Friday, March 03, 2006

Playing the mind guerrilla

Disclaimer: I am a bit odd just now. I seem to have a wound somewhere which is bleeding words. I thought better of this post because I am not sure it came out as I intended, but I hate to pull something which will have been read already. I could not write explicitly about what I wanted to write about, but that last bit is really about an individual as opposed to people in general. Lots of words, not very articulate today.

The reason I decided to study psychology was that somebody said that I would save lives. He said I had a gift for understanding people and if I trained to be a clinical psychologist then within ten years there would be at least fifty people walking the Earth who wouldn’t be alive if I hadn’t take this course. The subject had always interested me, Kant was getting up my nose and then this. It happened to come from someone I greatly respected and duty-bound, I accepted his counsel.

The reason I stopped studying psychology was that I got too ill to carry on, even with the uber-flexible regime of the Open University. That was the crux of it. But there was an inevitable degree of disillusionment with both myself and the subject.

Psychology is a very young science, conceived when philosophy and medicine got drunk at a Christmas party. Right now, one may think of psychology as being in its adolescence and thus full of controversy and contradiction. I’m not talking about that slight inconsistency between quantum mechanics and particle theory which we are all so familiar with in physics, but a far more profound quagmire, with various theories being presented as the complete answer when really they are only a small part of the question. Different learned gentlemen will tell you that it is all about our mothers, it is all about where we sit between neurosis and psychosis, it is all about our repressed libidos.

As a theoretical science, this is confusing enough. As a branch of medicine*, it is an intimidating minefield. It is as if you have a tummy ache and you know that if you go to one doctor she will propose a radical change in diet, another doctor will prescribe a course of tablets and another will propose major surgery. Still another will suggest it has nothing to do with your tummy and will diagnose an ingrowing toenail. Unsurprisingly, there are a lot of sick people who are not getting any better, and still others who have acquired further complications along the way. However, this is the best we can do just now.

All this is further complicated by the fact that we all want to maximise the happiness in our lives and are tempted by glossy books, seminars and cult-like arrangements which propose Instant Confidence or that It's Not How Good You Are, It's How Good You Want To Be. On Radio 4’s Old Harry’s Game (currently being repeated on BBC 7), Satan makes mischief in the world of men by publishing the self-help book, You’re Really Special and Everyone Else is A Git.

So anyway, studying psychology is like studying physics before Newton. A great deal is known. A great deal can be speculated upon. But how it all fits together is anyone’s guess. Meanwhile, a significant number of people seek power and money purporting to have discovered the secret of happiness **.

The second great disillusionment was with myself. I never actually believed I had a gift for understanding people, only that I am more interested in them than many other people so I pay a more attention to what they say and do and so see patterns that other people don’t always see. Even so, you have always baffled me. Yes, you. But the enigma is not without its charm.

I certainly don’t have a gift for dealing with people. How could I? I have extraordinarily little experience and bumble through all my human interactions. I can be incredibly clumsy with people and whilst this would improve with practice, I think perhaps the damage is done; I shall never have the extreme tact and sensitivity necessary for dealing with people in extreme distress.

However, the greatest realisation was that I am not a very sympathetic person.

It seems that there is a great contradiction in our attitudes towards mental health in our culture. On the one hand, we want to believe that those with mental ill health are simply lacking in moral fibre and just need to pull themselves together. This is, of course, nonsense. With both physical and mental illness, an individual’s attitudes and behaviour may contribute much to their prognosis, management and rehabilitation, but nobody can simply decide to get better.

On the other hand, our society wants to imagine that some people with mental ill health are completely out of control and not responsible for their own actions. This can lead to very paternalistic, even draconian treatment; people must be looked after and coerced into the correct course of action. But it can also be incredibly indulgent.

If you live with or care for someone with physical or mental ill health, you are likely to see some unpleasant sights from time to time. I think a good comparison can be found between watching the manifestations of mental ill health and watching a loved-one in a fit of vomiting; it is not at all pretty, it is makes you feel sick yourself and at the same time you can see that this person is suffering and there’s little you can do but be on hand and help clear things up afterwards.

But nobody has an excuse to be an arsehole. Nobody has an excuse to vomit on you and walk away without apology. And when a person really doesn’t have a choice about it, if they are in a state of genuine diminished responsibility then the situation requires outside intervention. When a child misbehaves, one may quite rightly think, “This person cannot fully understand the consequences of their actions.” However one doesn’t then sit by and do nothing while the child sets fire to the nursery.

Yet I hear that often; they can’t help it because they are ill. We should be kind to them. We should submit to whatever abuse they dole out. Well, I cannot buy it, mostly because I have known enough people in extreme states of mental distress who somehow manage to be reasonably decent human beings, at least towards other people if not towards themselves.

Hmm, yeah I know. When one cannot be explicit, it is difficult to conclude with the revelation which prompted one to write. Anyway, unlike psychologists, writers of fiction don't need to be sympathetic, just empathetic, which is a different thing entirely, so we are all better off for both the illness that stopped me in my tracks and my disillusionment.

* In case anyone is confused, the practical difference between psychology and psychiatry is that your psychiatrist has a medical degree, can therefore prescribe drugs and thus tends to deal with a different group of conditions – or as part of a team, the more clinical aspects of a problem. Someone once said that a psychiatrist is concerned with the brain, whereas a psychologist is concerned with the mind. In fact both are concerned with the brain and the mind, but it is perhaps a helpful generalisation.

** Despite everything, I was a brilliant student and did discover the Secret of Happiness during my studies but I will save that for another day.


Anonymous said...

A brilliant and thought-provoking post.

And whilst I can certainly understand completely not having the gift to *deal* with people, I would also say that you absolutely *do* have a gift for understanding people (in my experience).

Anonymous said...

Random thoughts on clinical psychiatry.....I hope pete reads this post because he knows much more about this than I don't have to be a "sympathetic" person; in fact, it's better if you are emotionally detached, because otherwise your feelings will get in the way of your judgement....far more important to be interested in what makes people tick, which you are....also important to have the intelligence and judgement to pick your way through the maze of theorizing, and to notice when the theorist is, in fact, projecting his/her own neuroses onto a subject......remember that "dealing with people" is a skill like any other, it comes, if at all, with practice.....and is most practised by car salesmen, estate agents, cold-callers and the like, not by clinicians.....the patient is more interested in the end result than in your charm and bedside manner.....nonetheless, uncertain health is a definite no-no, because you cannot afford not to be there when you are supposed to be; other people's lives depend on it.

The Goldfish said...

Vaughan, you are very kind.

Charles, yes, uncertain health. I suppose when I was into this I really had it in mind that I would, very soon, get completely better and never look back.

I did see a psychiatrist who hardly made eye-contact with me. I wound up telling him more than I intended in an attempt to shock the guy into looking up. But he was good, in the end, if disconcerting.