Community within an Anthroposophical Clinic
  

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By: James Dyson, M.D.
An interview with James Dyson, M.D.
of Park Attwood Clinic in England

What does ‘community’ make possible in a health care setting and what importance does it have for you at Park Attwood?

When Park Attwood was envisaged by the founding group 25 years ago, the question of how to connect a medical impulse and a social impulse was in the foreground of our discussions.  By a social impulse we meant a community building impulse.
 
Communities have, of course, always existed.  One may use this term to describe a military, religious, or even commercial organization.  What is generally meant, however, when the term ‘community’ is used is far more specific than this.  Those who are familiar with the writings of M. Scott Peck will recall how he once defined community as a space in which people may learn to fight together gracefully.  Expressed in more organizational terms this implies that management structures move away from a hierarchical form of control.  In Scott Peck’s terms this process involves three phases, namely: consultation, participation and consensus.  I think it is self-evident that the strength of any group working together will depend upon the degree to which everyone feels heard and, in turn, is able to hear the voice of the other.  To the extent that this is possible, each one will be motivated to give of their best.    

So in answer to your question I would say that the aspirations towards community building at Park Attwood were not icing on the cake for a medical impulse but were one of the very pillars which supported the initiative.

In what way do you feel that this aspect of community would be experienced and be important for the patient who comes to the clinic?

Patients can often be very explicit in their feedback in this respect.  Their ability to sense a deeper level of inner substance and interaction flowing between colleagues in an institution can, at times, be quite uncanny.  This does not seem to have  anything directly to do with the particular form or framework with which we are working -social forms are not engraved in stone for all time.  Rather is has to do with the sense of commitment to a higher goal and the preparedness to hang in there in the midst of what, at times, may seem to be considerable differences of approach and even serious tensions amongst close colleagues. But, of course, this can only be done, in all honesty, if the differences of feeling are able to be expressed and heard in a protected and safe space.  I think that this is an example of one of the conditions that Scott Peck identified as being important for the experience of a community spirit to become a tangible reality.

Working as doctors, caregivers, or therapists exposes one’s own weaknesses and limitations as perhaps nothing else does.  Of course if it comes to a certain kind of problem, such as setting a fractured bone, then technical competence is by far the most important factor, though, in fact, even here the inner attitude of the doctor can make an enormous difference to the outcome of a procedure.  If however, one is bringing a therapeutic process towards a patient in an artistic medium, or through a pastorally-oriented conversation, or even a substance being used medicinally, one’s own connection to the process or substance involved will convey itself very powerfully to the patient, and either enhance or detract from its inherent efficacy.  In the sphere of the helping conversation the therapist is more directly exposed with regard to their own attitudes, orientation, maturity, self-development, and so on.  With respect to these subtle levels, without the conviction that we are being upheld and are upholding our colleagues in our judgments, which also must include a preparedness for constructive critical feedback, a gap would open and this would immediately be experienced or at least intuited by the patient.  I believe that our authenticity as helpers depends upon our own preparedness to be authentic and to be helped by our colleagues in striving towards this high goal.  This ideal, which falls easily from the tongue, reveals challenges far greater than I would ever have imagined 25 years ago.

There is now, much more than 25 years ago, a recognition of the need for the caregiver/helper to be supported.  Processes of supervision or ‘intervision’ are being increasingly cultivated at all levels in a wide variety of different types of organizations.  Many books have been written on the subject.  Nowadays it is also quite customary to include in any course or study of management the study of self-development.  An example in our country is a book by Stephen Covey, The Seven Habits of Highly Effective People, which has become standard reading for many institutes of business and human relationships.  I have considerable personal confidence that many of these approaches lead to fruitful developments.  I believe, however, that through our work with anthroposophy even greater opportunities exist to further this aim both at a personal and interpersonal level were this to be made a central focus of endeavour.  In the long run I suspect that all endeavors will be the less effective to the extent that they fall short in realizing this goal.  It makes me happy that such ideas find more immediate resonance now than perhaps they have done at any other time in history.  However, the forces working against community are certainly stronger than ever before.




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