Monday, November 30, 2009

Motive for Metaphor

For years my appetite for fiction, once prodigious, has diminished, and in recent months, in reaction to what Wallace Stevens called "the pressure of reality," it has vanished altogether. Give me facts, give me philosophy; for the time being fantasy repels. I haven't read or seen, much less enjoyed, a story, novel, or film in months, but have I lived? Oh yes, I've lived a great deal these few months, for better and worse.

Intellectually I still see Aristotle's famous point that history merely deals in particulars, whereas poetry at its greatest deals in universals. However, there are stretches in life in which one is so bound by the brambles of particulars that universals are like the dark side of the moon. And fiction is, after all, a species of lying, that propensity that most distinguishes humanity from the other animals.

Fiction is a luxury of civilization, to be relished only so long as no barbarians are banging on the gates. But barbarians infiltrate the citadel all the time, one is never wholly safe...Even now I'm not sure whether art intensifies life or merely offers an escape therefrom.

Thursday, November 26, 2009


The Buddha's Last Instruction

"Make of yourself a light,"
said the Buddha,
before he died.
I think of this every morning
as the east begins
to tear off its many clouds
of darkness, to send up the first
signal--a white fan
streaked with pink and violet,
even green.
An old man, he lay down
between two sala trees,
and he might have said anything,
knowing it was his final hour.
The light burns upward,
it thickens and settles over the fields.
Around him, the villagers gathered
and stretched forward to listen.
Even before the sun itself
hangs, disattached, in the blue air,
I am touched everywhere
by its ocean of yellow waves.
No doubt he thought of everything
that had happened in his difficult life.
And then I feel the sun itself
as it blazes over the hills,
like a million flowers on fire--
clearly I'm not needed,
yet I feel myself turning
into something of inexplicable value.
Slowly, beneath the branches,
he raised his head.
He looked into the faces of that frightened crowd.

Mary Oliver

Monday, November 23, 2009

Missing the Forest

"But philosophy has no direct influence on the great mass of mankind; it is of interest to only a small number even of the top layer of intellectuals and is scarcely intelligible to anyone else. On the other hand, religion is an immense power which has the strongest emotions of human beings at its service."

Freud, "The Question of a Weltanschauung"

Unlike some of the highly vocal neo-atheists like Christopher Hitchens and Richard Dawkins, the militantly unbelieving Freud did not underestimate the opposition--he recognized that religion's roots go far deeper than the relatively thin soil of the intellect. A few sentences on in the essay quoted, he argues that religion performs three crucial functions: "It gives [human beings] information about the origin and coming into existence of the universe, it assures them of its protection and of ultimate happiness in the ups and downs of life and it directs their thoughts and actions by precepts which it lays down with its whole authority."

Providing (purported) knowledge, existential succor, and morality all at once, religion is the ultimate in one-stop shopping. Its transcendental simplicity is hard to beat, not least because the experience of it is both deeply personal and reassuringly communal.

Arts and Letters Daily today provides a link to an Edge article by Rebecca Newberger Goldstein that dispassionately dismantles 36 proposed arguments for the existence of God. All of the classic ones are there--the argument from ontology, from design, from pragmatism--and the fatal flaws of all are coolly and mercilessy exposed; I have come across many alleged proofs and disproofs of God, but never so neatly summarized in one place.

It's all there, literally in black and white, and yet the believer could still say that if this is what logic and consistency demonstrate, then so much the worse for logic and consistency. Indeed, considering the overwhelmingly religious history of humanity, this kind of logical coup de grace really shows how unphilosophical (in the narrow logical sense) human beings tend to be.

For believers, faith is least of all a matter of empiricism or logic. It is a tradition, a way of life, and a profound emotional need, but it is a philosophy only in the post hoc sense that cognitive dissonance must be suppressed somehow. And as some increasingly argue, religion's pride of place in human nature may have a deep evolutionary source.

Given that religious traditions have arisen independently but in parallel patterns across millenia and across the world, it isn't hard to imagine that faith may have offered a survival advantage to groups in a range of circumstances. In this respect religion has been likened to language--the innate capacity is there, and in both cases children famously absorb the tradition in which they are raised.

How to explain agnostics then? Language is so deeply genetic that, barring severe disorders or early linguistic deprivation, its capacity is universal. Religion obviously isn't like that. I wonder if evolution could have provided not only for the propensity for religion, but also for a certain fractional dissent therefrom. I'm speculating that groups with a truly universal religious "gene" may have tended to become rigid or complacent as compared to groups with more flexible religiosity, even if that made it possible, even inevitable, for agnostic psychology to flourish at least as part of a population. Indeed, religion may benefit, even require, an agnostic opposition in order to remain viable over the long term.

Evidence shows that agnostics and atheists, taken individually, can be as healthy, happy, and productive as believers. But the question for the future of religion is whether it is morally and culturally feasible for unbelievers to constitute a majority or even all of a population. Yes, Europe is famously growing quite secular, but birthrates there have also fallen alarmingly. Are relatively agnostic societies, like agnostics themselves, the exceptions that prove the rule?

Saturday, November 21, 2009

Figuratively Speaking

It will soon be eleven years since I read this to Julia:

In courtesy I'd have her chiefly learned;
Hearts are not had as a gift but hearts are earned
By those that are not entirely beautiful;
Yet many, that have played the fool
For beauty's very self, has charm made wise,
And many a poor man that has roved,
Loved and thought himself beloved,
From a glad kindness cannot take his eyes.

May she become a flourishing hidden tree
That all her thoughts may like the linnet be,
And have no business but dispensing round
Their magnanimities of sound,
Nor but in merriment begin a chase,
Nor but in merriment a quarrel.
O may she live like some green laurel
Rooted in one dear perpetual place.

From "A Prayer for my Daughter," W. B. Yeats (full poem here)

Friday, November 20, 2009

Caged Animals

"The fault, dear Brutus, lies not in our stars, but in ourselves, that we are underlings."


I've never found it easy to answer the occasional but predictable question, "Why did you become a psychiatrist?" but a succinct, if not simple, response is evoked for me by a Psychology Today blog post by Dr. Mark Goulston. Bluntly entitling his post "Maybe You're Just Wrong," he claims that for some people he works with--especially those with no major Axis I mental disorder--he gives them the option of being labelled ill on the one hand, or in mincing-no-words fashion, "psychologically flawed and emotionally immature" on the other. In the former case, psychotherapy and possible medication may be indicated, whereas in the latter case, some kind of education or training may be called for.

What this speaks to for me is the ever-present question: to what degree must or can we take responsibility for our lives and identities? There is no life without suffering, that's for sure; without being lugubrious about it, it is clear that on the scale of a moment, a day, or a lifetime, existence not infrequently doesn't turn out the way we seem to feel that it should. Why is that? I went into psychiatry not in order to relieve the most suffering in any kind of generic sense; it is impossible to quantify suffering, of course, but maybe I could do more good by working in a soup kitchen or by becoming a hedge fund manager and then donating the majority of my income to charity.

No, I went into psychiatry to try to relieve a particular kind of suffering, that associated with the "mind-forg'd manacles" that prevent us from being as psychologically or emotionally free as we might. There is an odd little Arcade Fire song called "My Body is a Cage." Well, the mind is a cage too, obviously, and this is a troubling notion only if one thinks freedom could possibly be infinite. All are limited by temperament and disposition, although to be sure, some have cages that are far more spacious and pliable--and in far closer proximity to other cages--than others.

The fundamental premise of medicine is that we are not wholly responsible for our own suffering. The sick role is a socially sanctioned kind of forbearance granted to incapacity, stemming from a recognition that it is deeply unjust to pretend that "the cage" isn't there. However, it is equally unjust--in an infantilizing way--to carry on as though another's cage is more restrictive than it has to be.

In his blog post Goulston claims that most of his clients prefer to be considered wrong--and responsible for their own plight--rather than innocent victims. I wish I had his confidence in human nature (personally I think Dostoevsky's Grand Inquisitor was more on the money). Obviously these people aren't paying him with insurance, which would require a listed diagnosis. And I refer to them as clients rather than patients for a reason.

Goulston sets out the free will conundrum in stark terms, which is why the piece struck me, but clearly he constructs a false opposition. For psychiatric care, if it is enlightened, should always endeavor to seek a fair balance between the claims of responsibility and "the natural shocks that flesh is heir to." After all, situations either of absolute responsibility or the absolute lack thereof are very rare. Life is continually lived in a state of partial--and never precisely known--responsibility. And science does not help much with this. Free will is profoundly social and political, relating to what one ultimately must answer for (to hypothetical others). In that sense there is no one Free Will, but a multiplicity of free wills in different social contexts.

So for instance, it is common for a depressed person not to take of himself. He doesn't exercise or eat healthfully, he gains weight, he isolates himself and loses friends, and perhaps even loses his job because he doesn't drag himself to work on time. To what degree is he responsible for his plight, as opposed to being a victim of the medical condition of depression? Arguably science cannot answer this question. To be sure, ever more sophisticated brain scans may show that depressed brains are different in certain ways than non-depressed brains, but inasmuch as psychology stems from neurobiology, such brain scans could theoretically also show differences between, say, lazy and selfish brains as opposed to motivated and selfless brains.

I would argue that responsibility in this case--in all cases--is a pragmatic construct. What helps this person to function better--varying degrees of encouragement, stigma, and penalty (e.g. unemployment) on the one hand, or direct support and perhaps biological intervention on the other? Of course it is likely to be a combination of the two. The depressed person may be given supportive therapy and even medication, but there is also an expectation that he will exercise and socialize more to improve his own lot. Medical and psychiatric care should aim to balance the sick role with social expectation, the latter being mirror image of social responsibility. What does it mean though to "function better?" Ah, the question of how life ought to be lived is beyond the scope of this post--or this lifetime most likely.

I've been curious about the emergence in recent years of "life coaching," "job coaching," etc. Does this stem from a lingering stigma of therapy, or does it derive from a desire for therapy that is more actively interventional? However, if one is primarily "wrong" and not "sick," then a better metaphor may be teaching or even tutoring. A "coach" implies that life is a sporting event to be won or lost, whereas life perhaps is better approached as a skill, like piano-playing or any other. Well no, life surely isn't so straightforward as that--composing may be the better metaphor. Or since this is my post and I have no head for musical composition (as opposed to appreciation), I'll say writing. Yes, life as writing.