The importance of this short book is out of proportion to its size. It should be made clear at the outset that it is not a heavily researched tome: there are references, but they are predominantly to other authors, not to studies, and there is hardly a number to be crunched in its pages. It is not just an ideas book, however, although ideas there are aplenty. It is the fruit of over 20 years of counselling experience by one individual in the United Kingdom and United States of America; years in which she has been a pioneer in providing a one-to-one service for persons with dementia, and also working with family members. It is only when you read an account such as this that you realise how lamentable our response has been to the challenge to our services posed by dementia. The condition is existential and asks of each person diagnosed to begin ‘making sense of self’ in new ways. In the vast majority of instances, we leave people and their equally bewildered relatives to fend for themselves. To a tiny minority we throw the lifeline of a support group. To an even tinier number there is a Danuta Lipinska on hand to accompany them through the process. The author is clearly a deeply sensitive person, which is why she is able to empathise so fully with her clients. Fighting for their right to receive help has infused her passion still further, which explains the unusual effusiveness of her tributes to colleagues and supporters. One believes her when she says that it is such people, and those on the receiving end of her emotional support, who have urged her to write this text.
Lipinska structured her account in a helpful manner. After an introduction she explains the theoretical basis of her practice. Here her intention is to marry the person-centred approach of Carl Rogers, and the exploration of the concept of selfhood of Dave Mearns and Brian Thorne from the counselling side, with the ‘person-centred approach to dementia care’ of Tom Kitwood. To this she adds her distinctive perspective on spiritual enlightenment. In the third chapter she outlines the movement to ‘depathologise’ dementia – rescuing the subjects from the impersonal clutches of the medical model – and recounts her process of learning from those with the diagnosis who come to her. The following two chapters (the longest in the book) mount a defence of counselling and a description of the process itself, with helpful excerpts of dialogue. A chapter on some of the characteristics of her clients is followed by one on the essential art of communication, and finally she offers insights from her unique understanding of the spiritual.
It is difficult to do justice to this book in a brief review. It is the kind I go through with pencil poised to underline a word, a phrase or sentence. There are quotations from disparate authors, not the least illuminating being people with dementia, but I will end with a paragraph from Danuta Lipinska herself. If this speaks to you then you will know that this is a book that you cannot afford to be without.
Occasionally, and more often than I would have at first thought possible, our communication takes place within the myriad realms of silence. In those positive encounters I imagine it akin to a beautiful prism being held aloft between us; tantalizing in its elusive beauty, inviting wonder and interest. As a prism reflects multiple facets of light and colour, alighting here and there, so too can silence reflect multiple facets of personality, meaning and spirit, separateness and communion. (p.100)