And the Greatest of These Is Love

I recently recorded an episode of the BBC World Service program called ‘The Forum’. This is a show in which three people discuss a topic that has been of some interest in their lives and/or work. The topic for this particular episode was (In)Dependence and my fellow speakers were Olive Senior, the noted Jamaican poet and cultural activist — singularly apt since the program went out on the 50th anniversary of Jamaican independence — and Dr. Adam Winstock, a British psychiatrist who has spent much of his career working on issues relating to dependency (drugs, alcohol, etc.).

Dr. Winstock was in the BBC’s London studios, Ms. Senior in Toronto, Canada, and I myself in the BBC’s Edinburgh studio. Quite a far-flung trio of conversationalists. However, our interest in the subject, and our engagement with each other was such that the producer was pleased enough to say that it had come over as if we had all been around one table.

The relevance of dependence and independence to my fellow guests is obvious, but I was pleased to have been invited to talk about the relationship between patient and staff in a secure psychiatric unit, such as I portray in m y book, The Locked Ward.

The presenter was keen to draw a parallel between my work as an orderly in the ward and my previous experience as a teacher of High School pupils. And, indeed, once we make the obvious distinction, that in the case of patients in a locked ward, we are dealing with a situation in which an adult’s independence has been removed from him or her (however temporarily, and however well-intentioned), there are some useful parallels that might be drawn.

Putting aside the educational aspect of a teacher’s work, he or she has the responsibility of developing young and impressionable minds, of providing them with the information and choices required, together with the training and background to make those choices, that will enable pupils to blossom into independent adults themselves. In the case of the patient detained against his or her will, whose independence has been removed, staff have a similar responsibility to provide a suitably safe and unthreatening environment in which a course of therapies and medications will enable that patient to reassemble, if you will, an identity and reassert an independence that has been removed.

I have said elsewhere, and I have said often, that no therapy, no medication, is as important to the improvement of a psychiatric patient’s condition, sufficient improvement to warrant discharge back into society, as the caring human being. The nursing staff are of paramount importance in this process. To some degree, the same can be said of the teacher. Facts imparted, study methods encouraged and skills developed will more readily be fruitful, if the man or woman leading the class does so with enthusiasm, understanding and sensitivity. We all relate to other people. People we admire, people we trust, people we find caring and concerned, can inspire us to great things. And they can help us find that within ourselves that we need to be what we want. The greatest psychiatric nurses do all of those things.

And we all have periods of dependence. It is part of the cycle of life. In childhood, we depend upon the good offices of others – parents, extended family, and teachers. In advanced age, we are often forced to rely once again on the good offices of others – children, family, and medical staff. We do not mind ceding independence to those who love us, who wish us well, who strive for our betterment. So, in nursing the psychiatric patient whose independence has been taken away, we must strive for those qualities we ourselves will look for in others – and the greatest of these is love.

The World Service program, ‘The Forum’, on (In)Dependence is available to download as a podcast from the BBC.