I was inspired to write this article after going through the terrible experience of watching my mother gradually deteriorate with a debilitating illness over two years and then not have a very peaceful passing. There’s no comfort to be had on my mother’s part, except that, as a family, we all pulled together to do the best we could for her, and we were all there with her at the end. Living through this difficult time was the biggest challenge I’ve had to face while continuing to work as a counsellor. For the first time, I wondered how I would cope and whether I would be able to carry my often-difficult client load.
As I walked along the beach recently, I was drawn to the many stones that decorate the shore in different colours. I love to mooch among the stones, which are treasure for me to borrow, be with, and for clients to be with. Recently, a stone caught my eye that had been severed in half, and the central edge was as smooth as glass. The severed edge reminded me of my mother’s cruel illness and how it gradually took her life, over what was a relatively short period of time. The severed shape felt brutal at first and repelled me after the initial attraction. Then I turned it over to see the rest of it. It naturally sat in my hand, with the severed edge as its base, and looked like a rugged mountain.
You may wonder what this has to do with swimming and grief. It’s all about making connections with this stone image and finding a stable base to climb and survive the mountain, both of which I could see in it.
The mountain
About two years ago my mother was diagnosed with a rare illness called progressive supranuclear palsy (PSP), a strain of Parkinson’s disease, which is very difficult to diagnose. It affects the brain and involves a gradual physical deterioration and weakening of the body, including the inner organs. My mother had been falling for some time before the diagnosis – with painful injuries as a result. However, when she received the diagnosis, as is often the case, there was some relief, as the symptoms matched hers exactly. But what followed was the revelation of the mountain we would have to climb to help Mam get through this illness. Dad was already beginning to struggle to cope with her but gradually took more and more responsibility for her and the household. Family members eventually persuaded him to let us help. He admirably continued to support Mam until she sadly died in November 2016.
I’m the second youngest of six children and the family came to terms with the illness within different timescales. Having been a carer and having seen Mam’s recent deterioration, I knew somewhere deep within me that she had probably been suffering with this illness for many years. So, what was given as a prognosis of up to nine years from diagnosis, I recognised would be much less for Mam.
I researched the illness, which helped me to pre-empt Mam’s needs as the PSP progressed. As a carer, support worker and counsellor I’ve had to attend multi-agency meetings but I never imagined what this would be like for my own mother and how difficult as a family it would be to negotiate our way through her illness. There were so many things we couldn’t control, both in relation to the illness and to the inadequate system that could help us, and eventually others, to care for Mam.
At the time of the diagnosis I was receiving counselling. I’ve developed a great respect for being able to reflect in a person-centred way in order to keep improving my ability to be the person I am. This was the first time that I had to consider that the challenge of counselling would be too much alongside the many difficult feelings and experiences this illness provoked in me. I needed to pull out all the stops just to survive the stress, sadness and other feelings evoked in me. I needed to manage my limitations, which were being enforced, both practically and emotionally, as I was maintaining two businesses, including a private counselling practice and a community interest company that cares for vulnerable people on the edge of communities.
Suddenly, I felt myself on the edge, often unheard by services and professionals in the care sector. In the main, people did their best. However, when an illness is rare, health professionals often want to believe that they know best and, if you try to share your own understanding with them, they defend their knowledge and dismiss your insight. I was unable to express my feelings to friends and colleagues, and needing to focus on work. All the family wanted the best for Mam, but we didn’t always agree on what that was, and I often felt isolated. This was a daily emotional challenge and I needed all of the personal insight I’d gained through counselling.
Even in these difficult days, old introjects came back to me about ‘doing my best’ and ‘being good enough’ for the task. One of the positive things about the experience was that my mother got to experience who I really am. My parents didn’t understand the field of therapy, being from a hard working, working class background where you ‘got on with life’. This was the one time in my mother’s life where I could offer, and strive for, a person-centred level of listening, and care for her, which she deserved. However, this was easier said than done. Health professionals found it hard to wait to listen to Mam, and give her time to communicate, and filled in the gaps with their projections. One of the things that is difficult about PSP is that the person’s mental state remains intact. The sufferer knows their needs and what they want to say but, unfortunately, a worsening symptom is dyspraxia, meaning they cannot get the words out. So, it wasn’t always easy to know what Mam wanted. There was often a sense of failure and lack of power on our part, which was hard to accept.
You may be wondering why I would write an article of this subject for Private Practice. As therapists, how do we cope when our family needs us to empathise and care for them, and when we may feel we have less energy to give to our client work? I was experiencing feelings that I knew could have triggered depression. I felt anxiety welling up in my stomach as I woke up in the morning to the realisation that we had to get through another day, helping Mam as best we could with her personal care and appointments, and being aware of keeping a handle on the mountain of potential work backing up behind me. I also needed to make sure that I was able to manage my own emotional wellbeing to a level that facilitated the ongoing work of counselling clients.
Stable base
I recognised that this was the time to practise what I preach when clients come to me for help. My approach at the beginning of counselling, particularly where anxiety and depression are present, is to acknowledge to clients that wellbeing requires taking care of the ‘whole’ person: body, mind and spirit. When mental health struggles hit, the rest of us often suffers due to a lack of motivation and neglect. I suggest that where motivation allows it, and clients are able, they can address their issues from different angles, and this can make for a more stable base and fruitful and buoyant healing process.
I recognise that exercise can be an important part of this process. What did this mean for me? I’d heard lots about how swimming can be beneficial, as the water is a support to your body when you exercise your muscles. It wasn’t something I’d been attracted to before, but I was prepared to try anything for safe, helpful exercise, if it was going to help me have a stable base and the strength to climb the mountain. I found a local pool and experimented with different times of day to go and swim. Time was becoming more and more difficult to find. It was only after I took the plunge for the first time at an early bird swim, that light glinted through. I really felt it for myself. It was like someone had given me a wash inside, and a fog lifted. There was an immediately noticeable difference when I finished. I put this down to a lovely welcome from staff and ladies there, the sense of achievement of having pushed through the fog to do it, and the chemical impact of the exercise on me. This gave me the motivation to keep at it.
I soon fell into a regular swim pattern. Did you know that there’s a whole swimming community out there who have been out and swum every day before most people (including me, previously) are awake in the mornings? It slowly became easier to face the days with this bit of time slotted in. This became my time. It got me out of bed with less dwelling and I even looked forward to it. Apart from long walks in the countryside, I can’t say I’ve ever looked forward to exercise, preferring to do more creative things; for example, making music, singing and painting. Don’t get me wrong, there were still days where I stayed in bed and dwelled, was angry and grieved, but this was natural and it didn’t send me into a depressed state.
The more I swam, the more I found different aspects of the swim helpful, and I went into a different space every time I attended. I watched YouTube videos to help me hone my strokes, swim safely and take care of my joints and bones. As different problems arose, some helpful, spontaneous thoughts came to me as I swam. People’s swim styles made me reflect on people in life. As I was beaten and splashed by the waves caused by others who dominated a lane, I encouraged myself to keep trying and to manage the splashes and be less fearful of them. I built resilience and the ability to be in this most difficult of spaces, in the pool and out.
I bought some swimming goggles to protect my eyes and facilitate the correct way to swim by going under the water. I was surprised by my fear, which hindered me from wearing them. I worried that this would stop me moving on with the swimming. Again, I drew from my learning and practised wearing the goggles a little at a time until I reached beyond the fear. I recently looked back and laughed at this experience. However, it reminded me of the fears I had worked through, and how I can keep going and overcome fear to meet the challenge. I reflected on tasks I was feeling overwhelmed with at work. Learning to swim ‘properly’ meant breaking down the strokes and focusing on one aspect; for example, the arms, legs, breath, a tight core, then bringing them all together until it became automatic – letting it happen and not forgetting to breathe.
Sometimes it was important not to think about the bigger picture and to go with the flow. Sometimes it was important to step back from everything, escape and breathe. I would never have known that getting the breathing right was central to building the swimming strokes. This became an important connection and I soon recognised that when I was anxious or particularly stressed, and I entered the water to swim, it felt like I was failing, that I couldn’t swim, and I felt panic emerging. I watched YouTube videos about how to breathe during the different strokes. I spent time at the end of the lane focusing on my breath, finding a rhythm to match the stroke I was doing. The impact of this time controlling my breath went beyond the swim and into my day. I was going into it with a sense of control and more natural breathing.
I’d benefitted in the past from the fruits of meditation and lately have enjoyed reading Eckhart Tolle’s The Art of Presence. Swimming brought me naturally into the moment, giving my mind, body and emotions a well-needed rest. Each time I swam, I felt generally less foggy, and was able to maintain a good clarity of thinking in the day, amidst all of the different feelings and responsibilities. I’ve lost count of all of my reflections, which are ongoing, and will draw from these for much time to come: being held by the water; tuning into the flow and being taken along by it; swimming harder when the tide seems to be coming in the opposite direction; reaching out in each stroke for that which feels right; recognising my physical limits; learning new strokes and new skills to manage life. I could go on, but I imagine by now you’re getting the picture.
Self-care is there in BACP’s Ethical Framework as an important factor in maintaining safe, healthy practice with our clients. I hope that there are elements of my experience that other therapists can gain insight and encouragement from, especially if they are faced with a difficult time in their own lives, which makes them question how they will maintain their practice and work responsibilities while going through this life-changing and difficult experience. Finally, it was a creative connection and holding place, which is core to my therapeutic work, which inspired me to write and share my experience. The severed base of this stone, which became a stable base, continues to support me through this mountainous experience as we grieve the loss of Mam. Swimming is now a lifestyle change, which I’m happy to keep.
Christine Flanders MBACP (Accred) is a counsellor and psychotherapist with 17 years’ experience, based in Stockton. As well as her private practice, Wellspring Connections, she is drawn to working with people on the edge of communities who often fall through the gaps of services. She is a director of The Road Ahead Community Interest Company, providing one-to-one counselling, creative therapy groups and courses using the person-centred approach to empower relationship building for life. She is also passionate about sharing the uses of creativity in counselling and runs workshops and a certificate in person-centred creative therapy skills for counsellors and workers from other therapeutic environments.