Religion and Spirituality in Psychiatry

Psychiatric Care Using Buddhist Principles 329with Julie, Beth’s confidence in Julie’s recoverywas strengthening. She was very appreciativeof how the team was being helpful to Julie andcould see the lessening of her dependence on thecompensatory nature of the team as her healthbecame more resilient.By the end of eighteen months, Julie had developeda reasonably energetic schedule of ordinarycommunity activities outside the team structure.This allowed the schedule to be reduced to fourbasic attendance shifts per week and one psychotherapysession per week. With fewer shifts, wewere able to reduce the number of basic attendersneeded.There was one more significant life developmentthat occurred in this phase that shouldn’thave been a surprise. Once Julie was more confidentin her ability to be in complex socialenvironments outside the team, she found a progressiveChristian church to attend that practicedmeditation and centering prayer. Besides participatingin many social activities and making somenice friendships, she began a daily meditationpractice.The end phase of Julie’s Windhorse Therapytreatment was brief, and it began with an argument.Her sister Lisa was coming to town for avisit, and this seemed like an opportunity to haveher join a family meeting. Julie really liked thatidea. Her life was in a much better place. She wasphysically healthier, was more mood stable, andthe voices had almost entirely disappeared. Shewas now doing most of the organizing of her lifethat the team had done. She continued to workon relationships both in and out of the team in awonderfully direct and honest way, and she hadlearned for the first time how to live with someoneher age in relative harmony and be close withthem at the same time. Once we settled into thefamily meeting, Lisa said in a heartfelt way howamazed she was to see her having such a goodlife. Julie exploded. “You think this is my life! I’min treatment and have paid friends! Don’t try tomake me feel good because I’ve learned to tie myshoes and you’ve got your life so together.” Lisawas stunned. She was glad that Julie was doingthis well and tried to express it. Julie acceptedher apology and over the next hour and a halfthey were able to resolve the immediate tensionbetween them. Something that was particularlymeaningful to Julie was an insight that both Bethand Lisa had when Julie had become angry andessentially declared that having half a life was notgoing to be settled for: “This feels like we’ve gotour Julie back.”Very significantly, we all noticed that Julie didnot experience any mood instability from thisvery intense emotional event, as she previouslymight have. She too was surprised by this andlater said, “This showed me that I was ready toleave treatment.”In the next week’s team meeting, Julieannounced that she was leaving the team in onemonth. She had been researching colleges whereshe could get a master’s degree in physical educationand had found one that she liked in a smallcity out of state, about an hour from where herfather lived. School would be starting in ninemonths and she wanted to move there, get her lifeestablished, and apply to school. Once there shewould also look for a psychiatrist and a psychotherapistto continue the work she had done withus. She expressed appreciation for all we had donetogether, “I think you actually saved my life,” butsaid she was tired of having training wheels andpaid friends, and needed to get on with her life. “Ithink I’ve learned the care and feeding and thinkingof Julie, and have a good toolbox for whenthings come up that I need to deal with.” Once shefinished talking, she seemed to glow with a quietresolve, confidence, and a bit of defiance.To say we were stunned was an understatement.Also, we knew this was absolutely the rightthing for her to do. But we were not ready forher to leave. We had a more graduated plan forthe eventual team reduction and how we couldcontinue to see her for years to come. We reallyliked her. We wanted to feel appreciated and valued.As is usually the case in the life of a family,artificial or not, emancipation isn’t how the parentsplanned it. And as is usually the case witha successful treatment, recovery is almost alwaysmore intelligent than the clinician imagines andcertainly not in the clinician’s control. John was