When children do not experience unconditional love in the holding worlds of family, child-minding and pre-primary, primary and post primary schools, inevitably, they suffer loss of self-esteem.  When their regular relationship experiences are of a conditional nature – ‘be good’, ‘be perfect’, ‘be quiet’,

‘be hardworking’, ‘be like me’, ‘be top of the class’, ‘be a winner’- they wisely conform or rebel or develop an avoidance strategy against these proscriptions.  When they conform they will do all in their power to measure up to the unrealistic expectations because they know that to fall short is to risk the greatest blow of all – harsh rejection or being a disappointment with the consequence of being ignored.  Those children who rebel act-out the hurt of their unique presence being confused with a specific behaviour and they equally do all in their power to ensure they get attention, albeit substitute, for being difficult and troublesome.  Some children attempt to go under the radar so that the risk of rejection is reduced but, nonetheless, they cleverly get attention for being the ‘invisible’ child – the one that causes no trouble – ‘you’d hardly know he’s there’.  The wise ploy being employed here is avoidance –“the less I do the less likely that I’ll fail to meet the conditions for recognition” – thereby reducing the risks of being rejected.

Thomas McKeown, author of The Role of Medicine: Dream, Mirage or Nemesis? wrote in l979:

                        “If I were St Peter, admitting to heaven on the basis of achievement

                        on earth, I would accept on proof of identity surgeons, the dentists

                        and with a few doubts, the obstetricians; all, it should be noted in

                        passing, dealing mainly with healthy people.  The rest I would refer

                        to some celestial equivalent of Ellis Island for close and prolonged

                        inspection of their credentials”.

It could be argued that the profession of psychiatry is in good company amongst medical professions. McKeown demonstrated convincingly that increases in life expectancy during the first half of the 20th century were largely attributable to improved nutrition and cleanliness, leading many health professions to concede that the impact of medical science on society was less dramatic than commonly perceived.

When Eleanor Roosevelt made her now famous quote “Nobody makes me feel inferior without my permission” she missed an important aspect of human behaviour and that is that we have an unconscious mind that the Self employs creatively and powerfully in times of threat to our wellbeing.

The implication from Eleanor Roosevelt’s quote is that the person who encounters a ‘put-down’ from another person consciously internalises it and, thereby, allows the other to define his worth.  Carrying this understanding to its logical conclusion it would equally be true to say that “Nobody makes me feel good without my permission”.

An elderly neighbour, a man who inspired me in many ways, recently passed away.  As for each one of us, his presence is irreplaceable but his way of being in relationship and of working are qualities I highly valued.  His passing inspired me to write on the least talked or written about subject – death. 

In my book the Compassionate Intentions of Illness (co-author Helen Ruddle) I write about how illness has the power to make us real and authentic.  I also believe that the experience of the death of a loved one or the thought of death itself equally can bring authenticity to our lives; indeed, the witnessing or the thought of death may create a shift to a truer and more significant life.

In the recently published book Relationship, Relationship, Relationship, The Heart of a Mature Society, myself and co-author Helen Ruddle write on what we call holding worlds and heads of holding worlds.  A holding world is where people gather together to live, learn, work, play, create, heal and pray.  The most important holding worlds are the family, the community, the school, the classroom, the church, the educational institution, the workplace, the wider society including, for example, the HSE, the Garda and the Social Welfare agencies.  Those who head these holding worlds – parents, teachers, lecturers, managers, employers, clergy ( priests, nuns, bishops, Pope) and medical and social welfare professionals doctors -  have a responsibility to know and govern themselves before they dare take on the governorship of a particular holding world.  Change in familial, social, political, educational, religious, work, recreational, health and social welfare systems needs to start from the top down as it is very threatening for individuals who are in a dependent place – particularly, children, teenagers, adults who are ill or vulnerable or poor or unemployed or suffering disabilities – to challenge the status quo.  Certainly, adults themselves need to find the wherewithal and support to come into possession of and responsibility for themselves but that road is more easily trod when heads of the relevant holding worlds have resolved their own identity issues, repressions and insecurities.