always in the thick of it..." (Jung, 1977: 5). This striking quote from Carl Jung acknowledges the vicarious trauma inherent in working in health and social care as well as the courage and resilience needed to follow such a vocation. I came across it in an excellent, recently-published book called Coping and Thriving in Nursing (Martin, 2018). It reminded me that, back in 1990, I'd reviewed a book called The Staff Nurse's Survival Guide (Horne, 1990) and I'm pleased to note that nurses are now being encouraged to cope and thrive rather than merely to survive.

Peter J Martin, the editor of Coping and Thriving in Nursing, explains in his introduction: "Our initial title used the word 'surviving' but ... we wanted to highlight that nurses can do more than survive... If nurses are coping and thriving, then they can discover or rediscover the satisfaction that led them into the job in the first place (and) then they are in a much stronger position to help people find a sense of hope in illness and adversity...." (Martin, 2018: 3). This is a similar argument to the one I make in my book Creativity, Wellbeing and Mental Health Practice, where I suggest that, if nurses can discover or rediscover creative ways of working, this can improve the wellbeing of service users and service providers alike (Gillam, 2018).

Coping and Thriving in Nursing deals, in a very readable and pragmatic way, with embracing change, reconnecting with our nursing values, the relationship between nursing and mindfulness and developing self-compassion. I especially liked the emphasis on the importance of kinship among healthcare staff. We need to understand that suffering and sometimes feeling inadequate to the task are shared experiences and that healthcare staff can support one another by being compassionate to themselves and to each other. The authors recognise that clinical workplace environments and healthcare organisations can be surprisingly hostile and unconductive to the cultivation of kinship. This being the case, it is all the more important that nurses and other health and social care professionals are self-compassionate, seeking out mutual support, supervision and connection. The book urges us to adopt an attitude of 'intelligent kindness' that "unsentimentally values kinship and kindness, understanding their creative power..." (Martin, 2018: 163). In the face of fire and poison, such kinship, kindness and creativity can be powerful resources.    

   

References

Gillam, T. (2018) Creativity, Wellbeing and Mental Health Practice. Basingstoke: Palgrave Macmillan.

Horne, E.M. (1990)The Staff Nurse's Survival Guide. London: Wolfe.

Jung, C.G. (1977) The Collected Works of C.G. Jung, original from University of Minnesota. New York: Pantheon Books.

Martin, P.J. (ed.) (2018) Coping and Thriving in Nursing. London: Sage.

A Manifesto for Creativity

I was intrigued to learn of the recent publication of a creativity manifesto. Published as a commentary in the Journal of Creative Behaviour, this manifesto is the product of a collaboration of twenty scholars, many of whom are familiar names in the field of creativity research (Glăveanu et al., 2019). Their aim is to build common ground and invite the community of creativity researchers and practitioners to reflect upon, study and cultivate creativity as a socio-cultural phenomenon. The authors remind us that a manifesto is a written statement of beliefs and aims intended to mark a conceptual shift within a field.

There is something confident and bold about writing and publishing a manifesto. I'm reminded of the surrealist poet André Breton who produced his first Manifesto of Surrealism in 1924. In this short pamphlet Breton tried to define surrealism. He provided examples of surrealist poetry and literature as well as attempting to place the movement in its artistic and cultural context. Being a surrealist, of course, Breton also included a certain amount of absurdist humour in his manifesto.

The authors of the new creativity manifesto offer their document in the spirit not of an exclusive list but as something to generate fruitful conversations. They warn readers against agreeing blindly with the manifesto's points or using them as a box-ticking exercise.

The paper, titled Advancing Creativity Theory and Research: A Socio-cultural Manifesto, is only five pages long and so it is admirably concise. One of the key points for me is the proposition that Creative action is, at all times, relational.  The authors explain:

"There is no form of human creativity that does not rely on direct, mediated, or implicit social interaction or exchanges. Even when working in solitude, we implicitly build on and respond to the views, knowledge, and expectations of other people. While creating, the person can recurrently become his or her own “audience” by standing back and evaluating his or her process and its outcome as others would. It is important to note here that we do not imply that people will always be more creative when working together in explicit collaborations. The social element should not be romanticized; personal conflicts, incompatible styles, and other issues may decrease collaborative creative efforts. However, the lifelong development of creativity cannot be conceived outside of self–other relations" (Glăveanu et al., 2019: 2).

While the manifesto makes no explicit reference to wellbeing or mental health, it seems to me that, apart from the above suggestion that creativity depends upon connecting with others, another assertion - that Creativity is meaningful - is highly relevant here. As the authors elaborate:

"Creative outcomes are not only new and appropriate for a certain task; they can give meaning and even joy to our existence and, as such, represent a key marker of our humanity. Creative acts – at all levels of expression and eminence – offer a legacy that can soften our impending mortality (...) it is imperative to reflect on how creativity can contribute to the development and cultivation of those values and virtues that lead to living meaningful, peaceful, sustainable, and wise lives." (Glăveanu et al., 2019: 3).

Meaning, sustainability, peace and wisdom. These are surely important elements of wellbeing and mental health and any manifesto that highlights them gets my vote.

References

Breton, André, (1972). Manifestoes of surrealism. Ann Arbor: University of Michigan Press.

Glăveanu, Vlad Petre & Hanchett Hanson, Michael & Baer, John & Barbot, Baptiste & Clapp, Edward & Corazza, Giovanni & Hennessey, Beth & Kaufman, James & Lebuda, Izabela & Lubart, Todd & Montuori, Alfonso & Ness, Ingunn & Plucker, Jonathan & Reiter-Palmon, Roni & Sierra, Zayda & Simonton, Dean Keith & Souza Neves-Pereira, Monica & J. Sternberg, Robert. (2019). Advancing Creativity Theory and Research: A Socio-cultural Manifesto. The Journal of Creative Behavior. 10.1002/jocb.395. Available at:  https://www.researchgate.net/publication/330606484_Advancing_Creativity_Theory_and_Research_A_Socio-cultural_Manifesto

On becoming a caretaker of the creative space

Professor Woody Caan is a professorial fellow of the Royal Society for Public Health and editor of the Journal of Public Mental Health. Earlier this year, Professor Caan kindly invited me to contribute an article to the journal which, I'm delighted to say, is published in this month's issue (Gillam, 2018a).  I ended up giving my article the rather wordy title: Enhancing public mental health and wellbeing through creative arts participation.  In it, I discuss how, as a mental health nurse with a lifelong interest in creativity and the creative arts I have, for many years now, explored creative approaches to fostering wellbeing. While my main professional focus has been on the wellbeing of the users and providers of mental health services, this has been in the context of an underlying assumption that the mental health and wellbeing of the wider community can also be enhanced through creative activity.

One of the areas of participatory arts on which the article focuses is my work in community music with an initiative called the Music Workshop Project. As I explain in the article: "in my most recent book, I wrote elegiacally about the Music Workshop Project, believing my days of therapeutic music-making were over. Serendipitously, however, I have more recently been invited by Dudley MIND (a local West Midlands branch of the Mental Health charity) to facilitate a series of music workshop sessions for wellbeing."

I go on to describe a shift in my attitude to this kind of work: "Although I remain a registered mental health nurse, I approach these sessions as participatory arts activities which I facilitate as a musician rather than as a nurse. In this context, I am a musical group leader or, as McNiff (2004) might more poetically describe it, the 'keeper' or 'caretaker' of the 'studio' or creative space. I have found it helpful, in being clear about my role, to identify with McNiff's view that:  "As a 'keeper' or 'caretaker' of the studio, my primary function is to kindle the soul of the place, to maintain its vitality and its ability to engage people in highly individual  ways..." (p.20). This is not how mental health nurses would typically describe their function though I would argue that, if nurses are to be truly concerned with the wellbeing of society (and not just the health of mental health service users) then they do need to be skilled at facilitating flourishing  (Gillam, 2018b.)"

At the end of November, I ran one of these sessions for Dudley MIND. All the participants seemed to enjoy the mixture of improvised extended 'jams' and on-the-hoof, ad-libbed renditions of half-remembered pop songs. We even did a few Christmas tunes, knowing that we would not be meeting again until after the festive season. After the session had ended, I asked a first-time participant how he found the group.

"Yes, it was alright that was,"  he said. "I've been to some of the other activities - quizzes and things - but I can't always think what to say quick enough.  But with this music group, that doesn't matter. I think I'll come again."

References

Gillam, T. (2018a). Enhancing public mental health and wellbeing through creative arts participation. Journal of Public Mental Health 17 (4), 148-156.

Gillam, T. (2018b). Creativity, wellbeing and mental health practice. London: Palgrave Macmillan.

McNiff, S. (2004). Art heals: How creativity cures the soul. Boston, Mass.: Shambala Publications.

Working at being of good cheer again

My last blog post here heralded in the summer and now, somehow, whether you judge these things meteorologically or astronomically, either way it is undeniably autumn. My family's summer became a blur, with my wife becoming unwell in July, her being diagnosed with a serious illness and then spending most of August in hospital 49 miles away. She is now thankfully at home with me, but needing ongoing support and treatment.  

People often don't know quite what to say. One friend emailed me in sympathy, referring to our situation as a "predicament", which seemed something of an understatement. A predicament is a troubling, embarrassing or ludicrous situation. To us, it seemed my wife's illness was a catastrophe, a calamity. Another colleague, sending best wishes, referred to my wife as my "beloved". This seemed quaint and completely apt. What had happened was not that my wife and I had found ourselves in a predicament, but that a calamity had befallen my beloved.

In the midst of all this, though I have found some solace in reading books and listening to music, it's not surprising that I have not felt much like engaging in my own creative activity over the past three months. I have neglected my blog, and had little appetite for writing, songwriting, performing or other means of self-expression. My own wellbeing has, of course, been affected by concerns about the health of my beloved and this has, in turn, affected my creativity. There is a paradox inherent in the relationship between creativity and wellbeing: while it's true that participating in creative activity generally enhances wellbeing (Stickley, Wright and Slade, 2018) it's also true that creativity calls for a level of equanimity (Sawyer, 2012). So, on the one hand, Shaun McNiff (the pioneering art therapist and professor of expressive therapies) is right to suggest "art and creativity are the soul's medicines – what the soul uses to minister to itself, cure its maladies, and restore its vitality" (McNiff, 2004: pxii-xiii); on the other hand, people are more likely to be creative when they are well-balanced (Sawyer, 2012) and enjoying a positive mood (Amabile et al., 2005) or, as Mozart once described it, "when I am completely myself ... and of good cheer..." (Vernon, 1970: p.55).  

This is not meant to be an excuse for a lack of creative activity – it's simply an acknowledgment that crises such as serious illness in the family can impact on the emotional wellbeing of the whole family and that this needs to be regained before we can fully partake of the healing power of art and creativity. But, here I am writing once again ... and it feels good.

References

Amabile, T. M., Barsade, S. G., Mueller, J. S. & Staw, B. M. (2005). Affect and creativity at work. Administrative Science Quarterly, 50 (3), 367-403.

McNiff, S. (2004). Art heals: How creativity cures the soul. Boston, Massachusetts: Shambala Publications.

Sawyer, R K. (2012). Explaining creativity: The science of human innovation. (2nd ed.) Oxford:  Oxford University Press. 

Stickley, T., Wright, N. and Slade M. (2018). The art of recovery: outcomes from participatory arts activities for people using mental health services. Journal of Mental Health. Feb 15:1-7. doi: 10.1080/09638237.2018.1437609. [Epub ahead of print]. Available at: https://www.tandfonline.com/doi/full/10.1080/09638237.2018.1437609

Vernon, P.E. (1970). Creativity. Middlesex: Penguin Books.

Midsummer madness and obstacle golf

Around this time of year, readers of this blog may well be enjoying - or preparing to enjoy - a summer holiday. Whether it's a modest 'staycation', a more exotic trip or just a few snatched moments relaxing in the outdoors, it's good to make the most of - in the words of the old song - "those lazy, hazy, crazy days of summer."

For those working in mental health, summer brings, along with its pleasures, its own particular challenges. For example, while most people's mood is improved by more sunlight and milder weather, some mental health practitioners observe people with bipolar disorder may be more prone to manic episodes in the summer. Could this be a manifestation of what Shakespeare called 'midsummer madness' - a temporary insanity attributed to the heat of the sun or the phases of the midsummer moon? Those working with younger adults sometimes report an upsurge in psychotic episodes which they relate to increased cannabis use as the music festival season gets underway. And then, of course, there is the increased risk of photo-sensitivity and dehydration which can have serious consequences for service users taking psychotropic medication. There's a lot for  practitioners to think about in these summer days, which could cause more haziness and craziness and leave little time for laziness.

This time of year always reminds me of those long, childhood summer holidays when my brother and I would while away time on the putting green. Neither of us grew up to have the slightest interest in golf yet those games of miniature golf kept us happy for hours. A variant of mini-golf was crazy golf, which seemed to delight in causing the players to put or chip the ball over, under or through various impossible obstacles. On a recent visit to Keswick in the Lake District I was pleased to see they still had a crazy golf course but surprised that the sign announced it as 'Obstacle Golf'. I imagined the heated debate that might have taken place in the local council chambers:

            "We can't call it crazy golf anymore. That's insensitive to people with mental health issues."

            "What about obstacle golf? After all, that would more accurately describe the nature of the game without using a term disparaging of psychological distress."

Perhaps renaming crazy golf as obstacle golf gets to an even deeper truth. Part of mental wellbeing is the ability to maintain equanimity whilst skilfully navigating life's obstacles. It is the obstacle course of life that makes people ...crazy. So let's all try to approach the gradients, mazes and tunnels ahead with calmness and good humour, to acknowledge their inherent absurdity and, nevertheless, endeavour to play the game.

Welcoming the new arrival

Academic books are not normally published with any great fanfare. Authors of fiction may, if they're lucky, expect signing events at their local bookstore or perhaps a launch party with champagne. But the writer of a scholarly work - "high protein nonfiction" as William Germano (2005, p.123) describes it - has to settle for a more modest welcome into the world for their creation. No academic book is going to be a bestseller and the lucrative sale of film rights is an even less likely prospect. Nevertheless, after years of research and long months of writing and editing, it is still something of an event when the newborn book arrives and the proud author finally gets to hold the pristine complimentary copies in his hands.

I remember when my firstborn book was delivered amid the mundane mayhem of domestic life. It was a Saturday afternoon and the carpet-fitters, having just conspicuously botched an ill-fitting piece of carpet around the fireplace, then decided they needed to completely remove the front door of our house, just as the postman arrived with the long-anticipated parcel. Of course, in the confusion, I wasn't able to savour that special moment when an author's first book is published. Later in the day, I tried to take time out to admire the look and feel of the finished product, but then life got in the way again as my teenage son announced he had just had his bike stolen. A day that had begun with the chaos of incompetent carpet-fitters ended with police officers' boots on our new carpet as they took a statement.

My latest book arrived, thankfully, amid less drama. Publishing nowadays is a very global affair so the book had already travelled halfway round the globe before landing eventually at my house. Commissioned - and written - in England, with series editors based in Switzerland and Denmark, contracts were drawn up in Switzerland, copy-editing took place in India before the book was printed in the Netherlands and dispatched from the distribution department in Germany.

I arrived home from work to be told a parcel had gone to the next-door neighbour. As I collected the package I resisted the temptation to brag to the neighbour that this wasn't any old order of books - it was my new book. Instead, I thanked her and returned home quietly to admire the new arrival. My wife had thoughtfully decorated the house with congratulations banners and balloons and my son had kindly made a playlist of celebratory songs to mark the event. Even if there was no book-signing or fancy launch party at least, this time, I was able to cherish my new book without the distractions of carpet-fitters or bicycle thieves.  

Reference

Germano, W. (2005). From Dissertation to Book. Chicago: University of Chicago Press.

Wellbeing lessons from living Danishly

The Year of Living Dangerously was a 1982 Australian film about a love affair set in Indonesia during the overthrow of President Sukarno. Helen Russell cleverly punned on the film's title when she wrote her (completely unrelated) 2015 book about her experiences of living in Denmark – The Year of Living Danishly. 

The book's blurb explains: "When she was suddenly given the opportunity of a new life in rural Jutland, journalist and archetypal Londoner Helen Russell discovered a startling statistic: the happiest place on earth isn’t Disneyland, but Denmark, a land often thought of by foreigners as consisting entirely of long dark winters, cured herring, Lego and pastries. What is the secret to their success? Are happy Danes born, or made? Helen decides there is only one way to find out: she will give herself a year, trying to uncover the formula for Danish happiness..."

Russell's book is a light-hearted and entertaining read but the belief that Denmark enjoys a high level of wellbeing is supported by good evidence. In 2006-7, Huppert and So measured the prevalence of flourishing across the (then) 22 countries of the European Union (Huppert & So, 2009). Data from 43,000 adults was surveyed to ascertain the percentage of Europeans who could be said to be flourishing. It was found Eastern European countries tended to have lower levels of wellbeing while Scandinavian countries enjoyed the highest.

So, studying what can be learnt from the Danish way of life could be a very valid exercise. Helpfully, at the end of The Year of Living Danishly, Russell provides her Top ten tips for living Danishly. These might be summarised as:

1.     Trust others (more) - avoid unnecessary stress by trusting others more which, in turn, will improve their behaviour

2.     Get hygge - Enjoy the cosy, simple pleasures of life

3.     Use your body - Move more, exercise more

4.     Address the aesthetics - attend to your environment, enjoy good design and clean, tidy everyday surroundings

5.     Streamline your options - Reduce the stress of too many options by adopting simplicity and freedom within boundaries

6.     Be proud - Take ownership of something you and your community do well and celebrate it 

7.     Value family - reach out to relatives and put your family and friends first

8.     Equal respect for equal work - Caregiving and breadwinning are equally important

9.     Play - a playful, creative activity is a worthwhile occupation at any age

10.  Share - sharing makes life easier, and, even if we can't easily influence our government to create a Danish-style welfare state, we can begin by being more neighbourly.

Russell's list may seem a bit flippant or fanciful but it has much in common with the wellbeing 'five-a-day' produced by the New Economic Foundation (NEF) - an evidence-based list of five actions to be incorporated into day-to-day lives to promote wellbeing (Aked et al., 2008). The NEF's list was:

•               Connect

•               Be active

•               Take notice

•               Keep learning

•               Give

It's worth reflecting on how much we incorporate these actions into our lives. The NEF wellbeing 'five-a-day' and Russell's Top ten tips for living Danishly are worthy of serious consideration. It seems there is indeed much more we could learn from the land of long dark winters.

References

Aked, J., Marks, N., Cordon, C. & Thompson, S. (2008). Five ways to wellbeing: The evidence. London: New Economics Foundation.

Huppert, F. (2008). Psychological well-being: Evidence regarding its causes and its           consequences. London: Foresight Mental Capital and Wellbeing Project.

Huppert, F. & So, T. (2009). What percentage of people in Europe are flourishing and what

characterizes them? Cambridge: The Wellbeing Institute, Cambridge University.

Russell, H. (2015).  The year of living Danishly. London:  Icon Books.