Held at the Royal College of Psychiatrists Annual Meeting 9
July 2001
Workshop conductors: Dr. Larry Culliford with Dr Sarah Eagger
and Dr Nikki Crowley
Reported by Larry Culliford
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The title was chosen to match the title of this conference,
'2001 - A Mind Odyssey: Science and Caring'. Our priMary
aim was to get spirituality and spiritual values in psychiatry onto
the agenda of the College. Our stated aim was 'To introduce and
facilitate a discussion about spiritual and material values in
psychiatry, then to offer suggestions on finding a balance between
them'. On the same day we gave a companion workshop on 'Meditation Techniques: An Introduction for
Psychiatrists'.
To foster a safe, intimate atmosphere, we offered only 20
places. In the event, the workshop was heavily over-subscribed.We
began by introducing ourselves, recommending the SIG and describing
its work. Participants were then invited to introduce themselves,
and to say what had attracted them to the workshop. Here are some
of the comments:
'Spirituality seems important in the training of
psychiatrists (but is omitted)'.
'I feel I have a vital personal stake in spiritual issues within
the profession'.
'Faith helps patients. How to acknowledge and make use of
this?'
'I decided to attend on the spur of the moment (thinking, there
must be more to psychiatry than this!)'
'I want to know how to retain my sanity - and bring peace to my
team'.
'I am seeking advice about self-disclosure: how much do I say about
my spirituality, religious practice and beliefs?'
'I have problems with the prevailing attitudes of materialism and
consumerism, and want the opportunity to discuss them with
colleagues, and receive advice'.
After a statement about the usefulness of stillness and silence,
Larry introduced a brief meditative pause. He then prepared the
ground for the two sets of small group discussion by offering a
definition of spirituality: 'A quality that goes beyond religious
affiliation, that strives for inspiration, reverence, awe, meaning
and purpose even in those who do not believe in God. The spiritual
dimension tries to be in harmony with the universe, strives for
answers about the infinite, and comes especially into focus in
times of emotional stress, physical (and mental) illness, loss,
bereavement and death'.
The first small group discussion focused on identifying
patients' spiritual requests and requirements: how firstly to
assess and secondly to meet these? Groups of five or six, including
presenters, met for 30 minutes and then gave plenary feedback, some
of it as follows:
'We should acknowledge that psychiatry is changing
(listening more to what patients actually want. Taking more account
of spiritual issues, of 'healing' as well as 'cure'.)'
'Spirituality is about recognising and valuing an aspect of
timelessness about things'.
'There is pressure to do more in less time, so there is a need to
establish limits: these should be based on genuine
limitations'.
'One way to cope is to seek to benefit from, even enjoy the
struggle. (Imagine Sysiphus smiling!)'
'Noting the value of humour, we should not always take things so
seriously.'
'Why not seek the middle way, the way of wisdom? This means always
doing something - enough, but not too much'.
After another meditative pause, and to introduce the second set
of small groups, focused more on practitioners, Larry read a poem,
'The Invitation', by Oriah Mountain Dreamer, a Native American
Elder, dated May 1994 (quoted in 'A Passion for the Possible' by
Jean Houston, Thorsons, London, 1998, and in 'SQ - Spiritual
Intelligence' by Danah Zohar and Ian Marshall, Bloomsbury, London,
2000).
The poem begins 'It doesn't interest me what you do for a
living. I want to know what you ache for'. It ends, 'I want to know
you, what sustains you from the inside, when all else falls away. I
want to know if you can be alone with yourself; and if you truly
like the company you keep in empty moments'. It challenges people
to reflect deeply on our values, our aims and deepest motives, and
served in the workshop to introduce the topic of 'spiritual
skills'. What are they? How may they be relevant to psychiatrists?
How may they be acquired and developed?
After a lengthy discussion, we had another pause, followed by a
general plenary discussion. We had to admit that we had too little
time to do full justice to a huge subject, spirituality, one that
is important since it pervades so much of life.
Larry reminded people about the handouts available, which
included suggestions about patients' spiritual needs, also the
declared benefits of spiritual care. He mentioned other resources
available, such as websites and books (including his own), also a
prototype leaflet, 'Healing From Within', generated by Larry with
Stuart Johnson (chaplain to South Downs Health NHS Trust) for use
in Brighton. This leaflet, which contains the Murray and Zentner
definition of spirituality, is aimed at helping mental health
professionals assess and gently explore the religious and spiritual
aspects of people's lives. Also listed in the handouts were
spiritual skills and attributes useful for psychiatrists.
Both Larry and Sarah recommended meditation as a reliable method
of improving emotional equanimity, spiritual skills and awareness.
Another of the handouts reproduced two articles on this subject by
Larry from 'Psychiatric Bulletin' - Meditation 1991, 15, 295, and
Meditation: Bringing the Mind Home 1994, 18, 366.
After a final brief silence, the 90-minute session ended on
time. People were invited to complete and return feedback forms. 11
(55%) did so. These were uniformly favourable, showing much about
what people brought to the workshop and what they thought they had
gained, such as a rekindled interest in spirituality, an
appreciation of its relevance to our work, a wish to join the SIG,
the value of stillness and silence, new ideas to try out and the
support of like-minded people.
My impression is that, even when encouraged to focus on
patients, people naturally spoke a lot about themselves. It was a
useful opportunity to share our stories, to give them meaning in
the context of the work of the College, and so increase our sense
of belonging. This was very satisfying. We are aiming to repeat the
workshops in Cardiff next year.