I look, this is what I see

“It’s not what you look at that matters, it’s what you see” Henry David Thoreau

I do psychology that is one of the things I do amongst many other things. I try with conscious intent not to say that I am a psychologist (although I often forget to stick to that resolution; I also often believe it).

I also do guitar playing, cooking, furniture making and restoration, web-site design, house painting, electrical repairs; but I am not these things; I just do these things. Perhaps what is more important is why I do these things and how I do these things; with what attitude and feeling do I do them and what does bringing these things out of me do for my soul?

All the years of training and learning in psychology had left me confused and frustrated. I asked myself why there were so many schools of psychotherapy. It seemed to me that virtually every practitioner believed that they had found the answer and created a new school or technique or model of psychotherapy; each named after the practitioner; each claiming to have “the final statement, the way”. I still found myself dubious; how could they all be right; have the panacea, the magic bullet?

I persisted with my questions; why were so many people so motivated to invent new theories, models and techniques of psychotherapy, what was wrong with the prevailing theories and models? Were all these different theories, models and techniques completely without any commonalities so as to actually be unified in some way? Were people not the common thread?

My frustration continued, thus I concluded that the only way to resolve the quandary was to take sides; I had to choose my war. I have never found it easy to take sides in this way; I am usually left with a nagging sense of inauthenticity, a sense of partisanship rather than a sense of coherence and contentment. Belonging is good yes, but truth is better.

Whichever theoretical technique I aligned myself with left me feeling uncomfortable.

Psychoanalytic stuff always ended with sex; ‘so you want to f**k your mother…’ no matter what the problem was (until the work of Davanloo as described by  David Malan and Patricia Coughlin Della Selva liberated psychoanalysis) . Behaviourism pretended that there was no person in the body experiencing and interpreting reality; just a black box that could be punished rewarded or extinguished. Humanism was appealing but carried a sense of romanticism that I could not seem to find easily in the actual world.

But the persistently irreconcilable problem for me was that all these therapies seemed to be imposing a pre-conceived template on each person’s life, something that didn’t seem to be an ethical or praiseworthy practice.

So am I suggesting that the answer lies in subjectivism; only the person’s subjective experience and reality being true? Certainly not, as my philosopher brother said, “so if a person says that he is something that he is not should one take that as true?”

Retrospectively it feels like psychology was on a journey of searching for self, a journey that is not yet completed, and a journey that has resulted in some of the kids leaving home and perhaps having a faribl, not speaking to each other, “because you are wrong and I am right! I’m the real thing and you are a fraud, a quack! I’m a scientist clinical psychologist and you are a Jungian analyst!” (A lecturer who is a clinical psychologist at Rhodes said that out loud one day)

Quackwatch

http://www.quackwatch.com/

Are they even a family anymore, are they related these kids of psychology?

So the winter spring summer and autumn of my discontent continued unabated and unabashed.

Richard III, William Shakespeare, Book | kalahari.com

http://www.kalahari.com/Books/Richard-III_p_437045;jsessionid=AD7E1A5EFDD91326628B7CF3D70E3D70

I did my honours degree at Rhodes in Grahamstown. The psychology department was well known for its particular theoretical bent; an emphasis on existential and phenomenological psychology. I struggled through my undergraduate psychology years at the first varsity feeling no connection at all to the words I was hearing in lectures.

Then I got to Rhodes and found the connection that I had been seeking. I had found a human psychology, a psychology about people and how they live their lives in the world. Up until that point people actually living their lives seemed to be almost extraneous to the discipline of psychology, the science of human behaviour.

Speaking of science….At Rhodes, Robert Romanyshyn a visiting lecturer gave a series of lectures on phenomenological psychology.

Robertromanyshyn.Com

http://robertromanyshyn.com/

Journal of Phenomenological Psychology | Brill

http://www.brill.com/journal-phenomenological-psychology

Amongst many other things this is what I remember him saying about science and human experience.

  1. By its nature science forces a split between what we experience and how we experience; it demands that we distance ourselves from our experiences.
  2. Science demands that we forget the body as we live it.
  3. The thinking eye replaces the experiencing eye. Things become suddenly (apparently) deceptive.
  4. Science demands an increasing withdrawal of the human body from the world.

Science, he said exemplifies the axiomatic determination characterised as a ‘refusal of things as they are given’; the narrowing of one’s focus.

Science is the embodiment of attempts to standardize and classify the world into separate, discreet, encapsulated bits of so called objective evidenced based reality.

Here’s the most important part to my mind, of what he said; “Science as a perspective is a psychological vision; inseparable from a physics of nature and a physiology of the body…..modern science addresses the minimal conditions of existence”.

Isn’t that simply beautiful in its succinctness and eloquence?

Psychological Life: From Science to Metaphor: Robert D. Romanyshyn: 9780292764736: Amazon.com: Books

http://www.amazon.com/Psychological-Life-From-Science-Metaphor/dp/0292764731

Technology as Symptom and Dream by Robert D Romanyshyn « Dreamflesh Library review

http://dreamflesh.com/library/robert-d-romanyshyn/technology-as-symptom-and-dream/

Science…. uncovers the minimal conditions of existence; these however mind-blowing, are simply insufficient for the challenge of being a human being living & meeting the demands of the world.

So the breath-taking work the scientists are doing at CERN (Conseil Européen pour la Recherche Nucléaire) to find the Higgs Boson (or should it be The God Particle, SM Squared, the Scalar Boson or the Engelert-Guralnik-Kibble-Brout-Hagen-Higgs Boson) in the hope that the building blocks of the universe will be revealed is truly reflective of human genius, creativity and determination.

Nonetheless, each of the scientists, the human beings involved in this reality altering quest still have to live their lives day by day meeting the demands, vicissitudes and vagaries of life as best they can in their bodies with the resources they possess, just like everyone else.

The search for the Higgs boson | CERN

http://home.web.cern.ch/about/physics/search-higgs-boson

I remember when I first came across the DSM; the Diagnostic and Statistical Manual of Mental Disorders. Wow I thought what else does one need to do this job, the ultimate universally shared definitive classification of mental disorders. I’m just kidding! I found it appalling. We used to joke around with the DSM giving each other quick instant arithmetical diagnoses by numbers. “You’re a 296.23 with an Axis II V71.09305.00”.

DSM-5

http://www.dsm5.org/Pages/Default.aspx

You may be aware that there is a permanent polemic possibly a war between those who advocate empirically supported psychotherapeutic treatments and those who rely on interventions that are more based on awareness, insight and transferential dynamics where problems of emotional processing and regulation have created (parataxic) distortions, illness and suffering; a lack of freedom.

The “EST scientist psychologists” maintain that;

  • Clinical psychologists are scientists.
  • Psychotherapy is based on scientific theory.
  • Science demands empirical validation of theory.
  • Therefore no form of psychotherapy that is not supported by empirical “proof” of its effectiveness should be countenanced.

Psychologists Debate Empirically Supported Treatment

http://www.academyprojects.org/est.htm

Looking for Evidence That Therapy Works – NYTimes.com

http://well.blogs.nytimes.com/2013/03/25/looking-for-evidence-that-therapy-works/?_r=1

Mental Health FAQs

http://www.tapartnership.org/content/mentalHealth/faq/03diffEBP_PBE_EBT_EST_CDE.php

I am reminded of a statement by Otto Rank.

“Psychoanalysis arrived to save the human soul in a materialistic era sick with self-consciousness and threatened by loss of belief in immortality and in its public expression, religion. Its greatness resides in having done this in the mind-set of our era, not simply symbolizing the soul exoterically or concretizing it socially as in the past, but attempting to demonstrate it scientifically. But realistic psychology is the death knell of the soul, whose source, nature, and value lie precisely in the abstract, the unfathomable, and the esoteric”.

Art and Artist, 1932, p. 109-110, Psychoanalysis and the Soul Art and Artist: Creative Urge and Personality Development: Otto Rank

http://www.amazon.com/Art-Artist-Creative-Personality-Development/dp/0393305740

I am also reminded of the words of Erich Fromm.

“But complete rational knowledge is possible only of things; things can be dissected without being destroyed, they can be manipulated without damage to their very nature, they can be reproduced. Man is not a thing; he cannot be dissected without being destroyed, he cannot be manipulated without being harmed, and he cannot be reproduced artificially”.

Link to Fromm’s article

http://www.theosophyonline.com/ler.php?id=3751#.Ue_AvRbfg4k

(Well perhaps man / woman can be reproduced).

Artificial human ear grown in lab

http://www.bbc.co.uk/news/health-23508688

BBC News – Doctors implant lab-grown vagina

http://www.bbc.com/news/health-26885335

I remember being at Ingutsheni hospital in Bulawayo and visiting the male long-term chronic psychiatric ward. It was a sad place. The men were dressed in knee high khaki shorts and shirts some with shoes and some not. Most were walking around often talking intensely to themselves sometimes directing their words at someone else whilst others were simply lying on the red stoep that surrounded the building located far off in the sprawling bush of the fenced isolated hospital complex.

Ingushteni

As I walked around looking at these poor souls understanding the significance of a long-term chronic facility I felt only devastation for the human lives that had been reduced to this forlorn quality of life; it was life no matter how bleak, it was still life. We don’t see this quality of life; it is usually hidden far from where we live and play, out of the light of day.

To my shock I came across a fellow who had been in the acute psychiatric ward of the Parirenyatwa annex just a few weeks before. We had attended the same school and shared some stories about our common past. Now here he was lying on the red polished stoep softly but resolutely whispering to himself, his hands intertwined in contortion, his eyeballs strained upwards pointed towards the heavens, unblinking.

I kneeled to put my hand on his shoulder but he was not present in any form that allowed any connection to anything outside of his incarcerated, desolate and solitary torment.

So yes here was an example of a 295.2 and yes he was receiving the relevant medication that a 295.2 should get for a diagnosis of Schizophrenia, Catatonic Type. I do not dispute that or even question it. It wasn’t helping much this time.

When I first started my internship at the hospital the registrar psychiatrist taunted me with the question he always asked young green idealistic psychology interns of which I was one.

“How long would you need to bring this patient out of his psychosis?” He said with a smirk, pointing to a much sedated patient sitting in the mattress room.

I replied confidently that I would need only 10 months; sucking that out of my thumb!

“I will have him back to reality in 10 days with medication”, he retorted.

So being the irreverent person that I am, I proceeded to ask him if that was so how he understood the need for and the role of the psychologist in the psychiatric hospital. This is what he told me.

“The psychologist is someone we refer to when we require tests, like an IQ test. It’s exactly the same as sending a stool specimen to the laboratory to confirm or exclude bilharzia”. What a crappy statement!

Stool sample

How should I collect and store a stool (faeces) sample? – Health questions – NHS Choices

http://www.nhs.uk/chq/Pages/how-should-i-collect-and-store-a-stool-faeces-sample.aspx?CategoryID=69

At that stage I was at a point where I still knew more or less how to shut my mouth, bite my tongue. I grunted turning away from his supercilious grinning face and walked off to my next appointment; an IQ test of a young school girl struggling with anxiety!

Today I have no qualms about medication. I have watched too much unnecessary suffering in the lives of people to hold on to the toxic psychiatry lobby, at least the medication part.

Toxic Psychiatry: Peter R. Breggin

http://www.amazon.com/Toxic-Psychiatry-Electroshock-Biochemical-Theories/dp/0312113668

On a tangent I wish to express the firm conviction based on my experience in the field that psychiatry should be a sub-speciality of neurology. Many psychiatrists I know simply diagnose and administer medication which is great and very useful.

Meds for depression, anxiety, psychosis and of course methylphenidate by the ton, but what a waste of a medical degree which could be used so much more usefully to help people.

So I believe that a neurologist could easily include in the practice the sub-speciality of psychiatry. I do not say this to generate conflict, I truly believe it.

If on the other hand a psychiatrist wants to practice therapeutic psychology, then train as a psychologist and refer to the neurologist for diagnosis and medication. There was a time a while back in South Africa when consideration was being given to license clinical psychologists to dispense psychoactive medication. I would need to think about that…maybe with supervision from a (psychiatric) -neurologist!

Some years ago I received a phone call from a woman who wanted my help. She was concerned that she might have ADHD and had reached a point in her life as a person, a mother and a wife where she decided that enough was enough. I listened to her and encouraged her to consult with a psychiatrist which she chose to do. Some weeks later I received this sms/text from her.

“Hi ther. Id like to thank u fr u help n encouragement as i queried fr u whether i hd adhd n u were so kind and helpful and even phoned me. I saw a psychiatrist and he said i hv panic disorder agorophobia n ocd so at least now after 3decades i hv a answer n cn work fr ther. Thx so much n god bless u”.

Her words were spot on; now that she had an accurate and useful description of her liquorice allsorts she still had to live each day meeting the demands of life with who she was and with the resources she had; but now she knew, she had a starting point to work from.

For her there was no grief to work through, the news the psychiatrist gave her was a relief, an unburdening, a point of embarkation…forward.

liq

So now she knows more about her nature, neurology and personality, her liquorice allsorts; in disease model terms; panic disorder, agoraphobia and obsessive compulsive disorder. More than ordinary anxiety in various forms is central to her nature, her being. So what can she do, what can she not do, what can change, what cannot change. If this is her liquorice allsorts how does she have to live her life? What support does she need?

Then there was the welfare meeting. There was an argument, sometimes quite passionate about who should be allowed, or specifically who qualified to receive counselling and other psycho-social interventions from the school. The two positions were; one, only kids of the faith should receive these services and two all kids of the school irrespective of faith should receive these services.

My response as a counsellor was to explain that when I looked at the kids in the school I did not see persons of different faiths or persuasions, those who belonged and those who didn’t…I only saw children, children who needed our help and support… and that was the school’s position too…I was proud to state.

So….what I came to realise is that even with medication and the stabilisation that it can bring, even with the highly developed mental illness classification system, even with science so usefully addressing the minimal conditions of existence……..a person still has to live their life facing the challenges of life being the person they are and using the resources they have at their disposal day by day.

People, each particular person, trying to cope with the tasks and demands of the world; it is the analysis, understanding and support of this that is the domain of therapeutic psychology.

  • So when I look at people what I see are human beings trying to understand who they are, trying to make sense of their lives and the impact of their experiences, trying to cope with the tasks and demands of the world, trying to live with dignity, striving for the same things as everybody else.
  • I find it useful to not confuse the things that people do or the things that people have, work, roles, power, money or status with whom they are even if they themselves do.
  • When I look at psychology I do not see pathology, abnormality, disease or science. I see the opportunity and the imperative to accurately and compassionately describe in clear descriptive terms the nature of a person’s being; their liquorice allsorts and how they got there.
  • The questions I ask when I do psychology are what is life like for this person with their particular liquorice allsorts? Is this person living their life with as much psychological freedom as possible, if not why not? What is the intentionality embedded in this person’s life actions?

Is Depression a Disease?

http://www.szasz.com/isdepressionadiseasetranscript.html

So in relation to ways of intervening in the world including psychology I am not advocating any particular practice or idea. Whatever practice is chosen should be useful to the person in that it increase the opportunity to live connectedly in the world with as many resources available as possible and with as much freedom as possible to manifest their intentionality.

The key is the perspective, the attitude one has when one sees people in the world simply trying to live in the human condition. What you look at and what you see makes a big difference in my book.

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SO….WHEN YOU LOOK AT PEOPLE WHAT DO YOU SEE?