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Creating Sacred Spaces in Opera and Behavioral Healthcare

July 23, 2019

Creating Sacred Spaces in Opera and Behavioral Healthcare

What does opera have to do with our work, you may have wondered as you read the title of this piece? Well, if you’re familiar with opera, there are lots of “mad” scenes in many. On occasion, those scenes are used at our national psychiatric meetings to discuss diagnosis and treatment. The stories in opera are often quite fanciful, sometimes like the more psychotic stories we hear from some patients.

However, after just reading an interview of the well-known opera conductor James Conlon in the cover story of the July issue of Opera News, there may be much more, at least from his perspective.

Both opera and behavioral healthcare have to be cost-conscious. In regard to that, the interviewer asked maestro Conlon how he balances his immersion in conducting the opera with other more practical activities for the prospective audience in his music director responsibilities. After pausing, he started to talk about meditation, which is one of the research-based recommendations for those clinicians who are among those struggling in the current burnout epidemic in medicine. Though it is unclear how common burnout is in opera conductors, it seems like Conlon thinks that meditation helps him get into a spiritual place when he needs to be. But this sounds like a unique adaptation of meditation. Instead of taking time off to meditate, he says “to make everything a meditation.” That translates into considering everything he does as having some sacred, spiritual value, which then allows him to feel connected and creative with whatever he has to do.

Can we transfer that process in part or whole to our own everyday work? As the very least, perhaps we can put an imaginary sacred boundary around our time with patients in order to keep alive the sacred calling that may have been our main motivation to become mental health caregivers?

This reminds me of the time not long ago when I tried to do something like this when my routine time to see patients for medication visits was cut down to 15 minutes by administration without any prior discussion of why that needed to be done. Such a lack of engagement by administration with clinicians is a primary cause of burnout.

Left to my own devices, I tried to find a way to put a sacred boundary around this time, a meditative process of focusing on the patient and our relationship. So, I decided to ask up front in every session: What is giving your life the most meaning? Quite quickly, that usually allowed us to delve into deep personal and, I dare say, holy spaces. Once I heard what this was, we tried to connect whatever benefit the medication might provide to that meaningful goal, other than perhaps the use of street drugs. If side effects, such as sedation, impaired reaching that goal, I sought an alternative medication. Once our brief discussion was complete, I could step out of the process, buoyed by a deep human contact, and complete the mundane electronic health record and related tasks without too much frustration. It worked.

Or, at least it worked until administration cut the time scheduled down even further, to 10 minutes. Then, we heard complaints from patients that the time wasn’t enough. Now, along with other wellness activities like exercise and support from my wife, I had reached the limit of what I could do to ward off my own burning out process. More help would have to come from what we know is the major cause of clinician burnout: a system that puts too many obstacles in the way of allowing us to competently provide care. That is the current challenge in so many of our systems. The challenge can be met, but in the meanwhile, as maestro Conlon has done, perhaps find meditative sacred spaces in your work that keep your passionate fires burning.

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