1: Leonard Cohen is a master of meaning, his words crafted and honed out of the struggle of human existence. It s a tortured process. As he said, If I knew where the good songs came from, I d go there more often. Instead he reckons that song writing is a mysterious condition, much like the life of a Catholic nun. You re married to a mystery. Born Jewish, Cohen is now a Rinzai Zen Buddhist monk whose wildly successful Hallelujah weaves together the sexual shenanigans of the biblical characters King David, Bathsheba, Samson and Delilah. Even if you re not religious you may be captivated by their stories because their humanity is as fraught as our own. Cohen knows that oh so well so when he begins 2: Ring the bells that still can ring, forget your perfect offering there s a crack in everything that s how the light gets in.. 3:..it resonates with our human awareness that it often takes our brokenness to allow new light and life to emerge. Rumi, the 13 th century Persian poet, theologian and Sufi mystic knew it well when he originally wrote, the wound is the place where the light enters you. 1
4: This is the language and truth of liminal space. Sometimes seen as a doorway, a portal, an in-between space, a place of transition that is often dark and unfamiliar. An uncomfortable space where, if we sit with it long enough, we begin to wake up to reality, life as it is, mortal, limited and often painful. 5: In religious language, this is the dark night of the soul. It s a journey I notice many cancer patients are on, but a journey that we struggle to address in any real sense partly: because we have lost the art of religious language that used to help us speak of this, because anxiety about religion gets in the way and the language used in healthcare settings is often scientific and somewhat reductionist. 6: Once many Kiwis were connected to a religion and in particular, Christianity with an accompanying awareness of the highly descriptive language that threads its way through the Judeo Christian tradition. However, a seismic shift has taken place across the Western world. The fastest growing group are the NONES, people who claim no religious tradition and along with that no adherence to any political grouping. In New Zealand, around 88% are considered to be flying solo in this way. Consequently, the ability to express the human journey with the language of religious mythology, story and imagery is rapidly diminishing, and with it the poetic language used to talk about the struggle of human existence. 2
7: This change has been underway since the Enlightenment alongside the rise of science, which has its own language to explain the discovery of truths about the human condition. The two languages can coexist but find it hard because as Thomas Moore in Care of the Soul in Medicine points out, We not only train doctors in science; we enculturate them, make them see the body as an object, and require them to honour the scientific method and be wary of any alternatives. 8: Here s a New Zealand story that might illustrate how difficult it is to combine different ways of seeing the world. Up the way a bit near Meremere was a killer stretch of road. The locals had long blamed a taniwha for the high death rate. Transit New Zealand thought a bit of modern, scientific road engineering could fix the problem. However, the local iwi, Ngati Naho, appeared to object to this, the bulldozers stopped in their tracks and all hell broke loose. Dr Ranginui Walker, former Professor of Maori Studies at Auckland University remembered being told as a child that he mustn t swim at the deep swimming hole at the bend in case the taniwha got him. A way of speaking about what runs deep. He also pointed out that local Maori may not have been opposed to the road changes but may have objected to the changes being foisted on them without their views being respected. Using language and understandings of wairua to talk about the spiritual dimension was then a perfectly reasonable thing to do. However, as Research Fellow Tess Moeke-Maxwell said, these things are not well understood by much of New Zealand society. Whatever we might think a taniwha does or doesn t mean, or whatever we think hell is, or isn t, it s likely that we will be having those thoughts based on a particular world view that we feel comfortable with and which makes some kind of rational sense to us. It might though be a somewhat monolingual approach. 3
9: This raises the question about what language we use to speak about what runs deep when our mortality is threatened. This is particularly difficult in a healthcare system controlled by professionals who tend to speak in scientific language far removed from human beings trying to make meaning on a difficult journey into darkness. In the Body of the World. 10: Eve Ensler, playwright, author and activist became famous in the 1990 s as author of the Vagina Monologues, created out of her dislocation from her own body. In 2010 Eve was diagnosed with cancer. Already experienced in the body/mind/spirit split, she struggled when she was only being seen as test results and particular grades of cancer. Out of this new dislocation emerged her memoir What if our understanding of ourselves, she said, were based not on static labels or stages but on our actions and our ability and our willingness to transform ourselves?.. What if, instead of being afraid of even talking about death, we saw our lives in some ways as preparation for it? What if we were taught to ponder it and reflect on it and talk about it and enter it and rehearse it and try it on?.. And cancer, just like having your heart broken, or getting a new job, or going to school, were a teacher? (p88) 11: At this point I thought our own Martin Crowe and Ensler had been in cahoots. He tweeted recently that, after a brilliant year of self-discovery and recovery I have more work to do. My friend & tough taskmaster Lymphoma is back to teach me. He went on to talk about the space between thoughts, between breaths, between fielders, between balls. They say to experience the gap wholly brings ultimate joy in what we do. In the gap there is nothing, and it's that nothing space in which lies the secret to our purpose. As I contemplate the meaning of much of my life, a life I now truly treasure, with dangers lurking, it is in this moment of nothing that I feel at peace. 4
12: Exploring the concept of nothing, no-thing, was central to my teaching of young people exploring God ideas in religious studies classes. Entry into that domain tends to blow their minds because spirituality, the art of awakening to what is real might be inextricably linked to the wonder of mathematics. Reality, says physics writer Amanda Gefter, may come down to mathematics, but mathematics comes down to nothing at all. She quotes the late physicist John Wheeler who said that the basis of mathematics is 0=0 and that all mathematical structures can be derived from something called the empty set, the set that contains no elements. According to mathematician Ian Stewart this is the dreadful secret of all mathematics, that it s all based on nothing. 13: Now, I m no mathematician but my observation and experience is that this nothingness, this no-thing, this darkness, this space devoid of creeds and controls seems to be highly significant in the spiritual journey. Take Mary s story as an example Mary was late 50 s, Pakeha with a chronic condition. There had been many hospital admissions, the possibility of being cured and ongoing relapses. She had a family church background but had been atheist since a teenager. However, she had worked out a spiritual framework that included the universe as being intelligent and reasonably benign, whilst holding everything together. Within this she felt held, understood and as though there was a greater purpose. During her illness this began to disintegrate. She talked about feeling abandoned, empty, alone and lost in the darkness. She reckoned she must have imagined or made up that feeling of being held. How stupid was that, she exclaimed. Out of this place, where everything we understand begins to fall apart into nothing, can come transformational conversations. Eve Ensler calls it the transformation that deepens your soul and opens your heart. This is how it was for Mary too. 5
There s that religious language again, the language of soul. We instinctively understand soul and are appreciative of it when it comes to us through music, but can sometimes be scornful when it appears to be associated with religion. Perhaps it s because we re left with lingering ideas of soul as a kind of ethereal body part that might zoom off somewhere interesting at death. Whilst there are people for whom that idea remains valid, it can be useful to reinterpret soul for our time. 14: Thomas Moore wrote the best seller, Care of the Soul in 1992 in which he reinterprets soul as a dimension of existence somewhere between our intellect and our unconscious. (pxx) Soul, says Moore, thrives on imagination and creativity. It is revealed in attachment, love and community. When soul is neglected, it doesn t just go away, it appears symptomatically in obsessions, addictions, violence and loss of meaning. (pxi) And just before you try to diagnose it and pare it down to its constituent parts, Moore also irritatingly says that it is impossible to define precisely what the soul is. After all, definition is an intellectual enterprise and the soul prefers to imagine. Leonard Cohen might well agree. 15: Interestingly, contemporary definitions of spirituality are encompassing this kind of language. Dr Richard Egan from the Department of Preventive and Social Medicine, The University of Otago: Spirituality means different things to different people. It may include (a search for) one s ultimate beliefs and values; a sense of meaning and a purpose in life; a sense of connectedness; identity and awareness; and for some people, religion. It may be understood at an individual or population level. (Egan, et al.,2011) Dr Christina Puchalski from The George Washington Institute for Spirituality and Health offers this approach: Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred (Puchalski, et ai., 2009). 6
But however erudite our new definitions might be, the rubber really hits the road as we try to highlight and embed spirituality in a busy public hospital. 16: At Palmerston North hospital we ve begun with a quality improvement project in the Regional Cancer Treatment Service. All new admissions are being given information about spirituality, asked four simple questions, receive a brief visit from me and get asked their views on discharge. We already knew it was hard for staff to talk about spirituality and despite the questions being relatively low key, it s still difficult and appears to be a bit too confronting for some patients. 17: I think this is because spirituality is like a shy beast. What runs deep in us is full of passion, power and paradox, not easily talked about. To add to that is the Kiwi preference to lean on the fence, not look each other in the eye, talk about the weather and/or dogs and punctuate anything important with grunts and silence. Interestingly enough, many of my deepest conversations about the journey to the interior start with dogs or cats, often a person s closest living relationship. Despite the struggle, we look forward to what we can learn from this project and the new MidCentral Spiritual Care Advisory Group that seeks to understand at a deeper level the spiritual needs of its consumers and staff, and how to address those in a very changed environment. 18: One of the demands will be that chaplains will have to become much better at articulating what they have to offer into the human spiritual journey. And to do this in ways that patients and other healthcare professionals with no interest in religion can understand and run with. 7
the dark. 19: For much of this wisdom is based in the human struggle with mortality. Not being concerned about what comes next but to stand firmly in this life and to wrestle with meaning in the dark. It is in some ways what we would call a mystical journey. St John of the Cross, mystic, born in 1542 was on about it then when he said, If a man wishes to be sure of the road he treads on, he must close his eyes and walk in To face the dark, to live within the reality of mortality is a journey of empowerment. It s a journey that is threaded through the thousands of years of wisdom contained within religious, cultural and philosophical traditions that can positively help with the vulnerable mortal journey of our patients. We all have to continue to value our own traditions but be able to see them as one part of the jigsaw that can contribute to human flourishing. From that position of certainty about your own turangawaewae, it is so much easier to value the contributions of other languages and traditions that seem so different from our own. But it can be done. 20: This year a group of psychotherapists, theologians and historians met at the Anna Freud Centre in London, part of the process of forging new links beyond Sigmund Freud s skepticism about God. Central to that gathering was a discussion of how the religious idea of purgatory, a place of struggle towards God, could work in contemporary psychotherapy. They came to the view that it could. Mark Vernon, English philosopher, psychotherapist and ex-anglican priest said that the key was to expand the notion of purgatory as a place we go to after death, and also think of it as a state of being that can be vividly known in life. Reframing old understandings. I have come to the view that to have any hope of embedding spirituality in healthcare, we first of all have to be prepared to live in the vulnerability of mortality and open this possibility up for our patients. This is uncomfortable for a system focused on fixing things. 8
21: We also will have to engage in a great deal of spacious conversation so that disparate groups can find ways to understand one another s language so that we can listen to each other s stories and wisdom. 22: It s almost certain that cracks will appear in this process. Those cracks become the liminal space where everything that we thought certain might be up for re-evaluation. It s the gap. It s vulnerable and wounding. But it s the journey that many of our patients find themselves on. I think we owe it to them and to ourselves to be more than scientific rationalists and to become soulful navigators of the wound where the light gets in. 23: Leonard & 9