At the symposium “Trust as a fundamental value in psychiatry and psychotherapy” («Vertrauen als Grundwert in Psychiatrie und Psychotherapie»), held on 6September 2018 and organised by the Clinic Hohenegg in the Swiss town of Meilen, the greying, mentally vivacious psychiatrist Luc Chiompiwas asked: “Mr Chiompi, you have an overview of the entire era of the last fifty or sixty years: What do you think the next generation needs to revise in order to give more weight to models of partnership-based treatment, including with people suffering from psychosis?”
And with his answer, Luc Chiompi created something lasting beyond death for us listeners and the next generation:
I believe the people who work in psychiatry, at every level, right down to the reception staff, but then also down to the cleaning lady, down to the woman who says “good morning” to the patient – and up to the doctors, up to the directors, up to the managers, everyone who is part of it: They should work there only if they work with heart. I think that’s the central demand. Without heart – I think it’s understandable what I mean by that, I could say a lot more about it – you simply can’t work in psychiatry – especially not in management, and not anywhere else either if you don’t have empathy, compassion, which is what it’s all about: It’s not about optimising profits. It’s not about reputation. It’s not about all sorts of things. It’s about helping these people in need.
And there is perhaps one more thing I can say that is part of this: I am convinced that it is necessary for us to allow ourselves to be touched – for example, in a conversation at the reception desk or wherever, to be personally touched by what is happening to this person. Everything else is not unimportant, of course. It would be nonsense to say that. Everything else has a foundation. And I think that’s what you have to demand and what you can demand.
And while I have the floor, I would like to “throw a cobblestone into the lake” and say very provocatively: For twenty or thirty years, a spirit has entered society, a spirit has entered psychiatry, which in my opinion is an evil spirit. Namely the whole digitalisation, the whole evaluation, the whole, dare I say it, “managerial plague”. The managerial plague. It’s something devastating. Everyone should stand up and say in a revolutionary way: This must not happen. This is not the top priority. The top priority is what I said earlier.
A long, large and grateful round of applause from the entire hall honoured the old colleague who had just exposed the heart of a devoted humanist who loved people. It was the quintessence of the life of an old-school psychiatrist who had painfully witnessed the devastating onset of what we call “biological psychiatry.” I will always remember him and what he said back then: This is something he will be as a human being for others, even after he has died. It will outlive him and will remain, because it touches us humans as if we would living forever.
At the funeral of a dear friend some time ago, someone said, “She’s over it now.” He was referring to her serious illness. She passed away, yet he spoke this sentence as if she were alive. What is it with us humans that death is not as absolute an end as we “enlightened” people would like to think?
When a person has grown up with his brother for 20 years and has shared everything with him, 24 hours a day, 365 days a year for 20 years, in joy and sorrow, from a very young age to adulthood…You did everything together, in fights and quarrels and strife but also with appreciation, love, and joy in doing things together, in working and arguing with each other, in doing things for the world by which you grow as young adults. On this path, as an 18-year-old, I have never forgotten being touched in the heart by my brother on the most difficult question of us humans: How I said to him without thinking that war comes from human nature and that we should look only to the children. He made a gesture that surprised me, as if he were holding a newborn baby in his arms – looked at it and said: “No, this little creature doesn’t have war in it: It’s good, not evil.” I was mortified by this kind gesture and agreed with him. That changed my spiritual life.
All human beings come into this world, and even before they arrive, there is a small ciecle of fellow human beings, the first people, with whom they grow into life together. By whom they are introduced to life and with whom they are introduced to life, a piece of this natural community of the inhabited world comes into being. When one brother takes a different path from the other, for whatever reason, there is a rift. And they don’t see each other again for 30 years. The brother is “gone” for the brother. He is not dead. But what lives in the heart of what my brother was before he “left” is as alive in these 30 years, and today as what lives in us from the deceased friend we buried when she “got over it.” When I think today that humans are good, the first thing I always see is the brother back then, who is no longer there and who is still there, looking at the little pretend being in his arms and being sure that this little human is not evil, that war does not come from our being.
Whether a person has died, or whether he or she is simply separated from us and living somewhere else, whether a relationship has broken off, it doesn’t matter: We remain inwardly, spiritually connected. So the brother, the living one, and the deceased live in my heart.
How strongly people live in my heart, how much another person lives or does not live in my inner self, does not depend on whether he is alive or dead, whether he has been dead for 300 years or died only five minutes ago, or whether he lives on another continent and is separated from me. By the same token, people can live side by side and it is as if the other person were dead. They don’t know anything about each other and the other person doesn’t exist inside them, as if the other person were not in this world. And yet they are.
But we humans can live not only in spiritual communion with people of flesh and blood whom we have known personally, with whom we have lived together, whom we have touched, with whom we have spoken, with whom we have spent our entire lives. Even people with whom we have never lived together can “live” in our hearts. I can get to know Aristotle by reading his writings and by reading, thinking, and feeling my way into his thoughts – insofar as they have been preserved – as if he were alive today. I also learn to understand his time from contemporary witnesses, as far as they have survived. In this way, I can experience a human relationship with this person who died 2,500 years ago as if he were alive. And there may even be more of a relationship with Aristotle than with someone alive today with whom I have nothing in common. And although I can no longer talk to him, a part of him lives in me. It doesn’t have to be the whole person. Even the people with whom we live are not, as a whole, in our inner world. We usually know only a little about others.
The fact is that we are only partly dead when we die. To know this, I don’t necessarily have to believe in God or in life after death. What biology, chemistry, physics and medicine call an organism perishes at death. But something that allows us to survive death remains. Something of us that can last forever, that can outlast the transient biology. It is not materially describable, does not consist of a biological “substance”: I mean the spiritual personality of every human being. What we have been for others remains. What we have created for the good life of all after me, as if humanity were eternal – this remains.
