philosophy


apocalypse-snow-end-of-the-world-is-nigh-as-snow-on-italian-beach-fulfils-prophecy-by-italys-nostradamus-136413594068803901-170112133733

Sea levels will continue to rise, Homes will be flooded. Weather will be more extreme with droughts, floods and hurricanes.  There will be shortages of food and widespread famine. There will be epidemics of disease, mass migration, civil unrest, war. People will suffer a loss of livelihood and liberty. There will be a complete breakdown of civilisation. Predictions of the effects of climate change are apocalyptic.  It seems that ‘the end of the world is nigh’, but is calamity that imminent or are our media outlets too short of money and too high on catastrophe and ‘fake news’.     

It does not seem to me so long ago that our then prime minister, The Right Honorable Mr Harold MacMillan, The Westminster Walrus, told us that we had never had it so good.  He was right.  The sixties were a time of optimism and freedom when everything seemed possible and few were aware of a warming planet.  Public optimism has been going downhill ever since.   

50 years on, we may have not quite have reached the point when governments must step in with radical solutions, but we have perhaps reached a critical stage of awareness.  If patterns of extreme weather continue and begin to impact on our way of life, we will all be spending more of our income on essentials like housing and food and less on holidays and entertainment. Cheap flights will disappear.  We may have to give up our car and get a bike.  Many of our individual freedoms will be curtailed or become very expensive. Our diet will become less diverse as imported food will cost more.  The attempts we may all have to make to avert or mitigate the most catastrophic losses, will threaten our aspiration, culture and identity and involve the loss of our accustomed lifestyle.

Nevertheless, many will respond to such doom-laden predictions with indifference, apathy or cynicism.  Increased awareness of climate change has not yet translated into appropriate concern and action.  How can we think about it without either going into denial or sinking into depression and inertia?  At a recent meeting of The Sheffield Psychoanalytical Journal Club, my friend and fellow therapist Stephanie Howlett presented for discussion a paper on ‘Loss and Climate Change’ by psychoanalytical psychotherapist, Rosemary Randall, director of Cambridge Carbon Footprint. 

Climate change is like getting old or facing a terminal illness; it’s a loss that is bound to happen. Life, of course, is a terminal illness, but we only become aware of that when we approach the end and can experience the symptoms of decline.  So we might gain some insight into how to cope with climate change by thinking about how elderly people cope with their impending demise.  But climate change is not just something that’s facing the elderly, it is something that affects the young as well.  And the elderly among us may never experience the changes that will affect our children or grandchildren; the major effects of climate change on food supply and population dynamics may not occur for another 20 years.  So is the fear of climate change something that affects the young more because they will experience the worst effects or does it predominantly affect the old because they are already aware of the end of their own lives?  Young people often regard themselves as immortal; death only happens to their grandparents.    

So how are people dealing with the reality of climate change?   Some, like Donald Trump, deny it is happening.  They regard it as fake news, exaggerated by a sensationalist media, but isn’t that itself an assault on truth?  More acknowledge the reality of climate change, but disavow its seriousness. Disavowal means you don’t have to face the anxiety; it is happening elsewhere.  The present continues to feel safe but fear is split off and projected into the future; on the one hand,  false comfort; on the other, nightmare.  If we can manage to stop catastrophising the future and wrapping the present in cotton wool, we may diminish both extremes and make loss manageable for our children and grandchildren.  

Others may accept the reality of climate change, but blame others; the Americans or the Chinese or those with expensive cars and life styles, all the while maintaining their own way of life. It’s the same with Brexit: the government are hopeless and the EU vindictive.  Ministers downplay the seriousness of the situation and affect an attitude of control; they have to, otherwise they would never be re-elected.  In psychoanalytical terms, both are examples of collective splitting and projection.

Even if we full acknowledge climate change, we all have to find our own way of dealing with that reality if we are to avoid sinking into hopelessness and depression.  Some may adopt a manic defence.  ‘I’m alright Jack: I can have a good life in New Zealand or Scandinavia. I am not going to let it affect me’. Or ‘ok I know it’s going to happen, but I will make the most of the time left to me’.  The broadcaster, Clive James, has been dying for years but in the meantime has managed to write some of his best poetry.  In The Story of San Michele, the Swedish doctor, Axel Munthe observed that during the devastating cholera epidemic in Naples, people took to making love, often with complete strangers – on park benches, in fountains, anywhere – as if in a frantic bid to find life in the midst of death. 

Although we may wish to accept what is happening and engage with it in a positive sense, most of us will probably protect ourselves by banishing it from our minds and not thinking about it until something forces us to. Death is going to happen but not yet.  Continual fretting about the impending loss can only lead to depression and inertia – the less you can do, the more loss you suffer. But when loss remains unspoken, then change and adjustment cannot follow.  A better understanding of the nature of the loss might allow it to be brought back into public discourse and for people to feel a sense of agency.  God-fearing members of religious communities may regard death a necessary sacrifice to assure everlasting life in Paradise.  Our current secular society does not have such comforting delusions.  

But is climate change something we can engage with?  Or is it, like a terminal illness, an overwhelming inevitability.  Engagement means facing up to our own destructiveness.  Mother Earth is both our breast and our toilet and we are destroying both by compromising food supply and polluting the planet.  Can we ever assuage our personal sense of guilt by getting a bike, not going on long haul flights and installing solar panels?  Maybe not, but by engaging, it may feel good to be part of a solution, however futile.

Loss, even anticipated loss, involves a gradual withdrawal of energy from the loved object. Grief is a process of adjustment and acceptance, always in progress, two steps forward, one step back, never complete.  When a loved one dies, life can never be the same again, but meaning can be restored and it may even become possible to flourish.  With climate change, it’s our world that must end. How can we ever get our minds around that?  Denial and disavowal may be part of an ongoing process that may allow that painful reality to be assimilated. Many of us may accept the idea of climate change intellectually but moving from there to the reality of a lived emotional experience and acceptance of its irreversibility may not be possible. 

Perhaps we should all join the Green Party and campaign for radical solutions?  Collective action can make people feel so much better when they are in the jaws of calamity. Sharing the enormity of the problem might paradoxically garner enough  support to make life tolerable if not enjoyable. During the dark days of 1940, Winston Churchill did not attempt to hide the stark reality of Britain’s situation and was able to appeal to a spirit of resilience in the British people.  Hope, however futile, can always stave off feelings of despair and the ensuing inertia.  But does the same communal sense of purpose still exist in our current narcissistic society, where every man and every woman are for themselves and posting it all on Facebook. It is likely that most will only engage when endgame is upon them, but that will only be to turn to religion. 

Advertisements

FreudFor many years, scientists thought that consciousness was a peculiarly human phenomenon that resided in the cerebral cortex, that deeply fissured cap of fatty substance that overlies the more primitive ‘brain stem’ that we share with other mammalian species. The things that we didn’t ‘know’, our ‘unconscious’ mind, that raison d’être of psychoanalysts that controls our instincts and drives, was thought to be hidden down in the brain stem adjacent to those centres that control basic functions like respiration, temperature control, sleep and eating. Under certain circumstances, however, this ‘dark matter’ in the unconscious was thought to surface and influence our feelings, thoughts and behaviour, but it may be accessed through the psychoanalytical interpretation of dreams, symptoms, free association and behaviour. Freud called the conscious mind, ‘the ego’, representing the self or ‘I’, while the ‘unconscious’ was the ‘id’ or ‘it’. The purpose of psychoanalysis, he asserted, was to make the unconscious conscious, so that our reason for our drives and behaviour could be understood and changed.

Once an idea has been accepted, scientists try to fit their observations to that theory, but in Science, there is never any absolute certainly, there are just ideas that seem to fit our observations better than others.

In the beginning was the feeling.

Earlier this month, at a conference venue overlooking the Regent’s Canal just before it disappears into the tunnel that burrows under the London Borough of Islington, the South African neuropsychoanalyst, Professor Mark Solms claimed that Freud got it the wrong way round. The great man confused the content of consciousness, all the associations stored in the cortex, with its function. In 1923, he wrote that the ‘conscious’ ego is derived from the environment as discerned by our major sense organs. The ‘unconscious’ id, on the other hand, detects certain changes within the body as fluctuations in the tension of instinctual needs (or drives), which are perceived as feelings. So how, declared Solms, can the ‘id’ be unconscious? Consciousness emanates from the brain stem as feelings that include include desire, joy, hunger, care, curiosity, play, fear, disgust, sadness, loss, pain and are related to certain basic physiological functions. After all, we can all feel happy or sad without the mental capacity to recognise we are happy or sad, let alone reflect on what caused the feeling.

So, in direct contrast to Freud, Solms asserted that the id, representing our feelings or needs, is conscious, while the ego – all the stuff stored in our cortex – aspires to be unconscious. After all, we can only hold a very limited range of content in our conscious mind at any one time. The vast majority, 99.999%, is sequestered away unregarded until required. Similarly, most of our actions are automatic. Think of the way we use a keyboard, drive a car, play tennis. If we tried to think about what we are doing, we would instantly make mistakes.

So do our feelings about what happens make us aware of content tagged with the same emotional salience stored in the cortex? Is consciousness rather like a librarian searching the stacks with a torch for relevant content? Are we only conscious of particular associations, stored in the cortical stacks, when those are triggered by feelings? This would seem unrealistic, since the range of feelings even allowing for every minor nuance would only run in the hundreds if that while database of memories in the cortex, even allowing for complex associations probably amounts to hundreds of thousands. So is it more that what happens accesses memories and that their emotional tag causes us to react in much the same way as the immune system reacts to bacterial antigens displayed on the surface of macrophages? After all, the way we think about things can certainly affect our feelings just as our feelings influence the way we think. In science as in life, things are rarely either/or, but both.

It seems likely current awareness is a feeling state that creates associations with stored memories and tags them with a particular emotional salience, transforming drives and feelings into object and verbal representations so they can be worked through and then restored to long term memory. We can sense the way this works when we recall our dreams. Dreaming is widely thought to be the way the brain consolidates experience. Dreams have a certain content, often related to what happened the day before, relevant, albeit somewhat abstracted, associations and a theme that is related to feeling. If it were not for the feeling, conscious perceiving and thinking would either not exist or would decay away. A mind unmotivated by feelings would be a hapless zombie, incapable of managing the basic tasks of life.

If we ever doubted the role of the brain stem in creating consciousness, consider those children born with hydranencephaly, who have no cortical development whatsoever; just a fluid filled space where the cortex should be. They not only wake up and go to sleep at appropriate times, but they also demonstrate the whole gamut of emotions: happiness, sadness, anger, love/care as well as what may regarded as pre-emotions such as hunger, thirst, discomfort. On the other hand, people with very discrete lesions in the brain stem, can go into a deep coma even though the cortex is completely intact.

Even cows can get the blues

Other mammals have the same brain stem structures as we do and, as any pet owner will testify, demonstrate the same range of emotions. It is a fallacy to say that animals have no feelings; they might not be able to reflect on those feelings but they feel everything and respond appropriately to a whole range of stimuli. It is their ability to think through situations, delay gratification and develop strategy, that seems limited compared with ours; though within their own environment, chimpanzees, dogs, dolphins and many other species, show remarkable cognitive capability. One of the books, I received last Christmas was ‘The Secret Life of Cows’. It described a whole range of caring, exploratory, aggressive, contented behaviours in animals which we often dismiss as stupid. James Rebanks described much the same in his Herdwick sheep in his book, The Shepherd’s Life. Even whales express a range of emotional behaviour. Perhaps we don’t wish to think that the animals we slaughter and eat have feelings too.

 

At the age of 14, Rene witnessed his mother, being pulled out of the river;  her lower body was exposed and her nightdress was over her head concealing her face.  Was it her, and if it wasn’t where had she gone, what had happened?   But Rene never talked about it;  he didn’t trust words.  He just expressed it through the medium he had control of; painting.  He was an artist philosopher.   Perhaps all ‘creative’ artists are.  What is art, if not visual metaphor?   

Rene Magritte just took it further.  His painterly skill allowed his imagination the freedom to use the image to describe the thought.  His images express the way the mind connects ideas.  They have a dream like quality because that’s how our mind sees things when we are not fixed by the consciousness of real time and space and the rules of language.  So like dreams, his images break the rules, size is relative, shape distorted, there are impossible associations.  In The Dominion of Light, he merges light and day, street lights illuminate a street against a bright afternoon sky,  a bird flies over a dark sea, its shape filled in by a bright cloudy sky.   A crescent moon is placed in painted in front of the dark tree,   the artist creates the woman by painting her, the landscape on the canvas becomes the view, the window pane breaks up into pieces of the landscape viewed through it, a  couple kiss with cloths over their heads, an act of intimacy between two people who are concealed from each other.   

The theme of concealment dominates his work.  He creates illusion by representation.  Magritte liked a mystery, the anonymous detectives in bowler hats coming to arrest and assailant, the woman’s body on the operating table, the same bowler-hatted figures of differing sizes descending like rain in front of the buildings of his home town.   

Magritte wasn’t so much looking for meaning, he was more interested in the process of how we represent ideas; he wanted to express ideas as he perceived them.  Our mind, as the extension of the vast neuronal network that is our brain, makes connections between ideas and actions and feelings.  Having conceived of a certain way of thinking, we return to it again and again, establishing neural connections like paths through the forest.   But our mind’s reality makes connections which are impossible in the real world.  Magritte shows us the way our mind thinks about things.  So a pipe is not always a pipe but represents something much more potent, a carrot morphs into a bottle, a bird becomes part of the sky, clouds are like object and thoughts. 

Magritte recognised how words condition our thought, fixing and channelling the meaning, so he experimented with different words for objects.  Words tell us what an object is, but our mind sees other connotations.  Poetry plays with this idea.  It explores the power of words, but also their limitations.  Freud and Jung explored the same territory in their papers on symbolism and dream, but at least Freud had the honesty to admit that ‘sometimes a cigar is just a cigar’.    

Magritte, The Pleasure Principle,  is currently being exhibited at Tate Liverpool on Albert Dock. 

‘You’re rather like Diogenes in his barrel’,  David declared on his fourth visit to my little cottage in Edensor.   Was that a compliment?   Well, on the principle of the glass being half full, I decided that it was.  I quite liked the idea of being perceived by the medical fraternity as a hermit, living the thoughtful life, so unworldly that I would ask the Dowager  (the nearest we have here to Alexander the Great,) to get out of the sun.  Though I did wonder if I have rather corrupted the ascetic image by becoming a bit too busy with politics and The Gut Trust.   

We spent the first hour grumbling about how our regulated society was stifling research, inhibiting education, undermining government, taking away the art and enjoyment of life, but risk aversion was part of a cycle.   In medicine, it was probably triggered by the dreadful revelations about Dr Harold Shipman; in economics,  by the greed of the bankers.    

A nervous society finds its ways of getting rid of those who will not conform to its stringent regulations.  We are both reading The Hemlock Cup by Bettany Hughes.   It’s about Socrates’ life, but takes as its starting point, his death.  Accused of being a free thinker and corrupting the youth by speaking against the Gods, Socrates was condemned to take his own death by drinking a cup of hemlock.   My old friend, Maurice, was incarcerated in a mental institution last year on the grounds that he was a danger to society.  Always resentful of authority,  Maurice was targeted by the police and neutralised.  Even the spurious interpretation of a brain scan using nuclear magnetic resonance was used to reinforce the case against him.    

David and I have reached an appropriate stage of seniority when we can with impunity comment on what we see as the failings of the medical establishment.  But this privilege has been hard won.  We are both first born and have both shouldered the burden of our parents’ ambitions for most of our lives.  David commented that it was not until the age of fifty that he escaped the straitjacket imposed by a reputation in medical research and felt free to indulge his interest in philosophy.  At around the same time, he became aware of his parents not just as projections of himself, mum and dad, but more objectively in the context of their own lives.  My trajectory ran parallel to his.  At 49, I started to retrain as a psychoanalytical psychotherapist and at 53 I retired and began writing my book.  Perhaps this was our age of reflection,  the time that we could at last be ourselves,  rail about the restrictions bequeathed to us by our parents indulge in a more liberal intellectual life. 

Does late middle age constitute a similar age of reflection for others besides the eldest sons of ambitious parents?

You’re driving me mad, I’m going crazy, I’m losing my mind, he’s just daft, it just doesn’t make sense!  How many times a day do you hear such sentiments?  How often do you express them yourself?   Our lives are so complex, so pressurised that we have to work very hard to keep things together.  And yet, we don’t see too many overtly mad people these days; most are medicated; a few locked up in institutions.  But we can all show pockets of paranoia when our buttons are pressed.   We can all go mad, especially if deprived of social contact and support.  There is, however, a distinction between being mad and going mad and some people are just nearer the edge than others.      

The medical term for madness is psychosis, which essentially implies having beliefs, attitudes and behaviour that are antithetic to social convention.  Psychosis is not the only category of mental illness; there is also neurosis.  The old adage captures the distinction nicely.  A neurotic thinks that 2 and 2 equals 4 and is worried about it.  A psychotic just knows that 2 and 2 equals five.  So neurosis is a disturbance of doubt while psychosis is a condition of certainty and conviction.  They are styles of being, different but not immiscible.   Although people may try to evade the torment of neurosis by developing  delusions , they can still be tortured by convictions  of victimisation, devastated by fears of fragmentation.  Life for somebody who is psychotic, can literally be hell!  Even when things are calm, there is no peace from their internal thoughts and voices.  No wonder so many people who have a psychotic breakdown, chose to end their own lives. 

The problem is not so much how we can distinguish between neurosis and psychosis but how we can we distinguish each from so called ‘normality’.   ‘Normal’ is a social construct, defined by reference to the culture a person comes from.  The Christian notion of God, his reincarnation as Jesus Christ, the virgin birth and the resurrection, is considered quite normal in the United States of America and much of the western world.  But as Richard Dawkins has emphasised, what is God but a massive delusion?   The only reason a religious conviction is not  considered mad is that the same delusion is shared by others.  Falling in love is another delusion that is widely encouraged by society even though it has such massive potential to shatter a person’s private web of meaning.   

Psychosis is a distortion of meaning and as such,  a logical consequence of being human.  We can all go a bit mad at times.  Human beings are creatures of meaning, compelled to find reasons for their existance and what happens.  They have a big brains that can see into the future, and a deep seated fear of what might exist in that void.  They have the imagination to invent stories and can be both comforted or tortured by the delusions they create. 

Meaning develops  through relationship with others, initially our mother, father, brothers, sisters, grandparents and later, a wider circle of family and friends , teachers, mentors, books and television.  It is conditioned by society, represents society and maintains us within that society.   Therefore, if we regard psychosis as an alternative or distorted state of meaning, it is a social disease.   It stands to reason that those who grow up isolated, conditioned by  perceptions that are incompletely normalised by others, develop their own fragile belief structure  that can set them apart from others.  Alone in a black and white world, where people are either idealised or denigrated, they can tend to be suspicious and blame others.   All the good stuff is located in themselves while the bad stuff is projected out though the opposite may attain.  

But there are shades of isolation. People who live on the cognitive borders of society are able to function quite normally for much of the time, but may exhibit uncompromising and paranoid ways of thinking when their meaning is challenged.  Mental illness might be regarded as a defence against the loss of meaning induced by change.     

As  creatures whose identity is created from meaning, we are all vulnerable to change.   Any of us can be overwhelmed and devastated by an event that is completely outside our experience,  and most of us, especially the more solitary, adopt strategies to prevent the devastation caused by a breakdown of meaning.  Some may assume an idealised persona, a special identity that offers a role and purpose.  This may be reinforced by special musical, literary or artistic talents perfected through the years of isolation.   Others may mould themselves to their environment, sensing what others want and adapting to it. Women are said to be better at this, readily adapting their personality to the needs of a new partner.  And finally some keep it all together by encapsulating themselves in an all consuming interest, an obession for work, a dedication, a faith.   

We can see examples of such behaviours in our colleagues, friends, family and in ourselves, but some people are more fragile, more susceptible to change and more clearly defended against it.  But fragility is no reason for segregation.  Society needs to achieve a democratisation of belief and thought.  People with conviction and creativity can be exciting and inspiring.  Most effective politicians have some spark of madness in them.  They can be dangerous unless reined in by their civil servants.  Society advances, not by the most stable, healthy members of society, but by those independent thinkers,  who may at times be considered mad by their colleagues.  Darwin, Einstein, Newton, and many of the great writers, artists and composers have all been considered mad at times.   Ignaz Semelweis, whose hygeinic principles saved the lives of millions of women from puerperal fever, spent much of his life incarcerated in mental institutions.

Some of the ideas in this article were inspired by a talk on psychotherapy and the psychoses given by Darian Leader at the Biennial Conference of the Hallam Institute of Psychotherapy on October 2nd.  

She didn’t believe in anything very much.  Communism, fascism, altruism, capitalism, collectivism; they were all the same to her; forms of subjugation and oppression.  No, what Ayn Rand believed in was objectivism, “the concept of man as a heroic being, with his own happiness as the moral purpose of his life, with productive achievement as his noblest activity, and reason as his only absolute.”   Rand argued for rational egoism (rational self-interest), as the only proper guiding moral principle. The individual “must exist for his own sake,” she wrote in 1962, “neither sacrificing himself to others nor sacrificing others to himself.”   

The difficulty is that she used her philosophy and the attention it attracted to justify her excesses of self aggrandisment and selfish behaviour.  Her’s was the philosophy of the narcissist.  Rand opposed every grouping that was not hers.  There had only ever been three great philosophers; the three A’s, Aristotle, Aquinas and Ayn Rand.  Her followers were disciples of a personality cult. 

Ayn was a formidable personality.  The film of the same name focussed on her love affair with the young Nathaniel Brandon, who together with his wife Barbara, had fallen under Ayn’s spell while callow psychology students.  Nathan was in thrall with Ayn and she soon exploited his infatuation to seduce him, but she insisted that they inform their partners and limit their relationship to a year, a strategy Ayn justified philosophically.  Of course,  it went wrong.  Barbara, not long married to Nathan, was deeply unhappy and found somebody else.  Nathan tired of Ayn’s demands and in turn exploited one of his own students.  When Ayn discovered this ‘infidelity’, she was furious.  How dare anybody betray her?   She slapped him across the face and excommunicated him from the Ayn Rand foundation;  assuring him that he could be nothing without her.

Ayn was so fascinating because she was so dangerous and forthright.  She demanded absolute devotion and control.  Hyperbolic and emotional, she possessed the passion of the hysteric.  She held her disciples in a vice-like grip of life and death; such was the unyielding power of her personality.  She could be effusive and kind to those who worshipped her, but woe betide anybody who ignored or betrayed her.   And her disregard for society was ruthless and uncompromising.  “What are your masses but mud to be ground underfoot, fuel to be burned for those who deserve it?”  

 Ayn, was born Alisa Zinovyevna Rosenbaum in St Petersburg  and grew up during the revolution,  escaping to America in 1931.   The alienation of the Russian jew,  the insecurity and danger of the civil war, the mobile allegiances, escape to a foreign culture; all of these had implanted a backbone of steel;  the single-minded self-centered determination of a remarkable survivor.  Her philosophy emanated from a unique and unusual experience.  It is worth studying as an idiosyncratic social commentary, but so dangerous to adopt as a template for western society. 

But I wonder how much influence she has had.  Doesn’t her attitude justify the narcissistic culture and the decline in community and society over the last 50 years.   Hasn’t ‘because you’re worth it’ has become the catch phrase for the material meaninglessness of a generation?

Jules Henri Poincare (1854 – 1912) was in trouble.  The most famous mathematician of his generation,  he set himself the task of predicting accurately the orbits of the earth, moon and sun.  His solution was brilliant. It was nominated for a prestigious international prize, but just before he was due to present his theory and collect his award, he found he had made a mistake.  If he had used different assumptions at the outset, he would get very different results.  Mortified, he wrote a follow up paper explaining his mistake, but in so doing, made the first mathematical contribution to what became known as chaos theory,  though this aspect of his work was largely ignored until the 1970s when ‘chaos’ became the rule for many systems.    

Chaos is evident in all aspects of life.  Weather forecasting is an exercise in probabilities because we can never be sure of the starting conditions.  We can’t factor in  all the variables.  This is why it is said that a butterfly flapping its wings in West Africa will result in a typhoon is south- east Asia.  It’s not meant to be taken literally, just a mathematical possibility to illustrate how small unconsidered variations can cause enormous effects.   

And take sport.  They said England had a good chance of winning The World Cup this year, but what went wrong?  Could a glance across the table by a teammate’s wife have set in train a sequence of events that unsettled the captain, led to a players revolt against the coach and culminated in a catastrophic collapse of confidence?

And what about politics, computing, and the stock market?  Somebody can’t sell his house in Wisconsin and we end up with a global recession.   Or the rail network.  The wrong leaves on the line in the Home Counties and business in the City of London slithers to a halt. Small variations can have massive effects.  A tiny wobble in the orbit of an asteroid could destroy all life on earth. 

And in medicine, a small change in environmental conditions, a particular event, can so easily bring about illness.   Perhaps a tune on the radio could revoke a memory that could upset the gut and result in an argument that ends a marriage.  With no chance at resolution the gut upset persists as unresolved IBS.   When scientists do trials of treatment, they try to hold all the conditions constant.  This is what is called a controlled study.   It relies on certain  assumptions about which factors are important.  Age and gender may be controlled,  diet might be in a few studies, emotional factors almost never and yet these may be crucial.  So they can never really control the outcome.  If they make the same measurements 100 times in the same patient and they will come up with a hundred different results.  So what do they do?  Employ a statistician to tell them an answer they might (or might not) be able to rely on!  But  they still might be ignoring certain crucial factors because they don’t think they count or they are impossible to control.  As Albert Einstein declared, ‘Not everything that counts can be counted.  And not everything that can be counted, counts.’  

Irritable Bowel Syndrome is an idiosyncratic disease.  It is more an expression of the personality, life experience and life style than those variables that can be easily measured.  Moreover it can’t be easily defined because there is no identifiable change in body structure or chemistry.  It is whatever doctors say it is.  No wonder treatment is so variable and so personal.  It’s an exercise in chaos; a bit of a lottery.  What works for one person may not necessarily work for another.  But you can cut down the variability by reading the self management programme and getting to know about your illness, yourself and with some guidance managing your own symptoms.

Next Page »