Monday, 25 February 2019

psychology of the rosary

The rosary is a Catholic prayer cycle. It consists principally of Our Fathers, Hail Marys, and Glorias, surrounded by a Creed and a couple of closing Marian prayers. I don't want to consider its religious significance, but instead to think a little on the psychological value of its recitation.

For striking about the Christian faith is its constant rehearsal of what the Kleinian lingo registers as significant positive internal object relations. We have the cultivation of those states of mind which comes when one is in relation both to a powerful and generous and safety-providing father figure and to a loving graceful mother figure. We have the rehearsal of the acknowledgement of guilt and of reparation through forgiveness. And the faith also invites its practitioners to identify with (or at least, to imitate!) Christ in their lives.

No doubt there's all sorts of perverse ways that prayers can be used. For example, perhaps the Our Father could be said in a servile way, rather than in a way which releases us from life-devaluing narcissism. Or perhaps their emphasis on guilt could strengthen not the conscience, not our trust in the essential value for the inner life of repentance and forgiveness, but instead merely the punitive or hope-quashing superego.

But there's no need to read the prayers that way. With the Our Father we're invited into a confident relationship with a benign, truthful, trustworthy, respect-worthy, father. With the Hail Mary we're invited to recollect the qualities of a good, graceful, forgiving mother. Both figures are life-givers; both prayers rehearse the hallowedness and blessedness of their objects, both encourage hope rather than despair.

The good functioning of the human heart and hence of the human mind depends, I'd say, on the following:

a. A sense of inner strength, power, courage, efficacy.
b. An inner sense of lovableness, a receptivity to and capacity to give love.
(a and b, with their courage and love, offer the two magic ingredients of a happy soul)
c. An acknowledgement of one's narcissistic failings.
d. A real knowledge of the possibility of true forgiveness and reconnection.
(c and d make for a good conscience, i.e. for that integrity that is itself essential for integration)
e. A hopeful attitude.

By their very nature these vanquish the loneliness, hopelessness and fragmentation that is otherwise at the heart of human misery and psychopathology.

Whatever its more distinctly religious functions (which, I imagine, are neither to be understood separately from, nor reduced to, its psychological functions), the rosary works to rehearse, bring imaginatively to mind, inculcate, encourage an indwelling in, a supremely good set of internal objects. Who'd not want to endlessly rehearse it?!


On the loving goodness beyond virtue of the saintly nun in the psychiatric hospital, Rai Gaita writes ‘I doubt that the love expressed in the nun’s demeanour would have been possible for her were it not for the place which the language of parental love had in her prayers.’ And that 'the unashamedly untheoretical, anthropocentric language of worship has greater power to reveal the structure of the concepts which make the nun's behaviour and what it revealed intelligible to us.'

Thursday, 21 February 2019

delusional façades

Why is it that those with active schizophrenic psychosis - in the early 'delusional mood/atmosphere' stage - tend to delusionally experience visible buildings as stage sets - as mere façades?

Thomas Fuchs provides a partial answer in his 2005 paper on delusional mood and delusional perception:
In delusional mood, the environment as perceived by the patient changes into a puzzling, mysterious and stage-like scenery. ... Husserl’s concept of intentional perception ... tells us how perception overcomes its own perspectivity [and] may also be understood as describing the intersubjective constitution of reality through common concepts which structure intentional perception: we see a table because we can name it a table as well. ... With the weakening of intentional perception in schizophrenia, objects and situations are not perceived as such any more, but as mere images or enigmatic sceneries. They lose their common-sense significance and turn into a ubiquitous puzzle. Strictly speaking, the significances may still be known in an abstract way, but they have stopped to mean anything to the patient. He is not able to relate them to a common intersubjective world any more.
Henriksen & Parnas also give something of an answer in their 2019 paper on delusional mood:
In delusional mood, the world appears strangely, yet indefinably different. Events or objects lose their natural sense of familiarity, purposefulness, and coherence, and the world itself becomes increasingly uncanny (“unheimlich,” literally meaning “non-homely”)—that is, the patient no longer feels at home or at ease in the world. ... In delusional mood, the context’s mutually implicative referential functions are somehow loosened or weakened, decontextualizing singular perceptual elements from their ordinary, contextual embeddedness and enabling new, unfamiliar meanings to emerge alongside the familiar ones (cf. Matussek 1987: 90). For example, the casual look of a stranger in the street or the tone of voice of a waitress could indicate that they “know” what is going on; the manufacturer’s print on the coffee mug could be a sign pointing to the nature of the impending, etc. Eventually, the patient may experience that objects, events, or others, as Fuchs puts it, no longer “present” themselves in the phenomenological sense of the term, but “only pretend to be just themselves” (Fuchs 2005: 136; author’s italics), leaving an impression of a strange, unreal, artificial, or staged world—a typical form of derealization in schizophrenia...
I'd like to supplement these with the answer given by Morag Coate in her 1964 autobiographical Beyond All Reason. Coate's philosophy of perception is enmeshed in misleading, non-phenomenological, merely empiricist/Cartesian/Kantian assumptions. Nevertheless her lived experience shines through, as do the possibilities of its phenomenological re-theorisation:
We take for granted the knowledge of the spaciousness and distinctness of our surroundings. But at first, all we knew of space was what our limbs could reach. Sense data from our moving limbs, received and co-ordinated in the brain, gave us a three-dimensional map of our immediate environment; to this was added information interpreted with growing skill from a pattern of sense impressions received on the small curved surface of each retina. ...
I have plenty of evidence that the room in which I write this is a real room. My view of it makes it possible for me to touch at will the various objects in it; my friends find it as real as I do myself. The fact remains that the room I see is an image projected in my own inner imagination. The image is based on externally received sense impressions, but an image it remains. ...
The space I see now extends only as far as the surface of the walls of my room, except where the windows give me a view of houses opposite and of sky beyond. This is the limit of the environment that I can derive from my senses; the rest is built up in imagination. I am aware beyond the wallpaper of the thickness of walls, and beyond them of other rooms whose known contents I can visualise. The houses opposite have rooms in them whose contents I do not know, though I can vaguely picture them. Beyond this street there is the wide extent of the city in which I live. Beyond the seen expanse of sky is the earth's atmosphere, and outer space, and a myriad unseen stars.
This imagined, though not imaginary, world is quickly altered or even disintegrated by illness. Suppose I suddenly become psychotic while writing this. I can now look across at the houses opposite and see that they are no more than a façade; beyond them is nothingness, and anyone who goes through their front doors will walk into oblivion. And if I go out of my room and walk downstairs I shall enter a different atmosphere which now envelops the earth's surface to a height of ten feet and has the effect of producing complete loss of memory. If at this point the tenant of the downstairs flat arrives to borrow a shilling for her gas meter, I shall be aware that an unseen spirit has entered into her and protected her from harm, and further that my shilling when put into her downstairs meter will affect the quality of the flame from her gas stove and so start regenerating the atmosphere down below.
I have invented this on the spur of the moment. I do not believe a word of it. That is because the imagined framework of my reality environment, based on past experience of life, is still intact. It is important to remember that we have no factual evidence for the vast proportion of what we know; once we have learnt to interpret the more usual phenomena of life we arrive at conclusions by leaping from one piece of evidence to another, and our mental faculty for doing this with reasonable accuracy enables us to lead a normal life. I have never in fact seen or touched the back walls of the houses opposite, and have never enquired from anyone else whether such walls exist. And if they did, I cannot prove that they have not suddenly disappeared. I simply take it for granted that they are there. I have built them into my mental organisation, and so long as this remains intact they can only be demolished by rational means.
In psychotic illness of the kind I have experienced, sense impressions are received clearly and with unusual vividness, but the mental organisation behind them and the critical faculty which sorts and examines and integrates internal ideas with external sense data is no longer functioning normally.

Friday, 8 February 2019

the springs of mercy

In a recent paper in Philosophy John Cottingham writes beautifully about the significance, for our ethical relations with others, of our animal responsivity to their suffering. We may be tempted by disengaged rationalistic schemas - of maximising our ethical utility by 'targeted altruism', and so on. But what such approaches ignore is that, whilst our ethical life cannot be reduced to our visceral compassion, it's also not extrinsic or merely externally related to it. What it is to be a good person is in part to be open to being moved by true pity in the face of another's suffering. Such emotionally alive pity isn't just some unfortunate, all-too-human, bias to be ironed out by some more rational goodness-maximising strategy; it's the very stuff of morality itself.

Having drawn our attention to the significance of such facts about human nature for the very meaning of a truly ethical response, Cottingham goes on, whilst discussing a passage of Simone Weil, to say that "it seems absurd to talk of grounding the requirement to be merciful in the way the world actually is... For it seems very doubtful that an appeal to our biologically and culturally evolved nature can generate the right kind of what today’s philosophers call normativity. In other words the question is whether human nature can imbue the value of loving kindness and mercy with the requisite moral authority to serve as an overriding principle of action." Since our nature is a congerie of good and selfish elements, "there seems nothing to entitle one particular set of instincts or desires to take normative precedence [... to have a "supreme normative force"... ] over the others". And, in discussing what's wrong with a Kantian approach, he writes "that there seems no contradiction, whether conceptually or in the will, in someone’s refusing to allow that the need or suffering of others is a reason to reach out to them in love and compassion."

The Good Samaritan - Hodler
In place of the naturalistic and Kantian schemes he rejects, Cottingham offers a Christian alternative: moral normativity derives from or is grounded in God's command to love our neighbour. He acknowledges that the truth of the Christian vision is not something which can be assessed by means of "‘spectator evidence’ – i.e. not with evidence of a kind that is accessible to any rational and impartial observer." Instead it's in "our deep responses of mercy, in our intuitive acknowledgement of the normative requirement to love our fellow humans – however much we may fall short, and however defiantly we may try to turn in the other direction – [that] we sense something beyond ourselves that commands our allegiance whether we like it or not (unless of course, we manage, to find a way of deflating these responses, as mere illusions). So our picture of the cosmos, or of ultimate reality, if it is to be a vision we can embrace with integrity, must be such as to support those intuitions."

I've a vast amount of sympathy for Cottingham's Christian vision of the centrality of love in its conception of the ethical life, and am also persuaded by his rejection of Kantian and utilitarian ethics. But I find myself dissatisfied by his question - the question which he answers by invoking the Christian God's commandment. The question is something like: "Why should we do the right thing?" "Why should we be guided by these rather than those instincts?" "Why should "the need or suffering of others" be "reason to reach out to them in love and compassion"?" And what I think is that the asking of such questions involves 'forgetting', in the way that only philosophers can 'forget', what it means to play an ethical language game and to live an ethical life. For the 'answer', I suggest, to the above questions, if we are even to allow them, is simply: "Because it's the right thing", "Because those are the morally good instincts", "The suffering of others just is what counts as reason here to reach out to them in love and compassion".

It's easy for me to imagine someone's exasperated reply to my 'answer': "But what I'm trying to inquire into is what makes this the right thing! You, sir, are simply refusing to play the philosophical game. Which is perhaps fine, but it's not ok to mistake your refusal to play for a move within the game!" But here I want to remind us of Wittgenstein's discussions of rule following and necessity. Many of the questions Wittgenstein looks at are ones he wants to reply to with a 'nothing' or a 'this is simply what we do' or a 'well, that's just what's called...'. For example, the philosopher wants to know what makes it the case that it's right to say '2+2=4' and not '2+2=5'. Wittgenstein rejects those Platonist and Conventionalist answers which say that 'the superstructure of the world' or 'how people tend to go on in practice' give the answer to the question. Instead he says simply "well, this just is how we do here go on; 4 just is what it is to add 2 to 2; 4 just is what we call 'the product of 2 and 2'. These are the rules..." It's precisely because the relations tracked here are internal that the 'what makes it the case that...?' question is out of line. Nothing 'makes it the case'. Just as when Bernard Williams, asked whether he was right to save the life of his wife or that of a stranger who had fallen off a boat, replied that to even attempt to justify the former would be to have 'one thought too many', so too do we have 'one thought too many' if we attempt justification where instead (depending on the context) either action or a reminder of what we mean by 'good' is required.

'These natural inclinations are the ones we call 'moral''. Which is to say: here there's no question as to whether we're right to call these and not those ones morally good. That just is what they're called.

At the end of all of this - and moving now away from Cottingham's paper - do we still have a place or need for talk of God in relation to our ethical life? Well, if you thought that the reason to believe in God was to make sense of our moral life, then you probably shouldn't believe. But, as I see it, such a form of theism which primarily invokes God to help us make sense of what we can apprehend non-theologically, this particular attempted invocation of 'reasons to believe', is itself another instance of the 'one thought too many' problem. "Why believe (what's the point of believing) in God?" ... There are plenty of good reasons internal to the Christian faith: 'Because he loves you, gave life to you, etc!'  But 'how does believing serve your own other projects of comprehension?' - well, that's just not going to cut the theological mustard.

Monday, 3 December 2018

"i'm dead"

An unintentionally humorous passage from Kurt Schneider's Clinical Psychopathology has it that 'complaints of cyclothymic depressives or schizophrenics that they are no longer alive should not be taken literally.' (p. 121).

The passage - less amusingly - continues: 'The very statement presupposes an experience of existence, dulled though this may be. Sometimes there is actual (nihilistic) delusion present. Distressing changes in bodily sensation or hallucinations may give rise to these utterances.'

Could someone literally believe that she had died? Does, say, the Cotard delusion sufferer literally believe that she has died? ... Surely anyone who answers either 'yes' or 'no' to such a question has quite a bit still to learn about severe psychopathology. (I'm not suggesting that Schneider would answer 'yes' or 'no'! He knew more than I about psychopathology...)

Does the schizophrenic intend her own words metaphorically? The new question is surely no better. When what we have to do with is delusion then we're dealing precisely with such thought as can no longer carry descriptions of it as either metaphorical or literal. (We must learn to hold our peace. To not do so is to insist that the mad be sane, and that is to fail to meet them where they're at.)

What for that matter would it mean to 'believe that one is alive'? At best, perhaps, that one knows how to use the word 'alive'?

To the extent that Schneider's passage means anything, I propose that he's wrong. He's wrong if he thinks that we may safely infer from this patient having a 'dulled experience of existence' to her meaning her 'I'm dead' complaint metaphorically.

'Perhaps the patient thinks he's died and is now in the afterlife?' Oh please! Enough already! Learn this: madness breaks the mind and, therefore, along with it, the language which expresses this mind's broken thought. But this provides no occasion for us to take empathic leave of the patient. It's in his broken language that we encounter him in his brokenness.

What in us is an apt registration of schizophrenic brokenness? A respectful silence? Heartbreak?

Friday, 23 November 2018

hinges, again

Today I've been rethinking what I recently wrote contra Bardina, Campbell, my earlier self, on delusions as hinge propositions. I think I need to own that I failed to do justice to the good intuition lying behind their nevertheless peculiar suggestion.

The suggestion was that we can shed light on delusions, in their defining peculiarity and intransigence, by construing them as alternative hinges. For like those hinges which constitute our sanity or 'reality contact', delusions truly are reasoned from and not about; they are the still points around which investigations are to turn. The thought here is that, despite the fact that delusions and hinges are chalk and cheese - hinges necessarily being paradigms of meaning and truth, delusions being paradigms of the opposite of these - they nevertheless share something of a functional role. It now seems to me that this comparison does real work: it explains or at least makes it clearer why a delusional person is so sure (lacking in doubt) in her delusion, why she can't be reasoned out of it. It offers a deeper characterisation of this intransigence than we had before.

To try to do justice to both the similarities and the differences, I begin by remarking on the fact that hinge propositions are never articulated outside of philosophy classes, whereas it is nearly always outside of philosophy classes that delusions are articulated. Hinge propositions are rather contrived verbal formulations of certainties which really have their life in our active habits - they are forced articulations of lived certainties.

In truth we don't so much pivot around hinge propositions - we instead pivot around the unreflective lived certainties of our worldly engagements (nb Wittgenstein's 'certain things are in deed not doubted' (OC 342)). One could equally say: we pivot around features of the world. For the point of the 'hinge' metaphor is that, at the point of the hinge, thought and world are not two different matters. Thought, here, is not a matter of representation of something other than it; it's not a matter of representation at all. Rather, thought here is what it is because of how the mind is directly conditioned, in-formed, by the world.

But next, note, the delusional person does, or at least can readily, articulate their delusions. They do not so much here have a lived sense-defining certainty - after all they have, in their delusion, lost contact with reality, whereas the person who is in touch with reality is so in virtue of being hinged to it in their praxis.

What I'm getting at is that the delusional person relates to their delusion thought somewhat as the sane person relates to their world.

How are we to make sense of that?

The literature contains two suggestions. The first is phenomenological, and finds (an albeit unhappy) expression in Spitzer's idea that the delusional certainty is helpfully modelled on the certainty of psychological first-person authority. The real point is: the delusional person has (necessarily, in this domain) lost reality testing. Where 'reality testing' means: enjoying thought of a form which instantiates an appearance/reality distinction - thought of which we (the observer) can meaningfully say 'it is imagination, or, it is world-directed'. (It's so hard to resist - even though we must - putting this in what I've been calling a 'cataphatic' mode - i.e. to resist offering an explanation of it, e.g. by wanting to understand delusion better by saying of what other psychological genus it's a species!)

The second is psychoanalytic, and is there in all the major psychoanalysts who've worked with psychotic patients. It is that delusions do work for the patient, binding fragmentation, providing stabilisation - and are in this sense motivated. This gets misarticulated in the cognitivist's view that true delusions are attempted 'explanations' of bizarre experiences - but we can see why one might be tempted to put things like that (that irresistible 'cataphatic' impulse again...) whilst also finding ways to do better justice to the underlying intuition.

The position we arrive at might be summarised like this: A delusion is akin to a hinge certainty in that it plays an analogous role in the 'economy' of an individual's thought. Both stabilise, both manifest an unchallengeable certainty.

But whereas the certainty of the hinge comes from our allowing the world to be sovereign in our thought, the certainty of the delusion comes from our attempting to usurp this role. The result is incoherence: the meaningful coherence of the mind depends on resisting the allure of psychotic omnipotence, and in trusting in - settling down into - the necessarily worldly foundations of any genuine thought.