There are different ways of reviewing a book. There is the speed read filleting that gives the gist of the argument, homes in on a few illustrative quotes, then writes about the general theme of the book with sufficient reference to the text to make it all sound credible. Such a review is a disgrace!
By contrast there is the conscientious reading of the book, with annotated margins / and or notes in notebook or laptop. The review is then presented as an essay that shows the book was given a fair hearing, by someone qualified to appreciate and critique, caution or commend. Such a review is a courtesy of scholarship.
Between these two is the quickly read book, but approached with enough care for the subject and respect for the author that the review is by and large fair, and helpful to those who want to know – is this book worth my money and my time? Such a review is useful.
In reviewing John Swinton's book Dementia, I want to do something different from these. A series of reflections or brief essays in which the overall thesis of the book is explored, and its contribution to a Christian theological understanding of dementia weighed and listened to. Make no mistake – this is a book of Christian theology, a constructive attempt to place the profound human challenge dementia poses for our understanding of our humanity, of God, and of what it means to live in the life and love of God.
This approach inevitably means I will be responding and making comments before the whole story is told, before the thesis is stated, defended and established, before the book is read through. But bear with me. That will enable conversations in which questions asked may encounter their answer later, and before such questions allow a more patient listening.
The Introduction plunges immediately into the depths of human experience by posing questions about the nature of our humanity. Identity, "who am I", is a far from straightforward question. Related to who I am is who loves me and what that love might mean. If I change over the years, or some decisive intervention such as dementia changes the way I am, in what sense can those who loved me be expected still to love a person who is no longer who they were? Swinton insists it is the divine recognition of who we are that is theologically decisive in questions of human identity. This is a crucial move in Swinton's approach. The book is self-consciously theological, and the question it addresses is fundamentally theological. While acknowledging the important role of other disciplines such as philosophy, psychology, psychiatry and neurology in the understanding of dementia, he is offering a different perspective. What does dementia look like, and how is the response to the person with dementia shaped by presuming "a world created by God, broken by sin, and in the process of being redeemed through the saving work of Jesus"?
Central to John Swinton's theology, both here and in other volumes such as Raging with Compassion is this paradigm shifting concept of the redemptive purposes of God. Swinton has professional experience as a psychiatric nurse, a mental health chaplain and as an academic theologian with an overt Christian commitment. That is why he offers not a disclaimer, but a claim that he spends the rest of the book justifying:
"dementia is a thoroughly theological condition. It makes a world of difference to suggest that dementia happens to people who are loved by God, who are made in God's image, and who reside within creation. The task of theology is to remind people of that distinction and to push our perceptions of dementia beyond what is expected, toward the surprising and the unexpected" (page 8)
Reconfiguring the relation between such a theological perspective and the multi-professional perspectives derived from other disciplines will be one of the challenges of the book. Another is the need for Christian theology itself to reconfigure how to articulate the relation between God and each human being. Swinton rightly interrogates a prevalent assumption in theological writing, that the one addressed is an "individuated, experiencing, cognitively able self, perceived as a reasoning, thinking, independent, decision-making entity". A theology of salvation based primarily on such assumptions has such far reaching consequences of exclusion and inclusion that a more viable approach is required when dealing with human beings who may be cognitively impaired. That is the theological challenge for a Christian understanding of dementia.
Who am I when I've forgotten who I am? Who am I when others have forgotten who I am? Into such frightening questions comes the Christian good news that God knows exactly who we are, in the divine recognition there is no forgetting of us, ever.
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