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Archive for November, 2017

Autumn’s Exodus

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I found myself staring outside my window earlier today, but not the same day that triggered my recent poem on the death of trees. I looked past the silver birch immediately outside, with most of its green or golden leaves in place, to the bare branches of the denuded sycamore, left with only a handful of its leaves on this cold but sunny November day. As I looked the words of the sonnet penned 400 years ago came floating into my mind:

That time of year thou mayst in me behold
When yellow leaves, or none, or few, do hang
Upon those boughs which shake against the cold,
Bare ruin’d choirs, where late the sweet birds sang.

Shakespeare, of course: sonnet 73.

That led me to Don Paterson’s reflections from his book on ‘Reading Shakespeare’s Sonnets: a new commentary.’ A later line of the sonnet reads: ‘Death’s second self, that seals up all in rest.’ Paterson observes (page 212) that ‘WS is referring to night, though Death’s brother has long been sleep, whom he’s also invoking indirectly.’ Inevitably, we go further yet. He adds, ‘Remember Macbeth’s Come seeling night,/Scarf up the tender eye of pitiful day.’ He reminds us that ‘seel’ is to ‘stitch the eyelids shut, as one would a hawk’s.’

The reference to Macbeth reminded me of the fascinating book that I had just finished reading: Why We Sleep by Matthew Walker.

He couldn’t resist wheeling out Macbeth either (page 108):

Ironically, most of the “new,” twenty-first-century discoveries regarding sleep were delightfully summarized in 1611 in Macbeth, act two, scene two, where Shakespeare prophetically states that sleep is “the chief nourisher in life’s feast.”

He argues that our industrialised society is chronically sleep deprived. And he harvests acres of evidence to prove (page 107) that sleep, amongst other things, ‘enhances memory,’ ‘makes [us] more creative,’ ‘protects from cancer and dementia,’ lowers our ‘risk of heart attacks and stroke,’ and leads to our feeling ‘happier, less depressed, and less anxious.’ We need to wake up to the danger we are in by not sleeping enough.

Three examples

Because I’m still a clinical psychologist at heart, to prove the value of the book I want to focus on his discussion of three problems: Autism, ‘Schizophrenia’ and Attention Deficit and Hyperactivity Disorder (ADHD). I have called them problems rather than illnesses or disorders because I am deeply sceptical, as I have explained elsewhere, about the value of such labeling.

But I can set aside such quibbling for now and focus on his demonstration of how much sleep can do to mitigate such problems and how much the lack of it makes them worse.

Autism

His link between autism and sleep abnormality is dramatically strong (page 82):

Autistic individuals show a 30 to 50 percent deficit in the amount of REM sleep they obtain relative to children without autism.

A word of explanation might be necessary here.

During waking hours, in terms of information, we are in reception mode, he argues. Non-rapid eye movement (NREM) sleep performs a kind of reflective function (page 52) and stores and strengthens the ‘raw ingredients of new facts and skills’ whereas rapid eye movement (REM) sleep (dreaming sleep) integrates the information, ‘interconnecting the raw ingredients with each other, with all past experiences, and, in doing so, building an ever more accurate model of how the world works.’

He accepts that this correlation does not prove that the sleep problem in humans is the cause of autism or vice versa. However, research using animals suggests that when infant rats are deprived of REM sleep ‘aberrant patterns of neural connectivity, or synaptogenesis’ occur in the brain, and the rats affected ‘go on to become socially withdrawn and isolated.’

He adds that, since ‘alcohol is one of the most powerful suppressors of REM sleep that we know of’ it can ‘inflict the same selective removal of REM sleep.’ ‘Vibrant electrical activity’ is the detectable sign of REM sleep. The infants (page 83) ‘of heavy-drinking mothers showed a 200 percent reduction in this measure of vibrant electrical activity relative to the infants born of non-alcohol-consuming mothers.’ However, even when pregnant mothers consumed only two glasses of wine (pages 83-84), it ‘significantly reduced the amount of time that the unborn babies spent in REM sleep, relative to the non-alcohol condition.’

While he acknowledges that for humans (page 85) ‘we do not yet fully understand what the long-term effects are of fetal or neonate REM sleep disruption, alcohol-triggered or otherwise,’ the abnormalities caused in adult animals is clear.

I also feel that the evidence adduced by Raine in his masterly book The Anatomy of Violence may be partly explicable in these terms, though Walker makes no reference to it. In this study of violent offenders, Raine finds that foetal alcohol exposure is very much a factor needing to be taken into account, and not just with violent offenders, the main focus of his book, as it has implications for cognitive functioning including memory as well as impulse control in general (pages 163-164):

Part of the reason for this is its effects upon the hippocampus. The hippocampus patrols the dangerous waters of emotion. It is critically important in associating a specific place with punishment – something that helps fear conditioning. Criminals have clear deficits in these areas. The hippocampus is also a key structure in the limbic circuit that regulates emotional behaviour . . .

This impairment then interacts with early experiences of attachment, and disruptions to attachment make the likelihood of later personality problems much higher. Sleep strongly impacts upon the functioning of the hippocampus as Walker explains (page 155):

The very latest work in this area has revealed that sleep deprivation even impacts the DNA and the learning-related genes in the brain cells of the hippocampus itself.

So, whatever the exact direction of causation, and regardless of what other factors may or may not be involved, REM sleep disruption and autism are undoubtedly linked.

‘Schizophrenia’:

Even though I worked in mental health over thirty years, until I read his book I never realised fully the important role of sleep in the problems I was looking at, even though I used to explain to lay audiences that psychosis, as it is termed, was a kind of waking dream, which, I used to say, meant that we all became psychotic at night, whether we remembered our dreams or not.

There is an additional twist to the role of NREM sleep here (page 89): ‘Of the many functions carried out by deep NREM sleep… it is that of synaptic pruning that features prominently during adolescence.’

He goes on to explain how important adequate sleep is for the adolescent brain, given that it is critically involved in determining what synapses (neuronal connections) are removed to mature the brain appropriately. Then he makes his key point early on in the book (page 92):

Individuals who developed schizophrenia had an abnormal pattern of brain maturation that was associated with synaptic pruning, especially in the frontal lobe regions where rational, logical thoughts are controlled – the inability to do so being a major symptom of schizophrenia. In a separate series of studies, we have also observed that in young individuals who are at a high risk of developing schizophrenia, and in teenagers and young adults with schizophrenia, there is a two- to three-fold reduction in deep NREM (non-rapid eye movement) sleep. . . . Faulty pruning of brain connections in schizophrenia caused by sleep abnormalities is now one of the most exciting areas of investigation in psychiatric illness.

He does not deal with this here except in terms of correlation. This therefore does not exclude the possibility that there are other causative elements at work.

Graph of the Model that states Psychosis is on a continuum with Normal Functioning (Source: The route to psychosis by Dr Emmanuelle Peters)

I am well aware, for example, of the strong evidence for the role of trauma in the development of so-called schizophrenia. His treatment of trauma is quite separate from his discussion of schizophrenia, as he is content to term it, and he relates the persistence of nightmares in the aftermath of trauma to the failure of the brain to suppress noradrenaline, a failure that keeps the terror alive. Normally the brain suppresses noradrenaline in sleep so that dream experiences do not create strong feelings of fear and the mind is desensitised to the terror by the calming dreams – a very different process from the NREM one he is describing here.

None the less, the correlation is significant and potentially valuable therapeutically. I would hope that future research is less diagnostically naïve and includes other potentially relevant factors in the mix.

Attention Deficit and Hyperactivity Disorder (ADHD)

His exposure of the way in which sleep deprivation is ignored as a fundamental factor in ADHD was music to my ears. He launches it by saying (page 314):

An added reason for making sleep a top priority in the education and lives of our children concerns the link between sleep deficiency and the epidemic of ADHD. … If you make a composite of the symptoms (unable to maintain focus and attention, deficient learning, behaviourally difficult, with mental health instability), and then strip away the label of ADHD, the symptoms are nearly identical to those caused by a lack of sleep.

The drugs we prescribe to treat it further prevent sleep.

He is not claiming there is no such thing as ADHD, simply that many people to whom the diagnosis has been attached are simply sleep deprived. The treatment makes it worse not better. He quotes the figures (page 316):

Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.

And more than that. Because our society undervalues sleep (ibid.):

Well over 70 percent of parents [believe] their child gets enough sleep, when in reality, less than 25 percent of children aged 11 to 18 actually obtain the necessary amount.

He points to early starting times in schools as one of the culprits and late bedtimes as another. This blind spot in our culture is damaging lives, he argues. We have to change.

Dreams

I can’t resist a quick postscript on dreams. Oliver Burkeman, in a recent Guardian article, nails the difficulty I have with Walker’s reductionist approach, which he describes accurately: ‘recent work by researchers including Matthew Walker, author of the new book Why We Sleep, strongly suggests dreams are a kind of “overnight therapy”: in REM sleep, we get to reprocess emotionally trying experiences, but without the presence of the anxiety-inducing neurotransmitter noradrenaline. In experiments, people exposed to emotional images reacted much more calmly to seeing them again after a good night’s dreaming.

He rightly argues that Jung would not have agreed that this was all there was to it, and neither would I. He even provides a counteracting argument that retains the magic of dreams even while conceding they might be random:

So you wrote down a dream, then studied it, with or without a therapist, trying out different interpretations, and if one rang true – if it gave you goosebumps or triggered strong emotions – you pursued it further. What’s striking, you may have noticed, is that this approach would work even if Jung were wrong, and dreams were just random. If you treat them as potentially meaningful, retaining only those interpretations that really “click”, you’re going to end up with meaningful insights anyway. I’ve dabbled in this, and highly recommend it. To ask what your dreams might be trying to tell you is to ask deep and difficult questions you’d otherwise avoid – even if, in reality, they weren’t trying to tell you anything at all.

Walker’s disappointing take on dreams does not for me diminish one jot the fundamental importance of his book. Sleep really matters and he marshals convincing evidence to prove just how vital it is that we recognise this and act accordingly. It’s a compelling, accessible, credible and critically important read.

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I ended the previous post with a quote concerning the influence of diet.

What has become abundantly clear is that what we eat affects many aspects of our health. A recent book[1] on psychobiotics explores one previously underestimated area to demonstrate the truth of this. A Guardian review pulls out the main points in detail including such statements as ‘Over the past decade, research has suggested the gut microbiome might potentially be as complex and influential as our genes when it comes to our health and happiness. As well as being implicated in mental health issues, it’s also thought the gut microbiome may influence our athleticism, weight, immune function, inflammation, allergies, metabolism and appetite.’

The inescapable conclusion, as all the researchers are keen to point out, is ‘that no matter how repetitive the advice, and difficult to achieve in the west, a varied diet rich in fresh vegetables and fermented foods such as sauerkraut, along with exercise and stress management, is the route to sustained gut (and general) health.’

Self-help

For reasons which modern medicine has made increasingly clear, Bahá’ís are prohibited from using alcohol and other mind altering substances: ‘Experience hath shown how greatly the renouncing of smoking, of intoxicating drink, and of opium, conduceth to health and vigour, to the expansion and keenness of the mind and to bodily strength.’[2]

We are also enjoined to take good care of our health ourselves in other simple ways, beyond just diet. ‘You should certainly safeguard your nerves,’ Shoghi Effendi says, ‘and force yourself to take time, and not only for prayer and meditation, but for real rest and relaxation….’ [3]

With great prescience he also emphasises the critical importance of sleep: ‘Regarding your question: there are very few people who can get along without eight hours sleep. If you are not one of those, you should protect your health by sleeping enough. The Guardian himself finds that it impairs his working capacity if he does not try and get a minimum of seven or eight hours.’[4]

It wasn’t until I recently read Matthew Walker’s Why We Sleep that I came to realise just how vitally important sleep is to our health. It pulls together evidence for the importance of sleep at every stage of life, and spells out in detail the damage lack of sleep causes not just to memory and concentration, but also to the health of body and brain in a multitude of ways: to name but a few, by raising the risk of Alzheimer’s, diabetes, stroke, heart attack, and cancer as well as by reducing the efficacy of the immune system. More of that in my next post.

Lucretia by Rembrandt

More Challenging Aspects

Other important points to bear in mind when helping those who are ill or whenever we are ill ourselves include the spiritual dimension of our being specifically, and not just prayer and meditation. ‘Abdu’l-Bahá explains that ‘The connection of the spirit with the body is like that of the sun with the mirror.’ The spirit or soul cannot be damaged by what damages the body nor helped by what cures it: ‘Briefly, the human spirit is in one condition. It neither becomes ill from the diseases of the body nor [is] cured by its health.’[5]

There are many reasons why factoring this in might enhance the way we treat others and the way we look at our own illness. Staff and relatives, if they believed in the soul, would find it even harder than they do to treat a comatose patient like an object rather than a human being. I also would find it easier, to some degree at least, to cope with a life impairing illness if I believed that I had a soul. These benefits do not, I know, amount to proof of the existence of a soul. I’ve dealt with that evidence at length elsewhere. What I believe this evidence strongly indicates is that, just as I cannot prove I have a soul, science cannot prove I don’t. To believe in a soul is as rational as not to believe in one: given the demonstrable benefits of belief to quality of life I know what side of this argument my money should be on, even if I didn’t already accept the reality of the soul.

An even more complex issue, which I have also dealt with at length elsewhere on this blog concerns pain and suffering. Shoghi Effendi gave this response to a question: ‘As to your question concerning the meaning of physical suffering and its relation to mental and spiritual healing: Physical pain is a necessary accompaniment of all human existence, and as such is unavoidable. As long as there will be life on earth, there will be also suffering, in various forms and degrees. But suffering, although an inescapable reality, can nevertheless be utilized as a means for the attainment of happiness. . . . Suffering is both a reminder and a guide. It stimulates us to better adapt ourselves to our environmental conditions, and thus leads the way to self-improvement. In every suffering one can find a meaning and a wisdom. But it is not always easy to find the secret of that wisdom. It is sometimes only when all our suffering has passed that we become aware of its usefulness.’[6]

The final tricky point concerns my previous professional vocation.

As I have explained elsewhere and will be republishing later, I am acutely aware that psychiatry has its limitations, which psychiatrists do not always recognise. Davies marshals a wealth of evidence in support of this contention.  If a mental health team acts as though all they really need to know is the diagnostic label, and what they suppose is the completely effective medication that goes with it, and all they have to do is make sure the patient swallows enough tablets, the outcome will be poor at best and potentially life-damaging at worst. If on the other hand, they take into account, not just the label and the tablets, but also the whole person and their context, working in consultation with the service user to create a recovery plan within the framework of a genuinely multi-disciplinary team, then the evidence suggests the outcome will be good and the recovery more stable.

This means that Shoghi Effendi’s cautious advocacy of psychiatry is music to my not necessarily objective ears: ‘Psychiatric treatment in general,’ he says, ‘is no doubt an important contribution to medicine, but we must believe it is still a growing rather than a perfected science. As Bahá’u’lláh has urged us to avail ourselves of the help of good physicians Bahá’ís are certainly not only free to turn to psychiatry for assistance but should, when advisable, do so. This does not mean psychiatrists are always wise or always right, it means we are free to avail ourselves of the best medicine has to offer us.’[7]

I’ll leave you to read my subsequent posts if you need to know more about my personal views on that one.

Hopefully this has been a reasonably clear helicopter view of the Bahá’í position on health and wellbeing. I think I’ve gone on long enough in any case. I’ll stop hear and catch my breath. I don’t want to precipitate a heart attack.

Footnotes:

[1] The Psychobiotic Revolution: Mood, Food and the New Science of the Gut-Brain Connection by Cryan, Dinan and Anderson.
[2] (Selections from the Writings of ‘Abdu’l-Bahá Sec. 129, page 150)
[3] 
(In a letter written on behalf of Shoghi Effendi, 23 November 1947 to an individual believer)
[4] 
(In a letter written on behalf of Shoghi Effendi, 15 September 1951 to two believers)
[5] (‘Abdu’l-Bahá, “Some Answered Questions”, pp. 228-29)
[6] 
(In a letter written on behalf of Shoghi Effendi, 29 May 1935 to an individual believer)
[7](In a letter written on behalf of Shoghi Effendi, 15 June 1950 to the National Spiritual Assembly of the British Isles)

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Holland House

Last Monday I was scheduled to give a short talk at Holland House, Cropthorne, to an interfaith group on the Bahá’í approach to health and well-being. It was an opportunity both to share the Bahá’í perspective on these matters and learn from other religions what their take on the matter is. I hope to deal with these other points of view in a separate post. This one is going to be long enough without them! It was another occasion when I had more to say than the time allowed and readers of this blog are paying the price!

More than that though, this time the talk I eventually gave was rather different from the one I planned, though it included some of the original points.

I was derailed by various things. No pun intended, but the train journey there was a nightmare. The four carriage train before mine had been cancelled when its brakes failed. The two carriage train I was on had to find space not just for us but for all the passengers from the first train who were still waiting. Sardine time! At every stop the wait got longer and longer as it became ever more difficult to squeeze more sardines into the tin. My chance of getting my connection faded gradually into Never Never Land.

I’d already begun to revise my talk when I got the final copy of the programme a few days before. It spelt out the topic of the day more clearly than the earlier version: ‘How does my faith community understand and support wholeness, wellbeing and health in individuals and communities?’ I’d started to rework it in the time available but needed to do more on the train.

That proved easier said than done. When I boarded the train I headed for a table with only one man sitting there. As soon as I started to sit down I realised I’d miscalculated. It was one man and his guide dog. No problem, I thought. I’ve done this before. These dogs are well-trained, quiet and docile. He readjusted his dog, and I did the same with my expectations as more passengers climbed on board and a lady joined us at the table. Still not a major problem as Milo, the brown-eyed labrador, still had room to lie down quietly. Until that is a second lady asked if she could sit at the window seat beside me.

From that point on, my revision of the talk was punctuated by unpredictable interactions with Milo who was clearly excited to be surrounded by so many people at close quarters. His harness was on the table. His owner explained that when Milo had his harness on he was in work mode. Without the harness it was playtime!

I arrived at the station for my connection with the train I planned to be on long gone. The next train was more than an hour away. Time for some lateral thinking. In the end, I bit the bullet and took a taxi to the venue. No way I could carry on revising my plan as we bounced along. I had to do that while the other speakers were doing their bit and before my turn came.

Anyway, I felt it might still be worth sharing in this sequence what I originally planned to say, before trying to type up what I actually said into a later post.

So, here it is.

The Basics

It’s probably best at the start to make two very basic points.

We need to use doctors when we are ill and Bahá’ís have no reservations about accepting medical best practice. ‘Abdu’l-Bahá is unequivocal: ‘the sick must refer to the doctor.’[1]

Also we have no Bahá’í healers as such, even if a Bahá’í feels they have healing powers. The Guardian of the Bahá’í Faith, Shoghi Effendi makes this crystal clear: ‘although there is no objection to your helping others to regain their health, he does not feel you should associate the name Bahá’í with your work, as it gives a wrong impression; we have no “Bahá’í healers” . . . You are a Bahá’í and a healer, and that is quite different.’[2]

We are free to use the material means at our disposal to help others in need: ‘There is nothing in the teachings which would forbid a Bahá’í to bequeath his eyes to another person or for a Hospital; on the contrary it seems a noble thing to do.’[3] and ‘There is nothing in the Teachings to prevent a Bahá’í from willing his body for medical research after death. However, it should be made clear that the remains must be buried eventually and not cremated, as this is according to Bahá’í law.’[4]

Complicating Factors

Now I’m going to complicate things a little.

Medicine is not the only option. ‘Abdu’l-Bahá explains: ‘There are two ways of healing sickness, material means and spiritual means. The first is by the treatment of physicians; the second consisteth in prayers offered by the spiritual ones to God and in turning to Him. Both means should be used and practised.’

He also adds an interesting rider to this: ‘Illnesses which occur by reason of physical causes should be treated by doctors with medical remedies; those which are due to spiritual causes disappear through spiritual means. Thus an illness caused by affliction, fear, nervous impressions, will be healed more effectively by spiritual rather than by physical treatment. Hence, both kinds of treatment should be followed; they are not contradictory.’[5]

This is not to say that spiritual means in some way trump material means. Shoghi Effendi wrote: ‘Healing through purely spiritual forces is undoubtedly as inadequate as that which materialist physicians and thinkers vainly seek to obtain by resorting entirely to mechanical devices and methods. The best result can be obtained by combining the two processes: spiritual and physical.’[6]

This sense of the complementary nature of the relationship between spiritual and material means is increasingly being endorsed by evidence such as that adduced in Goleman and Davidson’s excellent book on meditation where they explain that what matters most is our relationship to the pain we suffer from. Our experience, as the authors put it (page 148), is not based on the direct ‘apperception of what is happening, but to a great extent upon our expectations and projections.’ They add, ‘consciousness operates as an integrator, gluing together a vast amount of elementary mental processes, most of which we are oblivious to.’

In follow up studies they state (page 167) ‘no research so far has found that meditation produces clinical improvement in chronic pain by removing the biological cause of the pain – the relief comes in how people relate to that pain.’ And at the neurological level, the more you meditate, the lower are the levels of activation in the reactive areas of the brain. So, they are clear we don’t cure the pain by meditation: we maximize the efficacy of the way we deal with it and thus enhance our quality of life.

The value of human contact and support is endorsed by ‘Abdu’l-Bahá: ‘We should all visit the sick. When they are in sorrow and suffering, it is a real help and benefit to have a friend come. Happiness is a great healer to those who are ill. . . .You must always have this thought of love and affection when you visit the ailing and afflicted.[7]

It may even be legitimate at times to exploit the placebo effect: ‘…if a doctor consoles a sick man by saying, “Thank God you are better, and there is hope of your recovery,” though these words are contrary to the truth, yet they may become the consolation of the patient and the turning point of the illness. This is not blameworthy.’[8]

These points also strongly suggest that what we believe has an important role in recovery from illness, and, just as negative thoughts and feelings can impair our health, positive ones can enhance it.

The wealth of modern evidence pointing towards the power of the placebo reinforces this even when physical problems are involved. The nocebo effect, where our negativity undermines the benefits of interventions, points in the same direction in terms of the impact of our minds upon our bodies. It is also becoming increasingly recognised that the value of the medical approach can be augmented by adding psychological approaches into the mix, in terms, for example, of recovery from surgery.

Caveats

There are in addition some interesting and important caveats against blindly following medical advice.

First of all, Shoghi Effendi advises: ‘Before having any serious operation, you should consult more than one qualified physician.’[9]

Secondly, we should not become unnecessarily dependent upon medication: ‘Do not neglect medical treatment when it is necessary, but leave it off when health has been restored…. Treat disease through diet, by preference, refraining from the use of drugs; and if you find what is required in a single herb, do not resort to a compounded medicament. Abstain from drugs when the health is good, but administer them when necessary.[10]

This warning seems to apply to such situations as the abuse of antibiotics and the habituation and addiction to painkillers that escalates the dosage to dangerous levels over time.

Relevant aspects of diet include sugar, which ‘Abdu’l-Bahá consistently warns us is not good in excess, and possibly meat. ‘Abdu’l-Bahá goes as far as questioning its long-term value: ‘What will be the food of the future?’ he asks. ‘Fruit and grains,’ is his answer. ‘The time will come when meat will no longer be eaten. Medical science is only in its infancy, yet it has shown that our natural diet is that which grows out of the ground. The people will gradually develop up to the condition of this natural food.[11]

I must confess to a bias here. I am a vegetarian and have been for just over forty years. I must not though give the impression that the Faith prohibits the eating of meat. It does not. However, Shoghi Effendi states: ‘It is certain, however, that if man can live on a purely vegetarian diet and thus avoid killing animals, it would be much preferable. This is, however, a very controversial question and the Bahá’ís are free to express their views on it.’[12]

Next time I’ll be picking up on the importance of diet and exploring what else is said in the Bahá’í Writings about what we can do to improve our health.

Footnotes:

[1] From a Tablet – translated from the Persian.
[2] From a letter written on behalf of Shoghi Effendi, 13 December 1945 to an individual believer.
[3] From a letter written on behalf of Shoghi Effendi, 6 September 1946 to an individual believer.
[4] 
In a letter written on behalf of Shoghi Effendi, 26 June 1956 to the National Spiritual Assembly of Canada.
[5] Selections from the Writings of ‘Abdu’l-Bahá, Sec 133, pages 151-52.
[6] (In a letter written on behalf of Shoghi Effendi, 12 March 1934 to an individual believer)
[7] 
(The Promulgation of Universal Peace: Talks Delivered by ‘Abdu’l-Bahá during His Visit to the United States and Canada in 1912 2nd. ed. – Wilmette: Bahá’í Publishing Trust, 1982 – page 204).
[8] 
(‘Abdu’l-Bahá, “Some Answered Questions”, 1st pocket-sized ed. Wilmette: Bahá’í Publishing Trust, 1984), pp. 215-16)
[9] 
(In a letter written on behalf of Shoghi Effendi, 8 April 1954 to an individual believer)
[10] 
(Bahá’u’lláh, cited in J. E. Esslemont, “Bahá’u’lláh and the New Era”, 5th rev. ed. (Wilmette: Bahá’í Publishing Trust, 1987), p. 106)
[11] (‘Abdu’l-Bahá, cited in Julia M. Grundy. Ten Days in the Light of ‘Akka, rev. ed. – Wilmette: Bahá’í Publishing Trust – 1979, pages 8-9)
[12] 
(In a letter written on behalf of Shoghi Effendi, 9 July 1931 to an individual believer)

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At the end of October  published an excellent article in the Guardian which further reinforces the scepticism about psychiatric diagnosis that I have explored earlier on this blog. She succinctly makes what is a key point for me:

. . . the DSM [Diagnostic and Statistical Manual] only focuses on . . . “symptoms” and does not take into account the individual’s context. This in itself is a value judgment.

Below is a short extract. For the full post see link.

Psychiatric diagnosis must serve an ethical purpose: relieving certain forms of suffering and disease. Science alone can’t do that.

How do we decide what emotions, thoughts and behaviours are normal, abnormal or pathological?

This is essentially what a select group of psychiatrists decide each time they revise the Diagnostic and Statistical Manual of Mental Disorders (DSM), considered a “bible” for mental health professionals worldwide.

The DSM was first published by the American Psychiatric Association in 1952 to create a common language and standard criteria for the way we classify mental disorders. It’s now used around the world by clinicians, researchers, insurance and pharmaceutical companies, the legal system, health regulators and policy makers, to name a few.

Now in its fifth edition, revisions have gradually expanded the number of mental disorders, while also removing some as understanding or values change. Over the years many of these amendments have courted controversy.

These days, criticisms of the DSM are that it medicalises normal behaviour such as fidgetiness, noisiness and shyness.

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I see there are four? dimensions: all to be produced, in human life: and that leads to a far richer grouping and proportion. I mean: I; and the not I; and the outer and the inner – no I’m too tired to say: but I see it: and this will affect my book… (18.11.35)

(A Writer’s Diary: being extracts from the diary of Virginia Woolf – page 259):

A Blast from the Past

When I was writing the closing post of the last sequence on Virginia Woolf, a name rose up from the depths of my memory store, a name I had not consciously been aware of since I took my borrowed copy of A Glastonbury Romance back to the library more than 40 years ago. That in itself would not be particularly remarkable. I assumed he’d just popped into my head, as these things do, in response to my need at the time for the name of a reasonably well-regarded novelist who didn’t stick strictly to the materialistic script.

I checked with Wikipedia that my memory was basically accurate in that respect. But the name did not go away. I fuzzy fragment of half-remembered pleasure lingered on in connection with his work. Maybe more than that, as I discovered when I began to read the copy of Wolf Solent I had brought back from Cardiff.

Cardiff’s Castle Arcade hides a gem of a bookshop – Troutmark Books. Readers may remember this was where I found a replacement copy of Robert Browning’s The Ring & the Book, a treasure I had lost decades before. We were in Cardiff on other business on this occasion, but I had time to sneak off down one of my favourite rabbit holes into a bookaholic’s Wonderland.

It didn’t take me more than a minute to locate a couple of books by John Cowper Powys. One I didn’t recognise: the other I did – Wolf Solent. One of his handful of best works that I had never read. I’d wanted to find Weymouth Sands or A Glastonbury Romance in order to pick up the thread where I had left it off and to confirm my own vague memory of his mix of mysticism, humour, deft plot twists and weird characters.

But Wolf Solent it was meant to be and I bought it. I checked with the bookseller before I left, but she couldn’t find any other of his novels.

I’m glad I made the purchase.

Maybe my subconscious knew that it would be the perfect novel against which to test the ideas that brewed as I read Virginia Woolf. I needed a novel that captured consciousness but in a more balanced way than The Waves or To the Lighthouse. I wanted to pick up from her tentative formulation as expressed in my diagram at the time.

Somehow ‘Not I’ and ‘Outer’ were so much the same in my mind I couldn’t find a way of using them to test a narrative. I had to find an alternative set of co-ordinates for my quadrants, not completely different, but making the distinction she apparently does not.

Critical Quadrants

As a result I tweaked her wording and came up with the diagram a few paragraphs below.

As a way of explaining fairly simply what kind of narrative might fit into each quadrant, I’ve decided to pick some early passages from Wolf Solent. This will also flag up just how perfect a match this novel is to my needs of the moment.

I need to add here that I am aware that Powys’s narrative technique is far more conventional than Woolf’s, and does not rise to the levels of transliminal intensity that her novels achieve. Even so he makes a good enough fist of it for my purposes, especially given his tolerance for the eccentric, even mystical, in consciousness.

Right from the very first lines of the novel we are in Quadrant A (Penguin 1978 Edition -page 13):

From Waterloo Station to the small country town of Ramsgard in Dorset is a journey of not more than three or four hours, but having by good luck found a compartment to himself, Wolf Solent was able to indulge in such an orgy of concentrated thought, that these three or four hours lengthened themselves out into something beyond all human measurement.

Much of the text occupies this quadrant, but not at the expense of both what bubbles up in Quadrant D and impinges on his consciousness from Quadrant B.

Page 15 touches on Quadrant D:

One of the suppressed emotions they had burst forth on that January afternoon had had to do with the appalling misery of so many of his fellow Londoners. He recalled the figure of a man he had seen on the steps outside Waterloo Station. The inert despair upon the face that this figure had turned towards him came between him now and a hillside covered with budding beeches. The face was repeated many times among these great curving masses of emerald-clear foliage.

One more example of Quadrant A will hopefully convey something of the intensity Powys manages to achieve at times (pages 16-17):

As he stared through the open window and watched each span of telegraph-wires sink slowly down till the next telegraph-post pulled them  upward with a jerk, he indulged himself in a sensation which always gave him a peculiar pleasure, the sensation of imagining himself to be a prehistoric giant who, with an effortless ease, ran along by the side of the train, leaping over hedges, ditches, lanes, and ponds, and easily rivalled, in natural-born silent speed, the noisy mechanism of all those pistons and cog-wheeels!

He felt himself watching this other self, this leaping giant, with the positive satisfaction of a hooded snake, thrusting out a flickering forked tongue from coils that shimmered in the sun. And as the train rushed forward, it seemed to him is if his real self were neither giant nor snake; but rather that black-budded ash tree, still in the rearward of its leafy companions, whose hushed grey branches threw so contorted a shadow on the railway bank.

His only companion in the carriage is a bluebottle. Quadrant B pops up. He is not oblivious to its antics as it crawls across the adverts of seaside resorts (Page 21):

The bluebottle fly moved slowly and cautiously across Weymouth Bay, apparently seeking some invisible atom of sustenance, seeking it now off Redcliff, now off Ringstead, now off White Nore.

I’ll come back to Quadrant C in a moment.

Basically then, Quadrant A captures the unexpressed workings of a character’s mind. Quadrant B takes in the external world as it impinges consciously on the senses of a character.

Quadrant D most probably focuses most of the time as here upon leaks from the unconscious as they surface, and is therefore technically speaking no longer the unconscious from that point on.

However, it might theoretically be possible for the actions or emotions of a character to indicate that (s)he had been affected subliminally by some form of trigger although I am almost certainly going to treat such moments as belonging more appropriately in Quadrant C.

Jung gives a perfect example of this when he describes walking with friends and being overtaken by a sudden inexplicable feeling of sadness. It was so strong he felt compelled to leave the group to walk on ahead while he backtracked to see if he could find what had triggered this feeling. It did not take him long to walk past a hedge through which the scent of a particular flower was wafting in the breeze. Its associations brought back a painful memory. When he first walked past he had not consciously registered the scent but it had affected him subliminally and powerfully nonetheless.

Quadrant C could also contain neutral descriptions of the inanimate world, the material conditions surrounding the character at the time, by which the character is probably neither consciously nor unconsciously affected. It might even include the appearance of the character himself, as with Wolf Solent at the start of the book (page 13):

He was tall and lean; and as he stretched out his legs and clasped his hands in front of him and bowed his head over his bony wrists, it would have been difficult to tell whether the goblinish grimaces that occasionally wrinkled his physiognomy were fits of sardonic chuckling or spasms of reckless desperation.

It is hard to read this as Wolf Solent’s own view of himself. Occasionally then in this book we are going to find the ghost of the narrator stepping out of Wolf Solent’s mind.

There is a residual problem.

I am not yet sure where I should place mystical or transcendent experiences. Should they be in Quadrant A or Quadrant B? Perhaps this will depend upon what I conclude John Cowper Powys believes. If he clearly writes as though the transcendent world is real for him, descriptions of it could belong in Quadrant B: if not, they would belong in Quadrant A. The presumption then would be that they could not be shared with other characters, only experienced by one.

I am really looking forward to seeing whether this approach succeeds in teasing out how well John Cowper Powys captures consciousness in a broader context than Woolf was attempting to do in the novels I explored in the previous sequence, and whether that makes for a more satisfactory experience for me as a reader who is fascinated by the idea of learning more about this elusive yet all-pervading experience.

John Cowper Powys (For source of image see link)

Possible Plot Spoiler

I am now more than 100 hundred pages into this 600 page narrative, and can already detect that, for the right balance to be struck between consciousness and context, not only has the rendering of consciousness to be credible and engaging, which it has been so far for the most part, but the context also has to feel the same. Both have to be credible enough at least not to undermine my willingness to suspend my disbelief. I’m not so sure on that last point yet.

An example might help to illustrate what I mean.

What follows contains a plot spoiler so if you plan to find the novel and read it you may prefer to stop reading this post right now.

Wolf Solent has gone back to his roots and to the place where his father planted more than a few wild oats. Unexpectedly one day he learns that his mother is arriving that evening and planning to stay. He has to find her a place to sleep that night, prior to her moving with him to a cottage on the estate whose owner he is working for. He drops in on an old family friend, Selena Gault, and finds she has a child with her, Olwen Smith. Olwen almost immediately remarks upon the fact that his nose is the same as her Aunt Mattie’s.

On the very first page of the book I had learned that Solent has a hooked nose.

When the child twigs his mother needs somewhere to stay, she insists that it be with her aunt and her granddad, the hatter his father knew.

When he takes his mother to the hatter’s house he meets Mattie for the first time. His Quadrant A reactions to Quadrant B data are significant (page 140):

Mattie turned out to be a girl with a fine figure, but an unappealing face. She looked about twenty-five. She was not pretty in any sense at all, in spite of what [his mother] had said. Her thick, prominent nose was out of all proportion to the rest of her face. Her chin, her forehead, her eyes, were all rendered insignificant by the size of this dominant and uncomely feature.

This must be what Solent notices about Mattie as it is described as the result of his study of her. This, as we will see, is a Quadrant D trigger for some Quadrant C subliminally leaked reactions (page 142): ‘What was this queer attraction which he felt for her, so different from the interest excited in him by her father and by the little girl?’

This example is a good one as it contains material from all four quadrants and therefore illustrates the way in which Wolf Solent as a novel balances internal and external more completely than Woolf’s The Waves.

So what is the credibility problem here?

Given that the novel up to this point has conveyed a picture of Solent as both observant, perceptive and very tuned in to his own mind and its reactions, I find it hard to believe, given his understanding of his father’s waywardness, that it did not occur to him almost straightaway that there might be a family resemblance here resulting from a closer than socially acceptable connection between his father and her mother. The need to tease me as reader, which is quite amusing I agree, has trumped the need for consistency in Solent’s character, or so it seems at this point.

Admittedly we might adduce a degree of resistance in Solent to an unpalatable truth, so I am probably rushing to judgement a bit here. It seemed worth including it, even so, as a possible early example of how the capturing of consciousness can be compromised by the demands of a plot – not a problem that Woolf allows to happen given her abandonment of plot in any meaningfully accepted sense in the two novels I have examined so far.

Subsequent twists and turns of plot in Wolf Solent may cause me to revise my current estimate.

More of this later maybe!

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