to B ring H eatingDr. Richard Gilrr1artiI1

In. tro d u c ti o n.

I n all of our health professions, today, we are very concerned about the

impaired practitioner -the person who, because of physical, psycho-

logical or moral disabilities, or addictive issues, places others in poten-

tial harm. I would like to examine this from a much broader perspective and

look at our own psychological wel'- ness and wel'-being and its signifi- Dr. Richard J. Gilmartin IS a

cance for our work. ' psychotherapist practising in

Toronto and affiliated with

The HUIll8.n Focus Southdown, a residential

.treatment centre for clergyWe must never lose sight of the fact and the religious. Previously,

that we don't treat illnesses or dis- he served for 12 years as

eases. We treat people -people who Director of the House of

may have cancer, be depressed or Affinnation in Massachusetts

s~ffer from a disease. ~~t it is not the and held faculty positions in

dlse~se thatwe treat; It IS the person. three Eastem State colleges.

In this age oftechnol.o~y, when so He is an expert on wellness

~uc~ ofwhatwe do IS Instrumental- and the place of spirituality

Ized, It'S easy to forget that. in a healthy lifestyle.

The most significantforce any of us

has in our efforts to treat is probably not our knowledge, or expertise, or technical

skills; it is who and what we are as a person. This is whatwe bring into every

therapeutic encounter. This is clearly demonstrated in psychotherapy, where the

most significant healing force is likely the relationship between the therapist and

the client/patient. This has more potential to heal than all the technical expertise

the therapist has. My guess is that the same is true in every branch of medicine.

Crt:ieria £or Healt:h

Until a few years ago, probably the best statement about

psychological health was made by Freud, who offered twocriteria. " A healthy person," he said, "is someone who is

able to love and is able to work." Love and work. There

wasn't much done beyond that until recently.

Then, in 1980, the American Psychiatric Association came

out with an official position, outlining fourcriteri~ for psy-

chological and emotional health.

The Iu.porC:ance of" Being Healc:hf"ul

Does that mean that only the healthy can heal? I doubt that's true. Workingthrough our own pain and suffering may make us more effective in healing oth-ers. But if you don't value living healthfullyand are not practising it, you lessenyour effectiveness in some way. Trying to live healthfully is a fundamental com-mitment we need from all health practitioners.

What does it mean to be a whole person, to be healthful? We know a lot abouthow people get sick, get diseased, but very little aboutwhat it really means to behealthy; and about what constitutes health or wholeness. As the World HealthOrganization has stated: "You cannot define health as simply the absence of dis-ease. Because you don't have a disease, doesn't necessarily mean you arehealthy."

Self-care

This is the first criterion. It means a person is able to care

for himself (or herself), feed himself, toilet and bathe him-

self, and meet the cultural niceties about appropriateness

and how one presents oneself.

Meaningfulinterperson-al relationships

This second criterion is what Freud

called "love": the ability to engage in

meaningful interpersonal relationships.

Happiness requires being meaningfully

connected to other people.

Poductive activity or

study

The third criterion for health is to be

engaged in productive activity or study.

The sense of being productive, doing

something meaningful is essential. Inaddition to finding something meaning-

ful in our day-to-day work, we can also

find it in our family, the people around

us, or in those non-employment-con-

nected activities we choose to commit

ourselves to.

relate closely to only one sex, we warp

our personality development. This has

nothing to do with sexua/!genitalrela-

tionships {which are not intimacy but

rather a way of expressing intimacy,

anda way that I mayforgoJ.

In my work with those clergy who violat-

ed others in sexual ways, very few of

these abusers were predatory, necessi-

tating their removal from the ministry

because they were so characterologi-

cally defective that they were a danger

to others. The vast majority were men

who were desperate for intimacy but did

not know howto go about finding it.

They jumped into doing an intimate

thing, thinking itwould bring intimacy. Of

course, it doesn't. Not only did it put peo-

ple on the slippery slope for serious

harm; it also drove the abuser further

into isolation. The issue these people

needed help with was to form adequate

intimate relationships that were consis-

tent with their life choices.

Adequate use ofleisure time

The fourth criterion is to make adequateuse of leisure time. We professionalsHdon't have a job to do; we have a life tolive!" The true professional is notjob-involved but rather life-involved. Itis aterrible mistake when we make our lifecoextensive with our work.

Di:f:ferent Kinds o:fRelationships

We need our "cheerleaders," our allies,those people who -no matter what wedo-tell us how greatwe are. We knowwe can get support from them, thatword of understanding and encourage-ment. But we also need our critics,those people who call us to do more, cri-tique us, point out our shortfalls, help usbecome better. If you only have criticsand no cheerleaders, you can getdepressed. If you only have cheerlead-ers and no critics, you're going to havean unrealistic picture of yourself and failto develop. We need both.

We also need social friends, those peo-ple we enjoy recreational pursuits with,work or go to school with, have conver-sations with, whose company we enjoy.

Most importantly, we need those fewwith whom we are intimate. What doesit mean "to be intimate?" The Latin rootof the word, intimare, meansto "bring orput inside." In a sexual or an erotic rela-tionship we physically enter inside theother, orthe other inside of us. But realintimacy is a psychological entering

The Search :forIn t:ill:l.acy

Let me talk a bit more about relation-ships. Meaningful interpersonal rela-tionships are essential for us to behappy. People in meaningful relation-ships are happierthan people who arenot.

During my post-graduate training inNew York, there was a phrase reportedso often it almost became a cliche:"Good interpersonal relationships arethe best prophylactic against mental ill-ness." I still believe that's true, but itneeds elaboration. We need a variety ofrelationships. If we are to fully developour humaneness, we need close rela-tionships with people of both sexes. Aman calls for something in us that awoman does not, and a woman calls forsomething that a man does not. If we

inside the other, where we

permit ourselves to be known

by the other, putting aside the

masks, the pretences, the fak-

ing. To be fully human, this kind

of intimacy is absolutely

essential-whetherwe are

married or single, committed

to chastity or celibacy.

We started off talking about

impaired practitioners. They confuse

professional and personal relation-

ships by trying to fulfil their personal

needs among people with whom theyhave a professional relationship -

which is always potentially harmful to

the people they serve, and is always a

sign of impairment. We are most vul-

nerable to this when we lack ade-

quate intimacies in our own lives. Let

me note, here, that having a sense of

integrityis also essential to health: it is

essential that my intimate relation-

shipsbe consistent with myfunda-

mental life commitments.

not stress, but not being able to de-

stress. It is sustained stress that is

harmful for us. An inability to de-stress

causes distress, and can kill you.

How do we de-stress? Each of us

mustfind a waythatworks -be ittrav-

el, theatre, participating in orwatch-

ing sports, reading, listening to music,

exercise, hobbies or whatever. Find-

ing your own way of de-stressing is

an important part of health.

Additional

Criteria :for

Healthy Living

There are three other criteria that I

believe are importantfor healthy living:

lack of significant emotional distress,

knowing how to regulate our emo-

tions and spirituality.

Re,gulatin,g Our

E:lnotions

Another characteristic of healthy peo-

ple is that they know howto regulate

their emotions. In the 60s and 70s,

there was a tendency to "let it all hang

out." "If you're angry, let the person

know." That might be good for you, but

it's certainly not going to win you any

friends. We all have to control our

emotional expression, be it anger, sex-

ual feelings orfear. To regulate emo-

tions means we are neither over-

controlled (rigid) nor under-controlled

(impulsive) but, rather, that we choose

expressions appropriate to the cir-

cumstances.

As professionals, it's imperative for us

to regulate our anger. We don't have a

right to express anger towards some-

oneforwhomwe have a professional

responsibility. Teachers don't have a

right to express angertowards pupils,

nor physicians towards patients, nor

clergy towards their parishioners. A

professional relationships givespower and, within that relationship,

anger is always potentially abusive.

That doesn't mean we can't feel it. But

we have to contain it.

Lack of Significant

Emotional Distress

Not being in a state of emotional dis-

tress doesn't mean I don't have days

when I feel down. I sometimes get

"stressed," or have times when I feel

more relaxed than others. But signifi-

cant periods of depression, or bouts of

anxiety, are symptomatic of deeper

underlying issues.

Being a ble to cope with stress is

something each of us must learn to do.

Too many people feel "stressed out,"

but life without stress would be bor-

ing. We hunger for stress in the

movies we watch and the kinds of

entertainmentwe seek. We need

stress and seek it out. The problem is

This does not mean we should hold our emotion so tightly

that it destroys us; but we cannot let it pour out so that we

violate the boundaries between ourselves and others.

Healthy people regulate their emotional expression and

express their feelings appropriately.

Discovering Our Spirituality

In dynamic psychotherapy, the first phase is getting to

know yourself better. This means understanding the effects

your childhood had on you, how your parents, siblings and

other environmental influences shaped you. This gives a

deeper understanding of yourself, your needs and wants.

It leadsto a better feeling about who and what you are as a

person: "What I am is alright if only I can be that." You stop

trying to be like someone else and settle in to being your

own unique selt Even if we find inspiration in another, we

do not become them. We don't want to become another

Saint Francis, Saint Ursula, Saint Teresa or SaintAugus-

tine. Rather, whatwe want to do is to become the unique

self that God calls us to, as Saint Francis, SaintTeresa, etc.

became uniquely themselves.

This leads to what I would call spirituality. The healthiest people I encounter are

those who develop a spirituality. In a major worldwide study on happiness, one

of the life conditions that correlates significantly with happiness is having and

practising a religious belief system (itmade no significant difference which

belief system).

It would seem that spirituality is not

coextensive with religion. The two are

not the same. Although religion offers

a powerful spirituality, it can also be a

hindrance to spiritual growth. It is pos-

sible to be very religious and not spiri-

tual, or very spiritual and not at all reli-

gious. Similarly, you can be both.

What does it mean to be spiritual? It

does not require a belief in God. It

may, or may not, be based on a belief

in a "Transcendent Being." If, on yourway home tonight, you meet some person stranded on the side of the road and

help that person, you will leave that encounter feeling better about yourself.You'll feel good about what you did and who you are. For me, that is the key to

what it means to be spiritual.

Spirituality is thatwhich calls you to transcend yourselt to

go beyond self-centeredness, and have someone or some-thing be more important than self-gratification. That is why

movements and causes such as Pro-Life, Pro-Choice and

the Greening of the Environment are so appealing. They

call us to self-transcendance. They offer us a spirituality.

We find spirituality in anything that helps us transcend our

narrow self-interest. This is the foundation of all spirituali-

ties. It is present in all religions -whether it be Christianity,

Judaism, Mohammedism, Buddhism or Hinduism.

When you first hold your child in yourarms, it is an intense spiritual moment -

when you realize that you would die

for that person, to help him or her. That

person is more important than you are.

The second foundational pillar of spirituality is a surrendering of the selt a giving

up of control, an abandonment to a force greaterthan yourself. There are many

spiritualities, religious and non-religious, but each is built on this common foun-

dation.

Both of these must be present, for spirituality to be a positive force in your life.

Many people who see themselves as religious -who would not consider violat-

ing a single tenet of their religion -totallyfail to develop a spirituality. Their reli-

gion turns them inward into self-centeredness. They live for their institution,

their religion, without letting it take them into self-transcen-

dence. Healthy people develop a spirituality.

These, then, are the seven criteria I consider necessary for

wholeness.

Conclusion

I would like to close with a quote from I and Thou by Martin

Buber, the significant Jewish mystic and religious thinker,

and one of the founding minds of the state of Israel. He

offers these thoughts on living as a whole person:

Take the time to re-focus on what is really important for

you. To find your passion: this is worth more than an afflu-

ent lifestyle, prestige, recognition, power or security. To

find again that sense of awe toward life, curiosity and drive

that makes you want to know more, the delight in being

able to communicate with another, and that sense of inner

peace that comes from the conviction that life is good and I

am in the right place doing the right thing.