Archive for June, 2012

I noticed this (a fungus growing on a tree stump)


then I noticed this (a snail on a leaf)


…..nice to see the resonances in the shapes

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What do you see?

tree map of the sky

This is a photo I took in Africa. What do you see now?

Look at this next one….what do you see?

A loch the shape of Scotland

That’s a photo I took in Scotland. What do you see now?

Isn’t it interesting how we continuously look for and “recognise” patterns? How wherever we look we bring what we know to our experience of perception? I’m going to guess that, although it’s definitely not an exact match, in that first photo, you see Africa, and in that second one, you can see Scotland. I mean the shapes of those countries.
That’s certainly what I see. Of course, I bring something else too, to these photos, because in each case I was there. I stood in Africa and pointed my camera to the sky. However, I was taking a photo of trees. It was only afterwards that I thought – how like the shape of Africa! And I stood by the roadside on my way back south to Stirling from a holiday in Skye and thought what a lovely loch. Only later did I think, how like a map of Scotland!
Photos do that for me. They slow me down. They let my imagination kick in and then I SEE more and I EXPERIENCE more.
Photography is one of the tools I use to enrich my life.

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lightning strike

The long marks on this tree were caused by a lightning strike.

Although struck by lightning, this tree didn’t die, it survived. But it survives changed. The marks of the strike become part of the beauty and uniqueness of its bark.

Illness is like that.

Stuff happens. Bacteria are inhaled or swallowed, bones are broken, hearts are broken. Often we blame these external events or stimuli for our illnesses. We say we have an infection when our bodies develop a fever, pain, inflammation in response to bacteria or viruses. In fact we give the infection the name of the bacteria or virus – we say the patient has “E Coli”, or “TB”, or “measles”, despite the fact that most people who inhale or swallow that particular “bug” might not actually develop any fever, pain or inflammation. Thinking this way externalises the illness. It’s something that happens to us and we are the victims.

But it’s more complicated than that. The particulars of our illnesses are the results of our responses, our adaptive responses, to these events, or, more commonly in chronic illnesses, to multiple, often long distant factors/events. Not everyone with the same diagnosis will have the same symptoms, and certainly no two people with the same diagnose will narrate an identical story of their experience of this illness.

Understanding that illness emerges from within our lives changes the power balance. We reject the victim mindset and open up the possibility that this experience of illness presents us with an opportunity to learn something about who we are, what’s important to us, and how we adapt to the changes in our lives.

We are changed as a result of these responses. Kat Duff, in “The Alchemy of Illness”, puts it beautifully –

Our bodies remember it all: our births, the delights and terrors of a lifetime, the journeys of our ancestors, the very evolution of life on earth………in fact, every experience, from the sight of a field of daisies to the sudden shock of cold water, leaves a chemical footprint in the body, shimmering across the folds of the cortex like a wave across water, altering our attitudes, expectations, memories, and moods ever so slightly in a continual process of biological learning.


lightning in the forest

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Every day at work I’m focused on trying to understand another person. Every patient who comes to our hospital is seeking, amongst other things, an explanation.

If someone has been given a diagnosis of, say, Multiple Sclerosis, amongst the many questions they are likely to have, are “What does this mean?”, “What does it mean to me, and to my life?”, “How has it come about?”, “Why me?”, “What is this illness and what things are going to make it better, or worse?”

We all have many other questions too, but these questions are amongst the ones to do with explanation.

It’s perhaps even worse when a clear diagnostic label hasn’t been given. When someone suffers chronic pain, chronic fatigue or chronic low mood but “all the tests are normal”. What then? What’s going on?

Explanation involves getting to know someone. If we limit the explanation to a tissue level e.g. “arthritis”, or to an organ level e.g. “angina”, then we stop before we explain this illness in this particular person’s life. And if we want to help the person, not just the “arthritis” or the “angina”, then we’re going to have to take into account the uniqueness of this person’s experience of this particular illness.

A major way we can do that is through story.

It’s through the telling of a story that we gain our insights, and our explanations. For me, two of the questions I want to answer with every patient are “what kind of world does this person live in?” and “what are their coping strategies?”

The kind of world we live in is fashioned by our beliefs, our values and our circumstances (our contexts or environments, physical, relational, cultural), and the way we try to adapt to the changes in our lives are manifest in our default and learned strategies.

In an article entitled, “What do we know when we know a Person?”, Dan McAdams points out that the explainer, or the observer is also important  –

One must be able to describe the phenomenon before one can explain it. Astute social scientists know, however, that what one chooses to describe and how one describes it are infiuenced by the kinds of explanations one is presuming one will make. Thus, describing persons is never objective, is driven by theory which shapes both the observations that are made and the categories that are used to describe the observations, and therefore is, like explanation itself, essentially an interpretation.

In other words, my world view and my coping strategies will influence what I see, what I hear and what sense I make of the patients who consult me. I’ll return to that issue in another post, but Dan McAdams article starts with an interesting conceptual framework for what we know about another person.

Individual differences in personality may be described at three different levels. Level I consists of those broad, decontextualized, and relatively nonconditional constructs called “traits,”…….At Level II (called “personal concerns”), personality descriptions invoke personal strivings, life tasks, defense mechanisms, coping strategies, domain-specific skills and values, and a wide assortment of other motivational, developmental, or strategic constructs that are contextualized in time, place, or role……..Level III presents frameworks and constructs that may be uniquely relevant to adulthood only, and perhaps only within modern societies that put a premium on the individuation of the self…..Thus, in contemporary Western societies, a full description of personality commonly requires a consideration of the extent to which a human life ex- presses unity and purpose, which are the hallmarks of identity. Identity in adulthood is an inner story of the self that integrates the reconstructed past, perceived present, and anticipated future to provide a life with unity, purpose, and meaning.

You can read the full article by Dan McAdams here.

So, how do we get to know someone? Partly it involves knowing ourselves, being aware of our own way of seeing and experiencing the world, knowing what we pay attention to, what we are fascinated by, disinterested in, what we believe and what we value.

And, partly, it involves a focus on the telling of a story – one which “integrates the reconstructed past, perceived present, and anticipated future to provide a life with unity, purpose, and meaning”.

That’s a good start, I reckon.

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I’ve been thinking recently (again!) about two inter-related dimensions of being human – a creatureliness and a symbolic self, as Becker describes it, or as a visible and in invisible self, a body and a soul….an so on. Then yesterday I read in the superb “The Alchemy of Illness” by Kat Duff –

The Nahuatl peoples believed that we are born with a physical heart, but have to create a deified heart by finding a firm and enduring centre within ourselves from which to lead our lives, so that our hearts will shine through our faces, and our features will become reliable reflections of ourselves. Otherwise, they explained, we wander aimlessly through life, giving our hearts to everything and nothing, and so destroy them.

That set off my thought patterns down several roads…Heartmath and the intelligence of the heart – learning the ways to use our heart-thinking (yes, there is a neural network around the heart which we use to do a kind of thinking). Then I got to thinking, reflecting on a conversation my wife and I had on waking this morning, “imagine what it would be like if what was in your soul actually shaped your face so everyone could see it” – how would you appear to others if what was in your heart shaped your appearance?

Then that last line, “Otherwise, they explained, we wander aimlessly through life, giving our hearts to everything and nothing, and so destroy them.” brought me right back to heroes not zombies, and to Kierkegaard’s line about tranquillizing ourselves with the trivial.

Two hearts……..

two hearts


So, what’s in your heart right now?

Are you in touch with your soul’s purpose?

How are you responding to what your heart has to tell you?

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red dipper

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What is it to be human?

We have a tendency to break wholes into parts and then conceive of the parts as entities. This is just a conceptual skill however and often it doesn’t reflect reality terribly accurately. Mind and body, for example, is one such common division of a person. At one point I thought of myself as a “mind body doctor”, or as a doctor who “took a mind body approach”. I don’t do that any more. It’s too falsely dualistic for me. I think the mind and the body are no more separate than the wave and particle forms of light. (You know how light when considered in one way behaves as an energy wave, but in another way, as if it is made of individual particles?)

So from the conceptual perspective of looking at a human being in two ways, we can see that human beings are physical organisms. Becker, in his “The Denial of Death”, uses the term “creatureliness” for this aspect. I rather like that. Our creatureliness is what we share with all other creatures. Our bodies are physical and transient. They will degenerate and expire, like all other creatures. And like all other creatures, part of our behaviour and experience can be understood from an examination of instincts and “basic drives” – hunger, thirst, safety and so on.

However, we have another aspect, not shared with other creatures. It’s that invisible part of us. What shall we call it? Soul? Consciousness? Spirit? Becker calls it “the symbolic self”. I’m not sure I’m that keen on that particular term, but it does capture both our facility of imagination and our ability to give and gain meaning in all sensations and objects. We don’t just see the colour red. The colour red is laden with meaning. And this is true of the whole of our experience in life.

We live both a creaturely life, and a symbolic, invisible life.

Interesting, huh? And a consideration of a person which ignores either of these two perspectives, is a consideration of a person at a less than human level. Let’s always see a human being as fully human.

Heroes not zombies.

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