In Ken Wilber’s integral map of development, he describes an evolution from egocentric, to ethnocentric, to worldcentric. By this he means an initial focus on “me”, to an identification with others like us (“we”), to an identification with all living things.
He demonstrates how this relates to stages of moral development, from preconventional, where a child is self-absorbed, to conventional, where they learn the rules and norms of culture, and identify with their tribe or group, then onto postconventional, where their sense of identity expands out to include all humanity.
Interestingly he suggests there may be another map which lays nicely onto these – body (a focus on my physical body), mind (expanding to shared relationships and values) and spirit (all sentient beings).
Or even, from a neurological basis, from the reptilian brain stem (centred on me), to the mammalian limbic system (centred on we – the seat of attachment), to the neocortex (able to perceive and identify with the world).
Lovely piece on the School of Life site considering active and passive paths to wellness. The yin yang symbol is one of the most potent symbols we have – I wear one around my neck. One aspect of the symbol is the representation of a dynamic balance of active and passive principles. Taking this idea, Jules Evans writes about a session at the School of Life where representatives of each of these models tell their stories.
The active form of well-being lies in the happiness of pursuit, striving after a goal, making things happen. Its great champion is Aristotle, who defined happiness as a vital activity of the soul. The other form of well-being is passive. It finds happiness in the renunciation of the will – not in making things happen, but in accepting things happening as they do. This is the approach of the Stoics and Epicureans, both of whom define happiness as freedom from desire, and also of the Buddhists and Taoists.
I like this idea. My daily practice of medicine is grounded on the belief that all human beings are unique and by active, non-judgmental listening, I can come to understand the particular worldviews, coping strategies and pathological changes within each patient I meet (and, of course, how these are all linked). One consequence of this approach is to realise that different people have very different approaches to wellness. And that, fundamentally, is ok. There really is no one size fits all, and there is always an alternative.
Representing the Yang school of well-being, there is the entrepreneur Robert Kelsey, full of energy, leaping from mission to mission (‘first I was a journalist, then a banker, then a writer, then an entrepreneur’), picking himself up when a mission fails, only to launch himself on another voyage……[and, on the other hand, Ed Halliwell]….tells us that he only found peace from his battle with depression when he stopped “desperately striving to change my situation. When I did, a curious thing happened: my depression lifted”. Meditation is, he says, the opposite of striving: “It’s impossible to strive to do it. The process is about sitting and observing, being in the moment, rather than striving.”
Every day just now we see more and more scenes of devastation from the earthquake and tsunami in Japan. It’s quite overwhelming. I’ve been in touch with a couple of my friends in Tokyo, and what they tell me, plus what I see reported on the news, reminds me again of the incredible depth of quiet strength and resilience which seems common in Japan. It got me thinking again about the story of the Diospyros kaki tree – the tree which survived the nuclear bomb in Nagasaki whose shoots have been spread around the world as a Peace Tree.
Here’s a quote from a book entitled “Neuroethics“. This is from an essay by Nancey Murphy.
While Greek thought tended to regard the human being as made up of distinct parts, Hebraic thought saw the human being more as a whole person existing on different dimensions. As we might say, it was more characteristically Greek to conceive of the human person “partitively,” whereas it was more characteristically Hebrew to conceive of the human person “aspectively.” That is to say, we speak of a school having a gym (the gym is part of the school); but we say I am a Scot (my Scottishness is an aspect of my whole being.)
Until I read this, I’d never come across these particular terms. Nor did I know there was this difference between Greek and Hebrew thought. But what completely struck me was how congruent this idea is with what Ian McGilchrist says about the left and right hemispheres of the brain. In his “Master and His Emissary“, he makes the case for each hemisphere engaging with the world in its own unique way – the left engaging in a “representation” way, breaking reality down into parts to “grasp” it by mapping it against what’s already known, and the right engaging in a more holistic way, (what McGilchrist describes as a focus on the between-ness, rather on the things). Ken Wilber’s description focuses on the “interpretative” nature of this other way.
So this is interesting. This idea of a “partitive” world view is very much our dominant paradigm. We break experience into parts and we use the left hemisphere strongly to do that. It strikes me we are on the edge of a wave of change here though, and that this worldview is running out of steam. It’s failing to satisfy what it is to be fully human. If that’s true, then we should be seeking to develop our right hemispheric powers, creating a more “aspective” worldview.
This morning, as I walked to the railway station, I listed to a podcast from the BBC World Service. It was an old one (from last September) but I was catching up. This particular discussion was about rational and irrational behaviour in human beings and the section I listened to today involved Marilynne Robinson talking about altruism. She mentioned that it was Auguste Comte as one of the first to describe altruism, which he defined as
living for the sake of others
The debate on the podcast was around whether or not altruism had a self-interested root. That argument, I must say, doesn’t convince me. Human beings are social animals and we are hard wired for compassion and empathy just as we are also hard wired for self-interest. It’s the complicated entangling of these opposites that is at the root of so many human dilemmas.
Then, on the train, on the way home this evening, I started to read Karen Armstrong’s “12 Steps To A Compassionate Life” on the Kindle reader on my iPhone. Imagine my surprise when I read, in the opening chapter, her describing Auguste Comte’s description of altruism! Yet another interesting coincidence in my life!
Tomorrow being the hundredth anniversary of International Womans Day, I was especially struck by Karen Armstrong’s highlighting of Elizabeth Fry, Florence Nightingale and Dorothy Day as all “bywords for heroic philanthropy”. She then goes on to make, for me, a very convincing argument that we can track compassion from an evolutionary perspective to maternal love, without which no newborn infant could survive. There’s something worth thinking about on International Womans Day.
I find that people commonly have disorders of the boundaries, or their defences. When it’s hard to say “no” then it’s hard to have the self-care you need in order to respond to the desires or needs of others. Learning to say “no” appropriately requires assertiveness (not the same thing at all as selfishness or the pursuit of self-interest). When we find it hard to be assertive, our boundaries are weakened and we can either become overwhelmed, or our defences can go “hyper” to our disadvantage, driving everything from irritability with others, to auto-immune reactions. It’s really not uncommon to find this is an issue in a patient with an autoimmune disorder.
By strength, in addition to assertiveness, I also mean the ability to stick at things, to be both consistent and persistent. It’s not so much a matter of trying to have power over others, or trying to control life, but more a matter of resilience, resolve and stamina.
So, why not take the opportunity to reflect on that this month? How do you feel about your own personal strength? Not your power over others, but your autonomy, your resolve, and your staying power……
Once you learn that most of the activity of the brain goes on without either conscious awareness, or with conscious awareness only kicking after the initial response, you begin to doubt that all our choices are conscious ones…..or rational ones. In fact, the brain stem and the limbic system are the key centres for our survival responses, our drives, our avoidances, and our emotional processing. How often do we behave in ways which really can’t be understood from the premise of consciously choosing once presented with the facts? Is that how human beings function? Would that even be the best way for human beings to function? (consciously and rationally, whilst discarding other ways of perceiving, processing our experience and responding). What do you think once you learn that there is an enormous neural network around the hollow organs of the body, the heart, and the gut especially, which we might well use to figure things out….where we might process and produce what we call “gut reactions”, or “heart felt” beliefs?
I’ve stumbled on two very different texts in this area in the last couple of days. Isn’t that weird, actually? It’s that old “coincidence” thing again…..never quite got to a point of really figuring out how those “coincidences” come about, or what they mean.
A few days ago, I read about a report for the WWF called “common cause“. The report, written by Tom Crompton. Essentially it argues that if we look at the research evidence, it would seem that human beings don’t make decisions using rational thought very much. Here’s a paragraph from the Summary –
There is mounting evidence from a range of studies in cognitive science that the dominant ‘Enlightenment model’ of human decision-making is extremely incomplete. According to this model we imagine ourselves, when faced with a decision, to be capable of dispassionately assessing the facts, foreseeing probable outcomes of different responses, and then selecting and pursuing an optimal course of action. As a result, many approaches to campaigning on bigger-than-self problems still adhere to the conviction that ‘if only people really knew’ the true nature or full scale of the problems which we confront, then they would be galvanised into demanding more proportionate action in response. But this understanding of how people reach decisions is very incomplete. There is mounting evidence that facts play only a partial role in shaping people’s judgment. Emotion is often far more important [see Section 1.3]. It is increasingly apparent that our collective decisions are based importantly upon a set of factors that often lie beyond conscious awareness, and which are informed in important part by emotion – in particular, dominant cultural values, which are tied to emotion. It seems that individuals are often predisposed to reject information when accepting it would challenge their identity and values.
Then, this morning, I read a post about some interesting TED videos, and the first one was this, by Dan Airley. He makes the case that we suffer from “cognitive illusions” just as much, if not more than, we suffer from “optical illusions”. (It’s about how we make decisions. It’s VERY entertaining, and thought provoking, and it’s just 17 minutes long. Take the time to watch it)
I was going to title this post “And not or”, but then I realised that very title was falling into the trap which “or” always poses – it divides. The General Semanticists talk about “two value thinking”. Others say this tendency to categorise into two categories is “digital” thinking, in the sense of “on” or “off”, “1” or “0”. Of course we are often faced with such simple choices in life – “go left” or “go right”, “stay home” or “go out” and so on. The drawback of “or” comes when one of the choices is rated as “right” and the other as “wrong”. When that happens, the digital choice is reduced to only one option – the RIGHT one, or as Mrs Thatcher famously said, “There is no alternative”. We see this in health care in the dangerous distortion of “evidence based medicine” to create a digital rating system – treatments “which work” and those “which don’t”, which is then extrapolated to those treatments which should be made available and those which should be withdrawn. In so many instances this is a delusion. Most drugs don’t do what they’re “proven” to do for most of the people who take them.
So, what’s the alternative?
“And”
This insight has emerged from the internet, but applies to everything which could be considered using networks as a conceptual framework. On the net, you don’t have to think, will I publish my work on “Flickr” of “Blipfoto“? Will I “tweet” or post on “facebook“? Will I blog, or will I “stumble“, or will I “posterise“? You can do them all, link them all, and communicate much more widely than I could if I had to choose only one, and discard the other options.
But “and” has another great power. Instead of considering a reduced set of information, say, for example, from using “the scientific method”, we can also consider the perspectives brought from subjective experience, from cultural mores, from both individual and group perspectives and so on.
Think of Deleuze’s three ways of thinking – science – thinking about function; philosophy – thinking about concepts; art – thinking about percepts and affects.
Think of Wilber’s “Integral Theory” with it’s elegant four quadrants.
Think of the benefits of truly multidisciplinary working where all the disciplines bring relevant insights.
I much prefer “and” to “or”, and I rarely believe Mrs Thatcher’s “There is no Alternative”. Alternatives are always there. We just need to open our eyes to see them.
Here are two songs about “and” and “or” – I love them BOTH.
Are you well? How’s your energy? If I were to ask you to rate both your well-being and your energy on a ten point scale where 0 is the worst level you could imagine and 10 is the best, what numbers would you give me right now? You’re able to do that. Instantly. But how do you do it? You don’t check your blood pressure, your pulse, your blood sugar etc etc. You assess it holistically. It’s not actually possible to reduce your well-being or your energy to any single element. Yes, of course, individual elements play a part. They are factors, and influences. But your well-being cannot be reduced to component parts. The moment we reduce a human being to a part of a human being we don’t know that human being any more. Maybe we can know how much haemoglobin they have in their red blood cells, but we don’t know them.
There’s a similar thing happens when people say to me when someone gets better, what is it that got them better? Patients regularly say after an admission to our hospital that it was “the whole package”, or “the way everything fitted together”, or they’ll say it was the rest, and the physio and the way they were listened to, and…and….and. It’s not reducible.
What’s our obsession with breaking things down into pieces? According to Ian McGilchrist it’s because our left hemisphere works that way. It abstracts, selects, and then re-presents information to us. Our right hemisphere however processes the world more holistically. Its main focus is the world as it is, without filtering, selecting and re-presenting.
The moment we select only a part of something, we see only what we’ve selected. Some people seem to think if you examine a part of the whole you’ll get closer to the truth. Actually, you get further away.
Maybe it’s time we engaged our right hemispheres more, and quieted down that noisy, rather arrogant left hemisphere.
Health is not reducible to component parts.
Human beings are not reducible to component parts, not even genes.
We should stop treating patients as if they are only the containers of parts, and deluding ourselves into believing we know exactly what produces healing and wellbeing. We don’t.
In my monthly themes, taking the mid-point of February (14th) as my inspiration, I’ve allocated the them of love to the month.
This photo is one I took in France last year and it’s the moment where I caught the light of the sun shining directly down on this couple holding hands.
I know we celebrate Valentine’s Day on the 14th, but why not take this as your opportunity to share acts of loving kindness all month long……?
I welcome constructive criticism and suggestions. I will not, however, tolerate abuse, rudeness or negativity, whether it is directed at me or other people. It has no place here. ANYONE making nasty comments will be banned.
Heroes Not Zombies 