God does not exist.  Love is an illusion. There is no truth, only conviction.  Scientific proofs are but ingenious fictions.  Beauty, like character, cannot be quantified;  it is in the mind’s eye of the observer, a projection filtered by experience and shaped by  expectation.  Everything, absolutely everything, the house you purchase, the food you eat, the car you drive, the illnesses you suffer from, is driven by metaphor and infected by meaning. The team you support is, in reality, not especially imbued with talent, your shampoo just a weak detergent, expensively scented and packaged.  But then, what is reality?  Nothing is definite. There are no facts, only beliefs, convictions, assumptions and assertions.  We inhabit a world of our own make believe.       

‘Surely not!’, you exclaim.  ‘I know two and two equals four.  That is a fact!’ 

‘Not at all.  It is a fiction, conditioned by the decimal numerical system we have evolved – based on the ten digits we have.  Change this to a counting system based on just three ‘numbers’, and two and two equals eleven. 

‘OK, if I look outside the window, I can see my car.  I know that’s real.’

‘Well, is it?  It might be an illusion, constructed in your brain by expectation and imagination.  At the risk of appearing pedantic, what you ‘see’ is an image projected on your retina, converted into a pattern of electromagnetic pulses and interpreted according to our expectation into an abstraction, composed entirely of meaning.’ 

Physiological studies show that we rarely look at things, we scan them and generate the image we expect.  Bird watchers have a word for this – giss – they just have to catch a glimpse and their mind does the rest. Of course different observers may see it differently. It can lead to arguments, like the one I witnessed in the big hide in Albufera.  ‘Little Stint’, announced one expert,  ‘Knot’, said the other.  S’not a knot!’      So we see what we expect to see,  see what we expect to see, hear what we expect to hear, and understand in a way that is not only conditioned by our experience, but also coloured by mood.  If you are cheerful, you will perceive things through rose tinted spectacles, but if you are melancholic, then your glasses are dark and the same objects will acquire a different meaning.  The Rorschach Test, in which subjects say what they see in a featureless ink blot, illustrates our facility to extract meaning from shapes.  In a similar way, the night sky presented ancient travellers with a cast of mythical characters.  Tell somebody a story and ask them to relay it to somebody else, it will be altered by the meanings that condition their interpretation.  Ask people to relate the same event and they will do so in different ways.  Witness statements are never quite the same.  Identity parades are notoriously misleading.  Witnesses often select the person who looks most like a villain.  Reputations can be ruined by a hint  of gossip. Everything we perceive is infected with meaning. 

There is no reality, just shared perception, no fact, just an agreed fiction,  no truth, just a concensus of  belief.   We inhabit a world of meanings.  Knowledge is never written in stone but on the sand and when the tide comes in, it changes. 

We acquire meaning from our parents, teachers and colleagues through associations and experience. People, encultured in a different set of meanings, see things in different ways. A member of an Amazon tribe will witness the crash of an airliner in the jungle in a very different way to a white aid worker; same event – different meaning.  Even illness has different cultural meanings. A sensation of tight heaviness around the chest in a man from the Punjab is seen as an indication that he cannot control his daughter – a sign of shame.  .        

But civilised societies hate the uncertainty of unsubstantiated meaning.  They have to exert control by deducing facts, establishing the truth,  proving what is real.  But really, it is all fiction.  Politicians direct the meaning and enshrines it in law.   Teachers do not teach facts, they instil culturally approved ideas.  If people are brought up with the same set of meaning, then they can be more easily controlled.  But as they acquire knowledge, so they lose meaning and intuition. When teachers from the south went to ‘educate’ the Inuit,   they took them away from their meaningful wilderness and imposed Columbus, Maths and Three Little Pigs.  Scientists attempt to establish what is real, but their observations, measurements and theories are so conditioned by assumptions, that science is nothing but an elaborate  construct, a triumph of imagination, directed by the culture and consolidated in textbooks.  

The medical sociologist,  Brian Turner, once wrote that ‘Illness is a language, the body is representation and medicine is political practice’.  Most ill health does not have a basis in pathology.  If the doctor is to help the patient, it is more important to find out what the illness represents.  When the charismatic neurologist Jean-Martin Charcot was practicing in Paris,  patients quickly learnt to adopt the symptoms diagnostic of  his invention, ‘La Grande Hysterie’,  but after he retired, these symptoms quickly vanished.             

Theologians and ‘true’ believers may argue the existence of God, but the fact is there is no God, only faith – a projection of omnipotence that comforts us against the realities of death and evil.  

When we fall in love with somebody we invest them with the meaning of our lives.  They become everything we crave.  The things we give and receive, the places we visit, the people we meet, are touched with magic.  Our ordinary life becomes deeply meaningful.  But if our beloved lets us down or cheat on us, the meaning changes overnight.  Those that we love to distraction we will soon hate beyond measure.  They have tricked us, destroyed our meaning.  Meanings are fluid, like attitudes.  They are contingent on the situation or context.  The same poem can have a very different meaning at the end of a relationship than at the beginning.  And if we lose the person, we have invested so much meaning in, we lose the meaning and with it the will to live.  That is why the loss of a loved one can leave us bereft, sick and exhausted and devastated.  Philanderers are so destructive because their exploit and plunder meaning.           

It is not reality that holds individuals and societies together but meanings; religion, culture, the arts, law, science, love – these are all meaningful constructs.  It is the meaning embodied in self belief that drives human beings to be creative and successful.   If we lose the meaning, then we lose a sense of ourselves.  The same kind of devastation we experience over the loss of a loved one can occur when we lose the job that has given our life meaning or we lose the reputation we have created over the years or we lose our faith.  When elderly people lose their home and move into institutions, they tend to lose the meaning for life, and many succumb quite quickly.  It is well established that loss  makes us ill, but not any loss – only loss that is meaningful.  It’s the loss of meaning that makes us ill. 

So many of my patients tell me they have no meaning in life; they don’t know who they are.  Thus, to heal and become whole again, they need  to recover that sense of meaning – to withdraw the cathexis from what has been lost and reinvest it into something new.  Therapists and healers, who treat patients sick through loss of meaning, should not only seek first to understand the meaning of what has been lost but also help their patients find ways of restoring the meaning in their lives.