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Posts Tagged ‘mental health’

The primary question to be resolved is how the present world, with its entrenched pattern of conflict, can change to a world in which harmony and co-operation will prevail.

World order can be founded only on an unshakeable consciousness of the oneness of mankind, a spiritual truth which all the human sciences confirm. Anthropology, physiology, psychology, recognize only one human species, albeit infinitely varied in the secondary aspects of life. Recognition of this truth requires abandonment of prejudice—prejudice of every kind—race, class, colour, creed, nation, sex, degree of material civilization, everything which enables people to consider themselves superior to others.

(Universal House of Justice The Promise of World Peace Section III – 1985)

In the previous two posts I focused primarily on our major blindspots. Before going into more detail about the nature of bias, it needs to be clarified that solutions to problems and attitudes that create divisions are hard to come by because too many of us, perhaps especially in the individualistic West, have an investment in denying our collective and complex connectedness. This constitutes an additional and intractable blind spot. It may even be that as our complex interconnectedness becomes more irresistibly obvious we resort increasingly to a defensive protectionism, and fall prey to an increasing credulity in the face of simplistic and often scapegoating fixes to the problems that disturb us.

I’ve touched on the problems of Western individualism already in my previous sequence on balancing spirit and matter. I mentioned that, when I read Shweder’s Thinking Through Cultures, I learnt how biased in a potentially destructive way our implicit individualism is. I confessed to how this related to flaws in my own discipline of psychology, favoured in the Western world. Earlier in his book Shweder describes it as follows:

Not surprisingly, in most sociocentric role-based societies… it is sociology, not psychology, that thrives as an academic discipline. In other, more individualistic cultures (for example, the United States) it is psychology that flourishes at universities and popular bookstores, while sociology has an uneasy relationship to a public that find sociological discourse to be unreal and laden with ‘jargon.’[1]

In the years since he wrote that book, Shweder’s thesis has not ceased to be relevant, as Tom Oliver testifies in The Self Delusion, his powerful 2020 dismemberment of our myth of individualism:[2]

Our modern culture, from media advertising to our formal education system, all seem to emphasise extreme individuality, and these are arguably providing an overwhelming set of stimuli which are training our minds to increasingly perceive the world in an individuated away.

This affects our understanding of almost any situation and strongly influences our decision-making. Take mental health, my specialism, as one example:[3]

. . . Clinical medicine still labours under a biomedical model, focusing purely on biological factors. Thus, mental illnesses such as depression are treated with drugs… without dealing properly with root psychological, environmental and social causes.

Though he is clearly not a believer in any commonly understood paradigm of God, his attitude to the required relationship between religion and science, if we are to break through our block, is very refreshing:[4]

We see in the 21st century a genuine synergy emerging between science and spirituality… We can cut through the dogma and fables of organised religion and instead explore scientifically the moral and spiritual states that are often narrowly dubbed ‘religious experiences’ that may actually be just one possible way to see beneath the veil of self-delusion…

A new partnership is needed between science and religion in order to deal with the destruction of our natural world.

He believes firmly that ‘state-of-the-art scientific advances in understanding human interconnectedness – whether it be with the microbiome within us, the natural world around us, or with other people – open up considerable benefits in terms of personal and planetary health.’[5]

I will return to some of his other insights later in relation to bias, which is such a pervasive symptom of our failure to connect with others.

First though we need to look at Jennifer Eberhardt’s perspective on that.

Implicit Bias

Bias may not be as conscious and deliberate as we might be tempted to think, and we also may therefore not be as free from it as we would like. Bias can be internal, invisible even to us, resulting in unintended acts of discrimination.

In her engaging and accessible treatment of the subject in her book Biased, Jennifer Eberhardt begins her explanation by clarifying this, using the term ‘implicit bias’ to capture this pattern:[6]

Implicit bias is not a new way of calling someone a racist. In fact, you don’t have to be a racist at all to be influenced by it. Implicit bias is a kind of distorting lens that’s a product of both the architecture of our brain and the disparities in our society.

A key foundation stone for this is located in research she summarises by saying:[7]

For nearly fifty years, scientists have been documenting the fact that people are much better at recognising faces of their own race than faces of other races . . .

That cringe-worthy expression ‘They all look alike’ has long been considered the province of the bigot. But it is actually a function of biology and exposure. Our brains are better at processing faces that evoke a sense of familiarity.

As a result, when we have negative associations to the unfamiliar they are activated with amazing speed:[8]

The process of making these [negative] connections is called bias. It can happen unintentionally. It can happen unconsciously. It can happen effortlessly. And it can happen in a matter of milliseconds.

This is why I am treating aspects of bias as another form of blind spot, similar to those I have dealt with in the previous two posts.

Stereotypes, Biases and their Sources

Eberhardt quotes Lippman’s interesting definition of stereotypes as ‘impressions that reflect subjective perceptions but stand in for objective reality.’[9] To create a stereotype, the important link here is between harbouring an impression and mistaking it for truth. Not surprisingly stereotypes can blind us ‘to information that [doesn’t] conform to what [we] already believe.’[10]This ‘confirmation bias is a mechanism that allows inaccurate beliefs to spread and persist.’ It is also not surprising to know [11]that ‘studies confirm that biased parents tend to produce children who are biased as well.’

Researchers have found abundant evidence for the different shapes such biases can take in terms of racial prejudice:[12]

What researchers typically find is that people are faster to categorise . . . faces and words when they are using the same key to respond to faces that are black and words that are bad. But if they’re using a single key to respond to faces that are black and to words that are good, their brains seem to bog down. It takes more effort to connect black and good, because black and bad are more strongly associated in our minds.

What is equally or perhaps even more disturbing is that there are also ‘results [which] suggested that the implicit association between blacks and apes was much stronger than the black-crime association.’[13]

Sharing the same race does not exempt us from bias either:[14]

Black people are just as likely as whites to expect signs of disorder in heavily black neighbourhoods.

. . . That suggests a sort of implicit bias that has more to do with associations we’ve absorbed through history and culture than with explicit racial animus.

Various emotions are implicated in different aspects of bias.

Fear is one. For example Bargh found that:[15]

those who had not received flu shots expressed more negative views about immigration than those who had been inoculated against the virus. Their sense of vulnerability to disease was tied to unacknowledged fears about infected immigrants.

Fear operates more generally than this, of course: ‘The same fear response that’s supposed to keep us safe can activate bias in ways that stigmatise and threaten others.’[16]The situation is even worse if we have to make decisions quickly: ‘bias is most likely to surface in situations where we’re fearful and we’re moving fast.’[17]

Disgust is another emotion involved in bias:[18]

When Harris and Fiske showed pictures of homeless people to study participants inside a neuro-imaging scanner,… the insula and amygdala – areas of the brain associated with disgust – were more active.

An additional twist makes the situation worse for some victims of prejudice. That skin colours remain the same across generations impedes the assimilation of those with darker skins because differences remain visible no matter what else changes over time, and, as Sherman and Clore’s research confirmed, the prevalent association of white with pure and black with bad runs deep. ‘“Sin is not just dirty,” the authors write, “it is black. And moral virtue is not just clean, but also white.”’ They conclude that ‘these associations allow implicit bias to turn skin colour into a value judgement.’ [19]

As we will find later, even closer connections across racial divides do not necessarily bring harmony and reduce prejudice:[20]

Online social networks connect us to our neighbours. But the same tools that promise security and promote camaraderie can foster a sort of tunnel vision that distorts our sense of danger, heightens suspicion, and even puts the safety of others at risk. Residents can circulate photographs of a ‘suspicious’ strangers to neighbours and police with the touch of a button and without any evidence the person is doing anything wrong – a practice that can amplify and justify bias in the minds of locals primed by worries about the safety of their homes.

To quote Eberhardt’s summary so far:[21]

In many ways, this is how bias operates. It conditions how we look at the world and the people within it, despite our conscious motivations and desires, and even when such conditioning can put us in harm’s way. Just as drivers are conditioned by how the roads are constructed in their native land, so too are we conditioned by racial narratives that narrow our vision and bias how we see the world around us.

We are conditioned to be biased and bias warps our way of seeing the world.

Next time I will look at some of the consequences of this in more detail and also at the complications that lie across the path towards possible solutions.

Footnotes:

[1]. Shweder – page 169.
[2]. The Self Delusion – page 158.
[3]. The Self Delusion – page 185.
[4]. The Self Delusion – pages 186-87.
[5]. The Self Delusion – page 194.
[6]. Biased – page 6.
[7]. Biased – pages 13-14.
[8]. Biased – page 32.
[9]. Biased – page 32.
[10]. Biased – page 33.
[11]. Biased – page 39.
[12]. Biased – page 40.
[13]. Biased – Page 143
[14]. Biased – page 160.
[15]. Biased – page 163.
[16]. Biased – Page 181.
[17]. Biased – page 184.
[18]. Biased – Page 164.
[19]. Biased – pages 166-67.
[20]. Biased – page 180.
[21]. Biased – Page 170.

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I recently watched Nadiya’s very moving account of her experience in battling anxiety. The programme is still available on iPlayer and is well-worth watching , living up to all the site’s description of it claims:

Since Nadiya Hussain won Bake Off in 2015 she’s rarely been off our screens. But behind the scenes Nadiya suffers from extreme anxiety and debilitating panic attacks, which she’s had since childhood. For decades, she has kept her anxiety a secret, ashamed to speak out.

She’s never had a proper diagnosis but thinks she has an anxiety disorder, and with around 5 million people suffering from the condition in the UK, Nadiya is not alone.

In this one-off documentary for BBC One, Nadiya sets out to find the cause of her anxiety, exploring the most effective, available treatments, whilst having therapy herself, in the hope of managing her anxiety.

. . . .

Raw, open and honest, this documentary will speak to the millions of people in the UK suffering with anxiety disorders, shining a light and starting a debate about an increasingly pressing issue.

At the time of writing, I’ve still to catch up on David Harewood’s story, but intend to do so as soon as possible.

By some strange coincidence, when I was copying a presentation to a memory stick, I discovered a letter I’d written to someone I was working with who was battling anxiety. The feedback I gave, on the basis of work we had recently done, was very similar to that given by Nadiya’s therapist at one point. My letter dates from 2002 and I have absolutely no idea why it was on the memory stick. I thought it worth sharing here, with all identifying content removed.

I have been doing some thinking since the last time we met.  It seemed a good idea to put down on paper the core ideas that we developed over the last two sessions.  So here goes. If I don’t make things clear, we will have a chance to discuss it next time and we can improve on this first draft.

On the 26thof June we talked about the idea that the original horrible events were like an explosion and that the experiences that you have had since, at least in some respects, are more like echoes of the original explosion rather than new explosions in themselves.  We talked about how important it is to be able to distinguish between a new explosion and an old echo.  They can sound very much alike under certain conditions and at certain times. Distinguishing between them can be very difficult.

In the session that we had on the 2ndof July, I felt very strongly that we had moved further down a very constructive road.  This was very encouraging.

We drew a diagram – in fact two diagrams – which sought to capture what was happening.  We also sought to capture what might be a good antidote to the vicious circle that was carrying you down a spiral of negative feelings into increasingly horrible experiences.I include copies in computer form of those two diagrams.  I would also like to make some comments on those diagrams in case the explanation is easier to follow than the picture.

We agreed that as things presently stand, if nothing changes, you are caught in a vicious circle.  We agreed that the experiences that you have are very negative and very stressful. The stress that they create in you brings about very negative feelings which are often very powerful.  These are predominantly feelings of anger and fear. These negative feelings make your mind more vulnerable to further negative experiences of the kind that triggered the stress in the first place.

On the day, we discussed how the idea that these people who were so abusive of you in the past now have absolutely no power whatsoever to do you real physical damage by mental means.  We agreed that, no matter how the experiences you are having may have been triggered or instigated, they are mental events that cannot produce physical damage. Therefore, even if they are all a product of these other people’s activity, because it is all taking place in your mind no physical harm can result.

In the diagram I drew on the board and subsequently handed to you I realise that I have probably put this idea in the wrong place.  I have corrected that with the diagram you will see with this letter.

As I see it now we can turn the vicious circle into a creative spiral by placing this thought immediately after any stressful experience of those mental phenomena that are troubling you so much.  So, basically, if you have a negative experience immediately follow it by the thought: “These experiences can do me no physical damage whatsoever. I am safe to completely ignore them.”

This should effectively begin to reduce the degree of stress you experience, particularly if you find that idea credible.  If you don’t initially find it very believable it’s my view that repetition will make it increasingly credible as time goes on.  The effect of this will be to reduce the stress, which will in turn reduce the negative feelings, which will in turn reduce your vulnerability of mind, and which will ultimately reduce the intensity and frequency and probably the negativity of the experiences.

Obviously, and this was missing from clear expression in the first diagram, we cannot anticipate all conceivable things that might stress you other than these experiences.  So, there may be times when you will experience some kind of stress in your environment – for instance witnessing a car accident.  This increase in stress will momentarily cause an increase in the negative feelings, a consequent increase in your mind’s vulnerability and a probable increase in the negative experiences that are causing you such a problem.

However, if you can immediately realise that this increase of stress is the cause it will help. You will have the confidence to continue to assert the main idea. Because these experiences can do you no physical damage there is no need to keep on paying them attention, no need to worry about them. It is safe to ignore them. If you can do this you will cut off these experiences at the root and they will begin to fade and wither once more.

Our next meeting will give us a chance to go over the letter and make any alterations that can improve its usefulness. Once we have got a letter to which we both agree you might consider whether it’s useful to give your key worker a copy so that when you meet with her she can help you apply what we have planned.

I look forward to seeing you next time to discuss this letter.

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Suffering is life.

(Thomas Szasz quoted by James Davies in Cracked – page 276)

I threatened in an earlier post to republish this one. Here is it.

I was walking back from town one day when my phone pinged. It was a message telling me my book was ready for collection from Waterstones. I was puzzled to begin with then the penny dropped. Just before my birthday someone spotted that I had scribbled, in my list of books to buy, the title of Cracked by James Davies.

I turned round and headed back to town again. When I picked up the book, for some reason I wasn’t impressed by its cover. Maybe the words ‘Mail on Sunday’ put me off, though Wilf Self’s comment helped to redress the balance.

Anyhow, for whatever reason, I didn’t get round to reading it until after I’d finished Rovelli’s Reality is not What it Seems. I’ll be doing a short review of that later, possibly.

Once I started Davies’s book I was hooked.

I’ve already shared on this blog a review of Bentall’s book Doctoring the Mind, which brilliantly, for me at least, brings the more grandiose pretentions of psychiatry back to the earth with a bump. I quoted Salley Vickers’ verdict:

Bentall’s thesis is that, for all the apparent advances in understanding psychiatric disorders, psychiatric treatment has done little to improve human welfare, because the scientific research which has led to the favouring of mind-altering drugs is, as he puts it, “fatally flawed”. He cites some startling evidence from the World Health Organisation that suggests patients suffering psychotic episodes in developing countries recover “better” than those from the industrialised world and the aim of the book is broadly to suggest why this might be so. . . .

I summarised my own view by praising ‘its rigorous analysis of the misleading inadequacy of psychiatry’s diagnostic system, its powerful and carefully argued exposure of the myths surrounding psychotropic medications and their supposed efficacy, and its moving description of the critical importance of positive relationships to recovery.’

The Davies book also covers much of this same ground and is equally compelling. What needs to be acknowledged is that he also takes the argument to another level towards the end of his book. He is concerned that we are exporting our Western model with all its flaws to country after country and goes on to explore other implications as well.

In the chapter dealing with the export issue he first summarises his case up to that point (page 258 – square brackets pull in additional points he has made elsewhere):

Western psychiatry has just too many fissures in the system to warrant its wholesale exportation, not just because psychiatric diagnostic manuals are more products of culture than science (chapter 2) [and have labelled as disorders many normal responses to experience], or because the efficacy of our drugs is far from encouraging (Chapter 4), or because behind Western psychiatry lie a variety of cultural assumptions about human nature and the role of suffering of often questionable validity and utility (Chapter 9), or because pharmaceutical marketing can’t be relied on to report the facts unadulterated and unadorned [and its influence has helped consolidate the stranglehold of diagnosis and a simplistic psychiatric approach] (Chapter 10), or finally because our exported practices may undermine successful local ways of managing distress. If there is any conclusion to which the chapters of this book should point, it is that we must think twice before confidently imparting to unsuspecting people around the globe our particular brand of biological psychiatry, our wholly negative views of suffering, our medicalisation of everyday life, and our fearfulness of any emotion that may bring us down.

I can’t emphasise too strongly the value of reading through the details of his treatment of all these other aspects. I am of course aware that physical medicine, even though there are biological markers for diseases in this sphere unlike in mental health, has not been exempt from the disingenuous manipulation of data and unscrupulous marketing methods practiced by the pharmaceutical industry, as Malcolm Kendrick’s book Doctoring Data eloquently testifies, but the scale of that abuse is dwarfed in the arena of mental health – and I mean arena in the fullest sense of that word: the battle here is damaging more ‘patients’ and costing even more lives.

Davies’s examination of exactly how this exportation of the psychiatric perspective is coming about is also disturbing and compelling reading. He adduces for example how skilfully drug companies have learned to read the reality of cultures into which they want to make inroads with their products, how effectively they target key figures in the prescribing hierarchy of professionals, and how astutely they now reach out to the public themselves so they will go to their doctors and request what the drug company is selling – all this to detriment of the many ways the social cohesion of the receiving culture has often (though not always, of course) been supporting those who are suffering from some form of emotional distress.

Where he takes his case next, in Chapter 10, I found both compelling and resonant. He is in tune with Bentall in seeing the importance of supportive relationships but, I think, explores that aspect somewhat more deeply.

He repeats basic points, to begin with (page 266):

What the evidence shows… is that what matters most in mental health care is not diagnosing problems and prescribing medication, but developing meaningful relationships with sufferers with the aim of cultivating insight into their problems, so the right interventions can be individually tailored to their needs. Sometimes this means giving meds, but more often it does not.

He then quotes research done by a psychiatrist he interviewed (page 267). Using two existing MH teams, Dr Sami Timimi set up a study comparing the results from two groups, one diagnostic, the usual approach, and the other non-diagnostic, where medication was given only sparingly, diagnosis was hardly used at all, and individual treatment plans were tailored to the person’s unique needs.’

In the non-diagnostic group the psychiatrist spent far more time exploring with his clients the context of their problems.

The results were clear (page 269):

Only 9 per cent of patients treated by the non-diagnostic approach continued needing treatment after two years, compared with 34 per cent of patients who were being treated via the medical model. Furthermore, only one person from the non-diagnostic group ended up having to be hospitalised, whereas over 15 people in the medical-model team were referred for inpatient hospital treatment. Finally, the non-diagnostic approach led to more people being discharged more quickly, and to the lowest patient ‘no-show’ rate out of all the mental health teams in the county.

Davies also interviewed Dr Peter Breggin, a US psychiatrist who is critical of the medical model. Breggin explained his viewpoint (page 279):

Most problems are created by the contexts in which people live and therefore require contextual not chemical solutions. ‘People who are breaking down are often like canaries in a mineshafts,’ explained Breggin. ‘They are a signal of a severe family issue.’ .  . . . For Breggin, because the medical model fails to take context seriously – whether the family or the wider social context – it overlooks the importance of understanding and managing context to help the person in distress.

Davies quotes Dr Pat Bracken as singing from the same hymn sheet (page 273):

We should start turning the paradigm round, start seeing the non-medical approach as the real work of psychiatry, rather than as incidental to the main thrust of the job, which is about diagnosing people and then getting them on the right drugs.

It’s where he goes next that I found most unexpected but most welcome to my heart. He leads into it with an interview with Thomas Sasz just before his death at the age of 92 (page 276). He asks Szasz, ‘why do we believe as a culture that suffering must be removed chemically rather than understood in many cases as a natural human phenomenon, and possibly something from which we can learn and grow if worked through productively?’

Szasz’s response is fascinating:

Our age has replaced a religious point of view with a pseudo-scientific point of view. . .   Now everything is explained in terms of molecules and atoms and brain scans. It is a reduction of the human being to a biological machine. We don’t have existential or religious or mental suffering any more. Instead we have brain disorders.

Davies summarises Szasz’s position on psychiatry (page 277): ‘It had become deluded in its belief that its physical technologies, its ECT machines and laboratory-manufactured molecules, could solve the deeper dilemmas of the soul, society and self.

Bracken’s view on this brings in capitalism (page 278):

What complicates things more is that we also live in a capitalist society, where there is always going to be someone trying to sell you something… In fact, some people would argue that capitalism can only continue by constantly making us dissatisfied with our lives.… You know, if everybody said I am very happy with my television, my car and everything else I’ve got, and I’m perfectly content with my lifestyle, the whole economy would come shattering down around our ears.

He continues (page 279):

What we customarily call mental illness is not always illness in the medical sense. It’s often a natural outcome of struggling to make our way in a world where the traditional guides, props and understandings are rapidly disappearing… Not all mental strife is therefore due to an internal malfunction but often to the outcome of living in a malfunctioning world. The solution is not yet more medicalisation, but an overhaul of our cultural beliefs, a reinfusing of life with spiritual, religious or humanistic meaning with emphasis on the essential involvement of community, and with whatever helps bring us greater direction, understanding, courage and purpose.

Unfortunately psychiatry, as with economics according to the writers of Econocracy, is failing to train psychiatrists in the adoption of a critical perspective on their own practice. So, he concludes, the pressure to change perspective has to come from outside the psychiatric system. He quotes Timimi again (page 285):

The things that get powerful institutions to change don’t usually come from inside those institutions. They usually come from outside. So anything that can put pressure on psychiatry as an institution to critique its concepts and reform its ways must surely be a good thing.

So, it’s down to us then. For me, promoting this book is a start. We all need to think, though, what else could be done, whether as a patient, a volunteer, a friend, a family member, an MP, a clinician or simply a citizen.

Currently, help is often tied to diagnosis. One psychiatrist quoted in this book is concerned that if categories of mental disorder are not confirmed as diseases, services will never be funded at the required level, the level, say, at which cancer services are funded. Surely, though, if opinion shifts to a tipping point not only the greater humanity of non-diagnostic treatments but also their relative cost effectiveness must carry the day in the end. But opinion will only shift sufficiently if we all play our part.

I know! I’ve got it.

You all could start by reading these two books. How about that?

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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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