Maps for the journey


	Alan Bodnar, Ph.D. is the Co-Director of Psychology Training at Westborough State Hospital, Mass. and a consultant in the field of leadership development.

By Alan Bodnar, Ph.D.

With her brow creased in her usual perplexed expression, Mary joined the clinical team in the conference room to review her progress over the past month. Her perplexity was mixed with anticipation and a good deal of anxiety about a 45-minute car ride she would be taking with her case manager to visit her family. Whenever she started to tell us about her schedule, groups that she especially enjoyed or the challenges of living with her peers in the unlocked hospital residence, Mary would return to the subject of her weekend trip. "We're going all the way to Angstwich. That's far away. I don't know how to get there, but my case manager said we'll be taking Route 495 and then the Mass Pike. We'll be in the car for almost an hour. That's far. I wish I had a map. Is there some place I can get a map?"

It's not every day that a psychologist has a chance to be helpful in a concrete, material way that enhances a patient's ability to cope without blurring professional boundaries or fostering an unhealthy dependence. But, the woman asked for a map and here we were - representatives of psychology, psychiatry, social work and nursing - sitting at the computer controls that could provide what she wanted.

The computer was there to provide something else - easy access to the patient's treatment plan as we reviewed Mary's past 30 days in the hospital. After the mandatory review, we promised Mary that we would search the Internet and print out her map. Actually, we produced three maps, one showing the entire route from the hospital to her family's home, another highlighting the major approach road to the town and a third detailing the streets in her family's neighborhood.

I was not there when her social worker gave Mary the maps but I know how pleased she was to get them. There is something reassuring about a map's ability to give us the perspective from which we can project ourselves safely into unfamiliar territory, to anticipate the challenges and choices that the road will bring and finally to imagine ourselves securely at our destination. In a state hospital where some people have spent decades, maps also serve as reminders of the world beyond the front gate. Before the building was closed for repairs, one wall of our hospital café was papered with an enormous, brightly colored map of the world that stimulated many conversations about where customers had traveled in their lives and where they would like to go in the future.

When you eat lunch with the world spread out in front of you, you cannot help thinking beyond the confines of the place where you happen to be spending this difficult phase of your life. With imagination, names and places you may have only read about in the newspapers become the stages on which other lives not unlike your own are lived out with the same regularity of success and failure, heartache and delight.

Maps encourage us to be bold and inquisitive and fill us with hope that life might be better elsewhere. They may lead us astray with the false promise of a geographic cure or open our eyes to the possibility of making changes in our lives.

A map can be the starting point for a conversation by neutralizing the risk of self-disclosure as it was for a shy, quiet man in the hospital, who had come to this country from China nearly 50 years ago. When a staff member showed him a map of his native land, this usually silent man smiled and began to speak. Little by little he started to reminisce about the places where he had spent his childhood and to reflect on the changes that had taken place in the world and in his own life over the past half-century.

I've never been able to resist a good map, from the National Geological Survey's topographical charts of places I have lived or traveled to the computer-generated hybrids that let you toggle between aerial photographs and conventional presentations of landscapes and roadways. I have used maps to plan adventures and, in retrospect, to understand adventures that took me by surprise. Maps of land, sea, and the night sky have all been useful and often beautiful.

Least appealing are the Internet-generated maps showing only the route from the point of departure to the destination. They imply that there is one, best way to get from here to there and do not help the traveler adjust his route according to changing conditions. In the end, the only reliable solution is to cultivate the interior map. On the East Coast, we know we're headed north as long as we keep the ocean on our right.

Keeping on course in life is even more challenging but there is an interior map for that too. Perhaps that is the map that our patient needs most of all, but we have to start somewhere. For now, we were happy to begin with a map to Angstwich.

Maps for the journey (March 2007 Issue)

By Alan Bodnar, Ph.D.

Maps for the journey
(March 2007 Issue)