Resilience Spotlight – Clare Fleming

The Resilience Spotlight is an initiative of the Resilience Action Group (one of the Bristol Green Capital Partnership Action Groups). Every month in 2015, the group will invite nominations for someone in the city who demonstrates how we can work at a local level to develop Bristol’s capacity to respond to shocks and stresses. 

This month’s theme was Health and Wellbeing and we were looking for people who promote measures to improve health and wellbeing, develop ways to combat and respond to health issues and create community-led health services/provision. This month we had a tied vote so are doing two profiles – stay tuned for the next one later in the week!

With thanks to our interviewer, Steve Maslin (Building User Design Solutions, Member of the Resilience Action Group and Research Fellow at the Schumacher Institute).  

Clare Fleming

Clare arrives at my home in high visibility attire, having cycled a reasonable distance across the city.  Remarkable when one realises that for six years she had previously lived with chronic fatigue syndrome and that for over a year she was virtually confined to bed and used a wheelchair to get out.  Perhaps even more notable when one discovers that Clare trained as a doctor and practiced as a GP before her illness.

As we sit down to talk over cups of tea, Clare tells me that for her “life was turned upside down by her illness”.   Her children were young at the time, and one suspects therefore, that this made her experience of illness even more painful.   She had always enjoyed helping others, but even this was stripped away and could no longer work as a GP.

Clare tells me she believes that while helping others has very positive benefits for wellbeing, she knows from experience that we also need to pay attention to our own wellbeing if we are ever to effectively help others.   For Clare this involved an exploration of the meaning of life and a clear realization that she was here for a purpose despite the situation she found herself in.

Relatively few of us train even once in medicine but Clare felt the call to retrain and enter the profession a second time after a break of 15 years!  I know of doctors who would shudder at the thought!  And, yes, the thought didn’t initially seem attractive to Clare until she came to the inescapable conclusion that it was the right thing for her to do.  This was not before she trained in photography, which she now uses in her work. She tells me that although she retrained in general practice what she really wanted to do was to work deeper with fewer people.  Not something most GPs have time to do. Nevertheless, she found doors opening but ironically in areas where her training had given her little preparation.  One suspects though that her earlier experiences of life change and recovery from ill health had done much more to prepare her…

She is employed and accountable within the NHS but works with people for whom the conventional medical system is too difficult to access.  So she describes her work as “outside the usual system”.  Some of Clare’s work involves what is known as “wet clinics” where street drinkers can come as they are and are not expected to part with their alcohol in order to attend the clinic!  This enables trust and relationship to be built as a foundation for subsequent healthy behaviour change.

So while she provides medical services to people with drug and alcohol addiction she works with them where they are at “in the here and now” rather than the past or the future.  However to speak truth about the “here and now,” without breaking relationship Clare explains “one has to establish a basis of mutual respect and trust.”

Clare has found that relationships are the key. We may assume that people living with addiction and homelessness have a degree of resilience in order to survive living on the edge.  However Clare says that many of her patients are homeless and isolated as a result of things which cause a lack of resilience – through not having early positive relationships, losing relationships and/or difficulties in relating to others.  She reflects that, in general, people with good relationships are more able to weather the storms; many people in positive relationships rediscover a healthy state of functioning after knocks that come their way.   Clare adds that “this applies to communities as well as individuals”.

Clare has found in her work that many of her patients fail to pay attention to their whole being.  Many of her patients are neither well in body nor their mind and as such some aspects of her work involves paying attention to such issues as eating well, vitamins, sleep, housing, connecting with others, overcoming poor self-esteem and tackling depression and anxiety.  Nevertheless she believes that it is even deeper questions that make the difference and give rise to what she describes as the “yes factor” and people’s “sense of purpose.”  So her work involves helping her patients find “where they are at” and “who they are” leading to a more honest acceptance of their reality. Clare adds: “truth leads to freedom – and is therefore the starting point for real change” and that it is vital “to keep believing change is possible, no matter what the set-backs.”

“Do you think that improving health and wellbeing has a role to play in the wider sustainability agenda,” I ask?  Clare replies: “Absolutely!  A healthy mind leads to a healthy body; healthy individuals form healthy societies and healthy societies form a healthier relationship with their environment.”   One suspects that by “healthy” she isn’t referring to health in purely medical terms…!

On being asked why community led health provision is so important Clare explains that “healing a life is not like healing a bone.”  She goes on to explain that individual and local health action relates to lifestyle, networks, environment and relationships.  For her, relationship “with her Creator” has made the crucial difference.  Clare explains that the extent of faith she discovered during her illness and the insights that she has gained during her work has led her to becoming a trustee of CCM a Christian charity that runs a women’s night shelter and the Wild Goose café where homeless people get food and other help.

I put to Clare the question “what are the little things that contribute to health and wellbeiing in communities?”  She replies “smile!” and “treat others as you‘d like to be treated.”  She reflects that this involves “being interested in others, being appreciative, thankful and relentlessly kind!“  It is clear that this does not come easily and that she constantly contends with what she describes as her old ways of seeing things. She focusses on what is positive – having learnt that if you connect with what is good within a person you encourage the development of that which is good.  On the other hand if you expect the worst that is undoubtedly what you will provoke.  On asking her what was the most important lesson she had learnt, Clare explained that “you can only start where you are” but that “if your view of who you are and where you are is not accurate you will not be able to make effective change as you won’t be starting from a place of reality. Therefore a willingness to be honest with oneself about the bad as well as the good is crucial to effective change.”

In answering the question as to what would improve health and wellbeing for everyone in Bristol Clare answers: “to desire it; to not just agree that it’s a good idea, but to be really hungry for it – with a passion for one’s own wellbeing as well as that of others.”  However, “if you perceive yourself to be just a cog in a system then change is unobtainable.”   To her life has to have a greater purpose.  Meanwhile she has found that her work has taught her much that has helped her own way of thinking, living and resilience – which comes across as very circular and complete!

It’s interesting to note that within Clare’s slideshow presentation of her wet clinic work she states that current “professional care divides those who give help from those who receive help” and that “we no longer have the financial or personal resources to carry on this way.  Demands > resources = burnout.”  The way ahead she believes is to create a “recovery community” stating that “people who live with a recovery mind-set have a great capacity to inspire change in others.”

Clare concludes by asking whether it is time to “reduce one-way giving by professionals and to learn from those we prefer to keep at arm’s length?”