Religion and Spirituality in Psychiatry

326 Charles Knappthe past, and she was currently on mood stabilizersthat seemed to be having a positive effect. Shehad not tried these before, and significantly, sheseemed to be getting benefit without feeling “likemy head is full of concrete.” We were very carefulnot to push the idea of medications toward her,but rather to help explore whether or not now wasthe time to try an experiment with them, withina more structured environment. Consistent withher resolve to break out of the familiar, destructivecycle, Julie opted to try medications, “for sixmonths.”The immediate work at hand was creating therecovery environment. For the psychotherapist,a man named John was chosen and for the teamleader a woman named Sandy. Both were veryexperienced Windhorse Therapy clinicians withstrong expertise in bipolar disorders. BecauseJulie was quite intelligent and had a severe anddeadly mood disorder with psychosis, we knewthe team likewise needed skilled basic attenderswith experience in bipolar disorder. We wantedthem to be in their late twenties or early thirties,and the team needed a gender balance.Fortunately, just such candidates were available,and after the first interviews, Julie accepted themall. The team had three women basic attendersand two men. There was also a woman housemateavailable immediately whom Julie reallyliked. Rounding out the team was a psychiatristwith extensive Windhorse Therapy experience,and myself in the role of team supervisor. Withthe team selected, it was now time to gather forthe first supervision meeting to assemble theschedule and create a vision for the beginningphase of the journey we were about to take.As the treatment began, Julie ‘s terse guardednesswith me was in stark contrast to howshe spoke in one-on-one situations with John,the therapist, and with Sandy, the team leader.She related to them as if they were her students,and she was a spiritual teacher. She was a littleformal, tolerant, and “patient” with how distractedthey were by mundane life activity. Atany given opportunity, she would teach about thespiritual aspects of life, relationship, the universe,and anything at hand that had inspired her. Shewould let John and Sandy do their work, andshe would cooperate and teach them when shecould. She related to the basic attenders in a similarmanner.Our shift contact began when Julie was stillin the hospital, and shortly after she was discharged,the schedule began in full. A good dealof the early shift activity, especially for the teamleader and Donna, the housemate, was spentfinding an apartment and shopping for furnishings.Of anyone on the team, Donna seemed tohave the most relaxed relationship with Julie. Itwas the least professionally oriented relationship,and they often were just in the house together ina quiet way. They both enjoyed working togetherto make a comfortable home, and she did verylittle teaching with Donna.Julie settled into the basic attendance schedulein what appeared to be a surprisingly unconflictedmanner. She was on time for shifts, didn’tseem to get particularly close to people, still dida lot of teaching, and tended to be pretty organizedabout how the time was spent. She wouldtypically use shift time to do errands, get coffee,take a walk, or organize her art studio. Her psychotherapysessions, which were once per week,were rapidly evolving in a less comfortable way.She and John would meet in his office, and shebegan to be either completely silent or wouldshow the same kind of guardedness she had withme in the beginning. When she did talk it wasmostly to teach.Julie declined to be part of the family meetingto begin with, although she spoke with hermother several times per week.Although things were going well for a beginningphase, in the supervision meetings somebasic attenders expressed feeling useless and irritated.The shifts felt like a waste of time. My experiencewas almost always one of vigilance. Despitehow easy almost everything about the treatmentwas, I felt like we were constantly on the verge ofsomething dangerous happening, some disaster.We were also easily able to see what a lovely personJulie was, and her good-heartedness showedin many ways. Even her teaching felt like a generousoffering to us. It had a touch of a psychotic