Friday, 23 July 2021

does anxiety have a meaning?

Does anxiety have a meaning? I now recognise that, when I started out training as a psychologist, a tacit message I then imbibed was that it doesn't. Here's how I learned to think of it: Anxiety is just an aversive experience, an unwanted condition. It has a certain physiological, autonomic, cognitive and sensory character. Its reduction should be the central aim of such treatment as is provided to those who present because of it. In short it's simply something to be got rid of, managed, treated - with mindfulness, exercise, medication, whathaveyou. 

This, sometimes, is surely the right way of thinking about it - think of such anxiety as stems from, say, alcohol misuse, thyroid problems, and some trauma-generated anxiety. CBT, I think, often takes this view: the aim of treatment is to reduce anxiety by altering core beliefs, defusing from fraught thoughts, reinterpreting bodily sensations, etc. The patient may come into therapy thinking their anxiety has a meaning (e.g. "I’m going mad / dying"). The aim of therapy, however, is pretty much to convince the patient that it has no significance, carries no message, at all. It's just a set of bodily sensations and neurobiological activations that are receiving an optional and misinformed interpretation. A psychodynamic therapy may be similar: anxiety is caused by inner conflict - so to achieve the therapeutic goal of reducing the anxiety, address the conflict. Your superego's giving you gyp - so learn to challenge it and develop a gentler self-relation.

I now think that this way of thinking about anxiety can have considerable costs. What it ignores is the way in which anxiety may be taken to disclose valuable truths about your life and mind, which truths have a significance far beyond their anxiogenic character. A patient recently relayed to me a Joseph Campbell quote:

It is by going down into the abyss that we recover the treasures of life. Where you stumble, there lies your treasure. The very cave you are afraid to enter turns out to be the source of what you are looking for.

On such a view, anxiety is giving us a useful clue as regards our individuation. It's showing us where growth is required. Where is it that I have an inner conflict, which conflict I will do well to transcend not simply because it's anxiogenic, but rather because it is ennobling and mature, dignified and individuating, to do so? Being a divided self is intrinsically undignified; it reduces our capacity for truth telling. It reduces our self-possession, and leaves us liable to being buffeted by fate. To manage the anxiety which stems from inner division we deploy defences that damage or suppress ourselves and others. Anxiety provides valuable information about where the treasures of life, the source of what you're looking for, is. Listen to it, turn toward it whilst understanding what it tells of your as-yet un-met challenges, meet such challenges as become you, thereby living a life more attuned to your noble values. 


Such conflict anxiety is just one form anxiety takes. Another form is existential: my anxiety here constitutes the shaking apart of my insecure self when I'm facing life challenges such as isolation, illness, social socially holding my own, etc. Here too it can provide a valuable signal - that we're not yet fit to face all the facts of life. That we have some resilience to build, some exposure to undergo, a zone of proximal development to expand, facts to face, courage to build, shame to overcome, self-possession to develop, and integrity to muster. 


In what sense, then, does anxiety have a meaning? I think it's clear that the meaning isn't 'intrinsic'. That is to say, the meaning it enjoys is really a function of our living a life in an existential mode. It derives from our living it under the aspect of - to borrow another phrase from Campbell - the hero's journey. It implies we're actually interested in realising ourselves, individuating, become who we can be, growth, strengthening ourselves to better protect others, facing our fears, facing our failings, taking moral courage and making amends where we need to, desisting from letting ourselves and others down in a way which currently produces a diffuse guilty anxiety, and so on. Against such a set of values, anxiety has a valuable meaning for us. It shows us where to look.


The real tragedy of the view of anxiety with which I  started out, then, is not I think a function of anything it has to say about anxiety per se. It's rather the utter absence of an existential perspective that trots along with it, the absence of goals beyond the blandly affective ones of 'feeling better'. And yet it's almost a truism of psychology that 'feeling better' is rarely helpfully set as a goal in life, that hedonism is a dud, and that happiness comes from the pursuit of meaning in life rather than vice versa.


Monday, 12 July 2021

Loneliness, Love and Dignity

for a conference on Loneliness in Philosophy and Psychology

Bentley University, July 12-15, 2021

  1. Loneliness as felt want of sociality: We often hear that loneliness stands to company as, say, hunger stands to eating. That we’ve a basic human need for sociality, and that loneliness is our experience of the thwarting of this need’s fulfilment. This makes prima facie good sense. It’s best been elaborated by Roberts and Krueger who offer us a ‘frustrated pro-attitude account’ of loneliness as an ‘emotion of absence - an affective state in which certain [desired] social goods are regarded as out of [one’s] reach’. In this way it’s like ‘grief, yearning, homesickness, unrequited love, nostalgia’. The desired social goods include ‘companionship, moral support, physical contact and affection, sympathy, trust, romance, friendship, and the opportunity to act and interact - and so to flourish - as a social agent.’ 
  2. Critique: It’s true that the lonely person experiences others as out of reach. They feel exiled from sociality. That good which is others' company is now ‘over there between those others’, not ‘here where I am’. Love exists in the lonely person’s world, but it’s just not here where she is, and its absence is painful. Now, where shall we look for the truth-makers for Roberts & Krueger’s account? I suggest they consist at least in part in the phrases which the lonely are inclined to utter. ‘I feel so alone’; ‘I’m all by myself’, ’I feel exiled from humanity’. But now the question arises: what’s the nature of the condition which inspires such avowals? Should we compare them to ‘I feel so hungry’, or instead to what for example the BPD sufferer says: ‘I feel so empty’. ‘Emptiness’ is, for the borderline subject, le mot juste, but it’s not perspicuous to posit a normal sense of fullness which they’re lacking, or to posit an actual void in their body or mind. In other words, what makes something le mot juste needn’t be a matter of it corresponding to a fact which is here being described. Maybe the term ‘empty’ - and perhaps, I suggest, also ‘alone’ - is instead here used with what Wittgenstein called a ‘secondary sense’: a metaphorical use we grasp just through rolling with it once we’ve learned the more clearly normative primary sense of the term. It’s not obvious to me, then, that we can move from an appreciation of the lonely person’s avowals of their loneliness to a descriptive rather than expressive articulation of the state they’re in. Relevant to our critical concern here too may be the fact that two people may be equally aware of the absence of valued others from their life, but only one of them feel lonely. I think we needn’t say that the one who doesn’t feel lonely is out of touch with his true feelings, or that the lonely really do place a greater value on others'  company. Consider furthermore that the lonely person may be no more disposed to seek company than the non-lonely (contrast the hungry person’s actions) - so the typical behavioural criteria of pro-attitudes may here not be in play. Finally consider how loneliness is in a certain way more mood than emotion - we don’t follow it with a ‘that’ or a ‘for’ specifying an intentional object (contrast grief, nostalgia etc). Does it really then have as its intentional object the absence of a desired object? [Though in a different sense of 'intentional object' it's perhaps 'directed at' the absent relation between self and other.] Or is the link to others instead through, say, a causal relation to the object’s absence, or to avowals of ‘by-oneself-ness’ which deploy terms with a secondary sense? I don’t claim that loneliness might not be just the state of mind that will kick in when a widower, say, says goodbye to his children and their families when they leave at the end of a visit. Yet if a friend visits who’s also a widower, we can imagine him feeling rather less lonely on this friend’s departure; the sense that ‘life is elsewhere’ is now mitigated. (A further criticism I could make of aspects of Roberts' and Krueger's account is what we might call its articulation of a form of selfhood enacted by a liberal individualist - one who is after the 'goods' of friendship - the 'goods for me'. I engage in friendship because I 'get something out of' it on their view: what's desired is the affective products in me of the friendship, but not participation in friendship simpliciter. As I read it, such a worldview is itself run through with unacknowledged loneliness. This, however, is a question for another day.) 
  3. Solitude by Usmonov
    Love is not here where I am: The principal feature of loneliness I want to draw attention to here is how the lonely person envisages love to be at play in the world… but not here where she is. The consciously lonely feel - I believe - exiled from the place of life and love. And they feel that, by themselves, they are lacking. And the question arises as to why they feel thus. The frustrated pro-attitude account suggests that this sense of lack is simply a function of our social nature. What I want to suggest instead is that the phenomenology of loneliness is often characterised by a sense that the value, the good, the love, now lies not here in my own soul, but unattainably over there with the others. (To recall Kundera and a slogan from the 1968 Parisian student revolt: ‘life is elsewhere’.) In other words, I suggest it’s not simply our inexorable need for sociality that’s thwarted here. Loneliness is rather the product of a particular configuration of the soul. (NB by ‘soul’ I don’t mean anything metaphysical; I have in mind the use of ‘soul’ in such phrases as ‘soul-destroying work’ or ‘soulful glance’.)
  4. Loneliness as achievement: I’ll say some more about that in a moment. But to make now the first of three clinical points, I’d like to note that, for the mentally ill person, the capacity to feel loneliness is itself something of a psychological achievement. Thus when Frieda Fromm-Reichmann (and I think Harry Stack Sullivan) talked of their more mentally ill patients at Chestnut Lodge as ‘the lonely ones’, I don’t think this was because they - the patients - went around consciously feeling lonely. I think it was rather because they’d so sunk into their loneliness that they had as it were become loneliness itself. I will now try to say what I mean by this. So when you walk past that icon of loneliness, the muttering schizophrenic man on the street, the one with the staring eyes, in his own world, whose addresses and answers are offered to no mortal soul, I hope you’ll agree that we don’t do well to think him consciously suffering his loneliness. For the atmosphere of his loneliness to condense or crystallise out into a discrete affect would take quite some work, work that might indeed utterly overwhelm him. Loneliness after all requires that the space of potential sociality hasn’t been voided. I'm thinking here of an old patient of mine, an admirable young man, whose mental health difficulties prevented him from achieving anything like in life what he was intellectually capable of, such were his preoccupations and compulsions, and how one day he came in wearing nice new clothes, but putting them on and obsessing over them had made him ten minutes late. At first he thought about how he was worried about wearing them out. But gradually he came to understand that he was sad that he had at that time no-one (a lover, a family member, a friend) to appreciate them. He was lost in a loneliness beyond loneliness, a loneliness that couldn’t be felt so which turned instead into obsessional symptoms. 30 minutes into the session, he said "I can feel it now". This needed to happen in my presence - after he’d re-entered the zone of possible human connection - which is the same as the zone of inner ‘connection’ with one’s feelings.
  5. Loneliness and shame: So the question is: what is it for the lonely person to feel exiled from or bereft of love, if this doesn’t only have to do with the simple absence of desired company? The feature of loneliness to which I’d like to draw attention concerns the lonely person’s aliveness to the shame of rejection. So: consider now two people walking toward each other on a country lane. One is smiling in an open way, inviting eye contact. The other is looking down, basically anticipating rejection. We intuitively grasp that the latter, the one who seems enshrouded in shame and a sense of unworthiness, is the lonelier. … Or: think of saying goodbye to a close friend who you don’t often get to see. One person does this and, for sure, feels the pang of missing his friend, the gratitude of having been able to see her; yet he’s right now in touch with wanting the best for her, missing her in her particularity, and so on. He is, we might imagine, despite the keenness of his missing her, not at all lonely. Another also says goodbye to her close friend but instead of focusing clearly on him now lapses instead into a far more diffuse and objectless state, a mood of loneliness, a state of anonymous mourning in which the diverse joys of life are now unavailable. For this latter, lonely, person the very possibility of joy seems to have left with the friend. Clinically speaking we might wonder if she has in some ways been lost to a projective identification with the friend, so that she loses the life in herself when he leaves. Her self-possession is depleted, and love does not travel with her where she goes. Hope too is here taken out of play: the horizon of the future is not willingly populated with potential meaning. Or think now on the difference between two old women, one of whom has lost her loving husband, whilst the other has a husband who shuns her. It’s quite imaginable that the latter will be the more lonely. She feels unwanted by someone who’s there, and not just contingently not wanted because nobody’s there. When “nobody loves me!” is offered as a plaint, it often carries with it a feeling of rejection, unwantedness. The first well-loved widow, however, does not feel exiled from love by her husband’s death. The love still dwells within her; she doesn’t think of herself as unlovable. The fact that she’s not currently loved is but a contingency. Nothing stops her from dwelling in love; she doesn’t imagine that the source of a sense of worth resides in others; she doesn’t see herself as awaiting their bestowing of worth upon her. The lonely person, by contrast, is someone who fears and feels unlovedness, who doesn’t truly know herself as lovable. She needs the love of others to assure herself of her lovability. Contrast someone whose sense of his lovability - his authentic self-confidence and self-worth - is not damaged by experiences of social shunning. When others close their heart to him, he can see it as a function of the other’s defences, rather than chalk it up to his own deficits. Last week, for example, a young man came over to me in the gym and asked if I will spot for him on the barbell bench press for just 3 lifts. He was genial, open, looked me right in the eye, wasn’t after anything beyond what he requested, was quietly confident, polite; he also introduced himself. If I’d refused it wouldn’t have knocked him one bit; the ill grace would all have been on me. This, I think, was not a lonely man.
  6. Loneliness, the locus of evaluation, and dwelling in love: To borrow a term now from Carl Rogers, the lonely one has an ‘external locus of evaluation’. His sense of value comes from his belief that someone else wants to spend time with him. Here w’e’re at the second of three important therapeutic junctures - of helping someone make a shift from this fragile sense of worth to instead being able to dwell in love, to know it within, to live out of love, to bring it to bear on her interactions, to remain alive to love because of indwelling it and engaging lovingly with anyone or anything that comes along. And a practice to here be recommended, by way of cultivating aliveness to love, is… gratitude. Thanksgiving. Frequent recognition of what is good in life, and thankfulness for the gift of it. She who is able to say of life: ‘This is good’; she who prays prayers of thanks for a life that she didn’t herself muster and couldn’t by herself sustain; who calls to mind and secures there the fact of the earth about her being a blessing, a grace-filled phenomenon; who gives ready thanks for all her friends and health and who sees these as manifestations of grace …. this person is no Pollyanna. What she is instead is already someone who knows love in her heart. Recall here how on each of the 3rd, 4th, 5th and 6th days of creation God looks at what he has made - the land and plants, the heavens, the animals and man - and sees that they are good. This proclamation bespeaks the cultivation or promulgation of a certain attitude. And it is, I’m claiming, an attitude which repels loneliness. It’s the attitude expressed by the look of love. She who’s not lonely knows she is of love, and is able to dwell in love and have love dwell in her. My point here is not of course that loneliness can be understood as a deficit of gratitude. It’s rather that he who’s grateful for life, and who in this way cultivates appreciation for life, who dwells in this as an attitude, who is open to what is of value around him … he comes to enjoy love alive within his heart. And this love alive within him is what’s antithetical to loneliness.
  7. Dignity: The third clinical moment I want to discuss in relation to loneliness is dignity. What I have in mind here is an attitude, a way of living, which involves knowing clearly what it is you believe to be the right way to live your life - both morally, and in an ethically broader sense, so as to flourish - and living in that way so that you can truly hold your head up high. I spoke just now of he who knows about the goodness of life, who sees life under the aspect of grace i.e. as an unearned gift. What I’m now adding to this is seeing oneself as a dignified part of this life. The person who lives with dignity may be in dire straits, but he lives in such a way that he knows that he at least has done what he can, and with this he can be healthily proud. He manages his affairs, keeps a clean home, does’t let others disrespect him. With this dignity he enjoys a non-corrupt form of self-love. He who lives with this kind of dignity is, especially when that’s paired with the aliveness to love mentioned above, somewhat invulnerable to loneliness. What makes it that way is the self-possession that dignity and an inner aliveness to love afford a life. For the dignified person, for she who’s lovingly alive with gratitude - who sees the world under the aspect of grace - the good, the love, is not ‘over there, between the others’. It is instead here where she is. She’s not going to feel sorry for herself. A beautiful New Testament word may be useful here: Parrhesia - which the Catechism of the Catholic Church defines as “straightforward simplicity, filial trust, joyous assurance, humble boldness, the certainty of being loved.” (In secular terms we may substitute the certainty of being lovable.) The person who embodies Parrhesia doesn’t lose faith in love. Her life is instead relentlessly ‘interpreted by love’ - to borrow the words of the hymn/poem. She looks from love’s vantage; she looks with the look of love. And this vantage, I’m claiming, doesn’t know loneliness.
  8. Conclusions. Recall now where this talk started - with a questioning of the sufficiency of an understanding of loneliness as a painful emotion marking the absence of a basic human need - companionable others. Against this I offered the observations that loneliness is in many ways more a mood or state of mind than an emotion; and that it in one sense has no clear intentional object: one is not ‘lonely that or of’. Further, the fact that “I’m all by myself” is its natural expressive plaint needn’t, I think, be taken as the last word on loneliness’ meaning. My claim is that whilst friendship is an obvious good in life, and whilst of course we can deeply miss our friends or keenly feel their lack, such a view of loneliness is nevertheless partial. It presupposes, I suggest, a quite particular anthropology, one that looks at human life through the prism of quotidian needs. Against that I suggest that if we ourselves interpret human life by love, then we can gain a deeper reflective access to the being of loneliness, and make clearer sense of such of its ameliorations as don’t prescribe sociality; and make clearer too the place of dignity and self-possession in a character which is less vulnerable to loneliness. Reflection on a point of Roberts’ and Krueger’s is helpful here. They tell us that “someone who is supremely comfortable in their own skin, and who has no craving for social validation and reassurance, will not feel as though much is missing from the solitary life and may consider others to be a distraction or burden.” I think that here some rather separate matters have gotten mixed together. One has to do with having a relaxed confidence in and clear understanding of oneself and one's abilities, especially when presenting oneself to or interacting with other people. I’ve related this to self-possession and Parrhesia, and I think it too is inversely related to loneliness. But I don’t think it has anything to do with not caring about and for others. Far from considering others a distraction or burden, the person who’s very comfortable in her own skin may consider sociality one of life’s supreme blessings. It’s just that, for her, the fact of not now being lovingly engaged with by another doesn’t dent her inner aliveness to love. The anthropology which is immanent within Roberts and Krueger’s treatment of the lonely person is, one might say, of a distinctly ‘postlapsarian’ sort. From my perspective it’s one that risks living unawares in the shadow of our shame, in the threat of unlovability, in the loss of self-possession. By contrast I’ve considered today how loneliness can be ‘interpreted by love’, and in this way be understood as a sense of unlovability related to the loss of dignity, self-possession, and trust in love itself.