Therapeutic caring

As a professional care giver in health, looking back over last few decades of engagement in various ways of caring and facilitating systems of caring, I realize that my reasons of being in the field are not anymore that I started off with.

I remember, when I started off on my journey, as a young consultant, I was one who wanted to change the world.  Started off with an arrogance that “I know it all” and I with my knowledge and skills can change the world I am kept in! I started off with also the clear understanding that I have the knowledge and skills, and the “poor and the people in need” my “God given talents and abilities” so that they can live a better life. (I do no think I still have been completely cured of this paradigm, but it seems to have weaned off a bit over last few decades.)

And the institutional structures that I was part of, encouraged this paradigm. We are one of the best care providers, we have the knowledge, the ability and of course “compassion” as an added character, and so you need us! We can help you.

It was on most days, about me/we and what I/we can do for you.  Or about the institutional structures and what they can provide for you out there. We and they, we have it, you are there to receive. Little did I realize that this is a power equation, we as the custodians of the power of knowledge and ability to care and the community as the receivers of this care, because they need us. We are the Messiah’s. Our institutions were the context where these Messiah’s are available. These concepts remain in many institutions I suppose, every other day in my life too.

The start of a turnaround of perceptions was initiated when we spent few years in Delhi, trying to start the work among IDU’s, CSWs and many similar groups at risk for HIV infection in the slums of Delhi, and setting up a care center for HIV critical care.

Initially, we did not have an institution to work with. We were meeting them in their turf, and not within the four walls of an institution. The ‘they’ who we wanted to care for, did not behave as if they needed us. We thought they were happy in the situation they were and did not want to change their behavior. They did not know what we have and who we are! And that is why they would not welcome us! But soon a start of a realization emerged. They made it clear over time, that we do not know what they need. We do not understand who they are and why they are what they are. They were a close-knit community and they understood each other. But we were outsiders, who were coming in with a “power of knowledge” to care for the “under privileged” – they could easily see through this “power equation” more than we could! They would come to accessing what we could provide, after the institution was started, only when they recognized that we are willing to listen and learn about their own challenges and life beyond the care we were there to provide!

As we embarked on such a journey, it took a few years for me to understand that we needed them as much as they needed us. But to a professional care givers and understand that we needed them as much as they need us, we as a team had to go through much “perception changes” both in our understanding of caring and who holds the knowledge and skills. I remember one day when I was struggling to put a canula for an IV Drug user in hypotension, another IV user, a friend of the patient come and offered help. Telling me, that he can find a vein if I cannot. It was not easy to allow a nonprofessional to put a canula, but he did a much better job than me!

The perception change was one from we and they to, we are journeying together.  We do not come in as “higher mortal beings” who hold a higher power, but as people who want to journey with each other. “Equal mortal beings” on a life journey, hoping that through this co journeying, we would move from being mortal beings to an immortal eternal wholistic life. Both the care providers and care receivers’ lives being changed through these co-journeys!

Coming back to an institutional context after wandering off for a decade or so, was challenging. Institutional structures do not change. They are structures of power, that continue to communicate that we here to provide care with our greater knowledge. We are the givers, you are receivers! It is not about people who are in the institutions, but the model of institutional structures we have built over last 200 years that communicate this!  There are many in any given institution who think differently including the one I am part of.

To live amid such structures with an emerging learning of power and power equation and who is the care giver or receiver etc., one needs to be a reflective practioner. The more I engage in caring field, I realize that I need the context of care more than those who come to receive care! I need the context for a few reasons.

I need to be rooted amid the reality of the pain people go through – for my own growth and learning. It is easy to close one’s eyes and ears off from the brokenness around us. I need to listen to those stories of how people in pain and struggles for my own growth and journey of life.

I realize most times what people need is not the professional help I can provide, but the availability of a listening ear, a caring touch and compassionate heart. And I too need this opportunity to be that listening ear, touching hands and compassionate heart for my own internal growth!

I need to grow in my understanding that the professional help I can provide, is given to me, and not something I acquired alone! If it is given it is a privilege to give out. Give out not from a higher pedestal, from an equal footing – because they give me the privilege to give out! And through that privilege I receive, I am more enriched than they are!

My opportunity to care is therapeutic for me! I wonder who is care giver and the provider!