In 1995 I apparently gave a long talk to some meeting or other, after which the content of my talk was published by the BPS Psychotherapy Section. I have no memory whatsoever of giving any talk but I do remember writing the article. It seems worth publishing on this blog, with some updates in terms of the experience with Ian, a much shorter version of the original article as it complements with useful background the Approach to Psychosis sequence I republished some time back: I’ve also tried to reduce the psychobabble, though maybe not enough for everyone’s taste! I’ve in addition included references to later research that sheds further light on, for example, neuroplasticity and the relationship between trauma and psychotic experiences. This is the fourth of five instalments.
In working with Ian, as described last time, we later discovered that there were two anniversary effects that triggered a resurgence of the hostile voices: these related to two traumatic army experiences whose pain he was never able re-experience and integrate, preferring instead for the voices to get worse at that time of year. It was the lesser of two evils for him, even though it risked relapse and consequent hospitalisation sometimes. What the later discoveries revealed was that the loss of his partner was triggering his awareness of an earlier pool of pain he seemed to know nothing about at that point, and couldn’t bring himself to deal with later even when he knew it was there. Without all this additional information it would have been impossible to make sense of Ian’s psychotic experiences.
We have not come to the end, though, of ways to think through others.
Shweder, in his intriguing book Thinking Through Cultures, continues his list of ways of doing this:
(c) `thinking one’s way out of or beyond the other’, `passing through the other or intellectually transforming him or her . . . into something else . . . by revealing what the life and intentional world of the other has dogmatically hidden away, namely, its own incompleteness’ — `[this] properly comes later, after we have already appreciated what the intentional world of the other powerfully reveals and illuminates, from its special point of view’; and
(d) `a situated and perspectival observer, thinking while there in an alien land or with an alien other, trying to make sense of context-specific experiences’ when `the process of representing the other goes hand-in-hand with a process of portraying one’s own self as part of the process of representing the other, thereby encouraging the open-ended self-reflexive dialogic turn of mind.’
A concrete way of expressing this would be to liken the reality of another person to a cave. I join them in their cave. I notice it has stalactites which I have never seen before in my cave. I say: `My goodness! How interesting! Your cave has pointed things hanging from the roof. I’ve never seen those before. My cave doesn’t have them. I wonder how that has come about.’ The observation of the discrepancy, expressed in this way, involves non-judgemental reflection both on their world and on mine. This would hopefully result in two kinds of learning: we both might learn something about our worlds and a habit of reflection might be acquired or enhanced in one or both of us.
In short, this means that, after mastering the worldview of the other person in its own terms, we may reach a point where we can share the ways our world-views differ, in the hope that this will help us both reflect upon our models of reality and make good any omissions and distortions.
Another long example might illustrate both these ideas to some degree.
I have drawn on a 30 page long transcript of a sequence of letters for the account given below. What has been omitted therefore far exceeds what has been included. At the time they were written the writer was living in London and planning to move to Hereford. I described this young lady first when I spoke of how her hospitalisation story triggered my own unconscious material.
Dealing with Demons
Mary (19.9.94): `I’m getting quite long bouts of despondency these days. Sometimes I feel OK and I feel I can cope with the voices, but then I just seem to sink and I lose my spirit. I feel I’m never alone because I’m being watched all the time, but I couldn’t be more lonely.
`Time goes so slowly. I do go out for walks but my walks never give me peace of mind or relief, they’re a kind of compulsion — sometimes I think I want to go back home but part of me tells me to keep walking. And some times I can’t leave a particular part of the street or go home until I’ve been given a sign — like three buses going by or two dogs or whatever.’
Me (7.10.94): `Your loneliness is obviously a major source of pain. The pain will feed your demons further and your isolation gives them plenty of growing room. [In using the term `demons’ I am trying to speak of her world using a word that carries both her connotations and my rather different ones: she picks up on this later] . . . . . I feel you need to discuss this as a matter of urgency with anyone who might be able to help – perhaps you are already doing so.’
Mary (19.9.94): `The voices are continuing to tell me I’m really evil and everyone hates me. They say I look like the devil. I’ve been avoiding going to Church because I feel kind of “unclean” and demonated. When I did go a few weeks ago I got really distressed because during the sermon all those blasphemous thoughts started racing round my head and they were sounding out all over the church and I was terrified I’d be chased out and be ex-communicated, so I had to go back home.
`I feel painfully conscious of my loneliness whenever I attend Mass. And anyway my spirit seems to have died — so I’m getting all confused about whether I still believe or not.’
Me (7.10.94): `To have spiritual problems on top of everything else is very hard indeed. It is not unusual though for someone who has been on the receiving end of so much pain so young to conclude that they are evil. [Here I am trying to blunt the power of her feeling of being evil by contextualising it rather than arguing with it.] Obviously, people’s religious beliefs have to be the result of their own free choices. Perhaps though I could offer one idea from my own “rattle bag.”
`Though people often highlight punishing notions from their spiritual traditions, my own reading of many such traditions and ideologies has led me to a very different conclusion about the ground of being than the Old Testament or fundamentalist Islamic one. The fundamental universal law of all great systems of belief seems to me to be love. [I expanded on this much more in my letter but don’t include it here.]
Mary (14.10.94): `I found your thoughts on spiritual matters very uplifting. I actually felt quite relieved! I was brought up a Catholic — as you know guilt and punishment seem to be central themes of this Religion.
`The impulses to harm myself are becoming a bit more difficult to control recently. It’s happening through the day and not just at night anymore.
`You must think it’s terrible saying this, but the last time I harmed myself (a couple of days ago), I almost enjoyed it. I felt kind of high afterwards, like I’d rid my body of some terrible disease. I saw myself being released from my mental prison, and the voices were with me not against me, they were on my side spurring me on. I felt like an anarchist burning down buildings, whoever joins in becomes your friend — you all support each other. So it was like I was the leader in a violent gang-riot and all these strangers were applauding me as I smashed the windows of the Police-station. For about half-an-hour I was almost triumphant.
`Then I felt sick at what I’d done and how good it had made me feel. I got very depressed and had about three baths that night to try and “cleanse” myself.
`I did feel though that I was releasing evil spirits from inside my body. Sometimes I wonder whether I’m possessed by evil spirits. When you talk about my “inner demons” — is this what you mean? [She was not going to let me fudge this issue any longer!] I get frightened when I start thinking about things like this, so I’d better change the subject.’
Me (31.10.94): `Because I’m still pressed for time I can really take up at length only the question you raised about demons. This is a tough one to get down on paper. It would be much easier to discuss it face to face.
`I use demons to mean anything that a person experiences as evil and tormenting and by which they sometimes feel driven to do things they do not really want to do. I believe trauma and stress make one vulnerable to demons in this sense. Some people believe demons are spirits outside them: other people believe they are parts of their own being which have turned against them. [I am trying to offer alternative possibilities without implying that she’s mistaken.]
`I do not mind which position a person takes about their origin because from a psychological point of view roughly the same courses of action apply, it seems to me. Emotional pain feeds demons as does self-hatred. Healing emotional wounds and improving my opinion of myself will reduce the hold demons have on me. The worst thing to believe is that the demons are all-powerful, all-knowing and undefeatable. When people believe demons come from outside it is often the case that they also believe those other things about them too. If you believe they are part of you, it’s easier to cut them down to size and realize that they can be controlled, contained, even conquered. . . . .
`It is hard to convey these ideas in a letter. . . . . I can only say that my own experience of working with people suggests that if a victim of voices can only feel safe enough to work through traumatic pain, the demons will fade to a point where they are no longer a serious problem. Success includes the art of defying them without vilifying them in a supportive environment which facilitates healing and self-esteem.’
Mary (6.11.94): ‘Thank you for explaining what you mean by demons. I am quite confused by what is inside me and what is outside me. I feel that my inner evil is a kind of magnet which pulls in fear and horrible experiences and thoughts etc. — otherwise why would it all keep happening? There must be something about me which attracts even more evil.
`I’m very confused about everything — past and present.’
(17.11.94): “I heard today that I’ve got to go into hospital on December 5th to have an operation. Everything is getting too much. I keep having this feeling of wanting to hide and just let the world carry on and go past for a while.
`And when I’m feeling down like this the voices and everything that goes with them just escalate and I don’t even want to stand up.’
(24.11.94): `My nights are completely controlled by fear. I can’t even describe it. I just get this feeling I’m being hunted and I’m going to hell.’
Me (12.12.94): `I am a bit unclear as to whether this letter will arrive when you are still in hospital or whether you will have come out again by now. I hope you receive it fairly soon and I hope the surgery went ok.
`Because I look upon hell as a state of mind many people experience in this life rather than an exclusively post-mortem penal colony, I believe the torment you experience is already about as bad as it can get short of physical torture. You may feel that you are hunted but hell is where you already are in one sense. It can’t get any worse mentally at least. Don’t let the voices fool you that they can do any worse. You’ve been hit with their best shots and survived! They’ve nothing better in their armoury. If you can hold onto this and build on it you can cut the voices down to their proper size.’ [Again, from within the terms of her world, I was seeking to open out a small consolation, a way of diminishing the power of the voices.]
Mary (16.12.94): `Thank you for your thoughts on the voices and the fear of hell. I do see what you mean, I think I even agree with you — well, I want to agree with you because I really understand what you’re saying and I’ve almost come to think that myself, but I’ve still got a niggling doubt and I do think a lot about the possibility of things being even worse and more nightmarish.’
We both were doing our best to respectfully acknowledge the world the other lived in. It is obvious that neither of us was completely successful, but I think that the effort was none the less worthwhile. Hopefully it helped both of us cultivate our capacity for ‘the open-ended self-reflexive dialogic turn of mind’ Shweder advocates.
The next and last post attempts to pull some remaining threads together.