The Paradox of Growth and Decay

intervene against nature, as when we use medication to remove a symptom, and sometimes to let nature take its course, as when we allow our clients the freedom to reject treatment or to make what we believe to be “mis- taken” choices.

In today’s healthcare climate many decisions are based not on what is best for the client but on financial con- siderations. We, as nurses, must recognize the para- doxical nature of such situations and ask the necessary questions. If possible, we should take a stand for time, against the advocates of premature action. Such a stand may bring us into conflict with our colleagues who will, no doubt, question our wisdom and perhaps whether we truly care for our clients.

On a personal level, making room for paradoxical situ- ations means being willing to experience the uncom- fortable tension as both sides vie within the client, the system, and ourselves. Our only recourse at such times is to allow the paradox to unfold, to contain our anxi- ety and restrain our need for action, rather than to forge blindly ahead with plans and prescriptions. As advocates for growth and decay, and as human beings who recognize that paradoxical situations defy simple solutions, we must proceed slowly, feeling our way in the dark, guided by natural wisdom in the form of instincts and experience, until the solution presents itself.

Janet Muff, RN, MSN, is an editorial member of Perspectives and a psychotherapist/consultant in private practice, South Pasadena, CA.

Readers’ Corner

I’d like to comment on the article ”Gratification and the Failure to Separate” by Suzanne Lego and S. Lee Spray in your October-December 1993 issue.

Currently in psychiatry there’s a big emphasis on Multicultural Counselling and Cultural Sensitivity. The authors would do well to brush up on those skills. The idea that a child SHOULD leave home at age 18 is VERY DISTINCCTLY AMERICAN. In Hispanic culture it is quite common for offspring to live at home until they marry. Later, it is common for parents or grandparents to live with married offspring. Oriental cultures and many other groups do the same. Some groups would wonder what was WRONG with the family if the kids automatically left in their late teens. Our custom reflects American’s tradi- tional valuing of “rugged individualism.” These differ- ences in family structure are reflected in many of our staff library’s books on Multicultural Therapy, etc.

I personally lived at home until my mid-forties. I had my heart broke a couple of times-wanting to marry, but it didn’t work out. I also broke a couple of hearts-the bWy wanted to marry me, but 1 didn’t want to marry him. In the mean time I took lots of wonderful vacations to all part of the world. I also saved enough that when I finally bought a home I was able to pay over half as a down payment. Some members of the Presbyterian Church to which I belong thought it was strange that I didn’t move out long before I did. On the other hand, I was also active in a Catholic singles group. Many of their members were from Eastern European backgrounds. They didn’t think I was doing any thing strange. Most of them were also living at home.

I think the authors should broaden their cultural awareness; especially if they are going to label certain behaviors as abnormal or items to be ”treated.” I also think it was strange they believed males stayed at home for practical reasons but women had problems if they did the same thing. I find it very sigruficant that the women in the article were described as independent and having egalitarian relations with their parents. In my mind, that’s very healthy; but maybe I’m now showing MY values.

Nancy Ward Librarian, Hawthorn Center

Norfhville, Michigan

Perspectives in Psychiatric Care Vol. 30, No. 2, April-June, 1994 35