A small group of us talked about some of the problems with family dynamics, especially relating to taking care of a patient. We groused and groaned about patients and their families not listening to instructions, or having selective hearing when it comes to informing them about their condition and what they need to do. We talked a bit about how stress affects people, and sympathized that patients and their families do have a hard time hearing us when they are so overwhelmed by what is happening to them. We also acknowledged that when we were students, it took much repetition for us to get the basics of what we're expected to teach families.
We also talked about some deeper issues with families. That illness sometimes elevates dysfunctional relationships in a way that prevents the people involved from healing in any way - physically or emotionally. One of the dynamics that happens is when the patient becomes "The Messiah" (could also be "JFK", "Joan of Arc", "The Saint") - this person, because of their illness or death has all faults suspended indefinately and the suffering endured by the Saint eclipses all other problems or pain anyone else is feeling. To avoid facing their pain, the family gives all of its pain to the Saint. Sometimes, the Saint uses their pain as a sword to smite anyone in the family who dares to speak their personal pain. Who can dare consider their pain to be as important as The Saint's pain? And afterall, everything would be perfect if "St. Joan" could be restored to health or to life.
Others in the family can play the Martyr instead of facing their own issues. They can live their lives in service to, or grieving for the Saint. In some respects, it's almost better (for the dysfunction) when the person has died, since if the person is still alive, there is a chance that they will get better - then the dynamic has to take a different course to maintain itself.
It seems that there is always a Black Sheep, though - someone who dares to live outside the expectations of the rest of the family. That person often cries out at the unfairness of the Annointed One, much to the horror of the family. Afterall, how can a person criticise someone so ill? How heartless can they be? The Black Sheep often is doing things that will get him or her into trouble, and then works hard to try to get attention and help. In a family filled with a Saint and many Martyrs, the Black Sheep sticks out like a sore thumb.
I'm so glad we have so many good Social Workers on our staff. We nurses tend to be co-dependent/Martyr types, so we tend to be very impatient with the Black Sheep - wanting them to suck it up in service of the Saint - sometimes not seeing that we're doing more harm than good for this family. One of the Social Workers particularly, helps me in my understanding of these family dynamics, and he has a lot of time in grade working for many years with cancer patients. He's very balanced in his approach - both in understanding the many needs of the patient, but also helping the patient gain perspective. Not letting them get away with being "Drama Kings/Queens."
I'd love to see Matt become a counselor, especially working with our patients. It's one thing for a healthy or able-bodied person to tell someone who is ill to get off their high horse, another thing entirely for Matt to wheel up and do that! My favorite story that he tells is of walking along at school with a friend who was bellyaching about her broken foot - what a hassel the crutches were - until they got to a curb that she could hobble over, but he couldn't get down. She looked at him, and his only comment was "you were saying..." She turned bright crimson!
To me, the best part is how comfortable people can be with Matt. He's so present with others, that it's easy to forget that complaining about a temporary inconvinience to a person with quadraplegia is the height of lunacy. He doesn't see it that way, though. He's very willing to be sympathetic to any little "boo boo" and also very willing to remind someone to find some perspective in their situation. When Matt shows how generous of spirit he is, it helps me to find that generousity within myself as well.
It's easy to become impatient with people, though. Especially when they are doing things that are so clearly not good for them. Interesting thing about seeing things clearly - it's much easier to see when we're looking from the outside in, than when it's us in the situation. Perspective is so important - helping people give themselves a bit of distance to see the bigger picture is a terrific gift. Even if it's as simple as remembering that no matter how bad things are, they could be worse - and being grateful that things are as good as they are!
