This is a chapter of a book called “Too good to last: The death of a caring culture” Written by Dr Robert Crawford and reprinted here with his kind permission. There are a number of Maori words and you may need to search on google if they are not familiar though often the context will give them their meaning as well. This example is taken from the vast stores of Robert’s experiences. The patient’s are not real though the examples are. Details have been altered enough to make them indistinct and keep the anonymity of actual patients secure. You can download the file by clicking here.
Tana Maori Group
In the late 1970s I was approached by the Hanmer Springs postmistress Moutere Standford, a middle-aged woman who was bright, cheerful and outgoing, who told me she had noticed that more and more 'brown faces' were appearing in the post office to arrange for their social security payments to be directed to them in Hanmer while they were patients. Being Maori herself she felt a recognition and rapport when these patients met her. Moutere's husband worked as a porter at Queen MAry hospital (QMH). Familiar with our programme, she expressed interest in running a weekly group for Maori patients. We decided that it would indeed be possible one evening a week, and that the hospital would provide a nurse to be present to support Moutere, endorsing the group 'officially' and ensuring that the outcomes of the group meetings were fed back into the ward reporting system, so that it was an integral part of the therapy programme.
Such was the success of Moutere Standford's group that it was soon being attended by Pakeha patients as well as Maori. After a while, however, we realised that the number of Pakeha attending was overwhelming the Maori numbers. Why was this? One reason was the interest of Pakeha in Maori culture, which of course was healthy. However, it altered the atmosphere in the group to the point where the Maori folk could, we feared, almost become exhibits in their own setting. This would not promote a supportive environment. The second reason was the Maori concept of whanau. As has been described already, most addicts have severe attachment problems around their family of origin. Attachment disorders are so common, in fact, that some commentators have dismissed them as a normal part of growing up, and therefore of no relevance to the development of serious mental illness. I disagree with this point of view because the resolution of attachment disorders can occur naturally.
We concluded that many of our Pakeha patients sought to attend Maori Group because the atmosphere that developed there was one of Whanau – a natural acceptance of all who came, much as within Maori culture there is an acceptance of any who come by invitation to a Marae. We realised that this ancient privilege was being abused, right under our noses. The Maori group was for Maori, particularly the disenfranchised, who had lost contact with their traditional roots for one reason or another. The presence of large numbers of Pakeha was actually disturbing this healing process.
In the mid 80s we had recruited another member of staff, Monica Stockdale of Ngai Tahu Matawhaiti and Ngati Kahungunu descent. Monica was the wife of the new part time QMH Anglican Chaplain, Tony Stockdale. She had trained as a marriage guidance counsellor, and came onto the staff as a social worker/therapist. Monica had what in counselling literature is called 'Factor X'. Factor X people have an innate ability to make patients feels at once able to trust them, and as time goes on the patient is not disappointed. The empathetic warmth is continued, and this is evidence of sincerity: it has been shown that patients respect such sincerity beyond almost all other qualities. We were lucky Monica had all this in abundance. She was invited to join Moutere in Maori Group, and to discuss what we might do about the problem of swamping by Pakeha. Obviously we could not ban someone from attending on the basis of race. Knowing that many people who look Maori do not see them themselves as such, and vice versa, we began to feel discomfort about our original offering of a group to those, to use Moutere's original phrase, who had 'brown faces'. Clearly this was not precise enough, as well as being ethically inappropriate.
After some discussion we concluded that the source of our problem was in how we had structured the group. Other 'specialist' groups were joined only when the therapist referred the patient - for example Grief Group, when the therapist identified a patient with a significant grief issue. The solution to the Maori Group then became obvious: it should be a 'by referral only' group. We now had a member of staff of Maori descent with training in counselling, and who was rapidly upskilling in addiction therapy, so we decided the time had come to make the Taha Maori Group a formal part of the QMH therapy programme. Henceforth the group met three times a week, during clinical hours. This was a way to bestow the requisite mana on the group, and rank it alongside the other specialist groups.
The wharenui became very special over the years, with taonga donated by patients, ex-patients and their whanau. In time, Monica and her staff (unfortunately for us Moutere left Hanmer Springs in the late 1980s) collected portraits of famous ancestors, together with brief biographies, and these were displayed on the walls. The effect was both artistic and instructional. Each morning the Maori patients met for karakia and a meditative reading from one of the 'Day by Day' meditation books recommended for addicts or co-dependents. This routine had a combined effect: it started the day on the right path, and was a reminder to patients that when they left the hospital, here was a way to continually remind themselves of the qualities that lead to a serene life, good relationships with others, and a resolve to remain abstinent. The immersion in things Maori also removed the perhaps less conscious notion that the 12 Step Programme of recovery was a Pakeha method and somehow not applicable to Maori.
An aspect of Maori culture that came up frequently was the tipuna, or ancestors. In Pakeha culture we are taught to think of our ancestors as 'behind' us, with the future 'in front'. We even have the phrase in English of'Looking forward to the future'. There is this arrow of time, flying forever straight forward. Other cultures do not necessarily see it this way, and as a result of being immersed in Pacific Island cultures, I have come to alter my view of the linearity of time. These days I see time as more circular. Maori culture sees the past as 'in front' and the future as 'behind'. Tipuna are of central importance to one's actions now. Some people hear them speak, give advice, and make themselves felt. There is an openness to the 'spirit world' which Pakeha culture has moved away from, for good or ill. Whatever our individual spiritual beliefs, they have tremendous power in our lives. Note Freud's comment that 'If God didn't exist we would have had to invent him.' At QMH we respected patient's beliefs, of whatever spiritual or religious persuasion. Indeed we encouraged people to explore their spirituality.
Tipuna came up in many Taha Maori Group psychodrama sessions. Consider the following case study:
We are in the wharenui, and I am about to direct a psychodrama session as a result of a request from Monica to work with a particular patient, Manny, a Maori Group member from the Hawke's Bay. He is a Rangatira (a chief) by birth, but has lost his mana because of his addiction issues. We are to explore this situation, and see what might be involved in Manny's regaining the ability to appreciate his heritage. He knows he is doing wrong and letting people down, not least the woman who loves him, and whom he loves.
We begin by setting up a breakfast scene in the house where Manny lives with Rebecca, the mother of his children. They are having a row over the events of the previous evening. Manny went to the pub, and picked up a woman, with whom he slept, before returning to the family home in the early hours of the morning.
'Manny,' I say, 'remember that psychodrama is not about repeating history. We work with "surplus reality". So tell Rebecca and your children here someting that you thought but never said on the day after the night before.' Manny thinks for a while, then says: 'Rebecca, Princess, Johnny and Hine, I did what I did because of alcohol. I am not proud of it. I don't know what comes over me when I'm in this mood.'
'So,' I say, 'you do not know what comes over you when you are in this mood. Can we go to the moment when you are in the mood? Where are you?'
I suggest this move into a historic moment in order to expand awareness, and follow the protagonist's warm-up, which, as indicated, is back in a moment when he decided, consciously or not, to act in a certain way. 'We're in the pub,' says Manny. 'Take us there,' I say.
We dissolve the breakfast scene, and set up the pub scene. I welcome pub scenes in psychodrama, because they always result in a high level of sharing later on in the morning's work. Just about all patients will contact significant emotions during such a scene.
Manny calls up several participants to be his friends and acquaintances in the drinking circle he frequents. We have Tama, a big burly forestry worker, Jimmy, ditto, Herby and Henry, who are drivers, June, a young woman of sexy appearance, and a crowd of others in the busy bar. Most of the group have roles as extras in this scene — something else I welcome because role players who have to get into the role of drinker generally experience emotions that are relevant to dealing with the temptation of resuming drinking and cannabis smoking - the normal requisites of pub life.
'Take us to just before the moment you were referring to earlier,' I say. Manny indicates he needs to change roles with Tama. Tama then speaks:
'What have you been up to, bro? That missus of yours still giving you a hard time, eh?'
'Reverse roles,' I say.
Manny replies: 'Yeah. I'm supposed to be at the school right now, talking to the boy's teacher.'
'Reverse roles.'
Tama: 'Yeah! Those Pakeha teachers, they order you around, eh? My missus says the same. But school's no place for a man, bro. Women's work, that is.'
'Reverse!'
Manny now looks uncomfortable. He looks up and over the role player Tama. He seems far away.
I say: 'What are you feeling now: where have you gone?'
There is a silence. A tear forms in Manny's eye. Again I ask: 'Where are you now? Who is here?'
'My tipuna,' he whispers.
'We need to have them here,' I say.
'Is that all right? Can we do that?'
'You know how psychodrama works: we need them physically present so we can all see them.'
'Yes.'
He selects role players to be his grandfather, his father, his great-grandfather, and his great-great-grandfather, and some distant uncles. We end up with an arrangement in which the older folk are at the front, and the less old behind them. I ask who each person is.
'This is my warrior ancestor.' (Name not given to prevent identifictaion of the patient: we will call him Te M.) 'He was prominent in the Maori Wars in the Waikato. This is his brother, and these are his descendants. This one here is my father.'
'Reverse roles with Te M'
I now warm up Manny in the role of his famous tipuna, by interviewing him.
'Thank you for joining us here today, Te M, and for working with your great-great-grandson Manny. He is experiencing some difficulties living today, and we all want to help him understand what these difficulties are, and how they can be combated in the future. Tell us about yourself.
'I am a chief of the Waikato. I fought against the British, until our supplies ran out, and the people all went back to their maraes. I knew we could not win the fight. There were too many Pakeha soldiers for us, and they were too well organised. We had to go and get our food. They had theirs brought to them. We killed many of them, and we fooled them good and proper. But I told my brothers that there was no way we were going to win. If we defeated those Pakeha, then others would come. Eventually we would all be killed, and then what would the future hold for all of us? No, I said, we have to learn these Pakeha ways, and make sure we win the peaceful way, fighting is not going to work for this battle. I have heard that Britain is a big country with much wealth and many soldiers. They will send more and more until they defeat us.'
'Are you sad about this?' I ask.
'Of course I am sad. I am not stupid, though. I can see there is a new way to be mastered, and we have to learn this way. The world is always changing. We cannot stand still. The bird that learns to fly is the one that lives the best. Look at the moa. He never learned to fly, and so we caught them all. Don't be a moa, boy!' He shouts this last at Manny. This is an example of a spontaneous comment suddenly welling up when the warm-up is right. 'Reverse roles!'
Manny as himself looks at his tipuna. He weeps. 'These are great men,' he says to me. 'I am not worthy of them.' 'Tell your tipuna about that,' I say.
'Te M, I have not learned to be different from the moa. I am an alcoholic. I feel bad, limited, trapped in my life. I do not know how to rise above it. I cannot fly. I am not worthy of you.' 'Reverse roles.'
Te M speaks: 'Boy, you are my descendant. No descendant of mine can lack courage. I see you are a warrior at heart. You drink te waipiro to feel like a man. But it doesn't make you a man, it makes you a slave. You mistreat your woman. You take others, like a conqueror who takes prisoners. But that is the old way. The new way is different. There is a new battle to be fought. You must learn how to fight it. The old way with mere and spears, with fists and feet, is not the new way. We do not defeat the enemy unless we learn where they are and who they are, and what they want. That is a true warrior. Always thinking and always alert to new developments. Are you a true warrior, my son?' 'Reverse roles!'
The role player repeats what Te M has just said. There is a silence. Manny weeps again. Then he pulls himself up to his full height, looks Te M in the eye, and breaks into Maori. I have not the slightest idea what he is saying, but it doesn't matter because it is obvious he has contacted something positive deep inside himself. When he has finished, I invite him to reverse roles again. This time Te M makes a long speech in Maori, addressing Manny. When he has finished we reverse roles again.
Manny is back to being himself. 'Is there anything else we need to do before these men return to their homes?' I ask.
Manny looks at the tipuna, taking in the fullness of his ancestors. 'I think we're finished,' he says.
I say: 'I suggest we put your great-great-grandfather somewhere in the room so he can encourage you at all times. Where would he be if he was asked to stay?'
Manny puts him on the step of the former nursing station, which is in the middle of the wharenui, overlooking the whole room.
I dismiss this scene, and ask Manny to take us back to his home, to Rebecca and his children. I ask him to place the women with whom he has been unfaithful in this scene, and to choose something for the place of alcohol and drugs in his life. He thinks for a moment. 'All these women are alcohol and drugs,' he says, 'without alcohol and drugs I would not be unfaithful to my tipuna.' He looks over to his ancestor standing on the step.I say: 'We cannot get away from alcohol and drugs: they will always be available. We can separate ourselves from enslavement by them though. Decide how you are going to do that, and organise it.'
Manny goes up to each of the women role players, and moves them one at a time away to the end of the stage area. I suggest he puts words to his actions. He says: 'You stay out of my life now. I don't need you any more.'
Now we come to a crux in psychodrama. It is not real if there is no struggle, but how can we make this struggle realistic on the psychodrama stage? I ask each of the women/alcohol-and-drug role players to resist until they feel they have been dealt with. They are to use their own judgement of when this point has been reached. Sometimes the role players are too helpful, and we do not get a realistic struggle symbolising the commitment needed to win this battle. I remind the role players of this convention. I add: 'Nobody gets hurt in psychodrama. If you feel you are going to be hurt in some way, then you have been dealt with. When you get to that point you give up. Before that point, you make your resistance count. You all know how difficult it is to get and stay recovered. Use that knowledge to help you be real here and now.'
Manny puts each of the women away, but as soon as he attends to one, the others gravitate back to their original positions. Rebecca looks on at this.
'Reverse roles with Rebecca,' I say to Manny, 'and you other role players replay that last interaction as you experienced it.' This allows Manny in Rebecca's role to see how tentative he is with the women/alcohol-and-drug role players. I say to him in her role: 'Do you think he is a warrior at this moment, dealing with these enemies?'
'He doesn't seem to believe in what he is doing,' s/he says. 'Have you got any advice for him, or is there something you could do to maximise his response?' I ask.
Rebecca is silent for a moment. 'No,' she says. 'He has to do it himself. I can't do it for him.' (I am delighted to hear her — role played by Manny, of course - say this, because it is the response we want to hear from recovering co-dependents. They are taught that they cannot control their partners, and instead they need to focus on their own serenity and their own areas of responsibility. We teach them to learn to make their responses in the form of I messages, instead of 'You' messages. Thus, 'I can't do it for him' as above, is an example of an I message. It is a powerful personal statement of a position or a feeling and has quite a different quality to a 'You' message, like, 'Manny, you must do it yourself The I message contains the person making it, whereas the 'You' message is much weaker, because the person making it is absent, and they are concentrating on the person they are addressing, leaving themselves out of the equation. I messages ensure the addressee has to relate to the speaker. 'You' messages tend to be less powerful because they do not do this.
'Reverse roles - be yourself and make a new response,' I say to Manny. In psychodrama, spontaneity is often defined as an adequate response to a new situation or a new response to an old situation. It is this second response we are looking for now.
He sets about the task with renewed vigour. However the role players also up the ante, and seep back as soon as he puts them over to one side. He decides to make a 'wall' of people, with the alcohol/drugs/women behind it. 'You guys be my A A group,' he says to the remainder of the psychodrama group. You can make up a wall to keep these women away from me if I stick with you.'
This is a creative solution to the current situation, as well as for the future one when he returns home. The wall forms. 'Reverse roles with one of the wall people,' I say.
Manny does so.
Up comes a temptress. Alcohol and drugs are just as seductive as any woman looking for a man!
'Hullo, Duckie!' says one of the role players. 'How about it, then?' She makes as if to tickle him. He turns away and holds onto his mates. He starts a conversation with them, ignoring the temptress. He looks over to his ancestor, who encourages him by saying: 'That's a warrior's move - stick together in time of seige!'
Now, ignoring someone is remarkably potent. The temptress continues, but quite soon gets sick of it. 'He's a dead loss,' she says to one of her mates. 'Let's find someone else to have fun with.' They move off to bother other people in the "wall".
'Reverse roles,' I say. 'Repeat that interaction again, please.'
Manny stands as himself, alongside others in the wall. The temptress does her thing, gets fed up and turns away.
'Reverse roles - with this women,' I say to Manny, indicating the temptress. I do this so he can experience what it is like to be ignored, and feel the power of such a simple action when carried out with commitment.
He does this, pestering harder than the original role player did, but with no better result.
The atmosphere in the room lightens.
'Reverse roles and be yourself again.'
Manny turns to Rebecca.
'That's what I am going to do, one day at a time. Ok, girl?'
'Reverse roles!'
We see Manny and Rebecca have a touching interaction. I reverse them so that Manny is back to himself.
'We have one more thing to do before we finish and share,' I say. 'It is for you to speak to your ancestor here, and finish off with him. Where does this interaction take place?'
Manny thinks for a moment. 'In the marae,' he says.
'Take us there - set the scene for us.'
Manny orientates the group in his home marae. He has people be the poupou, and his original tipuna are present in this new place. Finally he addresses Te M.
'I am proud to be your descendant. You were brave and fearless, and a great leader in your time. Times are different now, but I know you would adapt to the change. I will follow your example, and adapt to the new times. I cannot be a warrior in the way you are, but I can be an urban warrior. I can be a dad to my kids. I can have healthier thrills than being drunk, and chasing women. I can be content with Rebecca here. You did your duty in your own way. I'll do my duty from now on as best I can.'
'Reverse roles!'
Te M regards his descendant. He then starts to sing a waiata. Although I do not understand a word, the sounds are peculiarly beautiful. It seems appropriate. Just after the last note has died away, Te M steps forward and embraces Manny, saying something in Maori in his ear. The action seems complete, so I ask them to reverse roles, picking up from the moment of the embrace.
The patient role-playing Te M speaks Maori, fortunately, and so is able to enact the sequence word perfect. Manny replies in Maori.
'Are we finished?' I ask him.
'Yes,' he replies.
We are all seated for the sharing session, which I begin by reminding the group that it is strictly for sharing: Manny can reach his own conclusions from his work. Little is gained by asking further questions or giving opinions, while a lot is added if feelings that emerged during the drama are shared with the group. Everyone had a role, so I ask to hear from everyone before we stop for lunch. It's important that nobody 'hides' in silence. Contributing feedback honours the protagonist of the drama, who has trusted us with his inner feelings, after all. He feels supported if others communicate with him at this level.
The first to speak is the patient who played Rebecca. 'Thanks for choosing me to play Rebecca, Manny. It was really helpful to me. I'm here on the Family Members' Programme. I can see how my husband is caught up in the same conflict as you. He hasn't reached the point you have yet -'
'Hang on, Julia,' I say. 'Remember we are sharing, not doing analysis. Say something about what you experienced playing that role - you personally.'
'Well,' she says. 'I realised when I said it in the drama that I couldn't do it for him. I want him to recover, but I have to let him go. He's got to find the way to recover himself. I need to protect myself and my kids from his alcoholism and drugs. If he wants to come with us as a recovering person, then he has to decide to want it. I wish he would decide this, but your drama helped me see that I have no power over that happening.'
'Wonderful, Julia!' I say.
'I was moved by your Tipuna being so present,' says a Pakeha man. (Pakeha and Maori groups that were at the same stage of the treatment programme came together for the psychodrama group.) 'I was thinking about my own grandparents, and their son, my father. He came from Hungary after the war. I remember his story of not having enough to eat during the war, when he was a teenager. He told me once that he couldn't bear to see the kiwi workers throwing away the crusts on their lunch sammies, so he crept back after dark and collected them all. I was thinking about what led him to leave his parents behind, and how I've lost my heritage too. Your ancestor telling you to be a warrior for today's times reminded me that I have to honour the chance my dad gave me by coming here. It was all communist at home, and lots of my family were killed in the 1956 revolution...' he weeps, visibly moved by this memory, and the group waits respectfully while he gathers himself again. 'My dad had to leave his parents: I guess he was being a warrior for the times too. I wonder how I will do the same. Thanks, Manny, for that inspiration.'
'Can we hear from people how they reacted to the pub scene?' I ask.
'Yes,' says a young Maori man, 'that was awesome, bro. I had a taste of booze when we were doing that scene. I got really frightened. I could see how easy it would be to return to boozing and smoking.'
'I spent a lot of time in pubs,' says a young Maori woman. 'I behaved really sluttishly. Like, I'd go with anyone who showed any interest in me. I'd go with good intentions not to fall, but it wouldn't make any difference. When you had us in the wall, I felt really strong, like I belonged to a better future. We really need to keep together unless we go back to our old ways, eh?'
'My gran was like your tipuna. She was a survivor. She brought me up. I loved her. I know she would have been so happy that I came here, that I wasn't just boozing away my life. I thought of her a lot while you were working. It was like she was really here with me, and I was not alone anymore.'
There's a theme here' I say, 'of the need to accept helpful friends and inspirational tipuna beside us as we live each day, one day at a time, in the ever present,' I say. 'Anyone else want to speak before we go to lunch? Is everyone de-roled, and back to being themselves? What about you, Kingi?' Kingi was the man who had taken the part of Te M.
Te Maori ora,' he begins. There follows a long speech in traditional format, listened to attentively by Manny. Again, I have not the least idea what he is saying, but it is clearly inspirational for Manny, and the other Maori speakers who understand. I do not need to know what is being said, merely to trust and respect the speaker. He turns to the rest of the group, and says in English: 'I've told Manny how his work today had a big influence on me. I've hated all Pakeha, and I came here this morning reluctantly. I didn't think Dr Crawford could help us Maoris, no way. As for psychodrama, well I thought it was a load of rubbish. Just game playing. Now I've acted a part, I've changed my mind. The whole drama this morning was alive for me. My tipuna never leave me. They always reproach me, and I fob them off. I say they don't know what it is to live in this land today. It was a lot easier for them. Now our people are lost, and you have not helped us. Well, after today, I see I had it wrong. The tipuna are right. We need to be warriors for today, and not to mourn yesterday. They did their best, and they thought it was for the best. I've been trying to turn the clock back. But as Te M said, there's no point in pushing, we must bend with the times, and turn them to our advantage, with the cunning displayed by the people of the old days. Thank you, Manny, for teaching me this. And,' he turns to me, 'thank you, Robert, for being here today, and for having faith in people like me. I see you are a good man, you are a warrior for these times who holds up a shining mirror for us to learn from.' He stands up, crosses the floor, embraces Manny, and then embraces me. Kingi suggests we sing a waiata, 'to celebrate the new way we have for the future.'
The musicians amongst the group reach for the guitars, and we sing Be Strong like a Totara Tree,' a favourite amongst Taha Maori Programme folk. There is nothing more to be said. Our session is complete.
Psychodramas in the wharenui seemed to me to have a special ambience. The place became imbued with the living spirit of recovery and self actualisa-tion for so many. Somehow the room played a part in melding together the old ways and the new, assisting patients towards valuing their cultural heritage, its particular nobility and strength, as well as the inspiration to adapt to the changing world. The same qualities passed through me: I could relax in the wharenui when conducting these dramas, in a way that was not possible working with Maori in the main psychodrama room.
Sensitivity to atmosphere is not talked about very often. In psychodrama it is described as part of the 'warm-up'. Our aim in psychodrama is to reconnect the group to their own creativity and spontaneity, temporarily submerged as it has been by addiction and depression. That aim is supported and boosted by the surroundings being a container for hope, respect and individuality. For do we not all crave to be related to as individuals? Anything that can enhance this quality is to be encouraged in healing environments.