Care, Science and the Human Spirit

Good quality care must have a spiritual element. It ultimately involves a meeting between minds where someone in need feels a connection with someone else who has the resources to attend to that need as a fellow human being. In traditional medicalised mental health science this is often mistakenly called a 'placebo' or a 'non-specific' effect but in psychological and spiritual terms this human connection is in truth a primary effect and a core aspect of all healing.

As Carl Rogers (3,4) demonstrated in his research decades ago, to be cared for successfully is by definition an interpersonal matter that involves empathy, warmth and genuineness. These vital human qualities can only be measured subjectively in our hearts and minds. From childhood onwards, human beings can quickly recognise when they are genuinely cared about and cared for. Empathy, warmth and genuineness are the easiest things to measure subjectively but in a scientific and policy framework that only values objective numerical values and outcomes, the spiritual essence of care can get completely lost, dishonoured and even violated.

However, even in traditional scientific studies all the clues are there. In particular, all psychotherapy outcome studies when taken collectively show the big picture that it is 'relationship factors' rather than therapy techniques or models that account for the bulk of the variance in outcomes (5). We also know that love and care are not simply 'soft' phenomena. The scientific evidence shows that love shapes even our brains and physical development (6). However, even when faced with these findings, rather than focussing on better understanding of these ancient and universal relationship factors, Western therapy research persists in looking for new and better 'objective' care techniques. This means that when it comes to the humanity of our public care services, our energies are going into examining behavioural technicalities rather than patterns of connection between the hearts, minds and souls of individuals (7). Of course, if there were no difference between these two levels it would be impossible for human beings to act, pretend, lie or be insincere. Care only works when it is sincere and sincerity can only be measured at the level of the heart and mind.

Contemporary Western health and social care science remains fixated on developing new clinical techniques of care rather than on illuminating the transformative human psychological and spiritual qualities that have been helping and healing people in all cultures since time immemorial. It is perhaps not surprising therefore that we have now entered an age of increased personal and spiritual burn-out where, over and above financial constraints and staff shortages, care professionals are being expected to function like robots, delivering manualised techniques according to prescribed methods and being measured less in terms of quality of care and more in terms of quantitative and financial targets. In the

West, even an initiative such as 'mindfulness' (8) which is aimed perhaps at injecting more spirituality into our care systems is in danger of becoming yet another manualised and prescriptive approach.

If care is personal but care science is depersonalised, it is clear that there will be a philosophical and cultural rift in providing care models that fully embrace what it means to be human. If the relationship between care provider and care recipient is being neglected, how much more is the relationship between the care provider and those on whom he or she depends for support and nurturance? In this chapter we examine the vital question of the care, support and back-up that the carer also needs if the caring role is to be sustainable and satisfying. We argue that care cannot be spiritually competent unless the spiritual energies of the carer are also continuously supported and refreshed. This means having a model of care that includes the relationship between the carer and the supportive environment. The spirituality of care can then be seen as not just an individual or intrapersonal phenomenon but also as an interpersonal, systemic and dynamic one.

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