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In Praise of Glacial Change

September 26, 2018

By Andrew Penn, RN, MS, NP, CNS, APRN-BC
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

When I set out to walk 250 miles along the John Muir Trail this summer, I realized that before I left I learned of others’ fears about being alone for 4 weeks in the wilderness in the questions they would ask me—“Are you afraid of bears? (not especially, we don’t have grizzlies in California,)” “What if you get lost? (I have a map, compass, and GPS,)” “Will you carry a gun? (uhm, no)”. But upon returning, I heard the fantasies others carried with them about the transformative power of solitude in the wilderness. “Did you have any big epiphanies?” I was often asked. When I didn’t have any ready revelations to report, I felt like I had somehow failed to deliver the wisdom that a month in the wilderness is expected to provide.

But now that I’ve been home for nearly 2 months, I have realized that walking along the rugged mountains of the Sierra Nevada gave me a different appreciation for the slow but certain force of change that is evolution and glaciation. I saw how solid mountains of granite were steadily carved over thousands of years by the most humble of substances, water in the form of snow and ice. What is the parallel process of evolution in the human heart?

MORE: An Intimacy With Gravity

We live in an impatient culture, one that privileges the cataclysmic over the slow. We love stories of epiphany and transformational change. Contemporary psychiatry is no stranger to this impatience and we delight in telling stories of catharsis, that moment of realization that suddenly changes the course of a patient’s life for the better. From brief therapy models, to graphs plotting change on the HAM-D in response to 8 weeks of an antidepressant, to anecdotes of psychedelic-assisted therapy, we are inspired to help our patients to move quickly from their current position to a different, seemingly better place. This is an admirable and understandable effort. I suspect many of us were drawn to our respective positions in mental health precisely because of the thrill we feel at witnessing this significant change.

But I would posit that there is another kind of important change that occurs in human beings, a slower, glacially paced, evolutionary change, where we live into the transformation that we are undergoing. This is the deeper work of the soul, of aligning our lives with our deepest values and callings. This kind of work does not lend itself to brief therapy models and sudden catharsis, but rather is more akin to the slow but steady power of the glacier. Underneath a seemingly immobile sea of ice, Yosemite Valley was once carved, only to be slowly revealed as the ice receded. This is the territory of depth psychotherapy; the gentle exploration aimed at understanding how the path of a life has led us to this present moment. This is also the territory of lifelong practices such as meditation, into which we enter uncertain of where they will take us, but dedicated to the practice nonetheless.

MORE: Disconnecting From Others to Explore our Inner World 

To engage in such practices is an act of deep faith in a process—it is to begin walking the path with no clear idea of how it will end, but to know that the path will eventually lead us there. I am reminded of poet Rainer Maria Rilke’s advice to the young Franz Kappus:

Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

Andrew Penn was trained as an adult nurse practitioner and psychiatric clinical nurse specialist at the University of California, San Francisco. He is board certified as an adult nurse practitioner and psychiatric nurse practitioner by the American Nurses Credentialing Center. Currently, he serves as an Associate Clinical Professor at the University of California-San Francisco School of Nursing. Mr. Penn is a psychiatric nurse practitioner with Kaiser Permanente in Redwood City, California, where he provides psychopharmacological treatment for adult patients and specializes in the treatment of affective disorders and PTSD. He is a former board member of the American Psychiatric Nurses Association, California Chapter, and has presented nationally on improving medication adherence, emerging drugs of abuse, treatment-resistant depression, diagnosis and treatment of bipolar disorder, and the art and science of psychopharmacologic practice. 

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.

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