Way Station

Adapted from a talk given by Roger Lienke
For TEENLINE Crisis Services
Mid 1990s
Oklahoma Health Science Center
Oklahoma City, Oklahoma

Thank you and hello. My theme for today depicts the sociology of a psychiatric inpatient environment for adolescents as a way station. Using this metaphor, I am going to describe an overall atmosphere of general conditions on a hospital adolescent unit where I was employed as a psychiatric nurse. I will then endeavor to place the way station metaphor in the broader cultural context of an emergent societal conflict in which our vitality as American citizens is being challenged.

By way station, I refer to a transitional terminal located beside a railway track out in “the middle of nowhere” at which a train will only stop when some agreed-upon signal, such as a red flag or light, indicates an occasionally-occurring need to drop somebody off or pick somebody up. Inside the way station, passengers negotiate the terms and wherewithal of their passage and are asked to consider where they’ve been and where they may be going. These passengers share one “truth” in common - if they are already where they are going, there wouldn’t be any need to go there.

On many days the train does not stop at the way station and on some days the train does not even go by it. It is then that those within the way station are truly in a world unto their own. At such times the outside world can almost be forgotten and life’s prevailing obligations “out there” can be temporarily held at a distance.

On other days, when a train does pull up and stop, the conductor on board can be heard telling the train passengers - “if you are going further, do not get off here.” Due only to an upheaval of certain specialized circumstances, a select few of the passengers are told that if they ever are to truly go further, then they can not afford to not get off there. And thus, based on the firm nudge of that outside motivation, or the instruction of a compelling inner imperative to engage this particular form of critical transition, these select few get off the train and enter the way station.

As the saying goes: I’ve “done that - been there.” Each of you, too, has certainly been in some way station or another (or work at one) navigating a critical transition of some kind, predicated on either external disruption or inner dissonance. This university, for instance, is a way station of its own. Growth space? In-between place? Ritual space?

We make of each way station that which suits the needs of its participants, but each way station is also impacted by the needs of the outside social order. It cannot be denied, without erosion of quality, character and integrity, that a way station is ultimately a specialized but open system that is interdependent with its sociological context, and assumes the responsibility to provide resolution for some form of conflict.

Conflict is a dynamic whereby the dilemmas of our existence as humans are illuminated. We are all “afflicted” with the condition of being human. Affliction is one way we come to know the nature of our experiences. Those that enter an inpatient, adolescent psychiatric unit as patients may find themselves labeled with names of afflictions that can be used to categorize or separate them in a limiting or superior way. Labeling can diminish the capacity of caregivers to provide healing response concerning the themes of disturbance those patients present. And yet, these disturbances can be the very catalysts required by caregivers in order to take a good hard personal look in the mirror. A caregiver’s best tool for helping others is the awareness of self. Keeping the focus on the experience of one’s own specific feelings can sometimes, in interaction with others, paradoxically reveal what the “other” feels. This dynamic becomes a bridge of empathy.

A movie theater can serve as another kind of way station. Like an inpatient adolescent milieu, it too can be a place of passage and critical transition. A while back, I viewed a movie called Gettysburg. Its focus was a single historical battle in the 1860’s in the United States of America. Over the course of two to three days, that cataclysm of conflict resulted in 50,000 plus people losing their lives in a form of societal self-destruction that became known as the Civil War. Such consequence of devastation could little be minimized at the time and its impact lives on more than a century and a half later.

Abraham Lincoln, who served as the American president in the time of the Civil War, implored the citizenry to commemorate the Gettysburg battlefield with the solemn intention to “never forget what they did here (and) to be dedicated to the unfinished work which they who have fought here have thus far so nobly advanced.” As a country, we pore over the history of that war in determined detail and pay different forms of tribute to its impact in countless writings, works of art, documentaries, fictionalizations, and reenactments. On the other hand, our short-term-memory about a subtler, but equally real devastation in our midst, is not as practiced and not as good.

There is currently a war going on in this country. It is a covert and misunderstood war that is primarily an “inner” war seeking to elbow its way into the spotlight of our contemporary collective consciousness. We might call it the Second Civil War. Fought inside a fog of misinformation, the Second Civil War, on a surface level, pits citizens against each other in differences of ideology and political opinion, whereas on a deeper level, it is really a conflict between fear and desire, a contentious pair of human emotions. The first Civil War littered battlefields with bodies. In the Second Civil War, the real casualties - lying wounded or dead, under the rubble of obscuring rhetoric and arbitrary division - are our ideas.

I will soon circle back to a specific focus on the way station of a psychiatric inpatient adolescent unit. But first, let’s broaden the scope of our attention to include the “outside” context in which that way station abides and the confluence of danger and opportunity that is inherent in the Second Civil War.

Somehow we know we can’t pick a fight with ourselves and win, but we assure ourselves that we’ll go down swinging anyway. And so our fear and our desire go on in conflict, fighting for supremacy, one over the other. In the process, fear has been elevated to a principle and desire has become a cause. Fear blames desire for causing moral and spiritual degradation and desire holds fear accountable for the alienation of hope. In truth, fear and desire are human feelings. We have a feelings problem. Feelings are not the end-all, be-all destination of human existence. But they can serve as “vehicles” of discovery that transport us along a journey of reconciliation and unification — with self, with others, and with our surroundings. At present, that inner work remains mostly not undertaken. Instead, we fight other fights, while fear and desire languish, at odds with each other.

In the cultural realm, the Second Civil War is a war between desire for substantive change in the prevailing social order, and fear of that very change held by those with the most to lose. The separation of opposites into categories is an integral part of conscious construction of order in the world. But the ongoing conflict between fear and desire is cloaked in secrecy, denial and misdirection, and goes on mostly unnoticed. The American people are saturated with news about other conflicts based on simplistic dichotomization of adversarial positions. We are being duped into duplicitous duality with disinformation about “both sides” of a mythological, ideological spectrum, as if there were just two sides to solution-minded consideration of our societal dilemmas.

The most blatant and misleading example of faux or pseudo conflict is the battle between the red and the blue areas designated on our political maps. Watching the news, we spectate the pontification of “experts” who move from one to the next dominion of opinion, while the real motive behind the presentation of pseudo conflict is, in fact, conflict avoidance. Authentic negotiation of the potent inner conflict between human fear and human desire, and the call for unification inherent within that conflict, is apparently just too daunting and too uncomfortable.

However, if we individually or collectively really dare to meet the challenges of our unification, desire and fear, at that point, have got to come to terms. The creative potential of desire must mitigate the self-destructive potential of fear. Desire for closeness and intimacy must wrangle with the fear of loss and annihilation. Desire for affection and acceptance must come to terms with the fear of being hurt and abandoned. The desire of initiative must confront the fear of inadequacy. Desire for growth must negotiate with the fear of the unknown and desire for security must reconcile with the fear of losing control.

True self-examination is motivated by the search for unifying patterns and principles that are ascendant from and emergent out of constructive conflict. True social discourse is motivated by the urge toward integration and is not content with simplistic polarization. True substantive interpersonal growth must tolerate the disorder and the discomfort it takes to get there.

Ideas are the foundation of personal, interpersonal, and societal change. They can become casualties when societal desire that is too imperialistic cuts itself off from societal fear that is too isolationist. Movement toward societal peace or unification is stymied when people line up on opposing sides of either/or positions. Merger and consensus become moot points when bloodied by fixed notions that are decided upon without introspection or intellectual rigor.

Yogi Berra, the iconic New York Yankee catcher, said: “when you come to the fork in the road, take it.” However, without surfacing certain contradictory inner directives and feelings that we operate by, we can’t even see the “fork.” Aldous Huxley, writer and philosopher, said that it wasn’t so much the totalitarian attack on dissenting public opinion, as in George Orwell’s dystopia novel 1984 that worried him most about the future, but rather the Brave New World vision of channeled, homogenized societal opinion, personified by the contented users of the public-issue drug, Soma. Huxley’s fear was not so much that tolerance for different answers to life’s important questions would decrease, but, more so, that the questions themselves would no longer occur to people to ask. Therefore he postulated a kind of social control that could rise to prominence founded on omission of ideas, via the uninformed consensus of the people, rather than the commission of dictatorial coercion of the people in the effort to repress those ideas.

An illusory battle is being waged “on either side” of an arbitrary line drawn across the map of the human heart. Our own denial is repressing the awareness of the real battle waged within our own nature. There are no winners in the Second Civil War between fear and desire — only losers. The biggest losers, those on the front lines, in the trenches, seeing the heaviest action and sustaining the greatest losses are, as in all wars, the young. This sad truth brings us back to the discussion of the plight of the “afflicted” and hospitalized adolescent.

I have discussed how we choose to categorize and compartmentalize and polarize and dichotomize our life exigencies so as to better make sense of ourselves. This is a survival and coping strategy that, when overused, creates injury. We divide our feelings and we divide our basic definitions of health and illness. Health and illness are different ways to perceive and experience an inseparable totality. There is a discoverable unity of purpose in the relationship between health and illness that can be explored in the way station of an inpatient psychiatric environment for adolescents.

Adolescents are raised on mixed messages. They must reconcile them in order to mature. For instance, I worked with an adolescent girl whose mother had imparted to her the basic knowledge that all men are “assholes.” She insisted, however, and lived by the principle, that you had to have one (a man) and she was never long without one. So what does this prophesize? The almost inevitable conclusion is that the daughter will grow up and align herself, likely in marriage, with a man who is an “asshole.” She wouldn’t form a relationship with a man who wasn’t an “asshole” because she wouldn’t recognize him. She wouldn’t know one that isn’t one.

The possibility of constructive change in long-held patterns and beliefs has to be “surfaced” into consciousness. The work of synthesizing contradictory and seemingly incompatible assimilated messages can then, at minimum, be feasible.

Erik Erikson, developmental theorist, said it is by virtue of identification with the modeling of significant mentors that adolescents are able to rise up out of the morass of role confusion and experimentation and latch on to a workable identity that propels them into young adulthood. Next they will then meet the developmental challenge of forming lasting intimacies outside the family of origin. The desire for life now meets fear of loss, face to face, in a most potent fashion.

For the adolescent — whether it be by loss through death of a boyfriend, girlfriend, grandparent, parent, sibling, teacher and friend or by loss through trauma of absence, divorce, neglect, bullying, physical or sexual harassment, abuse or assault, physical and learning challenges, illness, covert or overt incest, abortion or premature parenthood — all losses reverberate with the basic and inevitable loss of childhood. With our grief, let us honor this loss of childhood, and paradoxically we may then envision the real possibilities of adulthood through the unique perception of the child.

May we “long remember” that it is our perception that governs our reality. It has been said: “the best way to predict the future is to invent it.” In the ashes and bones of our own childhoods, there is a living presence that always was and always will be a part of us. Let us not heedlessly sacrifice that living presence in the war between fear and desire within us, but instead, let us wish a fruitful peace upon the efforts of each way station to light the path toward our necessary unification. We are one. That is our truth.

Thank you for the privilege of your company and for your attention.

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