Thursday, 25 August 2016

callanish

This morning I walked amongst the standing stones at Callanish. I was struck by the impression they made, and by the disjunct between that and what was on the information placard. Not that the information qua information was in-apt, but that what was striking and valuable to me about the stones was not something well articulated by the provision of such historical information and anthropological conjecture. (My observation was a variation on Wittgenstein's animadversions on Frazer.)

We call them 'standing stones'. It's worth noting this, I think. We don't say 'upright' or 'upended' stones. It doesn't capture the mystique. They are standing and in this, I believe, we see them under the aspect of the gravity-defying power of the animal. And because of their shape we spontaneously relate them in particular to one kind of animal: a human being. 'They stand there', one wants to say, 'like watchful sentinels'.

We may be drawn into speculating on the ritual uses of such stones, their alignments with celestial objects, etc. But much of what takes us even there is the impression they more directly make on us. They are like human sentinels, standing there - and yet they are of stone. They are of the mineral body of the earth itself, not subject to illness or pain or rash desire. They have this perpetual perdurance about them. About all this there is something comforting yet awesome, something which makes the vagaries and vicissitudes of our animal and social life more bearable, something quietening.

They are still and they point upwards to the sky above. Just through their shape - and let's leave aside speculation about the conscious intentions of their makers - and their circular arrangement they fulfil a 'sacred' role: to link the temporal and the eternal orders. They bring the balm and awe that comes when we see our lives sub specie aeternitatis. In this they are like vast columns in the nave of a cathedral, or the ancient sequoia of Yosemite. (But unlike the former are not man-made nor under a roof, so can link the resonant observer more directly with the cosmos; and unlike the latter are not subject to the vicissitudes of the living.)

You can't see it in my photo, but on the hilltop the stones are hemmed in by a sheep fence, and this automatically depletes their impact. Yet impact they still have, especially when seen against the hills and under the shifting skies, or when your body wanders amongst theirs, moving through whilst they stand there stock still.

Tuesday, 23 August 2016

platitudes, pleonasms and the present moment

I was chatting about mindfulness meditation at a wedding the other day. My interlocutor said she found the practice helpful to her, and from how she talked about it it was clear that this was true. It seemed it helped her stop catastrophising, become more realistic, become calmer, able to think 'what's the worst that can happen?', take stock, take a moment, show herself some encouragement and kindness, regain self-possession, and so on.

But what struck me was how the words she used to express how helpful it was often seemed to me, as is often the case in talk about mindfulness, fairly 'nonsensical'. At best they sometimes appeared to amount to little more than tautology, at worst to a metaphysics of the philosophically disreputable sort. And yet, such phrasing came naturally and seemed important to the 'sell'; what was going on?

The kinds of phrases I'm thinking of are: The past and future don't actually exist. All that exists is the present moment. Only the now is real. In the present moment nothing bad is actually happening. So attune with this present moment and you can be ok. (It doesn't matter what she actually said; here I'm interested in the kinds of things one generally finds oneself hearing or saying when talking about mindfulness meditation.)

First off: it's surely metaphysical blah to say that whilst the present exists the past either does or doesn't exist or that the future either does or doesn't exist. Of course if by 'exist' you mean 'exist now' then by definition only the present 'exists'. But how are we to get comfort from a mere definition?

And if not 'exist now' then what? We do - let's recall - have a language-game in which we talk of whether something did or did not happen, actually, as a matter of fact. We distinguish between 'imaginary' or 'fictitious' and 'real' in relation to past events. We don't use present tense verbs to talk of past tense events - that's just to mis-speak. But we do actually and properly say of a purported past event that it did or did not actually happen. So to the extent that it means anything to talk of existence or obtaining in relation to past events, then it can be referring either to events non-actual or actual. Similarly for the future: something either will or won't happen. By definition it isn't happening now, but it is nevertheless a fact that it will or won't happen later. There are, one could say, facts about the future. (You can say what you like as long as you make it clear what you're talking about ... and hopefully don't saddle us with a 'metaphysical theory' of 'future facts' or some such...) The facts just are those which will actually obtain.

Now the mindfulness practitioner as I'm caricaturing him or her here perhaps draws comfort from the fact that the feared phenomena are not happening now. The fear is merely about what might happen. But the phrases offered us here are either grammatical truisms or flagrant nonsense. What then is the relation between the genuine comfort and the pleonastic platitudes?

Well, perhaps it's this. That although the phrase 'all that exists exists now' is platitudinous or nonsense if we take it as aiming to communicate a fact, it is yet helpful if we see it as the right words to shake someone awake who has fallen into a dream. Being in a trance or in a dream they have lost 'reality testing'. By this I mean that they have stopped instantiating in their mind the distinction between now and then, or between here and there. The platitude does not provide information, but instead it prods us awake. It reminds us of the fact that there is a distinction between now and then that we can make and that we've stopped making. Catastrophic fantasy can be separated from tractable reality, and one can align oneself with the latter. (You're frightened of the monsters in the dark; but then your mum comes into the room with all her bustle and life and 'reality' and the fear dissolves. Later: you just turn the light on. Later still: you know full well what's just 'in your mind' and what's (not) in that cupboard in the corner of the room.)

I suggest that the platitude might also 'help' (pacify) in soporific self-deceiving ways. That is, we might say 'oh well the bad thing I fear will happen is not happening right now, and life is only ever a series of right-nows, so I don't need to worry because I can always live in the right-now.' Well, that's kinda dumb because the thing I fear might happen and then it would be correct to say, at that time, that it is happening right now, and this future possibility is what right now in the present time I'm worried about. I'm not, in this imagined scenario, worried about it happening right now: I'm worried about it happening in the future.

But leaving that aside the value of the phrase is, I suggest, that it helps the anxious mind reinstate a distinction between now and then which, in its anxiety, it had lost. Whilst it can sound rather metaphysical, or be presented as if it's some kind of positive realisation into the nature of existence or time or facts, really it is just a wake-up call for the anxiously somnolent to start functioning again. For when my anxiety is such that I fail to distinguish the possible and the actual, I get caught in runaway fears. Worry about the future is fine: it can help me face up to what will happen, or to take steps to prevent what might happen, etc. But some kinds of worry stop the mind from working and from doing precisely that. I panic because, losing sight of the distinction between the present and the future, or between what is likely to happen and what is the worst that can happen, I lose sight of, e.g., the possibility of taking this time to make sensible plans to avoid possible mishaps.

Here's where I'm arriving at: that something that sounds like the worst kind of metaphysics is actually a non-information-carrying device to help us put our feet back on the ground. It's tempting to imagine that the phrase works by speaking some kind of truth or expressing some kind of thought. It's tempting to imagine that it carries its effect through a cognisable propositional content. Through some truth one might come to realise or see. But that's not it. It's rather that it has an effect on the form - and not on the contents - of the mind. It recalls us to ourselves. In this respect what it offers is less like something to be understood or grasped, and more like ECT.

Now: that this can happen: that is an interesting thing! That is to say: we utter the words that make a conceptual distinction between here and there, now and then, present and past or future. And then the mind recalls itself to itself, becomes able to reinstantiate this distinction in its form, so that we can emerge from trance into this unhypnotic bliss. It risks too metaphysical an inquiry but I'm yet tempted to ask into the conditions of possibility ( - ask 'what the mind must be like for this to be possible? '- ) of the bliss-bestowing possibilities of mindfulness.

Thursday, 18 August 2016

i and thou

Martin Buber with his wife Paula
What's the deal with Buber's I & Thou?

The deal can be understood in terms of the defining difference between a) I-It and I-You relations - and also in terms of the relation between b) relationship itself and the individuals related. That much is common wisdom.

A quick note on b). Buber has it that relationship precedes the individuals in it. But surely that's sensu stricto nonsense. (The concept of a relation presupposes that of relata.) Just as much nonsense as the idea which he is challenging - that the individuals precede the relationship. What in any case I suspect he really meant to say was that, a la Heidegger, they are equiprimordial. I'll take it that this is what b) is all about: that I am the person I am in my relationship to you, and our recognition of one another partly constitutes us; I do not obtain independently of my relatedness. In the rest of this post I'll focus on a).

In an I-It relationship I approach the other as an object. OK, but what does that mean? It's not good enough to rely on a flabby pre-understanding of 'object' vs 'person', or of en soi vs pour soi, or of 'intersubjective' vs 'subject-object relations', to get us into Buber's categories. Surely we want instead to take something back from his thought to enhance our reflective understanding of, just, what is most helpfully meant by encountering someone as either an object or a subject. And in any case, Buber's Thous pertain not just to people or subjects of experience but in some sense, he tells us, to cats and trees as well. Or can I rely on something I read in Kant: that to relate to another as to a You is to see her also as an end in herself and not just as a means to an end of my own? This I think comes closer to it, but doesn't capture all that much of the meaning - and there'd be no point to the Buber if we could just rely on the Kant. Similarly we definitely don't find in Kant a conception of the human subject which is equiprimordial with that of the relationship - so the other (b) relational aspect of Buber's I-Thou is off the table there. (We definitely don't want to end up thinking that to understand an Other as such is to see her as importantly like Me!) Furthermore: sure, I grasp that you have your own ends, and I don't subordinate you to mine. But: what is the essential form taken by an encounter with a being with her own ends which encounter itself recognises just that about the other? That's what we want to know.

Here's a first distinction which looks psychological but which I think can also be grasped in an ontological register: that between being touched or moved by something and that of having a thought about something. I'd also now like to put another couple of contrasting pairs of terms on the table before moving on to the discussion. The second, owed to Piaget, is the distinction between assimilating in judgement something encountered to something already understood, and accommodating the shape of one's understanding to something new. The third, owed to Heidegger, is that between a conception of truth as adequatio or correspondence of judgement and object, and truth as alethia or truthful expressive revelation.

Here is one way to encounter, say, a tree. I go for a walk in the woods, and find a good one. I measure how tall it is, how broad it is. I estimate its age. I identify its species from its leaves and fruits. I perhaps think of what use it could be put to as timber, or as a tree house, or as a shady spot for a picnic. In these ways I encounter the tree as an It, and - let's be clear - there's nothing wrong with that.

But then I get chatting to a deep ecologist. (A 'deep ecologist' is not a profound biologist but someone who thinks of the natural world as possessing sui generic (non-instrumental) value.) And I learn from him that the tree is scheduled to be cut down because it is in the way of someone's building project. I feel sad because I won't be able to show it to my daughter, we won't be able to build a treehouse there, we won't be able to go on picnics under its boughs. He however feels sad that the tree is going to be cut down - punkt. This magnificent tree, this majestic tree, with its age and dignity, the life it has 'led' intersecting and making possible and itself being made possible by all the insects and algae and bacteria and birds and plants that live in and around its roots and branches, this dignified tree that has 'stood' here quietly, solidly, through the ages, this lively tree which pulses in its leaves and fruits with the cycles of the seasons... He lists such properties of the tree not because any of them make the tree valuable - as if the value lay more in the properties than in their bearer - but because, he tells me, he is trying to paint a picture which will help me, impoverished instrumentalist aspirant that I am, see the tree under the aspect of a being with intrinsic value.

Let's suppose he succeeds. Now I start to look at the tree differently. Regarding the tree I wake to wonder. I thereby become open to what we can call its Being. ... Wait - don't get put off by talk of wonder and 'Being'; instead let's understand together what's being talked about. ... Let's consider for
example the different state of mind of someone who is painting an expressive picture of the tree, or who is writing a poem about it. It is possible to do a semblance of either of these activities in an I-It mode: you are commissioned to write a poem about the tree, you putatively discharge your commission by finding some pithy observations and fragments of science and natural history and folklore that can be wrapped up in words that scan and rhyme. Or, you paint a picture which is a near-perfect 'photographic' resemblance of the tree. In neither of these activities do you give the tree a voice. You use your own voice to talk about it. But this isn't poetry or art. We (the reader, the viewer) are not yet addressed by the tree in the art. You (the wannabe artist) have just expressed yourself; you haven't yet expressed the world - or, better, allowed yourself to function as expressive mouthpiece for the (Being of the) tree.

This is the distinction I'm getting at: between me having a thought about the tree - making a judgement of some sort, assigning a species to a genus or a truth value to a proposition - the sense of which proposition is intelligible independently of an encounter with that which the judgement is about - and giving voice to the tree, allowing myself to be touched by it, allowing the weft of my mind to accommodate to the tree's presence, resonating to that presence, being informed by rather than about it. The tree poet is not expressing judgements about the tree, but rather voicing the encounter with it. He is not offering representational truths about it - his propositions are not independently intelligible and then made true or false depending on whether things are the way he suggests (adequatio). Instead he truly expresses the tree, becoming its mouthpiece, accommodating himself to its Being, receptive to its distinctive nature (alethia). (Buber called this 'inspiration'.) Here truth is like the 'truth' of a completely straight line: his words are true in the sense that a tight string is true. When we meet here with a failure of truth we don't meet with inaccurate representation but with a distorted voice, a defence mechanism, disingenuity, false consciousness, a kink in the line.

The person who avows a desire is not reporting their desire but expressing it. They may offer a pretend avowal though, or their avowal may partly distort the desire which finds its way to the verbal surface in garbled form. So too someone who 'avows' the being of tree - someone who invokes it through alethic poiesis - is not issuing a report of their findings, but instead letting the tree speak. The poet may fail in her poetic task, but this failure will not be a matter of false representation but rather of some kind of an intrusive narcissism which distorts the simplicity of avowal with something sentimental or hyperbolic which comes not from the tree's nature but from their own. As Buber has it, their voicing of the tree offers us a revelation of its presence or, as Heidegger might put it, an unconcealment of its Being.

I-It relations are far easier. We are less vulnerable in them. We can just stand back and speak about, rather than lean in in openness and be affected. We can impart or gather information about, rather than ourselves becoming in-formed by, the other.

If we are in an I-It relationship with another we are not vulnerable to intrusive projective identification and comparable enactments. That vulnerability is constitutive, I believe (but what do you think?), of the possibility of real I-You relating, but it's also an openness and vulnerability, a primal wound that lets in both the light (love) but also the darkness (gaslighting, projection, etc.).

Monday, 15 August 2016

on 'how psychotherapy works'

One effect of our sciencey psychological zeitgeist is to make various questions appear far more innocent and straightforwardly intelligible than really they are. 'How does psychotherapy work?' is one of them. It looks like someone asking how a process works... with an answer to be given in terms of causal mechanisms. Thus perhaps we could look at different therapists'  accounts of what makes for mutative therapy and then pursue empirical investigation (e.g. a 'component analysis') to assess the truth of these accounts.

For example, someone who claimed that what really did the work in CBT was changing pathogenic beliefs might be confounded by a study which showed the relevant changes in mood occurring after the behavioural activation phase, but before the cognitive restructuring phase, was introduced. ... In fact, once you start thinking and talking in the inhuman way I contrivedly did in the previous sentence, the idea of empirical research into 'how it actually works' starts to seem perfectly straightforward. What might not be straightforward is the answer, or the methods needed to reach it - but the question, that at least, supposedly, is perfectly clear.

Well, I don't think it at all clear. I think the appearance of clarity to be an illusion undergirded by latent conceptual confusion. In this post I spell out why I think this. My claim will be that for the question to find intelligible application we must surely be able to separately specify process and product. But when it comes to psychotherapy - in fact, when it comes to most everything of interest in psychology - we can't actually do this. Sure, we can create impoverished measures of success which don't make explicit reference to the therapeutic process, or banal measures of the process which don't make explicit reference to the product. However these, I claim, only give us the appearance of the kind of externally related relata which can cogently function as independent variables in a causal explanation. (Just because you give a rather thin description of something which doesn't overlap with another rather thin description of what is only allegedly a separate thing doesn't mean that you can then intelligibly relate the two through a causal explanation.)
Example. Marjorie's existence is misery-saturated. What does this misery consist in? When we and she get to know her better what we both come to understand is that she rather moralistically doesn't allow herself certain of her ordinary human feelings. Feelings of illness are morally judged as indulgent and as in any case unsafe to acknowledge since they may betoken serious unmanageable disease. Feelings of both her reasonable and her somewhat childish anger are tacitly judged as simply too shameful; no understanding is shown towards herself in them. Her hopelessness is a function of her sucking the imaginary poison out from fate's sting before the real, and inevitably more benign, deal comes anywhere near her. And so on, you get the picture. In all these ways she suppresses herself, offers herself no understanding or encouragement, and takes no courage in facing the challenges of life without having first denatured life in her imagination. Her misery is a function of this unwitting auto-restriction of her life-energy and her hope and her spontaneous emotionality. 
Marjorie's therapy looks like this. When she automatically acts in one of the above self-defeating ways in the therapy session, or when she reports having thoughts and feelings during the week which, on reflection in the therapy session, can be seen to be fit one of the above self-defeating ways, then the therapist gently and firmly calls her on it. Then Marjorie can see what she has been doing. But this isn't just a bit of intellectual self-knowledge that she gains. It is itself a liberatory experience: in being called out for her relentless fusion with her miserabilist superego, she experiences emancipation from it. She de-fuses from it. If she didn't de-fuse from it then she wouldn't be having a living understanding of what was being talked about. She would just be knowing that a sentence composed of certain words was true of her, without really understanding their significance for her. (Sometimes this pseudo-knowing is called 'intellectual insight'; my own view is that there is no such thing as merely intellectual insight.) 
Do these de-fusings take? Does Marjorie come to fully internalise her therapist's way of relating to her (Marjorie's) feelings - and thereby cultivate a more benign and unstressy superego? Well, let's suppose, to some degree: yes they do, yes she does.
Now, what would it mean to question, here, how the therapy works? What we'd need to do, to get our question off the ground - if, that is, we're pursuing it in a hypothesis-testing mode - is to parcel off our understanding of therapeutic action from our understanding of therapeutic boon. Thus we could think of the therapeutic action in terms of a 'therapeutic intervention' (the word 'intervention' is already nice and causal-sounding; that should rhetorically help the cause-effect game get into play), and we could also think of the therapeutic boon as a remission of 'depressive symptoms' (the word 'symptom' is already nice and distal-sounding, just ripe for taking the place of a product, an effect, of some otherwise-to-be-specified cause). We could measure these therapeutic 'interventions' (for example, we could count the number of interpretations that are offered!) and these depressive 'symptoms' (using the BDI, for example). And then we could see if these 'interventions' and these 'symptoms' are correlated. And if they were correlated then we could posit a causal relationship between them. ... ... ...

But why on earth would we want to do any of that - apart from to try and ape the procedures of natural science? For we already know full well that life isn't in any way like this. We know that it isn't the quantity of the interpretations given which makes them mutative. I can take in what you say to the degree that I can trust you, to the degree that I'm prepared to risk climbing out from under the thumb of my superego, to the degree that I can be touched and moved. This can sometimes take a long time to develop. It can take patience, perseverance, and courage. Sometimes the less you 'interpret', the more effective you are - it depends on what's live in the relationship between the two of you. But the point of what I'm saying is not to plead for complexity - not to say 'but there's all these other factors we will need to take into account in the causal model'. It is rather to question the very idea of the intelligibility of a causal model of therapeutic action. What I am saying is: the only meaningful description of the so-called 'intervention' is of a therapist saying something that actually touches the patient in such a way that they do start to see things differently, do step outside of their enmeshed relationship with their own inner critic, etc. And the only meaningful description of a life without depression is of a life without these vitality-stultifying defences ruling the interior roost. After all, life can be hard, painful feelings need to be felt, losses mourned, hopelessness endured. It's not the affects but the defensive relation to the affects which matters in stepping outside of depression and into authentic relationship with whatever is in the offing in one's inner and outer life.

I don't really expect to convince anyone with this post. My purpose in writing it has however been to start to articulate a very different vision of what it might mean to ask 'how does psychotherapy work?' The answer we can give which is actually intelligible is, I believe, one which includes within it an apt characterisation of the nature of the problems the patient faces, and includes within it a characterisation of the nature of the relationship with the therapist within which understanding is reached. Here understanding does not mediate change - for understanding is change. (If I truly come to understand myself anew, this is itself always-already transformational - and there's no need to hold onto a here-inappropriately third-person-type conception of understanding or knowledge as extrinsic to the being of that which is understood or known. 'Know thyself' is not an instruction to accumulate more true beliefs about yourself! It's already a matter of not being alienated from yourself, already about becoming more self-possessed.) The therapeutic relationship - i.e. the therapeutic aspect of the relationship between therapist and patient - is also not a vehicle for or mediator of change, but rather its locus. Being touched by the therapist, internalising (not, nb, learning facts from!) what she is saying, this is 'therapeutic action'. And in therapeutic action we don't have a cause followed by an effect. We have a transformational moment within a relationship.

Sure, it's important to go to therapy. But going to therapy does not by itself cause therapeutic improvement. You can go to therapy all you like and not get anything out of it. Once again it would be meaningless to correlate going to therapy with going better and say that the former must have caused the latter. We already know that going there isn't going to do anything except accidentally ('behavioural activation' or 'getting off your arse'). For you have to engage with the therapy. You can't have a change of heart unless your heart is in it to start with.

So, as I see it, the question 'how does psychotherapy work?' does not receive an empirical answer - it turns out to not have been an empirical question. At the end of our quest we might reach a better phenomenological explication of just what therapy is. That I'll take any day. But the component analysis or what have you - that we can hand back to the natural scientist.

Saturday, 13 August 2016

the case of m

Aaron T Beck
When recounting the history of his clinical disillusion with psychoanalysis Beck describes the reactions of two patients. One - the women who generously regaled him with stories about her sex life but whose transference was yet latently dominated by worries of being boring - I've written about before. But the story of the other patient - M - in 1956 - is perhaps less well known. (It gets told in Aaron T Beck. 1993. Cognitive Therapy of Depression: A Personal Reflection. Aberdeen: Scottish Cultural Press.) It seems to me that, despite it forming a lynchpin of Beck's turning away from psychoanalysis, it really cries out for  psychoanalytic treatment. To pre-empt my conclusion, I shall argue here that what Beck was really reacting to was a clumsy form of ego psychology; that cognitive therapy was a better bet in theory and practice than the (ego-psychological) form of psychoanalysis he was trained in; but that a version of psychoanalysis which pays proper attention to the complexity of unintegrated internal object relations is a better bet still. Further, that whilst the task of psychotherapy is integration, there are aspects of Beck's theorising of the mind which work against this. (I know it must seem like I'm trying to give this guy a hard time! But, really, it's not that - I suspect he was a much better and more creative psychotherapist than many of his analytic colleagues, and I value the pragmatism of his approach. It's just that I feel he also did psychotherapy a disservice when he threw the object-relational baby out with the ego-psychological bathwater.)

m

M was a depressed male patient in psychoanalysis who according to Beck followed the fundamental rule - 'of reporting everything that came to his mind. He had learned not to censor thoughts that he was concerned about and not to leave anything out.' M spends much of a session angrily criticising Beck. 'After a pause, I asked him, going according to the book, what he was feeling. He repeated he felt guilty.' Beck surmises that M 'was feeling angry, he expressed anger, and the anger itself evoked the affect of guilt. That is, hostility led directly without any intermediary variables to guilt – one emotion to another.' 'But then the patient surprised me with an observation... that the whole time while he was criticizing me, he was generally aware of another [un-expressed] stream of thoughts such as, “I said the wrong thing … I should not have said that … I’m wrong to criticize him. I’m bad… I have no excuse for being so mean.”'

Beck remarks several times on how surprised he was by the fact that his patient was, in effect, not actually following the fundamental rule. 'This incident constituted my first surprise and also presented me with an anomaly. If the patient was actually reporting everything that came to mind, how could he have experienced a conscious flow of associations and not report it? Further, how could two streams of thought [one conscious, the other preconscious - consisting of what Beck called 'automatic thoughts'] occur simultaneously?'

To conclude, Beck formulates that 'M’s self-critical thoughts were an intermediate variable between his angry expressions and his guilty feelings. The angry feelings did not directly activate guilty feelings but led to self-critical thoughts. ... This notion was contrary to my erstwhile understanding of the psychoanalytic dictum that anger leads directly to guilty feelings. Later, I was to discover that self-critical thoughts could lead to guilty feelings/sadness without there being any preceding anger.'

About this I offer three considerations:

the fundamental rule

There is one rather peculiar feature to Beck's description of the fundamental rule and free association. That is, he tells us that the patient was following it... but also that he wasn't following it. We now know the story: the thoughts the patient struggles to attend to are preconscious and are 'automatic'. According to Beck the difficulty in attention to them comes from the fact that they are fleeting, are on the fringe of consciousness, and that patients are not accustomed to verbalise them.

Well, yes, but... But psychoanalysis has always had a story to tell about why this is. Which is that the patient struggles to attend to such thoughts, or even to allow them to develop into fully fledged conscious thoughts, because they cause anxiety. The ignoring of them is not accidental but rather motivated - by the avoidance of anxiety, shame, guilt, awkwardness, etc.

I return below as to why M would be defended against such anxiogenic thoughts.

intervening variables

Beck tells us that in his opinion M's self-critical thoughts were an 'intermediate variable between his angry expressions and his guilty feelings' and that this was 'contrary to my erstwhile understanding of the psychoanalytic dictum that anger leads directly to guilty feelings'. 

First off, I think we can be confident that Beck didn't believe that anger led to guilty feelings for no reason. It is obvious why someone feels guilty on getting angry: they either realistically or neurotically take themselves to be unreasonable in this. I think we can also be confident that no psychoanalyst has ever thought that hostile feelings lead to guilt feelings for no meaningful reason, but just as a brute reflex.

Michael McEachrane
Second, isn't it just such takings that are given expression in the second stream of thoughts Beck describes? Here we need to remember to distinguish two senses of 'thought' - one is akin to 'belief', another to 'occurrent cogitation'. When someone says 'I think that...' they are probably reporting a belief - i.e. something with a primarily dispositional character; when they say 'I was just inwardly rehearsing what I'd say if...' they are talking of a more Jamesian stream of consciousness. (Michael McEachrane does a super job of showing how these two senses get conflated in CBT to the detriment of the theory.) Here it is surely M's belief that he has traduced Beck that is being expressed in M's semi-conscious inner chatter.

Yet whilst we do well to distinguish two senses of thought, we don't ordinarily do so well, I believe, to distinguish thoughts and feelings. If we take thoughts as merely bits of inner verbiage, and feelings as akin to sensations without any intrinsic intentional content, then we can push ourselves into thinking of them as needing bolstering from one another to make viable contributions to our inner life. But there's no need to take them in such reductive ways. M actually feels bad about his hostile treatment of Beck. There is a unity to this feeling. Defence mechanisms may sever the unity; they need no further help in doing this from a phenomenologically misguided cognitive theory.

internal object relations

What struck me the most on reading Beck's description of M was M's difficulty in managing ambivalence and how this difficulty relates to the structure and task of an analytic session. On the one hand M was angry with Beck (we don't know why); on the other he felt guilty about this. But up till this point in the session he didn't admit (to Beck certainly, but perhaps also to himself) that he felt the guilt. The fundamental rule, I surmise, gave him a novel kind of 'permission' to voice all his angry feelings - that, after all, is 'being a good analytic patient'. But actually he doesn't manage to be a 'good patient' - not because he has been angry, but because he has not also confessed to his guilty feelings. M's mind is not integrated. He can either have one or the other. If both come together - that's when he'd feel too anxious, and, I suggest a la analytic theory, defend against the anxiety by splitting into either his guilty or his angry self.

When M is out in the world, busy being depressed, we may imagine that often he is just aware of the guilt. When he is in the clinic, busy telling Beck with impunity just what he thinks of him, then he will just be aware of the anger. Neither are very helpful by themselves. What is required is integration. Let's assume for the sake of the discussion that Beck didn't really deserve M's anger. (It seems a reasonable assumption!) So now what we are arriving at is an understanding that M perhaps has some natural narcissistic difficulties (i.e. he struggles with not having his 'infantile' needs met in the way he feels entitled to), and that hitherto the only response to the anger that he feels has been an unsympathetic self-berating. 

M has, as yet, nowhere to turn. The situation is familiar to all of us on either side of the couch. He can either identify with his anger, and cut off from his guilt. This is all very well but hardly makes for being an integrated individual. (We all know the kind of spoiled unpersonable scold who is made for by the kind of pseudo-therapy which urges such an affective exchange.) Or he can identify with his guilt and cut off from his anger. Which is also all very well but is a surefire recipe for being a uncongenial depressive miserabilist. (The extreme Calvinist solution, perhaps.) These different positions are characteristically embodied in different internal object relations - either I cow-tow before a nasty superego or I become an all-id sociopath. The significance of the talk of complex object relations here is that we acknowledge the different uncomplementary positions which M is forced into and the relations between these in his psyche which make for associations either of the one stream or of another (which is different than saying simply that some of M's thoughts are best understood as conscious and some as subconscious, and that M just needs attentional training to report the latter), and the need for him to cultivate more benign relations (which means the same as 'integration') between these intrapsychic self-stances.

therapy

At this point what I believe M needs is ... therapy. By 'therapy' I mean, here ... an inwardly transformative encounter with a loving judge. I mean: an experience of engaging with someone who can smile kindly on his anger, know the distress it comes from, know how hard it is to not have what you want, not dismiss or disallow the anger, but yet not thereby condone or give it full rein, not exculpate yet not castigate. As M internalises this relationship he will himself become able to smile on his perfectly human impulses and reactions, engage in a more kind (which is not to say 'more permissive') inner dialogue, allow himself to suffer the pains of not having his needs met without devaluing them, face life with honesty and fortitude and forbearance, forgive himself whilst learning from his mistakes, and learn to shape such of his anger as is valuable into a fruitful assertiveness. That way we find ego where id was; that way M can cultivate a more benign superego, avoid the unenviable choice of being a brat or a misery guts, and grow as an integrated person.

Friday, 12 August 2016

allegiance effects

How did I miss this one before?

As you may know, an excellent predictor of whether an outcome study favours one over another flavour of psychotherapy is the therapeutic allegiance of the lead investigator. Thus if you fancy CBT, and want to prove it against psychodynamic therapy, then your comparative study is likely to find better results for CBT.

The effect is called 'researcher allegiance', and has been documented now in quite a few studies. These have been meta-analysed in turn. In 2013 Munder et al looked at all these various meta-analyses, and found that those meta-analyses conducted by researchers who believed in the researcher allegiance effect were more likely to find evidence of it.

Munder et al's meta-meta-analysis also found evidence of the allegiance effect in the primary data. I believe we're still waiting for someone with a different set of expectations to do another meta-meta-analysis and come up with a different result.

Empirical psychology, don't you know: it's all lies, damned lies, and statistics - as Twain, it seems wrongly, reported Disraeli as saying.

Tuesday, 9 August 2016

unconditional positive regard


A quick note on Rogers' third condition of learning in psychotherapy.

If there is any one aspect of person-centred psychotherapy which tends to come in for criticism it is 'unconditional positive regard'. 

I think the criticism may be summed up in the rhetorical question "But why should I be unconditionally positive in my regard for my patient?" 

...With the addendum "For that's hardly being authentic - it seems to contradict the second condition (the therapist's 'congruence' - his lack of contrivance, lack of pretence) if and when the patient is being a pain in the arse. Worse, it prevents the patient from recognising when she's being a pain in the arse, so precisely prevents her from 'learning in psychotherapy'."

...Even better: "It shows a lack of respect to the patient as a person to not be authentic ('congruent') - to not call her on her bullshit, for example, if that is what is at issue."

Well.

Yes.

If that's what Rogers meant by it.

But there's little evidence I can find that such was what he meant. And, well, it would be a bit weird if he really did mean that by it - given that, as I just wrote, it does rather contradict the second condition which he writes about just half a page earlier.

I think we'd do better, in grasping his meaning, to insert a couple of commas each side of 'positive'. ('Unconditional, positive, regard'.) Just to make it clear that he didn't write 'unconditionally positive regard'.

Here is what the man actually writes (283-4): 
A third condition is that the therapist experiences a warm caring for the client - a caring which is not possessive, which demonstrates no personal gratification. It is an atmosphere which simply demonstrates "I care"; not "I care for you if you behave thus and so." Standal ... has termed this attitude "unconditional positive regard," since it has no conditions of worth attached to it. I have often used the term "acceptance" to describe this aspect of the therapeutic climate. It involves as much feeling of acceptance for the client's expression of negative, "bad," painful, fearful, and abnormal feelings as for his expression of "good", positive, mature, confident and social feelings. It involves an acceptance of and a caring for the client as a separate person, with permission for him to have his own feelings and experiences, and to find his own meanings in them. To the degree that the therapist can provide this safety-creating climate of unconditional positive regard, significant learning is likely to take place.
Now what I'm not too comfortable with - perhaps taking it a bit too strictly - is this: who is the therapist to provide permission to the patient to have his own feelings and experiences? Surely it is the job of the therapist to help the patient see that she's gotten into an unfortunate state of mind of seeking permission to have her own thoughts and feelings, and then to encourage the patient withdraw that approval-seeking back into herself. Otherwise he just serves to maintain his patient's self-depleting transference.

But that's not the point here. Which is, instead, that what Rogers is talking about is hardly controversial. It hardly involves the therapist stifling his own warranted frustration or anger (although we might hope he'd think about it, understand what the patient is communicating, before expressing it). What it does involve is the therapist being generally caring, thoughtful, kind. It involves him not imposing meanings, not imposing himself, not imposing a theory, not imposing a criterion of mental health, not imposing a particular set of political values, on to his patient. It involves not being judgemental - which isn't the same thing as not making judgements! It involves treating the patient as an end in herself and not as a means to an end of the therapist - i.e. Kant's second formulation of his categorical imperative. Not using her. Coming to understand her in her particularity. Acknowledging her agential sovereignty.

Let's face it. If you can't treat your patient that way - if at least a good part of the time you can't attain your aspiration to treat her that way - then you should pack up shop.

Sure, Rogers could have done more to distance what he writes from a notion of offering approval of what his patient says and does. But can't we do that for him? One way to do it, by distinguishing between empirical and transcendental senses of 'acceptance' and 'condition'. (I think, by the way, this is a little different from urging that we distinguish between accepting a person and accepting her behaviour - although I suspect that those who make this latter distinction are really aiming at (if just missing) the distinction I'm drawing here.)

So, I may find your behaviour empirically unacceptable - for example when you treat me like an emotional dustbin, when you harangue me, when you endlessly test my patience, when you are selfish, when you gaslight, etc. But am I willing to work with you? Do I show you the respect of standing up to your bullshit? Whilst still offering the possibility of ongoing relationship? Now this presupposes, of course, that you are also genuinely committed to understanding yourself, to making changes, and to doing better by me. (There's no point my flogging a dead horse.) I'd not be showing myself 'unconditional positive regard' if I just kept sucking it up without any realistic commitment from you to work on it. But if you do make that commitment, if you do offer meaningful apologies, then I am - despite my finding you empirically unacceptable in your behaviour, still offering transcendental acceptance to you - when I don't just see you as, say, a 'problem to be managed'. 

Similarly for conditions as for acceptance: the therapeutic relationship is transcendentally conditioned - in so far as there are conditions on anyone who wants to enter into a relationship - conditions set by what counts as relationship. That's a different matter than someone saying they will only offer acceptance if certain empirical conditions are met - to say that is to not understand what it means to offer transcendental acceptance, i.e. to not understand what it would be to actually 'meet someone as a person', as we say.

There are I believe several things the matter with Rogers' program for psychotherapy. The fundamental one is the way he didn't get his head around the unconscious dynamics of the transference, and so was precluded from being able to grapple with aspects of the therapeutic relationship which, precisely, get in the way of its participants being able to offer one another 'unconditional, positive, regard'. But what is not the matter, so far as I can tell, is the very offering of such regard, nor the vision - which I suspect derives from the deeply humane and humble values he carried over from his pre-therapist Christian ministry - of human healing and growth obtaining not through the therapist being clever and instructional or 'delivering interventions' or what-have-you, but rather obtaining spontaneously to someone who is truly acknowledged by another as a person.

Friday, 5 August 2016

anger, depression and masochism - a postcript on Beck and ISTDP

Beck abandoned the psychoanalytic approach to depression because he found no evidence of self-hate in his depressed patients. To recap, he thought the psychoanalytic theory had it that depressed patients were depressed because they literally turned their anger back in on themselves. But his patients did not seem to evince such self-directed aggression. For this reason he abandoned the whole idea of depression being unconsciously motivated.

It's clear today that that was an enormous and unwarranted leap. First off Beck completely ignores the mainstay of psychoanalytic theorising about depression - depression as the result of avoided sadness over loss rather than mismanaged anger over slights. But leaving that aside, Beck's theory also entirely misses the two other most obvious dynamic explanations of unconsciously motivated self-depletion:

1. I provide myself with a lowered sense of self-worth relative to the worth I ascribe to you to preserve my good impression of you (rather than allow myself to be angry in a way which might challenge our relationship) and thereby maintain a relationship I depend on (and might, should I lose it, find too painful to mourn). 2. I rehearse a dismal auto-depleting vision of my situation and future and selfhood (Beck's triad) so that I can't be knocked by a fate worse than auto-depletion - namely, depletion by a world outside my control.

I don't mean to deny that we do sometimes also meet, in clinical practice, with something more masochistic (somewhat a la Beck's original-then-abandoned psychodynamic 'masochism theory' of depression) - namely ferocious attacks by the super-ego on the ego. But it would be an obvious stretch to have this cover most of the non-psychotic depression we see about us. So why did Beck miss 1. & 2. above?

Of course, I just don't know; I'd be interested to know what he himself would say today. But my best guess is that his psychoanalytic theorising and practice was simply far too constrained by the mid-century American ego-psychology he was trained in. Such a psychology takes rather literally various concepts like 'libido', 'ego' and 'aggression' as distinct psychological energies roaming around in search of an object. In such a framework we can easily imagine anger as a quantity of 'emotional energy' which, when denied its own natural object, must instead be turned somewhere else (e.g. against the self). Leave aside the arcane metapsychology, however, and what we instead arrive at are a range of more humanly tractable issues to do with how we manage our object relations. Thus I shame myself in my imagination to avoid being shamed by you when, as I fear it, you reject me. Anger might not come on the scene, or avoidance of it may not leave it stewing somewhere, seeking another object, but instead be achieved through a revaluation of one's worth and relationships which completely removes it (and part of oneself) from the table.

The notion that suppressed anger is at the root of much psychopathology is still remarkably common - e.g. in today's ISTDP. Speaking for myself, I no longer buy it as a general theory. Sure, if I recover my self-esteem then I may well feel anger towards those of my objects who I've let take me for granted or use or abuse me. And that might make it look as if the anger was there all along but just in a hidden suppressed ('unconscious') form. But isn't more than the (angry) form of the recovery needed to justify the ascription of unconscious anger in the as-yet-un-recovered patient?

At any rate, what I propose is needed by the patient is not so much a call to de-repress anger, but rather a call to overcome their fear. For what, it seems to me, the various forms of depression all involve is a failure of nerve. Thus I deplete myself to avoid suffering the knocks of fate. I devalue myself to pre-empt your abusive wrath. I avoid the pain of mourning and the call that mourning itself makes to us to now make a life of our own. In all such cases I keep my equilibrium under my own control, rather than face myself and my relationships in a clean and clear fashion. The real task of recovery, I propose, is heeding not a psychological call to emotion but a moral call to courage. Courage to face fate rather than pre-empt it. Courage to place oneself in the hands of the other. Courage to say not 'I will it' but, instead, 'bring it on', 'inshallah'.

Thursday, 4 August 2016

hallucination, cracked

In recent-ish posts I've been stumbling piecemeal towards an existential-phenomenological theory of hallucination. What I'm looking for is what I take to be the holy grail of psychopathology (alongside, you know, cracking das Wahnproblem; oh, and properly theorising thought disorder as dissociality). This is a theory which reveals the of-a-piece-ness of the form and the content of schizophrenic hallucination. Of course it's just a supposition of mine - a 'hope' if you like - that they are indeed of a piece. Most psychologists and psychiatrists think otherwise: they go all weakly bio-psycho-social on us before we've even got our existential investigations off the ground, parcelling off content to the psychological and form to the biological level of explanation. (En passant it seems to me that an existential-phenomenological investigation of the structuration of the mind operates at a different 'level' altogether than the three in the b-p-s scheme.)

Let me be clearer about what I'm (not) after. The kind of theory which posits a merely external relation between hallucinatory form and hallucinatory content might say: well, the content of hallucinations (excoriating voices, say) reflects the low self-esteem and the self-abasement, the personal preoccupations, the past traumas, the shadow or the harsh superego (take your pick), of the patient. Yes, but: why hallucinate? Why do such preoccupations take this form? Well, the standard b-p-s theory now flips to a different level of explanation to provide this, with a concept like 'anxiety' or 'stress' or 'dissociation' mediating between the levels. Basically: hallucinatory form is said to be a function of neurological overwhelm. The overwhelm may have happened because of those psychologically intelligible reactions documented above. But what it does to the brain is, as it were, accidental: it just happens that the associated stress put the brain into a state which couldn't support normal functioning. Hence hallucination. Accident. Punkt.

There is in fact a rather lazy further answer to our question which transcends the biopsychosocial mishmash - it's taken from psychoanalytic psychiatry. This is that the hallucinatory form is a function of the relations amongst intrapsychic agencies. You get hallucination because, say, the superego is directly addressing the ego. Or something like that. Now I don't disagree with this, I just think it's not yet ascended to the status of a real explanation. So far it's little more than redescription. This largely because, as yet, we don't have a clearer idea of what it is for the superego to address the ego than we do of what it is for the patient to hallucinate. Talk of 'superegos' possesses explanatory force when we're thinking about matters of the origin of the self-hating disposition, the form it takes, etc. (developmental 'internalising of the bad object' being the idea here). But it doesn't possess - so far as I can tell - explanatory force in relation to the hallucinatory form. We carry over, in our explanations, in only an impressionistic way from the externality of the superego and ego to the externality of the voice and the subject. So, well, I'm going to leave such talk behind here (also I find the metapsychology too arcane and self-satisfied).

Another answer will not appeal to pre-existing intrapsychic agencies, but will instead focus on dissociation into separate agencies. (Such approaches stem from Pierre Janet, the master of dissociation-based psychology.) Under conditions of stress the mind pulls apart. Such conditions might include the nastiness of certain thoughts. So: I think a terrible traumatic-abuse-induced thought ('I am worthless') but the associated affect overwhelms me and so I dissociate - now my thought is ego-alien - it's what we call 'a hallucination'. Again, this answer is not at all implausible, but it still leaves the content and the form externally related - even though now at least they both form part of a purely psychological explanation. The holy grail I'm seeking instead aims to help us 'think both form and content together', understanding them in terms of one another. ... Furthermore the dissociation-based explanation is still a little lazy in that it simply helps itself to the intuition that internal dissociation gives rise to hallucination. (You defensively split off from the thought, so now it appears ego-alien.) My concern is once more that this is non-explanatory redescription dressed up as explanatory redescription. For we still want to know, like: how does it actually happen?

Here's part of an answer - inspired by Dreyfus in turn inspired by Merleau-Ponty - that I find endlessly intriguing. It's that of the 'breadth unconscious'. The idea is that significant aspects of what we can call 'unconscious' (but bear in mind that this term is here as yet a placeholder) are not hidden unobserved in the back of the mind. Rather they form part of the structure of the 'clearing' (Heidegger) itself, or they permeate the 'atmosphere' (Merleau-Ponty). I am unconscious of my anger towards my father because I am so supersaturated by it that it is not graspable by me. It has defined and informed my measuring sticks and so cannot itself be measured. It is an automatically adopted window from which I look out at the world without realising it, a lens I don't - can't - notice I'm looking through. ... It forms part of the structure of the seeing eye, rather than itself being seen. ... I can't get my head around it because it is completely around my head. (The super-important point here is - whatever you do - not to assimilate the breadth to the depth unconscious - not to imagine that here we meet with a thought or feeling simply un-noticed or un-recognised...)

And here's another part of an answer - inspired by Freudian psychoanalysis (especially Anna Freud and W R D Fairbairn). It is that of introjective identification. When an object relation is not manageable I may instead identify with the bad object. (Think Stockholm syndrome.) If you can't beat them, join them... but join them in my bones: no calculated truce this. I don't feel your lack of love towards me if I join you in your values. That way I stay close to you. I become just like you - or, better perhaps, I become you. If I fear you will punch me I hug you: that way there's no distance between us for your fist to travel and gain momentum. The idea is that this is automatic: the identification becomes so entrenched that fear now doesn't even arise. Or you die and to avoid the pain of mourning I become you; this way I haven't lost you.

Let's now put those two parts together: I identify with you, and in doing that the feelings which I thereby avoid become part of the clearing/atmosphere/perceptual apparatus.

Here is the third part of my answer - inspired in some ways by Kleinian psychoanalysis but developed in my own vein. This is that there is yet a basic counter-identificatory, individuating, force in human life. This force is sometimes called 'symbolisation' or 'dreaming' or 'thinking' (I mean these terms in distinctive psychoanalytic senses - please don't read them with all their everyday connotations!). In (let's call it) 'thinking' what happens is I become able to separate from something with which I'm bound up. In so doing I have that comprehending affective experience which we call 'a thought'. I now enjoy a comprehending experiential relation to the object of the thought (I am no longer sunk into it in the identification: I can see it as itself). Because of the space that opens between me and the fist, once I stop embracing this opponent it can once again hurt me. But now I am at least free from my unwitting embrace of it; I can think what to do. I can express myself. I may take steps to get out of there, I may grieve, I may punch back or otherwise assert myself.

The fourth part: When I hallucinate what I am 'experiencing' is a 'negative' of an experience of something or someone. We don't have to do with 'seeing/hearing what we expect to see/hear' or with an 'inner image' of the thing hallucinated. (Let's leave such simplistic mentalistic and psychologistic notions aside... and instead plumb the existential-phenomenological depths...) Here I want to understand hallucination along the lines of a certain understanding of illusion. Like our lurch on the static escalator, like the ghostly watch around your wrist when you've finished the washing up (i.e. before you put it back on): the hallucination is an absence experienced as a presence.

Why is the absence experienced as a ghostly presence? Because the lived-body is still, in its identification with the object, partly readied for non-experience of it. The lived body still has the identified-with object/person sedimented in its background/clearing/atmosphere. It's only as yet on-the-way-to relinquishing it. I move from identification to relation and, then, whilst the move happens, I hallucinate. (The hallucination is the subjective experience of the disidentification.) I hallucinate the object the identification with which I am currently relinquishing: I experience what I'm here calling 'the negative of' this object as it 'leaves' me. (Now we can see more clearly how readily ideas of spirit possession spontaneously come about!)

It's like this (analogy:). You are utterly habituated to a certain sound. But then it stops. Now you hear a negative of it. (We might even try to do something with this by saying 'the silence seems really loud'.)

What is thinking? (I'm thinking of that kind of thinking which is mulling in foro interno.) It is, I imagine, rehearsal for conversation (which by definition is not currently happening) or it is, when we meet with creative thought, the disidentification from presupposition. (Presupposition is an enmeshment with (an identification with) an aspect of the world, a blindness to what may be.) If I fully take for granted, utterly automatically, that I'm a shithead, then I won't be able to hallucinate anyone telling me that. (Perhaps I totally internalised this message as a verbally abused child.) But imagine that I now achieve hallucination of that 'You're a shithead Richard'. Great! Individuation is underway. How do we get to full relinquishment? (I'm assuming that someone will only keep hallucinating if they don't fully relinquish the identification.) Well, understanding that the voice is something which was previously unconsciously believed by oneself would be a good place to start! (I hope it's clear how the existential-phenomenological perspective affords us rather more therapeutic subtly here than a more ontically grasped voice-dialogue approach.) It's not a matter of standing up to the voice - we don't need new enemies. It's a matter of furthering the standing up to the content of the voice which the very having of hallucination has already begun. (The voice is already not us.) For hearing voices already provides an entry point to not believing what they tell us. The super-saturated atmosphere - the breadth unconscious containing the toxic identifications - is starting to crystallise out a distinct content, freeing up the form of the clearing for more open world-relations.

Why are we more likely to see ghosts of the departed? Because, I suggest, it is when they are gone that we can begin to safely disidentify from them. Before then there's too much pressure to be them. Later on, though, we can achieve release.

Hallucination may be frightening. But when you think about it, it's pretty hard to see how living disidentification could obtain without it. Can we embrace it, then, as the form taken by that madness which itself is disidentificatory healing spontaneously at work?

Wednesday, 3 August 2016

lonely, part ii

What is loneliness?

If you search for 'loneliness' on Google Images you'll find that most every picture features a single person in a remote rural scene - and moreover that these people are always static, often seem to be staring, and usually have their back to the camera.

The dictionary doesn't help a great deal with answering the question. Sometimes the definitions offered relate to objective phenomena - such as when the farmhouse is isolated, or a state of being without company, etc. Sometimes they relate to the subjective phenomenon but don't tell us whether the feeling is caused by isolation or whether it is itself an apprehension of it.

Here are some rather obvious points to make about loneliness. First, that you can feel it when with others if you don't feel connected with them. You can feel it more when with others who don't understand you than when you are by yourself. Second, that when you are by yourself, even for long periods of time, you may or may not feel lonely. Solitude and loneliness are not coterminous. (Solitude can be enriching.)

A not so obvious one (that I'm just trying out). That loneliness is related to envy. That we are lonely when we feel that there is something or someone we want, and that it exists, but is not with us - but with someone else.

Or: that when we're lonely we might think that what we want is another person but that, really, what has happened is that we've located an idealised life-giving quality in the other for which we then pine. (This quality is really something which belongs, or could belong, to us ourselves.)

Another one: That the same psychological disposition which prompts loneliness also prompts irritability in close relationship. That is to say: that although the relevant feeling here, within the close relationship, is not at all loneliness, that feeling is yet a function of the fact that, here, the other is not living up to one's idealisation of them (and that we are annoyed with them for not providing something which in truth we ought to finding the courage to provide for ourselves). (The ideal never disappoints, but the person who is supposed to instantiate it can and does.)

In summary: that loneliness in isolation, and the correlative irritability in relationship, primarily involves a loss of part of the self. This, I think, ties in with the static quality of the figures in the Google image results. It's not just that these people are by themselves; it's that they are not going about any self-sustaining business (i.e. a loss of Dasein).

Naturally, our projects typically have a with-structure; our Dasein (being-in-the-world) is also a Mitsein (being-with-others). I don't mean to deny this for a moment. In fact if the self is socially constituted in this way it makes even clearer the link between loneliness and the loss of part of the self. But what I suggest here is that the best cure for much loneliness may not always be meet-ups but rather heeding a call to authenticity. (Meet-ups may after all be ways of distracting ourselves from our loneliness, rather than ways of genuinely addressing it.) The call invites us to reclaim the life-giving quality which has been projected into the other. It invites us to ask ourselves: how can I live today in a way with which I can be truly pleased? How can I do something worthwhile, something self- and project- actualising, something creative, something helpful, something satisfying? (The worst trap: putting off doing the thing which would truly give us our sense of meaning and purpose because we feel too out of sorts...)

Take the image that heads the post. Now imagine the man walking with a steady purpose, taking an interest in his surroundings, or engrossed in meaningful thought about something other than himself. Imagine that he is on-the-way-to-something. Sure, to be 'cut off', to be 'isolated', from (mutually engaging) others - these can be painful states to be in. But having the company of one's own engaged-with life-projects is not a bad place to start. 

Tuesday, 2 August 2016

bimagining, pimagining

There is, it seems to me, something right and something wrong with the suggestion that delusion and hallucination are helpfully seen as hybrid states between believing or perceiving on the one hand and imagining on the other.

It is helpful in so far as it steers us away from misidentification-based accounts - i.e. those which would have it that the hallucinator is imagining but mistaking their imagining for perceiving.

It does this by stressing that the conflation is in the states themselves and not in their apt identification.

What is wrong with it is something which I think the term 'state' also doesn't really help with. What is wrong is the way it overlooks two existential considerations. First, that the distinction between reality cognition (in perception or belief) and imagination is not just that between two separately individuatable states. For, I suggest, the phenomenon (and not just the concept) of imagination is defined as such in opposition to reality cognition. Only a being who can enjoy one can enjoy the other. When the distinction is instantiated in a human subject then that subject becomes both a perceiver and an imaginer. Before it is instantiated - well, say what you like but it's all a bit of a mush. Second, it also ignores the way in which the perceptual act not only defines an intentional object for itself but also defines a perceiving subject. Perception enacts selfhood - the self being constantly born, constituted, afresh as the subject pole in the subject-object perceptual opposition.

So, yes, talk of two 'states' which a subject contingently happens to be in does rather ignore the existential oppositional relations both between these two 'states' and between self and world in either perception or belief.  

Another way of putting it: the suggestion is helpfully phenomenological, but unhelpfully un-existential. What we need here is a genuine existential phenomenology. Only in that way will we stand a chance of grasping the relation between severe ego-disturbance on the one hand and the psychopathological experience of the discombobulated ego on the other.


Monday, 1 August 2016

what is consciousness?

I was speaking with a neurosurgeon the other evening and he expressed the view that we don't know what consciousness is.

I accept that my interlocutor was genuinely puzzled about consciousness. However I disagree with him both that he is puzzled about the nature of something and that what could relieve him of his puzzlement is a substantive theory which explains what that something is. That is, I don't believe his puzzlement is - despite the reflective self-understanding he with all integrity carries with him - akin to 'we don't know what meteorites are made of' (as uttered by, say, an 18th century scientist). I believe that, to the extent that his puzzlement really is best articulated in terms of a want of knowledge, what in truth he is wanting is knowledge of how to handle 'what is Y?' questions when the concept of Y is constructed by the substantialisation of an adjective (i.e. when you put 'ness' on the end of a word like 'sad', 'egregious' or 'conscious').

I believe then that we ought to be able to completely relieve him of his puzzlement by offering the following three considerations.

1. First off I'd remind him that, of all people, he knows perfectly well how to use the Glasgow coma scale. He knows perfectly well what it is for someone to be conscious - they can respond to stimuli, are oriented in time and space, can answer questions and so on. In fact he knows about this better than a layperson such as myself because, as a neurosurgeon, he is aware that being conscious or being unconscious is not an all or nothing, binary, matter. There are different degrees of responsivity or reactivity, and he knows what these are.

2. Next I'd invite him to think about all the various nouns which are constructed by putting a 'ness' on the end of an adjective. Happiness, sadness, wistfulness, consciousness, tiredness, egregiousness, greediness, hopelessness, etc. Of these would we not say that the meaning of the noun form is best explicated in terms of a phrase like 'the quality of being X' where 'X' is the relevant adjective? Imagine someone saying 'but we just don't yet know what happiness is!' Wouldn't we want to say 'Well old chap, surely you do know what it is to be happy? It's to be light-hearted, optimistic, have a spring in your step, be of good cheer, lively, etc. etc.' You don't need a scientific or philosophical theory to tell you what happiness is; you just need to have got some kind of elementary handle on the English language. So, here we'd not get troubled about not knowing about the nature of Xness; instead we'd refer ourselves back to the good old tractable adjectival X - by reminding ourselves what the ascription conditions are for being X.

3. Finally I'd want to check in with him that he hadn't accidentally imagined that if we have to do with a meaningful noun then we must here meet with reference and with a referent - with a thing (a substance, entity or process, say) designated by that noun. It's a seductive idea - after all, plenty of nouns do work by referring to entities or processes. Meaning sometimes is referentially secured. But there's surely no reason to generalise such cases. If we did generalise rashly then, in cases for which there really is no obvious physical entity acting as a referent, we're inclined to think there must be a non-obvious one - a mysterious phenomenon of some sort - perhaps a ghostly phenomenon or something like an electrical field or something spookily quantum or... (you get the picture...). Again
...what happens to your brain when you get
 seduced by referentialist conceptions of meaning
with happiness: surely no-one really thinks that there is some entity or process picked out by the term 'happiness'. They know instead that happiness is the quality of being happy and to be happy is to be lively, light-hearted, have a spring in your step etc etc. You don't for a moment start to think that you need to know what, say, happiness is made of, unless you somehow get to thinking of it as e.g. a mysterious substance. But you wouldn't think that unless you'd already started to think that nouns inevitably work by referring to substances etc. If you were a dualist and believed in immaterial substances then you might be happy to think of happiness as a special mental substance. Eschew dualism, but fail to relieve yourself of the assumption the inner-world-of-consciousness-pundit shares with the dualist ( - that nouns always work by designating, e.g. by designating substances - ), and now you might be tempted by the view that 'happiness' must stand for some kind of mysterious physical (neurological, perhaps) substance, state, entity, process. But really, er, why cleave to that assumption?

Now I'm not denying for one moment that people who are happy have a range of distinctive endocrine/neurological/physiological profiles. But surely - to return from happiness to consciousness - my interlocutor wasn't saying to me that we don't know what consciousness is in the sense that we don't know what the neural mechanisms are which sustain my capacity to respond to verbal questions, react to visual stimuli, etc. After all, we do know quite a bit about such things! There's surely no more of a mystery about how my being all happy relates to the bodily movements and hormonal secretions and neural activations. (The thing to do is: make sure you don't accidentally think of happiness/consciousness/whateverness as some kind of evanescent end-product of all those bodily goings on! That way you're guaranteed to remain locked in your puzzlement forever! Instead, make sure you think of them as its physiological substrate.)

The appearance of mystery - this mysterious phenomenon called 'consciousness' - is, I'm suggesting, generated mainly by a muddle about how abstract nouns work. It's generated primarily by an over-application of a referentialist conception of meaning. We think, since we can't find a non-mysterious ('physical') entity or process for it to refer to, that the term 'consciousness' must refer to some mysterious phenomenon for which we haven't yet got a good theory. But why think the term gains its meaning by referring to any phenomenon at all? And why think it works by referring punkt? ... As Wittgenstein put it, what we meet with here, at the end of our mystery-busting conceptual therapy, is: 'a whole cloud of philosophy condensed into a drop of grammar'.