Archive for January, 2013

The self is relatedness. The self doesn’t exist without relationship. The self appears in your deeds, and deeds always mean relationship.

James Hollis wrote that. It stopped me. You find there are books like that, don’t you? Books which you can’t read all the way through without stopping. I don’t mean the stopping for tea, or to answer the phone. I mean that stopping in the middle of the page, or anywhere in the page actually, because what you just read provokes such a mental reaction. This was one of the many places where I stopped when reading Creating a Life by James Hollis.
My first thought was, “how true”. I see connections everywhere, and I see the constancy of change. In fact, that is so important to me that I put the phrase, “becoming not being….” as the sub-head of this blog.
We are constantly becoming, ever interacting, exchanging, adapting and changing.
So, it’s true. The self doesn’t exist without relationship. I’ve thought many times that you could never know a person by observing them, through a one way glass,in an empty room. You have to see how a person interacts, with you, or with others, to have any sense of who they are.
Reminds me too, of “Ubuntu” – “I am because you are”
But then it seemed to me he’d gone too far when he added “deeds always mean relationship”.
Surely there must be deeds we commit alone?
But hold on, am I narrowing the definition of relationship too far here? Am I assuming a relationship is between two PEOPLE?
What about how I relate to Nature, to the built environment, to music and images and art? To this very book I am reading in fact!
It’s true what he says – the self really does appear in our actions, our reactions, and our interactions. It’s not a phenomenon which emerges in total isolation (even our memories and our imaginings are the creation of relationships aren’t they?)
So here’s something to consider today – what sense of self do I notice emerging from my deeds? my choices? my interactions?

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I come across this issue all the time – there is a gap between reality and fantasy, and that’s where suffering occurs.

By fantasy, I really mean imagination, but that includes hopes, dreams, and idealised wishes for how things could be. It includes memories too, because I don’t believe memories are like objects tucked into some cerebral drawer – we recreate them, imagine them anew, every time we bring them into the present.

Some terrible things happen to people. Things that will never go away. And those things keep jumping into the present. We wish those memories weren’t there. We wish those things had never happened, those words had never been said, those choices had never been made. But they did and they were. And in that gap, in that space or difference between how we wish things had been and how they actually were, there’s where suffering lies – hurt, pain, anger, sadness, regret…..

Some people imagine how things might turn out, and those imaginings might either be terrible and they live them now in the fears and paralysing anxieties which emerge in the space between the awful future and the actual present. Or they imagine how things would be so much better than they are and in that gap they find frustration, dissatisfaction and discontent.

What do we can we do with this gap? Can we narrow it a bit, even if we can’t make it go away?

Partly. But, wait a minute. Should our first thought be “let’s get rid of this suffering”? Because if it is, we might reach for the painkillers and the sedatives, or hit the escape routes, before we understand what this pain is about. Might it not be better to see if we can see what the roots of this pain are? Where is it coming from? Why is it here? What sense do I make of it? We are meaning seeking creatures and we want to make sense of lives. What sense do we make of this particular suffering? What it is telling us?

Sometimes, when we understand the suffering better, we understand that something needs to change, that we need to make different choices. And sometimes when we understand it better, we realise that right now, right here, in the present moment, we are actually ok. Better than that, we discover that the everyday, so called ordinary world, right here, right now, is extraordinary and amazing, and that our suffering is fear or anxiety about what might be, overwhelming the present moment and hiding from us the fact that life, here and now, is not just welcome, but something to be grateful for.

There’s another role for suffering of course – creative energy. In the gap between how things are and how we imagine they could be, dissatisfaction or discontent can drive creative solutions, generate new ways of thinking or inspirational art. (I’m not saying you have to suffer to create great art – I’m just saying that sometimes great artists turn their alchemical skills to their suffering and their struggles and create gold)

Anyway, however you handle it, whatever choices you make, next time you feel you are suffering…..Mind the Gap – and reflect on why it’s there. Then you might be able to make a different choice.

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There’s a chapter in James Hollis, the Jungian analyst’s book, Creating a Life, entitled, “Attending the Soul”. This particular chapter is about the practice of psychiatry and he completely nails an important point.

If we consider health, acute and chronic illness, to be a spectrum of experience, then we need to do more than control or manage disease in order to be healthy.

Here’s how James Hollis puts it….

In seeking scientific verification of success, many of these practitioners [psychiatrists] have narrowed the definitions of pathology to behavioural patterns, faulty cognitions and flawed chemistry. While it is certainly true that we are behaviours, and behaviours may be corrected, and we are cognitions which may be challenged by other cognitions, and we are chemical processes which may be compensated by other chemical processes, none of these modalities – behaviourism, cognitive restructuring and psychopharmacology – should be confused with psychotherapy.

He goes on to say that psychotherapy seeks to address the whole person, even the meaning of the person, the meaning of their suffering or even the meaning of their life.

This same point applies across the whole of Medicine. Illness may include physical pathologies which can, and may, be addressed with drugs or surgery, or it may include adaptive, or protective symptoms and behaviours which can be changed. However, if we are interested in healing, in facilitating the experience of wellbeing, resilience, and health, then we face the fact that a whole human being is more than the sum of his or her parts.

Here’s how he concludes his chapter…

To stop at behavioural change, as important as it is, or cognitive restructuring, liberating as it may be, and pharmacology, necessary as it sometimes becomes, betokens a failure of nerve and sells the soul very short indeed.


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To describe health as the absence of disease is inadequate and unsatisfying. We have defined diseases for the last four hundred years or so according to the presence of certain lesions, or the presence of “abnormal” readings measured by instruments of investigation. Illness is a related, but different, term from disease. It is used mainly to refer to the experience of being unwell, incorporating our concept of disease, but actually describing the subjective experience of a person. Only a person can tell you they feel nauseated, or that they have pain. Instruments won’t reveal those phenomena.

Similarly, health should be understood as a phenomenon, or an experience, in its own right. For sure, if you have either a disease or an illness, this will impact on your experience of health, but is it really such a black and white issue? I don’t think so.

Consider these three concepts as a spectrum

spectrum of health

H = health; A = acute disease; C = chronic illness

From the condition of health, we can move rapidly into the red zone as we experience an acute illness. Think of “winter vomiting”, which only this morning was reported as having affected one in every five people in Scotland this winter. Suddenly, you feel unwell, and then you start to vomit, and/or, have diarrhoea. You pretty much have to wait it out, resting, and replacing the fluid losses as best you can. Although caused by a virus, we don’t have antiviral drugs which effectively and quickly kill this particular one (and even if we did, killing the virus is only one part of becoming well). What helps?

The body heals itself. Any intervention, including rest and replacing fluids, will only help by supporting the body’s capacity to self-heal. Personally, I and my family, used homeopathic medicines in addition, to speed our recovery from this nasty acute illness.

In other acute situations, relying on the body’s self-healing is not enough. In the situation of acute heart failure, a heart attack, severe acute asthma, a diabetic crisis (hypo or “DKA”), and so on, medical treatments including drugs or surgical procedures can make the difference between living and dying during this acute event.

However, once the acute episode settles, the person may move up into the healthy blue zone of the spectrum, or may slip around into the chronic yellow one. We see this in diseases such as MS (Multiple sclerosis), where the acute episode might settle completely and the person returns to an experience of health, or it might progress into a more chronic pattern.

Similarly, someone might develop a chronic illness insidiously, without any acute episode at the outset, and they might move towards the healthy zone, or they might occasionally fall directly into the acute red zone as they experience a flare-up (as we might see with inflammatory bowel disease, for example).

Why is this spectrum helpful?

Well I think it shows that health, acute and chronic disease and illness, are different, but related phenomena. However, it also shows us that different tools are required depending on where the person is on the spectrum. There are drugs and operations which can assist in the management of problems in the acute or chronic zones, but any movement towards health always requires the good functioning of the individual’s self-healing capacity.

This is one of the main things I find missing in modern health care. We attend to the lesions and dysfunctions, but we lack the technologies for directly supporting and stimulating the body’s necessary self-healing capacity.

This is the area being explored by doctors interested in “integrative medicine” ie interventions which are intended to support greater integration or coherence of the whole system.

We need research to better understand self-healing. In fact, we need to become better able to describe and understand the condition we call health. If we want to increase the health of populations we will probably find the answers, not in drugs, operations or therapies, but in creating the conditions, and supporting the contexts, for adaptation, creating and engagement – characteristics of health.

In relation to illness, however, we also need to explore interventions which are intended to be integrative by examining their impact on health, not on lesions.

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For many years when I’ve taught about the different ways in which we develop an identity I’ve described a line with two poles.

At one end is “I”, the unique, separate, different “me”. We have a whole body system, the immune system, developed to be constantly on the alert for what is not “I”, whether it be a virus, another person’s genetic material, or a chemical substance from “outside”. The immune system is primed to quickly recognise any such foreign material and isolate or remove it.

At the other end is “we”, the connected self, the “me” which is part of “we”, whether that be in relationship with another single person, or with a group.

We all need to know that we are unique, that we are different and separate from others. What can come with that however, is a sense of disconnection, or loneliness. Just as importantly we need to know that we are connected, that we belong, that we “fit in” and that we love and are loved. What can come with that can be a loss of personal identity, a feeling of just being a number within the group.

I pointed out that this line with its two poles didn’t have a point somewhere along it where everything was balanced. It doesn’t work like that. We move continuously along the line, back and forth, changing our focus, our awareness and our sense of self, but never wholly living at only one of those poles.

Then last year, I read two books which mentioned concepts which fitted right in to this simple diagram. Thomas Berry’s The Great Work, where he beautifully describes the twin polar opposites of “wildness and discipline“.

When first the solar system gathered itself together with the sun as the center surrounded by the nine fragments of matter shaped into planets, the planets that we observe in the sky each night, these were all composed of the same matter; yet Mars turned into rock so firm that nothing fluid can exist there, and Jupiter remained a fiery mass of gases so fluid that nothing firm can exist there. Only the Earth became a living planet filled with those innumerable forms of geological structure and biological expression that we observe throughout the natural world……….The excess of discipline suppressed the wildness of Mars. The excess of wildness overcame the discipline of Jupiter. Their creativity was lost by an excess of one over the other.

The greater the wildness, the greater the emphasis on “I”, on separateness. The greater the discipline, the greater the emphasis on “we”, on the bonds, the connections.

And Howard Bloom’s The Global Mind, where he picks out five characteristics of complex adaptive systems and highlights the first two as “diversity generators” and “conformity enforcers”. Diversity generators increase the wildness and the sense of “I”, whilst the conformity enforcers increase the discipline and the sense of belonging.

I now have two lists with a line connecting them, and it still didn’t look right. It wasn’t a simple spectrum for example, and it wasn’t a line where there was some balanced point half way along where we “should” be. So, I turned the horizontal line into a vertical line running between the two lists, and then I bent the line into an “S” shape. Drawing a circle right around the whole image turned it into a yin yang symbol and I thought, “Yes, that’s it” – that’s the heart of the universe.

yin yang

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“lub dub, lub dub, lub dub”

That’s what I was taught to listen for when I was first shown how to use a stethoscope. This was the natural sound of the heart. It was a beautiful rhythm. I think you can’t help being impressed, or even moved by it. I remember the first time I was taught to use another, similar, but different device – the pinna. A pinna was a plastic cone which you placed on a pregnant mum’s tum to listen to the baby’s heart beat. So fast, but so amazing. Thrilling every time. But it was a kind of private thrill because nobody else could hear it. These days, we use technology to show the beating heart of the baby, or to play the fast lub dubs through speakers so everyone can hear it.

The heart beat is a constant alternation of opposite states – systole, where the heart muscle is contracted and the chambers of the heart are emptied, and asystole, where the muscle rests and the chambers fill with blood. There is a such an amazing truth in that observation.

At the heart of the universe there is creation. There is a story of the universe, from The Big Bang, to the emergence of hydrogen and helium, the cycles of growth, expansion and contraction of the great billions of stars, to the creation of Planet Earth, at first lifeless, then rapidly (in universe timescales!), creating simple, single celled life forms, complex, multicellular ones, plants, creatures of the sea and the land, right up to our continually developing, evolving human race with its most peculiar characteristic of consciousness. This story is the the story of constant becoming. It’s a story of ever increasing amounts of uniqueness. The universe loves diversity. And it loves to make connections.

This is the heart of the universe. Two opposite processes, tightly bound together – diversification and integration.

We need both the diversity generators and the conformity enforcers as Howard Bloom refers to them in The Global Brain.

Can you hear it?

This constant creative heart beat?

Lub dub, lub dub.

yin yang

Right here inside you, right here and right now, in your unique and singular life, the amazing, constant rhythm of becoming…..

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Sometimes (quite often actually), I wake up with a word or phrase in my head. This morning it was “heart of the universe”. The particular word or phrase can set off all kinds of different thoughts and where this one quickly went was “It’s 2013. It’s 40 years since I dissected a human heart. Second year, Medical School, Edinburgh University. That year we learned Anatomy and Physiology. I was amazed at the structure of the heart. It’s four chambers, the valves, the specialised heart muscle cells which each had their own rhythm, the conduction pathways from the “AV node” which carried the co-ordinating electrical beat to produce the two, opposite states of the heart – systole and asystole.

It was two years later before they told us to put on white coats, buy a good quality stethoscope, and led us on ward rounds, to stand collectively around patients’ beds, and one by one, place our shiny new stethoscopes on their chests to listen for the “lub dub” of the “normal” heart, and listen carefully for the clicks and sounds which filled the silences and revealed the disorders of the valves.

Over the years as a GP, I prescribed the drugs to slow hearts down, to regulate disordered rhythms, and to improve the blood supply to get the oxygen to the cells starved by blocked arteries and causing angina. I also found people presenting with pain, flutters and skipped beats of the heart whose investigation results showed no obvious pathologies. What were we to do with them? And where was the explanation for their symptoms? If their symptoms weren’t signposts to pathology, then what were they?

Gradually, I became aware of how we use heart in our language, as people told me about “broken hearts”, “heart ache”, “longings of the heart”, “an emptiness in my heart”, “getting to the heart of the problem”, “filling my heart with joy”. Of course, from early years I became familiar with the shape of a heart as we would draw it to communicate love. We see that shape everywhere.

three leaves

cafe love



Why the heart? Why not the liver, or the pancreas, or the spleen? Why not the kidneys?

I knew there were intimate connections between the brain and the heart, mainly channeled through the “autonomic nervous system”. Then only in the last few years did I learn we’ve discovered that there is a neural network around the heart and associated with that is the production of neuropeptides (the small proteins which act on the brain) within the heart and its neural network. So, the links are more intimate than I realised, and, most importantly, more two way than I realised – the brain acts on the heart, but the heart also acts on the brain. In fact, it seems we do some of our mental processing using these neurones around the heart. (That dismissive phrase which I never liked – “it’s all in your head” – turns out to be even more stupid than I always thought it was)

And as time passed, and I experienced encounters with more patients, I began to see that sometimes (not always but often enough to always consider), there were direct links between “heart issues”, “heart language” and “heart symptoms”, irrespective of the presence or absence of pathologies.

So, here’s something to consider as you think ahead into 2013. How about building your “heart intelligence”? That’s a concept that means somewhat different things to different people, but let’s just use it as it is, without detailed definition.

Try the Heartmath technique. Sit quietly, focus on your heart area, take three deep, slow heart breaths, then recreate for yourself a heart feeling (you can find the details here). In this state of “coherence”, ask your heart a question, and wait to see what answer appears. Write it down.

What does your heart tell you about 2013?

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