Spirituality and Recovery in Mental Health

Last Monday Tim Teeling, the Pembrokeshire Mental Health Development Officer at West Wales Action for Mental Health, travelled up to Mid Wales to join us for our regular monthly team meeting. We had invited him to talk to us about an innovative project he set up for WWAMH on Spirituality and Recovery in Mental Health. 

Our team had made a trip down to Carmarthen and WWAMH HQ earlier this year to find out more about the organisation’s work generally. 

We discovered TONIC for surfing, watched the Recovery Wall Project and heard a veteran’s story, but the day just raced by – they have so much exciting stuff going on down there! And we ran right out of time to pick up more than a passing hint at Tim’s work. 

It was enough to whet our appetite to find out more, however, and so here is a taste of what we enjoyed on Monday.

Beginnings

Tim was originally inspired to set up the Spirituality project for WWAMH about four years ago when he became aware that whilst much had been written on the topic, very little was available about how to work with spirituality as part of an individual’s recovery. Tim did not want to set up a project that looked at faiths in particular, but rather at “how my feelings and thoughts can help me recover from mental health problems. Instead of seeing our beliefs as signs of illness, we explore them as strengths in recovery.”

Whilst the statutory mental health sector concentrates on reducing symptoms such as hallucinations, the spiritual approach focuses on hope and optimism. There is a shift away from problems to look at a person’s strengths.

What the project does

Three monthly groups, which are open to individuals and their carers, run in Aberaeron, Haverfordwest and Llanelli. After initially experimenting with standalone groups, Tim now works closely with pre-existing organisations such as Mind which has proved more successful.

At the start of each meeting Tim introduces a theme, such as joy, courage, or forgiveness, and following a brief introduction participants then discuss. Revealing our attitudes to our own spirituality could potentially be awkward in a group setting, but ground rules such as “respect for each other” and “no preaching allowed” ensure confidence and enthusiasm to talk. The project is non-denominational and a belief in God is not necessary.

Knowing our own Minds – the starting point

In 1997 the Mental Health Foundation carried out a survey which revealed that 50% of people in contact with mental health services relied on spiritual and religious feelings to help their recovery. This is not that surprising as 60 – 70% of people believed in “something”, even though church attendance was down to 5%. Tim has worked in mental health for 27 years now and is always aware of the importance of spirituality or the non-material aspects of life for many people, particularly in relation to recovery. “It gives a meaning and purpose to life, an optimism, and a much-needed connection to others and the outside world.”

Tim Teeling meets our mental health team
L:R Jackie Newey (Info Service), Jane Cooke (Senior Officer), Anne Woods (Participation Officer)

Spirituality and themes in spiritual therapy

One of the criticisms that people in contact with mental health services sometimes make is that those delivering these services don’t understand them or what makes them tick. “The big question is – what is the most important thing for you in your life? What brings hope and purpose into your life?” The values of peace, compassion and happiness – the sense of the inner self, and the search for a meaning and purpose in life, these themes are rarely explored in any depth. Even more radical, perhaps, is the possibility that problems could be viewed as opportunities for growth.

Spiritual practices and assets

Engaging with our spiritual side does not necessarily mean (although it might – it so much depends on the individual) praying, reading scripture or taking part in a particular faith’s rituals. It could be as simple as enjoying nature, cooking, or helping others. “One guy just loves fishing down by the river. That is his spiritual practice – standing in the river and listening to the birds – not how many fish he catches”.

Once they engage with their spiritual side people start to realise that life is “not just about me – I am part of a greater whole. It gives the courage and grounding that people need, and hope in the face of distress”.

Spirituality and religion

The difference between spirituality and religion is a subject often discussed. Tim said that spirituality is usually something we do on our own and covers beliefs and practices found outside organised religion. Religion, meanwhile, whilst intrinsically spiritual, tends to be organised and communal.

Research

There is a wealth of research in the area, and evidence shows a statistically significant relationship between those who engage in spiritual practices and greater life satisfaction, including: an increase in hope and optimism, a sense of purpose and well meaning, increased self esteem, less depression, fewer suicides, less substance abuse, and less psychosis and psychotic tendencies.

Of course, negative experiences are also possible – people may feel persecuted by spirits or punished by an intolerant deity, and it would be unwise to suggest someone cut out all their medication in favour of prayer, for example.

Mental health assessments and spirituality

A particularly interesting part of Tim’s talk related to the way in which mental health nurses struggle to explore an individual’s spiritual life with them, in care and treatment planning for example. The Mental Health (Wales) Measure 2010 acknowledges the importance of spirituality in its Code of Practice:

“Spirituality can play an important role in helping people live with, or recover from, mental health problems. Spirituality is often seen as a broader concept than simply religion”.

But for the nurses it is often an awkward area to discuss. Where do they start? What questions can they ask? They may be fearful about stepping on sensibilities, but actually exploring spiritual issues with someone can be therapeutic in itself. In Tim’s workshops he looks at ways this can be done, using practical exercises and prompting questions such as:

• Are you spiritual and religious in any way?
• What do you really value in your life?
• What keeps you going when things get tough?
• Has being ill affected your thoughts about the future?

Once a conversation has been started, and if an individual is keen to pursue the subject, further questions can be asked about specific scenarios. Nurses could find out more about someone’s experience of talking to GPs, psychiatrists and nurses about their spirituality. And ask if they are worried about any conflicts between their beliefs and their care. At his sessions Tim talks through the specific skills which aid such conversations. These include attentive listening, suspending your own judgment, and accepting that spiritual pain may not be solved as a problem, but as a question to be lived.

So far Tim has met with two groups of nurses in Pembrokeshire – a Community Mental Health Team and staff on an inpatient ward. He has a third session coming up soon. It sounded to the rest of us as if his session on spirituality would be invaluable for all those working in the field of mental health!

Tim ended his talk by reminding us that “our health services are very much involved in symptom relief. Recovery is about living with hope, even with our problems.”

Thanks so much to Tim for telling us about the Spirituality and Recovery Project run by WWAMH in West Wales. What are your thoughts on spirituality and mental health? We’d love to hear from you. Let us know in the comments box below.

You can watch a video in which Tim talks about the project at the 2014 Annual International Think Tank Conference.

If you are interested in finding out more about the project please contact Tim Teeling by emailing tim@wwamh.org.uk

Read about other research on spirituality and mental health:

Taken seriously: Somerset spirituality Project 2002

The impact of spirituality on mental health 2006

Hope blooms out of depression

Last week my sister-in-law told us that she had successfully completed Level 2 of a creative floristry qualification, and she spoke so passionately about the impact that learning her new skill had had on her wellbeing that I asked her to write a piece for the blog. Thank you Linda! 

"I first started suffering from depression when I was 17. I feel the reason for this was partly genetic and also the fact that I was developing a tumour on my pituitary gland which was not diagnosed until I was 24. I am from the generation where educating girls was not a priority. All that was expected of me was to get married and have babies! My last 2 years at school were not happy - my older brother went to the same school and also my very gifted cousin who is a concert pianist. I was constantly compared to them both. 

I grew up feeling I was not particularly good at anything despite knitting and doing crochet for Harrods and Browns. I knew I had to be perfect but due to my total lack of self esteem I took no pride in the fact and felt so what, anyone can knit or crochet! These feelings stayed with me most of my life and I suffered some very severe bouts of depression that meant I needed to be hospitalised.

I was told my handwriting was nice. I could write poetry. I have bought up two children who are nice stable adults but still my lack of self worth persisted. I constantly compared myself to other people - they were all more intelligent than I was, they were nicer than I was etc etc etc!

In October 2011 my husband paid for me to do a flower arranging course for my birthday. This was something I had wanted to do for at least 30 years but there again my negative attitude stopped me. My first college lesson fell on my birthday and to say I was terrified of going is putting it very mildly. I begged my husband not to make me go, and he actually had to take me and it was just like my first day at school. I loved it once I started.

At the end of the six weeks I was really sad that the course had ended although I still felt I was not particularly good at it. My tutor asked me to stay behind after the last lesson and told me they were now taking Disability Living Allowance as a benefit and why didn't I enrol on a qualification course. My answer I remember was "what, me?"

I have a very complex medical history and am in a lot of pain but my tutor convinced me that she would help me as much as I needed. I enrolled in September 2012 at level 1 in NAFAS (National Association of Flower Arrangement Societies) qualification in creative floristry and my Thursday at college, although I found it difficult pain wise, soon became the best day of my week. I passed my Level 1 at Christmas 2012 and to my utter surprise people were actually wanting to buy my Christmas wreaths! My final level 1 assessment was a hand tie for a bride with white roses and tiny pearl beads bound with antique lace and secured with pearls. I achieved a grade 3 - the highest grade! Way hay! I thought to myself I can actually do this.

The course involves a massive amount of course work and I hated studying at 18 let alone at 60 but I have come to enjoy the business side of floristry. I embarked on level 2 in January 2013 and finish at the end of June. It has become very challenging now, both the practical and theory tests my brain somewhat. I had my practical assessment for level 2 last Thursday and chose to create a heart shaped wreath and passed at the highest grade again. The comments that were made on my practical work were that it was highly saleable and showed a high standard of creative talent. This is me I thought, I am now qualified enough to work in a florist’s and beginning to get more orders from family and friends. I love selecting my flowers, and I know my colour co-ordination is good (yes, I did say good!) and I love seeing what I can create from them.

Not only do I love my floristry it has made me look at all the other gifts I have been given. I believe that not many people are creative enough to work for Harrods. I am a nice, reasonably intelligent person who dresses well and am quite articulate. It is never too late to follow your dream whatever the obstacles you may have on the way. There is always a way around things!"