From today’s clinic
It was a pleasant Spring morning in Somerset during a week-long silent retreat. We were being guided, very capably, through exercises based on the four ways of grounding mindfulness by paying attention to: body, feeling tone, mooded mind, dhammas. This particular morning we had been invited to ‘take our mood for a walk’. Initially as I walked I felt quite shaky but this unsteadiness eased when walking barefoot and soon gave way to an inquisitiveness and quiet reflective state. At least on one occasion I felt sad, perhaps even lonely, and it was at this point that the temptation was strongest to race ahead in my thoughts, as if to cheer myself up, imagining and planning, distractions designed to gladden the mind. In the midst of this new-found confidence, time and again, I so easily lose connection with the present, embodied moment. Then in the distance there existed the most beautiful vista – bright yellow rape against big bold trees on the hillside. I saw some children running, chasing each other through the tall meadow and in this moment I remembered so clearly the fun (embodied fun) we all once had as children, thoughts no more of distant thunder.
This analogy came to me during a recent silent retreat, and came in the form of an invitation to imagine the future as a stranger. This not only introduces a degree of apprehension and trepidation of the future, not usually present when we imagine ourselves some years ahead, but also crucially encourages one to take a graded approach to planning, to not assume too much or plan too far ahead. Of course when one meets a stranger one may also be cautiously optimistic that this new person, who let us remember has come into our lives at a particular moment in time, may become an ally or friend at some point in the future, given sufficient time, energy and investment! However then there is a sense of the mind as resisting this notion, as if believing that if one focuses long and hard enough one can anticipate and know the future without having to wait. On the contrary, the future is built on moments and these unfold over days and weeks, each preceding the other, one influencing the next.
Inspired by Eckhart Tolle, and his appeal to each of us to find the ‘watcher’ within, I set out thinking about this and what used to be called ‘the Ego’… The first thing I notice when considering this topic is a strong pull in one direction at the outset, to say that I believe in the need for such a watcher and that a general wariness of the ego is wise counsel. The ego certainly has got lost in translation and requires refreshing and so I begin with a definition taken from the Oxford English dictionary (2012) that hints at the source of the problem because there is not just one but two definitions … here the ego is defined as “a person’s sense of self-esteem or self-importance” (layman definition), and “the part of the mind that mediates between the conscious and the unconscious and is responsible for reality testing and a sense of personal identity” (psychoanalytical). Taking the middle ground, my suggestion is that ‘ego’ is strong will, and here we may even use the analogy of the horse whisperer who, rather than ‘breaking’ the will of the horse (the part that hitherto needed controlling), instead he/ she tries to understand it, even befriend it, in order to transform it.
So why, this urge to chastise the ego as is so often done these days? Is this a misunderstanding out there in the general, public domain of what remains, a technical word? Or is this an example of how we take a word and socially create and expand the definition to fit our purposes? And what of the more ‘positive’ aspects of the ego should they exist? After-all is it not the ego that has a certain strength of conviction, to stand apart from the crowd, and speak out on issues it holds dear and to worry not about appearing ‘different’ to others and what they might or might not think? Here I connect to my roots, of being born of dual-heritage, and to sensing my different-ness, on occasions uncomfortably so, then at other times, recognizing it also allows me a degree of freedom to stand apart, not needing to try too hard to ‘fit in’ (over time, a blessing).
So what of the ego we started out trying to understand? The ego may indeed need watching over, but rather than chastising the ego let us instead embrace it! In fact the ego may even be the watcher we seek, able to occupy that middle ground, overseeing, taking executive control – in short, the ego, is not all that bad!
During a recent Fellowship in London, I completed a number of papers detailing the processes of family adaptation following neurological injury. This impact can be seen across various settings – for example, for children in school and home settings, and for adults in the role of spouse, parent, friend, work colleague and so on. What is clear is that as well as achieving the maximum physical recovery, rehabilitation also needs to redress the disruption felt at the level of self-identity and relationships. For children there is the added factor that the full impact of injury may take years to unfold and become clear, and at each stage of life (e.g. moving schools, leaving home, starting a job) new challenges may present.
Attached are two papers – one that appeared in the journal Human Systems which presents primarily case study material, and a second from the International Journal of Rehabilitation and Therapy in which I chart the theory and research base in this field at the time of writing (2007). I highlight specific service examples of good practice, and countries where this work is flourishing. Further papers (not available here) focus specifically on Multiple Sclerosis, a most disabling condition partly because of its unpredictability, the likely time of onset (midlife/ childbearing), and because it affects more women than men and so plays havoc for aspiring families. I am indebted to the ‘The Multiple Sclerosis Trust’ (UK) who supported this work and a number of succinct reports are available from their website, see Open Door and Way Ahead article. Another paper (below) discusses the interface between music therapy and social relations after brain injury.
My time in London culminated with the publication of a book entitled “A Relational Approach to Rehabilitation” (co-edited with Giles Yeates & Siobhán Palmer), which updates and develops these earlier ideas, and a sample of this work can be seen on Google Scholar at Sample pages. Finally, for those with an interest in the impact of neurological problems on the family, together with colleagues I used to run a networking group for disseminating new research, training events and funding opportunities. For further details, go to TBIFAMILIES network and click ‘subscribe’.
Bowen, C. (2007) Family therapy and neuro rehabilitation: Forging a link. International Journal of Therapy and Rehabilitation, 14: 344–349.
Bowen, C., Hall, T., Newby, G., Walsh, B., Weatherhead, S., & Yeates, G. (2009). The impact of brain injury on relationships across the lifespan and across school, family and work contexts. Human Systems: The Journal of Consultation and Training, 20: 65–80.
Bowen, C., & MacLehose, A. (2010) Multiple sclerosis: Long-term care and the ‘family care pathway’. Social Care and Neurodisability, 1(1): 31–38.
Bowen, C., MacLehose, A., & Beaumont, J.G. (2011). Advanced multiple sclerosis and the Psychosocial Impact on Families. Psychology & Health, 26(1): 113-127.
Magee, W.L. & Bowen, C. (2008) Using music in leisure to enhance social relationships with patients with complex disabilities. NeuroRehabilitation, 23(4): 305-311.
Bowen, C., Yeates, G., & Palmer, S. (2010) A Relational Approach to Rehabilitation: Thinking about relationships after brain injury. London: Karnac.