Article
Change
Mental Health
4 min read

Don't try and cope on your own

The company of those who care helps when handling traumas.
a man in a wheelchair sits in a subway station holding a sign reading 'seeking human kindness'.
Michael, Boston, 2018.
Matt Collamer on Unsplash.

I did a horrible piece of training at the weekend. You have to do a lot of continual learning if you’re a counsellor, and some of it is hard going. This particular session (with Cruse, a national bereavement charity) was about self-harm, and it contained sheets and slides and lists of the ways in which people hurt, damage and punish themselves. Usually as a way of expressing another kind of pain or because it’s the only thing they can control in a chaotic world. Six hours of it, on Zoom. 

All of us have topics that we struggle with – areas that we find difficult to contemplate – and self-harm is one of mine. It is so far from my own experience of reality that it makes me feel square and naïve and overprotected, and every part of me revolts against it in some way. How terrible that people who are already suffering can only find relief by inflicting further harm on themselves! And some of the injuries are so grievous. Mortifyingly, my main reaction on this occasion was an urge to put my fingers in my ears and tell everyone to STOP IT... not just the trainer, but the poor souls involved in hurting themselves too. Training can be humbling, in the way it reveals the limits of your own compassion to you.  

Clearly though, telling people to ‘stop it’ is not an option, however you might feel! So what to do? 

Christianity, usefully, offers quite a lot of different options for coping with difficult life stuff, so I started considering some of these as I attended to the trainer. The peaceful, thoughtful series of Lent reflections I’ve been listening to recently, for instance… might they help? Um no, not suitable really. Too meditative. You can’t ‘gather the scattered pieces of your consciousness and centre them on God’ when someone is talking about teenagers cutting themselves in ‘risky places, or too deep’ I found. Tranquillity of mind is too passive a response.  

So then I thought about people talking sometimes of being able to hand over their troubles to Christ. He ‘takest away the sins of the world’, as the communion service puts it... his arms are open and he is God, so he can bear the weight. But that didn’t work either. Too mystical. It felt as if action was required, not meek handing over of sorrows because I couldn’t bear to contemplate them. I don’t think we’re meant to dodge responsibility and simply go, ‘Ugh, you have these ones Lord because I don’t want them’.  

So, I sat there writhing inwardly and feeling sweaty and miserable and wishing I was somewhere else. 

This kind, accepting, unshocked conversation was immensely comforting and reassuring, I found. There was safety in it, and daylight, and hope. 

But then I started wondering how everyone else at Cruse copes with such things. I began looking at the other faces on my screen… the 21 of my colleagues who were also attending the training, almost all of them volunteers.  

There was the strong, calm face of Manju, an Indian doctor lady, and Suki, a smiley gappy-toothed African lady, who both work on the triaging team, assessing callers as they come in and assigning them to helpers. There was Richard the First and Richard the Second, both white, one younger than me, one older, both friendly and knowledgeable and kind. There was Naga, a retired nursing sister who looked Scandewegian, and Christina, ditto – except she’d been a teacher. And Nick, not much more than a teenager by the look of him, and Sat, a big Brummie taxi driver in a turban. William looked as if he might be an academic, with his leather elbow patches, and Keith had his sound off due to the presence of a large cat on his desk, which leaned over periodically to miaow into his mike. Lots of others too. 

And suddenly I realised that there was my answer: all those good people, giving up their Saturday because they cared. Listening to stories of suffering because they wanted to understand better, in order to be able to help – to do something for the broken and the sad among us. 

That’s the presence of God, surely: that an army of people turn out, day in, day out, to do things simply because they are good. There is no payment, no special recognition. They have to listen to some very difficult things and contemplate darkness that they wouldn’t necessarily in their own lives. But there they all were that morning, one small group among thousands of others all over the country no doubt – ready to serve, and cheerful and friendly and attentive. 

They talked matter-of-factly about cases they’d encountered and situations which can lead people to injure themselves, and about self-harm as a phenomenon in certain social groups. About how it can be treated, about how it can heal and disappear with the right care and compassion. About how sometimes it can even be preferable to other alternatives. It is much easier, for example, to stop self-harming than it is to recover from an eating disorder. 

This kind, accepting, unshocked conversation was immensely comforting and reassuring, I found. There was safety in it, and daylight, and hope. A feeling that even if someone is suffering, there are others who are able to meet them there, to keep them warm and hold them up. That people do act as the hands and feet of God actually sometimes, regardless of creed or faith or fallenness. 

Looking at them all I felt so much better… and that if they could do it, I could. We only need to work in company together and our collective strength will keep us all afloat, rescuers and rescued alike. ‘Be not afraid’ the Bible says over and over again. It is very much easier not to be, when you’re not trying to be brave by yourself. 

  

Article
Assisted dying
Care
Comment
Politics
4 min read

Assisted dying is not a medical procedure; it is a social one

Another vote, and an age-related amendment, highlight the complex community of care.
Graffiti reads 'I miss me' with u crossed out under the 'mem'
Sidd Inban on Unsplash.

Scottish Parliament’s Assisted Dying bill will go to a stage one vote on Tuesday 13th May, with some amendments having been made in response to public and political consultation. This includes the age of eligibility, originally proposed as 16 years. In the new draft of the bill, those requesting assistance to die must be at least 18.  

MSPs have been given a free vote on this bill, which means they can follow their consciences. Clearly, amongst those who support it, there is a hope that raising the age threshold will calm the troubled consciences of some who are threatening to oppose. When asked if this age amendment was a response to weakening support, The Times reports that one “seasoned parliamentarian” (unnamed) agreed, and commented: 

“The age thing was always there to be traded, a tactical retreat.”  

The callousness of this language chills me. Whilst it is well known that politics is more of an art than a science, there are moments when our parliamentarians literally hold matters of life and death in their hands. How can someone speak of such matters as if they are bargaining chips or military manoeuvres? But my discomfort aside, there is a certain truth in what this unnamed strategist says.  

When Liam McArthur MSP was first proposed the bill, he already suggested that the age limit would be a point of debate, accepting that there were “persuasive” arguments for raising it to 18. Fortunately, McArthur’s language choices were more appropriate to the subject matter. “The rationale for opting for 16 was because of that being the age of capacity for making medical decisions,” he said, but at the same time he acknowledged that in other countries where similar assisted dying laws are already in operation, the age limit is typically 18.  

McArthur correctly observes that at 16 years old young people are considered legally competent to consent to medical procedures without needing the permission of a parent or guardian. But surely there is a difference, at a fundamental level, between consenting to a medical procedure that is designed to improve or extend one’s life and consenting to a medical procedure that will end it?  

Viewed philosophically, it would seem to me that Assisted Dying is actually not a medical procedure at all, but a social one. This claim is best illustrated by considering one of the key arguments given for protecting 16- and 17- year-olds from being allowed to make this decision, which is the risk of coercion. The adolescent brain is highly social; therefore, some argue, a young person might be particularly sensitive to the burden that their terminal illness is placing on loved ones. Or worse, socially motivated young people may be particularly vulnerable to pressure from exhausted care givers, applied subtly and behind closed doors.  

Whilst 16- and 17- year-olds are considered to have legal capacity, guidance for medical staff already indicates that under 18s should be strongly advised to seek parent or guardian advice before consenting to any decision that would have major consequences. Nothing gets more major than consenting to die, but sadly, some observe, we cannot be sure that a parent or guardian’s advice in that moment will be always in the young person’s best interests. All of this discussion implies that we know we are not asking young people to make just a medical decision that impacts their own body, but a social one that impacts multiple people in their wider networks.  

For me, this further raises the question of why 18 is even considered to be a suitable age threshold. If anything, the more ‘adult’ one gets, the more one realises one’s place in the world is part of a complex web of relationships with friends and family, in which one is not the centre. Typically, the more we grow up, the more we respect our parents, because we begin to learn that other people’s care of us has come at a cost to themselves. This is bound to affect how we feel about needing other people’s care in the case of disabling and degenerative illness. Could it even be argued that the risk of feeling socially pressured to end one’s life early actually increases with age? Indeed, there is as much concern about this bill leaving the elderly vulnerable to coercion as there is for young people, not to mention disabled adults. As MSP Pam Duncan-Glancey (a wheelchair-user) observes, “Many people with disabilities feel that they don’t get the right to live, never mind the right to die.” 

There is just a fundamental flawed logic to equating Assisted Dying with a medical procedure; one is about the mode of one’s existence in this world, but the other is about the very fact of it. The more we grow, the more we learn that we exist in communities – communities in which sometimes we are the care giver and sometimes we are the cared for. The legalisation of Assisted Dying will impact our communities in ways which cannot be undone, but none of that is accounted for if Assisted Dying is construed as nothing more than a medical choice.  

As our parliamentarians prepare to vote, I pray that they really will listen to their consciences. This is one of those moments when our elected leaders literally hold matters of life and death in their hands. Now is not the time for ‘tactical’ moves that might simply sweep the cared-for off of the table, like so many discarded bargaining chips. As MSPs consider making this very fundamental change to the way our communities in Scotland are constituted, they are not debating over the mode of the cared-for’s existence, they are debating their very right to it.