Archive for the ‘Psychology & Society’ Category

As a regular attender at our local Death Cafe in Hereford I found the following Guardian article an irresistible read. It puts my interest in the subject into an intriguing but not entirely flattering context. Below is a short extract: for the full post see link. Another article of similar interest – It was an incredibly enriching day – can be found at the following link.

Death is hot right now, and upbeat gatherings in cemeteries are just a small part of the trend. One of the chief desires of our time is to turn everything we touch into a reflection of who we are, how we live and how we want others to view us – and death is no exception. Once merely the inevitable, death has become a new bourgeois rite of passage that, much like weddings or births, must now be minutely planned and personalised. Not since the Victorian era’s fetishisation of death, with its all-black attire, elaborate mourning jewellery and seances, has death been so appealingly packaged. Every death must be in some way special and on-trend. Finally, the hipster can die as he lived. . .

For people . . .  more worried about the terrifying prospect of dying alone, there are now solutions (or at least partial ones). You can hire a death doula, a trained professional who will assist at the end of life in the same catch-all manner that birth doulas are there during labour. You can request a home funeral, in which your friends and family pay their respects to your corpse in the comfort of your living room, with every detail as carefully planned as a wedding. And before that day arrives, you can discuss the facts of death with like-minded souls at a Death Cafe, a meeting of the global movement started by Jon Underwood in 2011 (who died last summer of acute promyelocytic leukaemia) as a way for people to gather and reflect on mortality.

One of the people pioneering this new way of approaching death is Caitlin Doughty, a young, Los Angeles-based mortician who looks like a lost member of the Addams Family. She has written a bestselling memoir, hosts a YouTube series called Ask a Mortician and has founded a “death acceptance collective” called The Order of the Good Death, whose youthful members promote positive approaches to mortality.

“It’s OK to be openly interested in death practices,” Doughty told me while driving through LA one afternoon last autumn. “It makes you an engaged human who cares about all aspects of life. Ghettoising it as an interest particular to goths, weirdos or people obsessed with murder creates a dearth of honest conversation about death in the western world.”


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Video May 1993

In the main video interview transcript, an extract from which features at the beginning of the first post in this sequence, there is a very important passage focusing on one aspect of the impact of consultation on a key aspect of Ian’s difficulty with the voices. It concerns his memories of what he had done that made him feel so guilty.

I.: Well, when I was ill, it didn’t seem real. You know what I mean? My memory didn’t seem real. It was like a dream. And it was as if I’d never done anything. But talking to you reminded me that I’d actually done these things, you know? And that it was memory. And that I’d actually done the things.

P.: It was memory not imagination?

I.: That’s right. It was reality.

P.: And how did knowing that it was reality prove so helpful? What did it do?

I.: Well, it proved the voices wrong for a start.

P.: Ah. Why? Were they saying that they were real and your memories weren’t?

I.: Yeh. It proved the voices were wrong. And that my memory was right. And talking to you fetched it out into the open.

In a later video interview in September the following year, Ian explained that he felt as though talking helped get the feelings he had repressed ‘out into the open.’ He was in effect able to consult about them. Reflection had paved the way towards his being able to think about the feelings and begin to feel them. Talking about them brought them more fully into the open and enabled him to make better sense of them. The voices on the other hand fed on his habit of suppressing his feelings.

The September interview also explained how we had refined our understanding of his pattern of suppression. If he began to feel low, slightly depressed, he’d switch off his feelings which then brought the voices back.

But I must not make this process sound too simple. Yes, it is true that learning to reflect can pave the way both to a better understanding of our own mind and heart as well as potentially enabling us to share our discoveries with someone else and compare notes in a consultative fashion. But the transition is not necessarily automatic.

Video September 1994

The Importance of Trust

Take this extract from the May 1993 video. Jenny was his care worker.

P.: And it was in November that we first met, wasn’t it?

I.: Yeh. Jenny had started talking about you, you know? And it was coming up to the meeting with you. And I can remember going to the meeting with you that first time. And I can remember thinking who’s this bloke asking me all these questions, you know? And I didn’t trust you. But Jen was persistent that I could trust you, so I decided to trust Jenny . . .

P.: Right.

I.: . . . and to talk to you.

P.: And you actually asked if Jenny could come to sessions, didn’t you?

I.: Yeh, I asked if Jenny could come, yeh.

P.: Right. And I think she came about the second or third time you came.

I.: Yeh.

P.: And did you feel more comfortable with her there?

I.: I did, yeh.

P.: And did that make you feel more able to begin to trust me at least personally if not what I was doing?

I.: It took about a month to start to trust you. And that was with Jenny backing you up.

P.: And that was by being there in the sessions and by talking to you between whiles . . .

I.: With Jenny.

P.: . . . betweentimes.

I.: Inbetweentimes, yeh. And we’d talk about what we’d talked about, you know? And she supported you in what she said.

This extract testifies to how hard Ian found it to trust me. If it had not been for the fact that he had been living for some time, since his discharge from hospital, in a social services home specialising in the care of people with serious mental health problems, and if he had not had the time to build up a trust relationship with his care worker, Jenny, over that period, on an almost daily basis, who knows how long it would have taken him to trust me enough to work with me, or whether he would ever have been able to trust me enough at all, given we met only once a week. A sense of trust is not easy for someone who has been abused and a sense of safety is not easy for someone who has been traumatised. Ian had experienced both abuse and trauma.

After the May interview, the field of consultation had expanded beyond his Thursday meetings with me and his regular conversations with Jenny to include a Voicework Group, which had been set up at his instigation. He felt strongly that these opportunities for consultation were as important for him as his medication. Without Jenny, though, building sufficient trust to do effective work it would have taken far longer to reach this point, though he felt it would have happened in the end even so. I’m not so sure on that as he was.


There is one quality that has been implicit in much that I’ve said so far. It is both the fruit of even the early stages of reflection and the soil from which a further ability to reflect more deeply springs. It is also an essential prerequisite of consultation. Those who are too attached to their own perspective will always find it hard to consult. I am speaking of the quality of detachment. Its power goes even further than this. Bahá’u’lláh, the Founder of the Bahá’í Faith, wrote (Arabic Hidden Words No 68 – my emphases):

Know ye not why We created you all from the same dust? That no one should exalt himself over the other. Ponder at all times in your hearts how ye were created. Since We have created you all from one same substance it is incumbent on you to be even as one soul, to walk with the same feet, eat with the same mouth and dwell in the same land, that from your inmost being, by your deeds and actions, the signs of oneness and the essence of detachment may be made manifest.’

If we are divided against ourselves we are also going to be in conflict with others. If we can, by a process of reflection, become both more detached and more integrated, we can transcend both our inner conflicts and our conflicts with others.

‘Abdu’l-Bahá describes this possibility in the following words (Selections from the Writings of ‘Abdu’l-Bahá 1978 – page 76):

. . . .all souls [must] become as one soul, and all hearts as one heart. Let all be set free from the multiple identities that were born of passion and desire, and in the oneness of their love for God find a new way of life.

Even if we do not believe in a God but at least have faith in the essential oneness of all humanity, this will help remedy our current conflicted state, wherein we are at war with ourselves as well as with others. This is Bahá’u’lláh’s description of the challenge we face compared with the reality most of us are blind to (Gleanings from the Writings of Bahá’u’lláh = CXII):

No two men can be found who may be said to be outwardly and inwardly united. The evidences of discord and malice are apparent everywhere, though all were made for harmony and union. The Great Being saith: O well-beloved ones! The tabernacle of unity hath been raised; regard ye not one another as strangers. Ye are the fruits of one tree, and the leaves of one branch.

This is another two way street. As individuals in harmony with ourselves we become more able to love and care for others, and as communities in harmony with one another we become more able to support and care for our fellow human beings.

Such levels of detachment, reflection and consultation are not easy to reach and are even harder to sustain, but the effort of attempting to do so is amply rewarded. Usually the effort is more than compensated for by the benefits gained.

Crucial Caveats

However, it would be too simplistic to suggest that people struggling with challenges as monumental as those Ian had to battle with can always achieve these benefits in a sustainable way. I am not arguing that reflection and consultation are always possible for people in such extreme distress.

Many of the contexts in which a person struggling with psychosis is placed seem neither safe not trustworthy. Sometimes the contents of a client’s consciousness prove so terrifying or distressing they cannot feel safe dealing with them nor trust their ability to manage them.

There came a point where the lady with the history of abuse chose mind-numbing medication rather than deal with the worst of her experiences.

After almost a year of our work together things seemed to be going well. Then came the unexpected. She found herself in a building that closely resembled the building strongly connected with the worst episode of abuse she had experienced at the hands of her father. Just being there was more than she could cope with. She became retraumatised in a way we none of us could have anticipated or prevented. The next time we met she could not stop sobbing.

We discussed what she might do. There were two main options.

She could, if she wished, continue on her current low levels of medication and move into a social services hostel where she would be well supported while we continued our work together, or she could be admitted onto the ward and given higher levels of medication in order to tranquillise her out of all awareness of her pain.

She chose the second option and I could not blame her in any way for doing so. It would be a betrayal of the word’s meaning to suppose she had any real choice at that point but to remain psychotic while the medication kicked in rather than deal with the toxic emotions in which she felt herself to be drowning.

Ian did the same when it came to his memories of slaughter from his army days. It was in June that he experienced a devastating return of the voices that led to his hospitalisation. Further exploration discovered a link between a traumatic army experience, which had occurred at that time of year, and an overwhelming reactivation of the voice-inducing guilt – far stronger than anything he had experienced in connection with his breach with his alcoholic partner. Each year after that he preferred to allow himself to become psychotic rather than attempt to process the intolerable guilt. He chose increased medication and admission to hospital till the anniversary effect was over, when he would be discharged to resume a relatively normal life until the next anniversary.

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

A Genuine Help

What I am contending from my decades working with ‘psychosis’ in the NHS is that my CBT training was made more effective by my spiritual practice and the facilitation of those twin skills: reflection and consultation. The meanings achieved as a result facilitated flexibility and personal integration, as against the distressing rigidity and disturbing inner and outer conflict of the psychotic experience.

Hopefully one day these conclusions from personal practice will be validated in systematic studies.

An additional point to mention is that this is not just a model for psychosis. Take Laura for example, with her diagnosis of endogenous depression, ie one that her doctor felt was not explicable in terms of her life situation. She used to believe that her parents were more or less perfect. The work we were doing became very stuck and seemed to be going nowhere.

We had plateaued on bleak and distressing terrain, more tolerable than her previous habitat but too unwelcoming to live on comfortably for the rest of her life, and yet with no detectable path towards more hospitable ground.

Frustrated by the protracted lack of movement, I began to see discharge as a very attractive option. I discussed this with my peer supervision group.

Effective group supervision provides a context where fruitful consultation can take place and better decisions about the most fruitful line of action can be made. We decided that I should continue with the processes of exploration but make sure that I did not continue my habit of stepping in relatively early to rescue her in sessions from her frequent experiences of intense distress.

I continued to see her. Laura and I consulted carefully and jointly agreed that I would allow her to sink right into the “heart of darkness” in order to explore it more fully and understand it more clearly. The very next session, when we first put this plan into action, after I had left her alone in her silence for something like half an hour, Laura came to a powerful realisation at the heart of a very intense darkness. She said: “I think my mother threw me away even before I was born.” Thankfully consultation had helped me manage to avoid doing something similar by discharging her before we had resolved the causes of her depression.

This paved the way for deeper and more fruitful explorations of the reality of her childhood, continuing to use the same reflective and consultative process I have been describing in this sequence of posts.

Ian’s Last Word on the Matter

P.: Is there anything else that you feel that you want to say that I haven’t brought out by the questions I’ve asked you?

I.: No, except that the pain, you know, the questions you asked were painful. And I didn’t want to answer them.

P.: And you didn’t see the point of answering them either, did you?

I.: No, I didn’t see the point in answering them because I didn’t recognise myself that the problem lay there. But once I could see where the problem was I could bargain with the voices.

P.: Yeh. And you had to know where the problem lay, roughly . . .

I.: Yeh.

P.: . . . before you could bargain with them?

I.: And talking to you showed me where the problem was. So, I was able to deal with the voices in a positive way.

P.: Yeh. But before you had gone through this whole process there was no way you would have realised that the problems were what they turned out to be.

I.: No. I thought it was just schizophrenia.

P.: Yeh. And that was the end of it.

I.: And that was the end of it. I was schizophrenic and that was it. And I had nothing to look forward to except hospital and more medication. And I couldn’t stand the thought of that, you know? So that jumping under a train was looking very attractive. But it doesn’t look attractive now.

P.: Because life seems to have more to offer?

I.: Yeh.

I need to add here, though, to put all this fully into context, that I visited him in the hospice when he was dying of emphysema and other complications consequent upon what he knew was his self-damaging habit of heavy smoking. He was well aware of the implications of the injury to his lungs caused by the bomb blast that led to his being discharged from the army on health grounds.

I sat by his bed watching him breath in oxygen from the cylinder at his bedside. When he had taken in sufficient oxygen, I felt moved to ask him the question I had asked once before during our therapeutic relationship.

‘In the light of all you know now, were the gains you made worth the pain you had to go through?’

‘No,’ was the answer he gave. ‘They weren’t in the end.’

As he did not spell out exactly why not, I did not feel it right to press him for his reasons. Even so, his answer taught me a lot, not least how difficult it is to be sure you have obtained fully informed consent before embarking on any intervention.

I’ll leave it there until the New Year, and pause my posts until then as I did last year. I wish all my readers well over this festive season.

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PTSD and war

Before we plunge further in from where we got to last time, I need to look briefly at what is known about the impact of war trauma on those affected by killing other human beings. This will help clarify just how disabling the effects of Ian’s experiences were likely to be on someone who was already undoubtedly very vulnerable.

There was an in-depth look at this in a television documentary in the wake of the Falklands War. The programme adduced a wealth of evidence that most human beings have a powerful and deep-seated aversion to killing other people. Approximately 98% of us are to varying degrees averse. For example, there were soldiers in the days of muzzle-loading muskets, who died with their muskets in their hands, the barrel full of undischarged ammunition balls. They had faked reloading without firing, so reluctant were they to risk killing anyone. Others, using rifles, were known to aim to miss or to wound slightly rather than to kill.

There are two outliers, representing about 1% in each case, who have no such inhibitions. One such exception is, not surprisingly, the psychopath. The other exception, which is very surprising, is an otherwise morally and emotionally normal individual who has no compunction about killing.

Psychologists, to their shame, devised training methods, using probable battle scenarios, that made rapid and automatic shooting to kill seem easy and unproblematic. These scenarios were practiced repeatedly until the lethal reaction was instinctive. What no one predicted was how traumatic many soldiers found it, to be confronted in battle with the consequence of their training: a dead soldier they had killed without a moment’s thought. As with Ian, the post-traumatic reactions were often devastating, with guilt and horror as key components of flashbacks and nightmares. In his case the signs of trauma were the unrelenting voices, a waking nightmare in effect.

Some of the horror of this is captured in Keith Douglas’s poem of the Second World War, How to Kill.


Keith Douglas

Under the parabola of a ball,
a child turning into a man,
I looked into the air too long.
The ball fell in my hand, it sang
in the closed fist: Open Open
Behold a gift designed to kill.

Now in my dial of glass appears
the soldier who is going to die.
He smiles, and moves about in ways
his mother knows, habits of his.
The wires touch his face: I cry
NOW. Death, like a familiar, hears

And look, has made a man of dust
of a man of flesh. This sorcery
I do. Being damned, I am amused
to see the centre of love diffused
and the wave of love travel into vacancy.
How easy it is to make a ghost.

The weightless mosquito touches
her tiny shadow on the stone,
and with how like, how infinite
a lightness, man and shadow meet.
They fuse. A shadow is a man
when the mosquito death approaches.

This is an equally disturbing but different kind of trauma from the kind captured in Wilfred Owen’s poems, such as Dulce et Decorum Est.

The intense guilt Ian harboured about his army experiences was too hard to bear and he had buried it. However, his subsequent guilt over throwing his alcoholic partner out of the house because her drinking was consuming his income from three jobs and he couldn’t cope any longer, reactivated the earlier even more intense guilt, because he thought she might die on the street, meaning that he might in a sense have killed her.

During the first period of therapy he felt that he was dealing only with his guilt about her, and that this was the main problem in terms of his voices. This was hard enough. Only later did he come to realise, by the impact of an anniversary effect I’ll come to in the next post, that the far darker army experiences, that he hadn’t yet dealt with, lay still active in this respect underneath.

What use is religious practice here?

There is much evidence that faith and religion are beneficial to mental (and physical) health. They reduce amongst other difficulties: depression, anxiety, suicide, & psychosis. The protectors they provide include: greater meaning and purpose, higher self-esteem, social support, less loneliness and more hope. (Harold Koenig at al. in Religion and Health’ Chapter 15)

My focus now will be on two aspects: reflection and consultation. Buddhism offers the most obvious example of powerful reflective processes. There is also a wealth of information that suggests most strongly that the process of collaborative conversation (Andersen and Swim), of consultation in the Bahá’í sense (see John Kolstoe), of inquiry (see Senge), of interthinking, can achieve remarkable results: Neil Mercer talks of the crucial function of language and says:

it enables human brains to combine their intellects into a mega-brain, a problem-solving device whose power can be greater than that of its individual components. With language we are able not only to share or exchange information, but also to work together on it. We are able not only to influence the actions of other people, but also to alter their understandings. . . . . Language does not only enable us to interact, it enables us to interthink.

It is the special combination of both these processes that is unique to the Bahá’í Faith as far as I am aware, though variations of each alone can be found in other either religious or educational/therapeutic contexts.

After I qualified and became a member of the Bahá’í community, fully integrating my understanding and practice of these processes into my clinical repertoire took a couple of years. I came to feel the benefits of that were considerable.

These weren’t the only factors I tried to accommodate. The hardest to digest was the belief that the mind is not dependent upon the brain. I have dealt with that in detail elsewhere.

The easiest was the notion that not only is the spiritual core of all religions essentially the same, but also humanity is in essence one: we are all part of the human family and all interconnected, not just at a material level but at a spiritual one as well. This is relevant here. This concept of unity not only serves to dispel any residual sense we might have that someone with a diagnosis of schizophrenia is somehow a different kind of being from us, but it also clarified that being inwardly divided, as many of us are, is not only a betrayal of our own essential inner oneness but an obstacle to our connecting with others, not just as a therapist but in any relationship. Similarly a community that is at odds with itself with find it hard to connect with everyone on a harmonious basis. I will be returning to that point.

My shorthand description of reflection is to say that it involves separating consciousness from its contents. Consultation, in similarly brisk terms, is the dispassionate comparison of notes, with the emphasis here on the word ‘dispassionate.’


In discussing the nature and power of reflection I usually start with Peter Koestenbaum’s book, New Image of the Person: Theory and Practice of Clinical Philosophy.

Reflection, he says (page 99): ‘. . . releases consciousness from its objects and gives us the opportunity to experience our conscious inwardness in all its purity.’ I will look more closely at exactly what this might mean in a moment. Before we move on from his take on the matter, what he says at another point is even more intriguing (page 49): ‘The name Western Civilisation has given to . . . the extreme inward region of consciousness is God.’

I am quoting this upfront so that, if you find what I’m going to say from a faith perspective hard to accept, this might help.

In earlier posts I have discussed how psychosis is a very rigid and inflexible state of mind. I believe it is simply at the end of a continuum along which we all are placed. We all to some degree at times overvalue our beliefs, our perceptions, our simulation of reality. This can bring about a degree of attachment to them that makes us inflexible and highly resistant to contradictory evidence or different perspectives. This does not create a huge problem if our take on reality is not also destructive or frightening or both.

Fixity in the face of often extremely unpleasant phenomena causes an unacceptable and virtually inescapable amount of distress to the sufferer and of anxiety in his friends and family. The distress is what brings the sufferer to the attention of the psychiatric services. Psychiatry then applies the label schizophrenia. This label, in my view, mixes up the content of the experiences with the person’s relationship to those experiences in what can be a most unhelpful way.

Just as it is important to separate our perceptions (voices, visions and other internally generated experiences in other sensory modalities) from our understanding (beliefs, models, assumptions, meaning systems etc), it is crucial also to separate out, from the nature of these experiences in themselves, this loss of perspective and flexibility which I am calling fixity.

I have examined elsewhere on this blog the various ways that this fixity can be dispelled. Here I plan to focus simply on reflection. This is not because they are irrelevant. One, which I term disowning, by which I meant discounting or suppressing uncomfortable contents of consciousness such as pain, grief or guilt, was something Ian described in in the process of our shared reflections: he saw himself as increasingly ‘recognising’ his feelings rather than ‘repressing’ them.

My focus though will be on how reflection enables us to contain unpleasant material in consciousness, giving us time to think about and explore it, prior to integrating it.

Bahá’u’lláh, the Founder of the Bahá’í Faith, in the Kitáb-i-Íqán (Book of Certitude) quoted a hadith from the Islamic tradition: ‘One hour’s reflection is preferable to 70 years’ pious worship.’


His son ‘Abdu’l-Bahá, explored this in a talk he gave at a Friends’ Meeting House in London in 1913. He spoke of reflection, meditation and contemplation as virtually equivalent concepts. He went on to explain their power (Paris Talks – pages 174-176):

This faculty of meditation frees man from the animal nature, discerns the reality of things, puts man in touch with God. . . .

Through this faculty man enters into the very Kingdom of God. . .

The meditative faculty is akin to the mirror; if you put it before earthly objects it will reflect them. Therefore if the spirit of man is contemplating earthly subjects he will be informed of these. . . .

What he says for me maps onto Koestenbaum but in more directly spiritual terms. It explains why reflection, also connected with meditation and contemplation, is so powerful from a Bahá’í point of view.

The mirror analogy along with Bahá’u’lláh’s various references to the human heart as a mirror, led me to ask: what are the possible similarities between consciousness and a mirror?

Basically, a mirror is NOT what is reflected in it. In the same way, consciousness is not its contents. We are not what we think, feel, sense, plan, intend, remember, imagine and so on. This is also known as Disidentification in Psychosynthesis. In Jessica Davidson’s very brief summary, the affirmation exercise this form of therapy uses reads like this:

I have a body and sensations, but I am not my body and sensations. I have feelings and emotions, but I am not my feelings and emotions. I have a mind and thoughts, but I am not my mind and thoughts. I am I, a centre of Pure Awareness and Power.

Less controversially for most people I suspect, I would prefer to affirm that I have sensations, but these change from moment to moment so I cannot be my sensations. I am the capacity to sense. And so on with feelings, thoughts, plans, memories and imaginings, including our ideas about ourselves and what or who we are. Assagioli’s final affirmation was, as I remember, ‘I am a centre of pure consciousness and will.’

Reflection enables us to find meaning in what we are tempted to call ‘madness.’ It gives us the freedom to examine it even if only in our own minds. Psychosis is almost always meaningfully rooted in a client’s experience.

How might reflection help us find meaning?

Reflection helps counteract the fixity of attachment to the contents of consciousness that characterises what is called the ‘psychotic’ experience. The crucial stepping back relates not just to the experiences themselves, such as visions and voices, but to the explanations the sufferer has created for the experiences, which then cease to be delusional.

What Ian thought was just schizophrenia had meaning. Understanding and integrating that meaning released him from his voices. To understand his psychotic experiences he had to neither suppress them nor surrender to them: he had to contain them so he could examine them.

Recognising that they were simply the contents of his consciousness enabled him to step back, experience and think about them. They no longer had power over him.

I will sharing some of his thoughts on this in the final post.


But there is one step further we can go.

When Ian loosened his identification with his experiences, he was able not just to think about them, he could also compare notes with others about what they might mean: he could consult in a Bahá’í sense of that undervalued word.

The Bahá’í International Community, which represents the Faith at the United Nations, quotes Bahá’u’lláh on consultation (The Prosperity of Humankind Section III): ‘In all things it is necessary to consult. The maturity of the gift of understanding is made manifest through consultation.’

What might He mean by that. Paul Lample in his excellent book Revelation and Social Reality puts forward his view: (page 199):

Consultation is the method of Bahá’í discourse that allows decisions to be made from the bottom up and enacted, to the extent possible, through rational, dispassionate, and just means, while minimising personal machinations, argumentation, or self-interested manipulation.’

Key words and phrases here are: ‘from the bottom up’ which I take to mean not imposed in some condescending fashion by those who feel superior; ‘dispassionate’ meaning objective and detached (something I’ll come back to in more detail in the next and last post); and ‘minimising . . . manipulation,’ so no ulterior motives or advantage seeking creep in.

Later he adds further illumination (page 215):

[C]onsultation is the tool that enables a collective investigation of reality in order to search for truth and achieve a consensus of understanding in order to determine the best practical course of action to follow.… [C]onsultation serves to assess needs, apply principles, and make judgements in a manner suited to a particular context.’

The key concept here is the ‘collective investigation of reality.’ This means that all parties involved in consultation are comparing notes, sharing perspectives, without undue attachment to their own point of view and not in an attempt to win an argument but with a sincere striving to understand reality better.

Just as the client needs to reflect, so does the ‘therapist.’ It is a two way street. And the therapist needs to model what she wants the client to learn: reflection. If she does not consultation is not possible. She must be as detached from her conclusions as she wants the client to be. If both client and therapist can reflect together as equals they are genuinely consulting. They can achieve a higher level of understanding, a better simulation of reality, together, than they ever could alone.

We are now ready to explore the impact of these processes on Ian and to examine some other important factors and considerations. More of that next time.

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‘Reflection takes a collective form through consultation.’

(Paul Lample in Revelation and Social Reality – page 212)

One evening, towards the end of last month, I gave a talk at Birmingham University, concerning a Bahá’í perspective on making sense of mental illness as derived from my own clinical experience. Even though I had two hours at my disposal, I still had more planned than I had time to say. This was partly because some of the comments and questions sparked a lengthier diversion than I had intended. Anyway, I thought I’d publish everything I intended to say on this blog.

The quote at the top defines what processes this sequence of posts will be exploring in more depth in terms of their positive impact upon helping people find meaning in their experiences when they are struggling to cope with psychotic phenomena.

But before we home in on those we need a helicopter view of the overall context of the problems and processes we’ll be examining here.

Trauma, Transliminality and Psychosis

Previous posts on this blog have explored the possible relationship between the factors captured by this diagram. The focus though right now will be on trauma and psychosis.

Hearing voices and strange but strongly held beliefs are two key supposedly correlated signs we will be looking at today. Thought disorder and extreme withdrawal from contact with other people are also taken to be signs. I don’t propose to delve into the validity of the label all too frequently attached when more two or more of these come together in distressing form. For anyone interested, see Mary Boyle’s Schizophrenia: a scientific delusion for a clear exposition of the sceptical case against the idea these form a real syndrome.

For an understanding of the evidence for a relationship between psychotic phenomena and trauma see Longden and Read’s The Role of Social Adversity in the Etiology of Psychosis. They deal extensively with this problem (pages 7-8):

Large-scale population studies have shown that associations between adversity and psychotic experience remain significant when controlling for possible confounders, including: family history of psychosis and other mental health problems (which negates the notion that psychosis only occurs in those genetically predisposed), age, sex, ethnicity, marital status, exposure to discrimination, other psychiatric diagnoses, education level, neuroticism, and substance use. Furthermore, the association has repeatedly demonstrated a dose-response relationship; that is, the likelihood of psychosis increases relative to the extent of adversity exposure.

Transliminality refers to the permeability of the filters surrounding our consciousness, whether that be from beneath (the brain’s subconscious) or above (some kind of transcendent level). Helpful analogies that illustrate the idea of such thresholds of access are our eye/brain system’s limited perception of light’s spectrum, a receiver such as a radio that only translates into intelligible sound the frequencies it is tuned into, or a transceiver such as a computer that can access and decode appropriate data stored in a cloud site as well on its own hard drive. Accessing outside those given ranges is taken to be impossible for the manmade devices. However whether the brain can access outside its normal range is a vex question. Good sources for evidence that this might be so can be found in Mario Beauregard’s The Spiritual Brain or in Irreducible Mind by the Kellys.

Ian’s Experiences of Psychosis

There are two people who were tormented by so-called psychotic phenomena from whom I learned a great deal more than they probably learned from me about what these are and how to deal with them. The lady in the poem above is one: Ian, whom I’ll consider in a moment, was another.

The lady had asked for help to deal with her childhood experiences of extreme abuse. Unlike with Ian, I do not have her permission to go into detail. However, what I can say to illustrate the depth of her problem is that the one-hour sessions dealing with her work on the abuse had to be divided into three roughly equal parts. The first part checked up on how things were going and that she wanted to continue the painful work. The second part looked at the abuse and her intensely painful memories of it, and the third part involved calming her down sufficiently after this to dispel the powerful and reactivated visual and auditory hallucinations of her father, the abuser.

I will look later in the sequence at one other indication of the painful and powerful hold the past abuse still had over her.

I can directly use Ian’s own words to convey the kinds of experiences he was grappling with. This is an extract from the transcript of a video interview which took place in late May 1993. Obviously P is me and I is Ian.

P. Could I ask you to describe at first how things were, say, a year ago before there was ever any question of our meeting and when things were not too good for you?

I.: Well, I’d got the voices nearly all the time. They used to wake me up at night, you know?

P.: Yeh. And can you say what kind of things they used to say, just as an example?

I.: `Get out of bed, you lazy bastard. Get up and wake up. Come flying with us. Go and jump in front of a train,’ you know?

P.: Right. And they were saying this to you constantly, were they?

I.: Constantly, yeh.

P.: Were they constant in the day?

I.: Yeh.

P.: Were they very loud?

I.: Yeh. They got loud when I was ill, you know, they got loud.

P.: Right. So, say last May, or last Spring, May, June, July, is this how it was with the voices . . .

I.: Yeh. They were pretty bad. They were loud, you know? They were right down in my ears. And – er – I was seeing things as well. I was seeing what I call the – the `Boss’, you know? He only come at night, yeh.

P.: Right. Where did you think these voices came from?

I.: The spirit world.

P.: So you thought they were ghosts of some kind, or . . .

I.: I thought they were spirits, come from the spirit world for me, you know? And that they wanted me to go with them. I didn’t think that I was going to hurt myself by killing myself, you see? But something inside me just wouldn’t let me do it, you know?

P.: Yeh. You held back?

I.: I think it was because I was afraid of hurting myself.

P.: Right. Because you did say at the time that unless you actually did it instantly it wouldn’t really count, would it?

I.: No.

P.: Right. So it was very important to you that you didn’t end up injured or in a worse state.

I.: Yeh. It was important not to get injured. It had to be a certain thing, you know? And the Express train looked the part.

P.: Right.

In an earlier exchange that month on audiotape, in response to my question as to whether his ‘experiences . . . were shutting [him] out from the world and shutting [him] out from the future,’ he replied, ‘Yeh. I was living in a dream world, you know.’ He also described it in the same interview as ‘brainwashing.’ He said:

They were so loud that I couldn’t hold a conversation, you know. And I couldn’t listen to the radio. They just blocked everything out. And I couldn’t think because they just sidetracked me, you know, saying the same thing over and over and over.

In an interview in September of the following year, he clarified further by saying that he no longer did what the voices told him to do, as he had in the beginning. He knew now they were not spirits but the products of his own head. Even so it was still hard work to keep them at bay.

In working with people experiencing psychotic phenomena, I found it important to distinguish the experience, with which I never sought to argue, from the explanation, which could be modified in helpful ways, for instance here in terms of the power of the voices. It is possible that this will lead, as in Ian’s case, to a recognition that the voices come from inside the person’s own head. This though is neither necessary nor inevitable. It is sufficient that a more benign explanation of the voices is arrived at that gives them far less power and, if possible, reduces any malignity.

Ian’s Life

For those interested in the full back ground to his psychotic experiences and how far back in his life traumatic events and situations began helping to shape his sensibility I have included at the end here a brief summary, which I helped him write, of his life up to the point I worked with him.  

By the time I was 14 months old my mother was dying of tuberculosis and I was failing to thrive. I was abandoned by my dad. My aunt rescued me and took me to live with her. She applied to the courts to adopt me. My dad, at the 11th hour, began to contest this. The proceedings dragged on until I’d started school. My situation with my aunt was not secure until I was six years old.

When I was seven my grandfather died suddenly. I was extremely close to him.  The pain of that still haunts me.

When I was nine I was walking to school through a farmyard, when I saw the farmer hanging in his barn. Shortly after that, the voices started, but they were nice and friendly, and kept me company as I walked the hills near home.

I went down the mines as soon as I left school. I wasn’t happy with that and joined the army. Within the first couple of years a bullying sergeant major triggered a psychotic episode. The voices turned nasty. I heard the voice of the sergeant major mocking and insulting me all the time. I faked my way out the army hospital by denying I was hearing voices any longer.

The army didn’t know what to do with me. As they reckoned people with schizophrenia were antisocial, they decided a solitary job within the army would be the best thing for me. They came up with what they felt was the ideal solution: they’d train me to be a sniper. You spend long periods alone and when anyone comes along to disturb you, you kill them – a great idea in their view. There’d be none of that stressful social contact!

At least two incidents in which I was involved in the army left me with strong feelings of guilt. The pain of the deaths I caused, I know now,underlay the later experiences of psychosis.

I was discharged from the army after I was seriously injured walking towards a bomb. I did this deliberately. It was part of a pattern. From time to time I felt I didn’t deserve to live so I put myself in danger. If I lived I felt I was meant to live and maybe I deserved to do so. When the feeling built up again, as it kept on doing even in civvy street because the guilt about the deaths never left me, I’d play the same kind of Russian Roulette.

Once out of the army I used to do this by lying down on a railway line in the early hours of the morning. If no train came within a certain period of time, I reckoned I deserved to continue living.

After leaving the army my marriage broke up and I ended up living with someone with a serious drink problem. I held down three jobs, working all hours, in order to make ends meet and finance her habit. Eventually, I got completely exhausted and depressed. I couldn’t cope any longer and threw her out.

That didn’t finish it though. I was so convinced that she would die on the streets, I felt like I’d killed her. I became tortured by guilt. I shut himself away in my room with my dog. I survived on frozen chips for six weeks, until my boss became so concerned he got the police to break in. They found me completely psychotic, they say. I think I was determined to die this way. They sectioned me. That began an eight year history of sections, medications, with long and frequent admissions, until I felt that life had nothing to offer me.

At the end of this eight year period our work together began. At the end of the first phase, the May 1993 video interview took place.

We are now at a point to move onto examining how far we were able to help Ian make sense of his psychotic experiences in terms of his life history. More of that next time.

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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.


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.


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.


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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Grave & Courtyard v2

I went to the DeathCafe by car this time. A musician friend of mine had expressed an interest in attending, so he popped into our place for soup, then we drove together to the Courtyard. He seemed as fascinated by death as I am, a rare meeting of minds.

We dropped the car in a side road to save parking expenses. As we walked back to the venue we spotted another frequenter of the Death Cafe, someone previously connected with mental health as I was. We headed together straight for the bar to get our drinks, and amazingly there was yet another member of the group waiting at the bar for her giant sized mocha. As we chatted I noticed the facilitator from the local hospice passing behind us to check out the room. It was going to be another big meeting again.

The man in the hat turned up next. We exchanged greetings. We left him at the bar once we got our drinks and headed to the ground floor meeting room. It was the one we all liked best. It is easily accessible and you don’t get the full blast of the theatre performances coming through the wall.

As always it’s impossible to summarise all the topics we covered in two hours of energised discussion, spiced with humour and laced with sadness.

What I remember most, perhaps understandably, is that I was not the only one to be coming to terms with a body no longer responding energetically to the demands of the mind. There was at least one other person there with the same issue. We kicked that topic around for a while before the focus moved on to other things.

Inevitably, I suppose, we came back at one point to the big question: what happens when we die? Do we circle back through the loop of reincarnation, do we pass on to a journey through the next world, or do we simply black out.

In Gustave Doré’s illustrations for the fourth circle of Dante’s hell, the weights are huge money bags. (For source of image see link.)

Some weren’t sure but worked on a variation of Pascal’s wager. As Wikipedia explains: ‘Pascal argues that a rational person should live as though God exists and seek to believe in God. If God does not actually exist, such a person will have only a finite loss (some pleasures, luxury, etc.), whereas they stand to receive infinite gains (as represented by eternity in Heaven) and avoid infinite losses (eternity in Hell).’ A strong prompt for a pause of thought, even if with me you don’t share a belief in the medieval concept of hell so grimly portrayed in Dante’s Inferno. Some in the group had decided that it was just a happier place to be, to assume that there was a life beyond death, even though they couldn’t prove it.

Others, including my friend and I, were pretty clear we believed there was something after death, and it was a source of comfort and even joy, one of us quoting the words of Bahá’u’lláh in support of this:

I have made death a messenger of joy to thee. Wherefore dost thou grieve?

Yes, we would grieve at the loss of a relative or friend, because they were no longer with us, but this pain would be tempered by the knowledge (yes, we used that word) they were in a better place.

At least one person doubted there was anything beyond death while another, who had a strong sense at times of having been here before, has placed her money on coming back again and again.

I didn’t have the chance to share my own thoughts in detail on that one. Though the Bahá’í Faith teaches that we do not come back, there are examples not easily dismissed of evidence that points in the direction of some kind of knowledge of a previous life. I’ve dealt with most of that in detail in previous posts. One thing I’ve recently read in Fontana’s excellent book on the after life suggests that returning spirits say that some people ask to come back and some are sent back. Given the rigour with which he examines evidence, I feel I need to give this idea due weight. It needs an explanation of some kind. The evidence needs taking seriously: though we may explain it in different ways, it should not be ignored.

As part of that discussion, the problem with how to deal with the pain of grief came up. Many of us had noticed that some seem broken by grief and never really recover, while others pick themselves up and, when the intense pain of the first period of grief is over, begin to engage in activities that lead to a more positive life. The idea put forward by Acceptance and Commitment Therapy (ACT) was briefly explored: there is pain, which is inescapable, and suffering, which is the avoidable layer that we add to pain by our own take on it.

I couldn’t resist plugging my own panacea for pain and other uncomfortable experiences: reflection. I won’t bang on about it here at any length as I’ve explored it over and over on this blog already, except to say that developing the ability to step back from the contents of our consciousness, whether that be intrusive and negative thoughts or strong feelings of pain, enables us to contain them, rather than repress them or be their victim. Containment allow us to explore them safely and decide how to deal with them constructively.

As we walked back to the car together my friend said, with no prompting from me,’That was great. I really enjoyed it.’

The next meeting of the Hereford Death Cafe is on Wednesday 18th October at 18.00. See you there maybe?

Death Cafes are held in many places. Maybe there’s one near you. Do you dare to give it a go?

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Hamlet almost kills Claudius Hamlet (2009) Royal Shakespeare Company Directed by Gregory Doran

Hamlet almost kills Claudius (For source of image see link)
Hamlet (2009) Royal Shakespeare Company. Directed by Gregory Doran

Now might I do it pat, now he is praying;
And now I’ll do’t. And so he goes to heaven;
And so am I revenged. That would be scann’d:
A villain kills my father; and for that,
I, his sole son, do this same villain send
To heaven.
O, this is hire and salary, not revenge.

(Hamlet, Act III, Scene 3, lines 73-80)

This sequence last seen two years ago seems to follow on naturally from the Understanding Heart sequence I’ve just republished. So here it comes again on three consecutive days this time.

I ended the last post with a question:

Maybe this is partly why I ignored the whispers to hang on in there, shot the albatross in the heat of a conflict situation, and betrayed myself in the process. At least I think it was. Maybe this, rather surprisingly, is the lesson Bahá’u’lláh wants me to learn from all this crackle in my system. Can I, should I make a virtue of uncertainty, at least in some circumstances, and have the courage of my confusion?

This leaves another question still hanging in the air: ‘Maybe there are situations where waiting is clearly a mistake, and then isn’t doing something better than dithering indefinitely?’ And if so, how do I tell the difference? And when I sense a difference, how do I step back from the clamour in my head and stay still with no sense of guilt? We’ll be coming onto that aspect of things soon now.


Given my default position of doubt, it’s no wonder that Hamlet is the Shakespeare play I resonate to most strongly. ‘Now could I do it pat!’ except he can’t. Instinct gives way to the scanning of intellect. He stands ‘mammering,’ as Othello scathingly refers to this kind of hesitation.

Othello & Desdemona

Othello after killing Desdemona (for source of image see link)

It is intriguing to note at this point that if Othello had been in Hamlet’s shoes, Hamlet would have been much shorter and far less interesting, probably ending at Act I, Scene 2, shortly after Othello had left the battlements and cut his uncle’s throat before breakfast, whereas, if Hamlet had starred in Othello, Desdemona would probably still be alive, with Iago on a perilous mission somewhere in Africa, probably never to return. Neither play would have worked as a tragedy, or even as a comedy for that matter, as it would have lacked the necessary mismatch between character and situation.[1]

To return to the main issue, ‘mammering’ has a bad press in our culture. ‘He who hesitates is lost,’ we parrot, ‘Strike while the iron is hot!’ quite forgetting that it might just possibly be better to look before we leap. Such a bad press in fact that it has taken me quite some time to recognise the possibility that there could be times when mammering is the best policy. He who hesitates may well be the wisest of them all.

Indecision is pathologised in our culture, but that should be when it’s a pattern which disables our ability to decide what to eat, where to go for a walk, what book or clothes to buy – none of which is the case with me as far as I can tell. Maybe refusing to decide to act when the stakes are too high, nothing is clear and we don’t really have to, is quite rational and in fact the toughest decision to make, not a sign of weakness at all.

The question though that confronts me every time in every situation is, ‘Is this situation one of those where mammering is best?’

Trying to apply this kind of thinking more closely to the actuality of an experience is also difficult for all of us. What happens when a specific situation presses a button, for example when we are convinced that someone close has lied to us? What do we say or do when a trusted friend has refused to help us? How do we deal with the soreness left after we feel betrayed and an important bond had been badly damaged if not completely broken?

Well, I think I might have a glimpse of the answer to those kinds of questions.

I think I now realise, and not just intellectually, that there is a huge difference between the reality we see when we stand back and the reality we experience when we allow the hurt to distort our perceptions, and the crucial Trafalgar we fight is when we battle not to board the ship whose sails are perceptions with the wind of hurt behind them.

When the pain and the reality collide and pressurise me to warp my perception and experience and decide something destructive, I need to learn to stand back and, first, tell myself that storm water on the mind’s window doesn’t alter what’s outside, and, second, that, with friends and family especially but perhaps with human kind as a whole, the basic relationship can only be blurred by pain but need not be destroyed by it – not even if we plan never to speak to or spend time with them again.

We are all inextricably linked, as Coleridge’s poem The Rime of the Ancient Mariner implies, so to use emotional pain on the spur of the moment as an excuse, for example, for not speaking again ever, while human and understandable, is not a viable way forward. (Physical harm is a different matter of course and requires that measures be taken as soon as possible to secure our safety.) I also agree that there are a very few people we might know whose speech comes to be too dangerous to listen to ever again: verbal abuse and systematic denigration, for example, should not be endured. I’d have to be sure you’re such a person before I cut you off completely.

But I am dealing now with what I would call the routine mainstream of human relationships, where there are serious mistakes but no calculated malice. In such circumstances, ‘I’m not taking this crap any more!’ and walking out might sound like strong minded forthrightness, but all too often it’s only camouflaged cowardice.

So, what has all this got to do with the Three-Brain model? How could that possible help?

The Three Brain Model Revisited

Well, a key issue is to learn how to step back from all the usual programming that tempts us to press the button marked ‘Fire’ too early, in case we kill an albatross. As we discussed earlier, different parts of our brain system are triggered in different ways along different time-scales.

When we lived in caves and usually had only one chance to learn how to recognise and escape from a tiger, instinct was really handy. It still is. It helps us get out of the way of an oncoming train and sense if an attack in a dark alley is likely to happen. It also tends to mistake a black plastic bag for a mugger.

So, basically, it’s a good idea to put our instincts on a leash when we’re not in clear physical danger. We can allow the warning light to keep flashing, but we don’t have to attack or escape until we’ve made sure that the threat is real. Sometimes, even when the threat is real, we can keep the leash tight in order, for example, to help others out of danger before we escape ourselves. We can even save an albatross before we save ourselves. This over-ride is one of the things that makes us human rather than simply animal, though I accept that some animals can demonstrate something remarkably like altruism.

The ability to pull on the leash before the leopard leaps needs constant practice. Mindfulness helps. The earlier we can learn to spot the reaction the better the chance we have of stopping it and swapping it for a more considered response.

If we can keep the leash tight and keep calm as well, something that also comes with practice as we learn how to step mindfully back from our reactions, thinking remains possible.

In our culture, thinking tends to have pride of place. Science and logic are highly valued. We love the way we can analyse experience. There are huge advantages to this way of working. We go way beyond gut reactions, which can only really be trusted when situations are crisp, clear and self-evident or else, if complex, are predictably patterned and deeply familiar.

Such situations are most certainly not the only ones we meet in our complex and global society, far different from the forests of our distant origins. Snap judgements can now be seriously flawed, and the flaws grow in size as situations become more complex and chaotic. So, taking the time and making the effort to work things out carefully pays off in all complex situations where the consequences, though not necessarily life-threatening, could be scarily high. My home, my health or my wealth could be at stake. In addition to Kahneman’s work already referred to, Daniel Levitin, in his book The Organised Mind, has much to say about how, for example, we can become better at making difficult decisions about what steps to take to mend our health (page 219-267).


3 brain awareness v4

We need to dig a bit deeper still.

I have produced a very left-brain diagram to roughly illustrate a right-brain model. Hopefully, if my left-brain buys it, there might be some chance it will give my right-brain enough space and time to function! The ellipse labelled Conscious Awareness represents a process and is not meant to be reified (or deified for that matter). In terms of the discussion below it is primarily to be seen as ‘consciousness influenced by brain systems/processes’ and restricted by the brain’s limited but nonetheless impressive capacity to act as a receiver of signals.

To place this in a context, which I won’t be exploring in this post, conscious awareness (CA) is underpinned by preconscious processes and rests on a brain foundation of unconscious responses, usually termed ‘subliminal’ in the psychology literature. Also, for a Bahá’í and an Irreducible Mind enthusiast such as me, Mind in its totality is a sphere of potential consciousness, within which the ellipse of CA resides, and which emanates from a spiritual dimension to which our brains can only achieve an intermittent connection at best for most of us.

Signal RedAs the diagram attempts to show, if we think of the input from each of these brain systems as radio, television or satellite signals, then the instinctual signal is strongest. In the brain as it is wired, it also has a fast track and begins to trigger a reaction before the higher centres know what’s going on, hence the long thin wiring to the intellect and intuition. Also the descending neural pathways used to help the higher centres of the brain keep calm are fewer in number than the ascending ones raising the alarm. They do win in the end though if we use them enough and wisely.

So, putting instinct on hold can be very difficult in situations where our feelings are running high. Also, as Baumeister and Tierney have analysed in detail, our ability to restrain ourselves can tire just like a muscle, and our grip on our instincts is loosened. They wrote in February 2012’s edition of The Psychologist:

. . . . self-control is like a muscle that gets tired. People may start the day fresh and rested, but as they exert self-control over the course of the day, their powers may diminish. Many researchers have observed that self-control tends to break down late in the day, especially if it has been a demanding or stressful day. . . .

A series of experiments confirmed that willpower is tied to glucose (Gailliot et al., 2007). After people exert self-control, even on artificial lab tasks, their blood glucose levels drop. Low levels of blood glucose predict poor performance on tests of self- control.

Signal OrangeHowever, as the brain learns with practice to use the higher centres to hold back the tiger on each particular issue, we can get better at it, self-restraint develops more stamina, can hold on longer, and our fangs and claws may therefore more rarely rip into impetuous action.

The signal from the intellect is weaker than instinct’s and, although the diagram can’t show it clearly without muddling the main issue, the emotional centre of the archaic brain can keep interfering with the thinking process and colouring its deliberations. We can be infected by irrational fear, anger, impatience and so on, and, to make matters worse, because of our confirmation bias we will be very tempted to look only at the evidence that feeds our prejudices. We have to work very hard to keep the tiger in check, and to make ourselves look at evidence that contradicts our instinctive assumptions. That’s why paradigm shifts are so difficult to make in science as well as everywhere else: scientists are not immune to the impact of the primitive emotional investments they’ve made in what they have come to believe. Anyone interested in that area of exasperation need only read Mario Beauregard’s The Spiritual Brain, the Kellys’ Irreducible Mindor Malcolm Kendrick’s Doctoring Data.

Signal GreenHowever, more often than we realise, there are other serious limitations to our logical thinking processes in themselves as well, against which we also have to guard. Iain McGilchrist has explored the ramifications of this in his excellent book The Master & His Emissary, in which he argues that the way we privilege our left-brain logical linguistic mode of processing is fraught with danger: we have to balance it with the right-brain holistic intuitive approach, which is sensitive to our connectedness with others and able to correct distortions in our schematic mapping. The so-called ‘rational’ processes aren’t geared to securing a good grasp of values, human relationships, complex organic interactions, spiritual dimensions, wholes rather than parts and so on. Through right-brain processes we can have access to a mind that is far better at dealing with such things, but we do not often give it the time to operate effectively nor are we good at attending to its findings, which tend to come not in words but in intimations, metaphors, symbols, dreams, and other intuitive shapes. At least this is how it seems to me things usually are in our spiritually illiterate culture.

When any factors such as values are involved we would do well to step back from our thoughts, quieten our minds and wait – and I don’t mean wait for just a few minutes. Sometimes I have waited for days, weeks or in rare cases, with various difficult issues, months before either meditation, dreams or apparently random flashes of insight come bursting in with the answer – or possibly not bursting in but whispering the solution quietly in the background, waving somewhere from a far corner of my mind’s eye. Unfortunately our receiver is not good at tuning into the signal from the wisest part of ourselves that makes the best decisions, and we experience its signal as frustratingly weak, so weak sometimes we convince ourselves it does not exist, and blast on regardless.

So when reason has done all it’s work, it can be best to wait if there is no real urgency, but waiting is very hard to do, especially when we do not believe there will be anything worth waiting for – I’m sure that there will be all sorts of imaginary reasons our mind can manufacture to persuade us that we cannot and need not wait. Under mindful inspection such spurious reasons burst like soap bubbles on a pin. If there is a valid reason why we must act now, then perhaps we should, but not unless. Rushing to react kills albatrosses, something that waiting for the wisdom of intuition will help us avoid.

A Traffic-Light System

What I am suggesting is a simple set of traffic lights.

Sorry they’re up side down in the picture above but I couldn’t reconcile myself to placing instinct on a higher level than intuition and reason, even to create a more familiar symbol. But at least I discussed them in the familiar order. It’s a simple visual reminder, when there is a lot at stake, to stop, put all action on hold, if no danger threatens. Then to think hard for as long as necessary to get a grip on what’s really going on, and even then, only to act if it’s genuinely urgent. If we can do that, marinating our minds in the complexity of the issue, we will inevitably gain access to a rich and subtle vein of creative processing that will enable us to make truly wise as against hastily quick, or apparently clever decisions that might be missing something vital and doing serious harm.

It is my belief also that once we achieve this level of consciousness, can tune into it at will, though not necessarily consistently, and can begin to avoid our usual mistakes, even perhaps beginning to compensate for some past errors as well, the weight of unnecessary guilt, rage, self-blame and angst will fall off our shoulders, we will stand straighter and see much further.

At least that’s where I’ve got up to in my thinking so far! I hope it was worth sharing my mariner experience. If not, writing it down as clearly as I can might help me remember when the next albatross is in danger.


[1] I was shocked to discover (or perhaps to be reminded) that I wasn’t the first person to think of this possibility. In December 2015, six months after posting this, I read, on page 149 of Mark Edmundson’s brilliant Self & Soul, ‘A. C. Bradley has said that if you put Hamlet into Othello’s play, the prince will quickly make Iago [out] for what he is and just laugh him to scorn. In Hamlet’s place, Othello would draw his sword and slice Claudius nave to chops in the first act. In either case: no play.’ I definitely read Bradley 50 years ago. Was this then a case of cryptoamnesia? I think so. What does that suggest about the rest of what I write? I dread to think and feel obliged to apologise to anyone I have inadvertently plagiarised.

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