All posts by Peter Goble

About Peter Goble

I am an Englishman aged 77 years, married with 3 adult children. I am retired from professional life which was in mental health and teaching. I have been a (sort of) practising (sort of) Buddhist for about 30 years, and was active in the hospice sector, and more recently served as a Buddhist chaplain specialising (sort of) in mental health. My wife and I now live in north-western France (Normandy).

No speak the language (1)……on being disarmed, and perhaps re-skilled

french-3-mime

It’s just over a year since we decided to live in France, my wife and I.  We hadn’t planned to when we bought the house, but having moved in we decided to stay, instead of using it just for holidays.  The decision sort of made itself.  Perhaps the journeys back and forth were too exhausting, and there were other reasonable justifications we both agreed on.

We haven’t regretted it so far, although there have been challenges for us both; some we saw coming, some we didn’t, but none were overwhelming and most gave us sense of achievement as we tackled them together.  I’ve taken up new pursuits and my wife is enjoying a much-deserved freedom from the tyranny of round-the-clock shifts as a hospital nurse in a collapsing NHS.

But I’ve been challenged by not being able to speak or understand anything other than simple French.  I learned French at school over sixty years ago and learned it well, without ever being required to speak a word or listen to native speaker.  I read 19th century French literature (Moliere’s ‘Le Misanthrope’) and more – at that time – modern novels (Alain Fournier’s “Le Grand Meaulnes” – a kind of French ‘Catcher in the Rye’):  about three stuttering pages per 40 minute lesson. Yet though I passed my written exams well enough, I could hardly utter or understand a spoken word.

So since arriving here I’ve had to start the linguistic journey again from scratch, and from a different starting point: person-to-person communication.  One of my first efforts at making sense was in a local shop selling electrical items.  I had practised asking (in French) “Do you sell the things that allow a British plug to be inserted into a French socket?”  In the shop, the meaning was somehow totally derailed, either because I’d used the wrong word for plug, or socket, or allowed, or inserted; or all of them; or because my accent was unintelligible;  or because I was awkward and self-conscious;  or because I’d neglected to say the customary polite “Bonjour” on entering the shop.  I left without an adaptor, the shop assistant indicated somehow that they hadn’t got what she thought I wanted, and my feelings of hurt pride were soothed by her saying in English (and looking) “Sorry” , as I left.

Listening to spoken French is even more of a struggle.  We have a next door neighbour whom we met when we first went to look over the house and its untended overgrown jungle of a garden.  The estate agent had told him I spoke good French, and he followed us round keeping up a running commentary in almost unintelligible Norman dialect, from which I managed to catch an occasional familiar word, but hardly any sense whatever.  But his friendliness was infectious and, on parting, I felt in fine good humour and was able to thank him for his kind welcome which, I stammered in schoolboy French, had “touched our hearts”.

Reflecting on this later, I felt I had perhaps over-done the emotional loading in delivering this phrase in an unfamiliar language to a stranger.  The whole experience felt surreal, as I had no idea if he had understood what I said, or what impression it had made on him. I felt  uncomfortably ‘disarmed’.  It’s no co-incidence that, in using that particular word, I admit to having lost my ‘weapon’, language, or ‘weapons’, there being many others at my disposal.   On further reflection, it dawned on me that I always speak to impress or, as that is too much of a generalisation, attempting to impress is often a feature of what I say  (and write).  What impression am I trying to create in others?  It’s a daunting question, and so important to me that I get to the bottom if it, that I shan’t try to answer it here, maybe another time.

The surreal quality of living in France where I have a very diminished capacity for communicating using the comfortable conversational language of everyday life, the ‘vernacular’, has gradually faded, but is still around.  For one thing, now my ear is a little better attuned to French voices, and I’ve started to notice that, as far as my understanding goes, everyday French is much more straightforward and simply constructed than the French I learned at school.  People talk about the weather (I thought this was just a particularly English trait), and exchange ‘small talk’ (some of which escapes my understanding),  involving nods, smiles, sighs, tuts, sympathetic shrugs and head shakes of the familiar “Oh dear!” kind.

All this might seem blindingly obvious, but to me it’s a revelation, and it’s almost as if I’m learning how to communicate with my fellows from scratch.  For one thing, I’m having to give thought to what I want to say before I open my mouth.  Time and again, I realise that my default position is to impress, instead of to communicate a need or to respond to someone else’s.  This just doesn’t work.  If, as I suspect, I am trying to impress the other with my presumed superiority, communication becomes a battle of strength: either I prevail and ‘conquer’, or I submit and ‘grovel’.  Sometimes, I think, I do both!

So, I’m learning, communication seems to work much better from a position of parity of esteem, not a battle of wills.  So far, so (provisionally) good as a working theory and as a daily practice……..(more to follow on this)

 

Pain (2)

Although this page will pick up the threads from Pain (1), I want to mention two comments received already, because they’re relevant to where we go from here.  One was about working with the ideas and assumptions that may be associated with pain, and I shall propose some that I’ve used myself, or supported others in using, and report what happened as a result.  Another interesting comment asked if physical pain and mental pain are different, and in what way.   Both writers seem to acknowledge a physical and a mental component to pain, and to suggest that these two may interact at the level of causation, on the experience of pain, and perhaps figure in its relief.

Although it might be stretching a point to assert that anger, fear or anxiety cause pain, these emotions could well modify our experience of it, lessening it in some cases (as when a badly wounded soldier fights for his life in unarmed combat against an enemy) , or increasing it (as can  happen when the cause of the pain is not obvious to the patient, who fears it may be a sign of impending death).

These and other psychological modifiers I shall explore, albeit not in great detail, and not necessarily as a specialist practitioner in evidence-based pain management techniques.  I therefore welcome other contributors who can challenge, supplement or break new ground in this investigative effort.

*************

In 1970 I emigrated to sub-Saharan Africa (Zambia) on a three year contract in the medical department of a huge American copper-mining consortium.  My job was primarily as a qualified nurse-teacher, but I also had substantial personal hospital nursing experience, including tropical and some emergency medicine and surgery,  gained in UK before setting out for the sub-tropics.  I had never set foot outside the British Isles, however.  I had no knowledge about other countries or cultures, and had earned an examination grade D for “Disgraceful” (Mr “Sniffer” Ellis, my geography teacher) in Geography.

The work involved a lot of hands-on clinical work as well as teaching and I felt reasonably at home in the modern hospital where I was based. This was on the edge of a huge mine “township” where mine employees and their families lived.  Almost all the patients were indigenous African workers and their immediate families.  Most of the nurses were African, though all the doctors were white as were the senior sisters and matrons.

A few months after I started there was a catastrophic underground collapse and flooding in a major section of the mine workings, which were several hundred metres below ground, and full of workers and heavy plant (machinery, earth movers, and giant transporters). About 400 workers were trapped by falling rock along a 1 km long lateral traverse twice as wide and high as a London Underground tunnel.

I was woken in the early hours and summoned to work to help with the recovery and treatment of injured and dead miners.  Within twelve hours, scores of bodies had been raised to the surface, and the hospital was full of crushed and mangled survivors.  The rescue teams were brave, well-trained, and as determined to save the lives of their comrades as miners anywhere in the world.  But the situation was generally ‘organised chaos’.

As I worked with others on the badly injured patients, some devastatingly so,  I was struck by how undemanding the patients seemed to be and,  in the case of patients who weren’t unconscious or anaesthetised,  by their not showing signs of serious physical distress or pain. The same seemed true of the African staff, whose approach to care was not that of the “soothing hand on fevered brow” kind, but brisk, matter-of-fact, and cheerful, whilst observing the simple protocols of African social behaviour.  The concept of ‘sick role’ which is very prevalent in British hospitals even to this day, seemed to be absent.

Professor Michael Gelfand, “one of Africa’s most distinguished medical practitioners”*, founding professor of African medicine at the University of Rhodesia (now Zimbabwe), and author of ‘The Sick African’ (1957) has posited that Africans have ‘a high pain threshold’, meaning that they have a lower susceptibility to pain than white races, the implication being that bantu (negro) races have a coarser and less refined physical and neurological endowment than that of the superior European race, thus lower sensitivity to pain.

This was the received wisdom (amongst white practitioners) at the African hospital where I worked.  I did not believe it then, and Professor Gelfand has himself recanted his opinions (he is now deceased), in the light of his own ethnographic and cultural researches. In my own experience, pain has a different meaning to the African patient than it does to most of us northern Europeans.  Although it may be inconvenient and uncomfortable,  it is generally much less disabling and has fewer emotional correlates (such as fear or anxiety), than it does for non-indigenous people brought up in a different culture.

After the mine accident, men who had endured serious crush injuries or fractures necessitating whole-limb amputations, or major burns, were able to get up from their beds within hours of admission or major surgery without prompting or assistance, to clean their teeth, take themselves to the shower rooms to wash, and to use the toilets unaided.  The level of resilience, self-care and independence was astounding to me.  Little analgesia was required or requested.  This impression I inferred about the meaning and significance of pain for indigenous African people survived my whole experience in Zambia over many years of work there.

However small my justification for a firm conclusion on the matter, I am inclined to think that culture and upbringing is likely to be a key determinant in the human response to pain, alongside psychology.  I confess to not knowing how to proceed with this idea beyond the point stated here.

* Unattributed source, http://en.wikipedia.org/wiki/Michael_Gelfand

Pain (1)

Pain is an almost universal human experience, and one which almost all of us want to avoid.  It’s said (and many might agree) that whereas we can tolerate the thought that we shall die, the thought that our deaths may be excruciatingly painful is hard to contemplate, and for some of us that fear justifies euthanasia, or legally assisted suicide, even when doctors reassure us that pain relief is available at the end of life, and is generally effective in controlling it.

Pain probably doesn’t need definition, it even defies definition.  But pain can be usefully described in terms of its characteristics.  Doctors use the terms crushing, lancinating, throbbing, colicky, gnawing, boring, burning and twisting because these are regularly used by patients to describe their experience  of pain, and are subjectively recognisable, as well as being characteristic of certain medical conditions to the extent that they can sometimes justify diagnosis of medical conditions without much further examination or tests.

Pain is also subjectively measurable, and a simple scale of pain intensity has been used for years: it runs from 0 to 10, with ten being the most intense, excruciating or unbearable pain, and one the least.  Practitioners are taught to accept the patient’s own assessment of intensity.  The days when nurses could say, “She’s exaggerating her pain to get attention, or to get pain-relief” are generally over: “Pain is what the patient says it is” is the accepted dictum.

Besides the administration of analgesic (pain-relieving) medicines, much attention is presently given to ways that people can manage pain without analgesia, to complement analgesia where its use isn’t completely effective, or where its use is not well tolerated by patients because of the unpleasant effects or side-effects it may produce.  Not a few patients decline the offer of analgesia on principle (because they shun chemicals in favour of more ‘natural’ remedies); or because (like some Buddhists), analgesia is deemed likely to cloud consciousness in breach of the religious precepts they observe as an aspect of practice.

Although there are several ways of managing pain that don’t involve medication, the one I shall concentrate on here, because it may relate usefully to the Middle Way, is concerned with the idea of pain, or the ideas and assumptions that surround the experience of pain, and may influence our subjective experience of it.

One very prevalent idea about pain is that it is a kind of suffering.  It is almost always described as disagreeable, often extremely so, although for some otherwise ‘normal’ people it’s a sought-after item on the menu of aphrodisiacs that heighten sexual pleasure .  However, it also disables, or is prone to disable, the “sufferer”.  I attach quotes because this is a hugely typical way of describing an individual who is experiencing pain.  Pain can seriously and adversely affect the “sufferer’s” capability and capacity to discharge normal functions, including automatic ones like breathing, swallowing or eliminating.  Pain may make life very difficult.

Pain can also cause mental distress, and often does so.  The experience of pain may be accompanied by thoughts that preoccupy or dominate consciousness:  “What’s wrong with me?”, “What’s causing it?” “When will it stop?”, “What can I do to get rid of it?”, “Is it getting worse?”, “Why isn’t it going away?”,What have I done to deserve it?”,  “Can someone help me?” Pain may be attended by anxiety, fear, and sometimes by guilt or anger.  Pain which comes and goes (intermittent pain) may give rise to crippling apprehension and vigilance for signs that pain is returning, both of which can interfere with the activities of living.

Another possible accompaniment to pain is the idea that pain is a punishment, deserved or undeserved, and that to experience pain is to be a “victim” of some kind of retribution.  The idea that “it’s my own fault” may pop into a “victim’s” mind without warning, and take firm root in consciousness.  Some patients find that to accept responsibility for one’s pain is a way of reconciling oneself to the experience, and even of mitigating it to an extent.  This capacity we may enjoy to change the subjective experience of pain is something I shall return to in the posts that will follow.

Readers’ comments will be very welcome, especially comments in which a personal experience of pain is addressed, or ideas about managing or coping with pain.  Readers will know how to stay within their ‘comfort zone’ in doing so, bearing in mind that these threads are accessible to the general public.

 

Refugees – our responsibility?

Italian navy rescuers help refugees climb on to their boat in the Mediterranean last month. Photograph: AFP/Getty Images
The Italian navy will continue a search and rescue mission which has saved the lives of an estimated 150,000 refugees, although a decision has already been taken by the Italian Government to replace it with a more limited scheme from 1 November.
The UK Foreign Office stirred ire in Brussels on Tuesday when it announced that it would not participate in any future search and rescue operations, because of their “pulling factor” in encouraging economic migrants to set sail for Europe.  An estimated 2,500 people are known to have died this year while making the perilous trip across the Mediterranean Sea.

Many of these are said to favour the UK as their destination, drawn by the welfare benefits they will be able to claim on arrival.  A prominent politician has remarked that it’s a difficult decision not to rescue people in international waters, and he’s glad the decision doesn’t rest with him, but there may be other options to be considered.

Is he right?  And what might those options be?  Or is his hard-headed pragmatism beyond the pale?

Meditation 8: and gender.

 

alarm clock

I woke from sleep in the early morning hours recently, and my first conscious thought consisted of the word “provisionality”.  It was as prominent as if a banner with the word had been hoisted across the foot of my bed.  And I knew at once why it was there, and what it meant.
A few hours earlier I’d been struggling unsuccessfully to draft an article on meditation for this blog.  This unannounced and unexpected banner-headline in the quiet of my bedroom, in the dark, turned a searchlight on my struggle, and resolved it.

While I was sitting in front of my monitor, I couldn’t put into words the conflict I was experiencing about Robert’s intelligent disquisition on the hindrances to meditation, which seemed to reflect the kind of stuff I’ve read before in Buddhist tracts and articles about how arduous and difficult meditation is, but worthwhile for the ultimate reward of solitary ecstasy .  They all have that hallmark of the experience of robed sitting by people, almost exclusively men, who – by sitting in meditation for many years and by assiduous effort, overcoming formidable obstacles and hindrances – have reached the pinnacle of spiritual attainment, personal enlightenment.

monk teaching westerner to meditate

  How could I question that?  Yet I still do, insistently.

Let me return to my sudden waking up, and set aside the conflict for a moment, though I think they’re linked somehow.  Maybe that’s my inner philosopher in me speaking, with new-found confidence, and in a softer, more open and provisional style.

What follows is a rather crude and simplistic comparison of two approaches to meditation, devised by me, and based on my own experience of, observation of, and talking with women, especially nurses, but also Buddhist women, and of women in Africa, where lifestyle is still quite other than here in the developed Northern hemisphere (still curiously referred to as ‘the West’).

‘Male ‘model of meditation and principles of practice

monks meditating

Emphasises physical stillness in a prescribed erect sitting posture, eyes closed to shut out worldly distractions.

More or less totally (and deliberately) divorced from all forms of common worldly activity or engagement with other people e.g. social or family relationships, childcare, sexuality, work (including housework and gardening or growing crops), play, leisure, celebration, contingent events etc.

Performed in complete silence, often regards sound as a distraction or as contamination.

Solitary practice encouraged, group meditation takes care to exclude the possibility of any physical contact by meditators.

Oriented to personal achievement of bliss, ascending hierarchy of attainment (simile: climbing a lofty mountain, leaving the world and its cares far below).

Highly structured, elaborately detailed, concept-laden and often ‘scripted’ technique to be followed, rigour recommended.

Narrow focus of attention, discipline and effort prized.

Body regarded as vehicle for mind, used instrumentally, often seen as source of undesirable distraction from mind (Body-Mind dualism).

Teaching (on technique and to provide ideological buttressing) originated, articulated, controlled and directed (almost exclusively) by men.

Women’s voices and unique experience marginalised.

‘Female’ model of meditation and principles of practice

feng shui

Allows and promotes activity and movement, spontaneous and  purposive, open to the world and embraces it, eyes open.

Integrates short, naturally occuring periods of stillness, silence and relaxed, comfortable repose (no imposed postural requirements) with activities of daily living, and seamlessly in relationship with other people (specially attentive to children, the elderly, or animals), on an emergent basis as life unfolds.

child care

Encourages and welcomes togetherness, especially the company of other women.

Characterised by shared conversation, or singing/crooning, and comfortable shared silence, especially when  carrying out shared activities (household tasks, cultivating gardens, fetching water or firewood, weaving or sewing, pounding or sieving grains, community cooking,

women cooking nshima

reciprocal grooming like hair plaiting, manicure etc).

Oriented to cooperative, cohesive and collective purposes.

Uncontrivedly self-effacing and ‘unselfish’.

Body-mind understood in ‘wholistic’ terms, expressed as an intuitive apprehending of feelings, and understanding sensations as metaphors of influence and meaning, a naturalistic and concept-free ‘integration of desires’.

Wide focus of attention, open to the whole visual (and aural and osmic) field, while (like a bird) able to pick up particular detail. (‘without stirring from the unity of self-refreshing pristine awareness, the details of experience are clearly differentiated without being contrived’ [Longchenpa])*

Uncontrived: elaborate conceptual expressions of technique and ideological underpinnings for meditation experienced as redundant, at variance with women’s experience, and ironically referred to as  “typically male” or in other earthy, bawdy terms…..!)

Teachings shared informally, in light jests or personal anecdotes, by story-telling, in songs or poems, in pictures, or by clothing, body adornments, experiment and innovation in make-up and hair-styling,

plaiting hair 1

through the positioning and re-arrangement of household articles, artefacts, flowers or elemental things (feng shui).

arranging flowers

Women will share generously and with no expectation of reward or desire for acclaim or special ‘recognition’.

Men only have to notice that they are there, and that their contribution to meditation practice, although divergent, is of equal value to mens’.

 colourful women

* Quoted from Longchenpa, You Are the Eyes of the World, translated by Lipman K, Peterson M (2000), Snow Lion Publications, New York