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Archive for the ‘from the reading room’ Category

I don’t think you can understand anything unless you see it in its’ context. The tricky thing about that is that everything exists in multiple contexts, so depending on the context which you choose to consider (the perspective you take), whatever it is you are considering can be understood in different ways. I like that. It means you can never FULLY know ALL there is to know about anyone.

During a consultation with a patient I think it’s important to consider several contexts. I drew myself a simple diagram to illustrate this – I’ve described it in the post about the “Human Spectrometer“.

Today I came across a great flash animation which really makes you think about how scaling up or down totally changes the relevant contexts. Try it out. It’s interactive, informative and fun.

It reminded me of the scale of ten project where a series of images are presented, each one being a magnification ten times greater than the previous one. Here’s one version of that from youtube …….

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I came across a great post entitled “Why it may be worth becoming more like a child” on the slow leadership blog. The main reasons to become more child-like laid out in this post were – being more imaginative, being encouraged to learn, forgiven for mistakes and becoming more creative. Carmine Coyote, the post’s author, asks what would work be like if people started to be a bit less adult? She argues it could be more exploratory, experimental, exciting and passionate. I like this post, and agree with it too. But let me tell you a little story, because this post fits in with one of those strange, synchronicity moments for me.

I regularly spend time in France. My French language skill isn’t great. I get by, understanding most of what I hear, but I’m not good at expressing myself in French. I love to read French however and I’m not too bad at that. I take my time and consult a dictionary when I need to. I never let a visit to France pass without a good browse in the bookshop. French language books are SO different from the English language ones I find in the UK. It’s really like a whole other world for me. Last month, as I browsed in one of my favourite bookshops, “Vents du Sud“, up past the market in Aix-en-Provence, I picked up an interesting-looking book, entitled “Donner un sens a l’existence” by Jean-Philippe Ravoux. I guess you could translate that as “Making sense of existence”, but “donner” means to give, so it’s more “Giving sense to existence”. I am convinced that one of the essential characteristics of human beings is that we are meaning-seeking/meaning-creating animals. A closer look revealed that this book is by an Aix-based philosophe and is an exposition of the work of Antoine Saint-Exupery – in particular, “Le Petit Prince” (The Little Prince) and “Citadelle” (Wisdom of the Sands). “Le Petit Prince” is THE top selling book in the world, second only to the Bible. I bought it, and I’ve been reading, underlining and annotating it since. I SO enjoyed it! I also decided it was time to refresh my memory of “Le Petit Prince” so re-read that too (first in French, then I bought myself a new English language copy and read that too, in case I didn’t understand anything in the French version). Well, I finished it during a train journey yesterday, and I’ve already gone back to the beginning to re-read the parts I’ve marked up for myself. I’m intending to write a few posts about the main themes over the coming days. But here’s the connection and the strange part –

The main theme of Le Petit Prince is how child-like innocence and wonder can challenge the adult view of reality. The little prince questions everything. He doesn’t just take things for granted. Ravoux claims that Saint-Exupery based this attitude on Descartes‘ “Discours de la Methode” (but more of that in another post!) Through his wonder and questioning, the little prince challenges our rather unthinking ways of living, our attitudes to power, money, belief and so on, and this questioning makes us “wake up” (become heroes not zombies?)

My head is full of these thoughts just now, so what a surprise to stumble this very day upon a post about becoming child-like!

What an amazing and curious world we live in! I love how it continually surprises me!

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the spider and the flower

I was photographing this lovely yellow flower when suddenly I noticed a bit of it was moving…….then I saw the little spider!

Look at it! See how the yellow of its body so PERFECTLY matches the yellow of the flower! Goodness! How does that happen? Isn’t it astonishing!

One of my favourite philosophers is Deleuze. He emphasises not thinking of discrete objects. He rejects the typical “arboreal” system of thought where we set every organism into a specific branch in a taxonomic tree. Instead he suggests we think in terms of the connections and borders and interactions. He emphasises a “rhizome” model (like grass, which has no single centre, but is, instead more like a vast web). I’ve always found that idea appealing because it rejects labelling and putting things into boxes. Instead it emphasises dynamic change. That’s why I have the byline at the top of my blog – “becoming not being…..”

When you think in terms of becoming, not being, you focus on the interactions, the connections and the development of organisms. After all, can we really understand either this flower or that spider without considering how, together, they make a little functioning unit, a little ecosystem?

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If you were asked to say what is the essence of medicine, I wonder what you’d say?

Something about “evidence based” or “scientific” or “effective treatment”?

Well, David Sokol, a lecturer in Ethics and Law took this as his subject for an article in this week’s BMJ. He reports attending a clinical neurology class at his local medical school and witnessing a patient with Motor Neurone Disease becoming upset when asked what she had been told about her disease. He sees the neurologist comfort her by taking her hand, and he says this –

As I watched him comfort the patient, my thoughts returned to Selzer’s essay and his concluding words: “Out of the resonance between the sick man and the one who tends him there may spring that profound courtesy that the religious call Love.” As I read this, it occurred to me that Paracelsus in the 16th century and the late French haematologist Jean Bernard also claimed that medicine was grounded on love.

and this –

The words of Paracelsus, Bernard, and Selzer, which hours earlier sounded fuzzy, now rang out with a newfound clarity. I saw, for the first time, the very essence of medicine.

Impressive. Very impressive.

I’ve often said that if I am ever ill and need a doctor I want one who, frankly, gives a damn! I want him or her to care whether or not I am suffering and for that to be the basis of their choices.

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I’m very taken by network theory. Linked is one of the most inspiring books I’ve ever read, and books like The Medici Effect, and Smart World develop aspects of network theory too. Currently I’m reading Clay Shirky’s Here Comes Everybody and he makes this simple but thought-provoking point –

Individuals in group settings exhibit behaviours that no one could predict by studying single minds. No one has ever been bashful or extroverted while sitting alone in their room, no one can be a social climber or a man of the people without reference to society, and these characteristics exist because groups are not just simple aggregations of individuals.

What characteristics do you think you have which only appear when you are in a group?

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Seth Godin is one of my favourite bloggers. I have his blog on my rss feed reader (google reader) and I frequently enjoy his short, thought-provoking posts.

Today he posted a piece entitled The wealthy gardener where he mentions that he was asked at a talk how to make a lot of money blogging. Seth says he wouldn’t be surprised if at another talk on orchid growing somebody asks how to make a lot of money growing orchids.

He says

Sure, people make money growing orchids. Some people probably get rich growing orchids. Not many though. And my guess is that the people who do make money gardening probably didn’t set out to do so.

The lesson he says is

the benefits kick in best when you don’t set out to achieve them.

This is a very different counsel from the one we read more commonly – that the way to get what you want is to set it as a clear goal, visualise it, then pursue it relentlessly.

I like this message – I think you should do what you feel passionate about – and sometimes, sure, that activity might bring a decent income.

What do you think?

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I’ve just finished reading Michio Kaku‘s “Hyperspace” – it’s a book I’ve had on my shelves for years but didn’t get round to reading (I’ve got LOADS like that – but I’m still convinced I’ll read them ALL eventually!). It’s about multi-dimensional thinking in physics and maths, and I read it because of a dream I had. It’s a fabulous book, which really does make difficult concepts understandable. I highly recommend it.

In the last chapter of the book, Michio tackles the reductionism vs holism issue, because in Physics, apparently, there are two very different groups of adherents to each of these viewpoints. He has an interesting exposition of the more extreme forms of these two groups, referring to the reductionists as “Belligerent science” and holists and “Know-nothing science” – OK, I know, both extremely judgmental and controversial terms but read this paragraph where he describes them –

Belligerent science clubs the opposition with a heavy, rigid view of science tht alienates rather than persuades. Belligerent science seeks to win points in a debate, rather than win over the audience. Instead of appealing to the finer instincts of the lay audience by presenting itself as the defender of enlightened reason and sound experiment, it comes off as a new Spanish Inquisition. Belligerent science is science with a chip on its shoulder. Its scientists accuse the holists of being soft-headed, of getting their physics confused, of throwing pseudoscientific gibberish to cover their ignorance. Thus belligerent science may be winning the individual battles, but it is ultimately losing the war. In every one-to-one skirmish, belligerent science may trounce the opposition by parading out mountains of data and learned PhDs. However, in the long run arrogance and conceit may eventually backfire by alienating the very audience that it is trying to persuade.

Know-nothing science goes to the opposite extreme, rejecting experiment and embracing whatever faddish philosophy happens to come along. Know-nothing science sees unpleasant facts as mere details, and the overall philosophy as everything. If the facts do not seem to fit the philosophy then obviously something is wrong with the facts. Know-nothing science comes in with a preformed agenda, based on personal fulfillment rather than objective observation, and tries to fit in the science as an afterthought.

I recognise these attitudes clearly. I have been on the receiving end of classic “belligerent science” communications – some of it so offensive, I just delete it straight after reading it (and wish I’d never read it in the first place!) “Belligerent scientists” clearly don’t like homeopathy! In fact, the tone of some of the comments I have received to posts I put up concerning homeopathy, led me to create a “Commenting policy” which you can read at the bottom of the right hand sidebar of this blog. On the other hand, I’ve read plenty of comments from the other extreme end of this axis. I find this latter group to be a lot nicer than the belligerent crowd I must say, but often not any easier to have a discussion with.

I confess to having a strong affiliation to holistic perspectives on the world, but science has always been a fascination for me and it thrills me to understand how things work so I see a real value in reductionist thinking too.

How to reconcile these two viewpoints? Well, you could read Kaku’s final chapter, but essentially he argues for taking a higher perspective and seeing that both methods are appropriate in different circumstances.

One contemporary philosopher who has considered this issue is Mary Midgely.

She argues against reductionism or the attempt to impose any one approach to understanding the world as the only right way to see things. She suggests that there are “many maps, many windows” on reality and argues that “we need scientific pluralism – the recognition that there are many independent forms and sources of knowledge – rather than reductivism, the conviction that one fundamental form underlies them all and settles everything” and that it is helpful to think about the world as “a huge aquarium. We cannot see it as a whole from above, so we peer in at it through a number of small windows … We can eventually make quite a lot of sense of this habitat if we patiently put together the data from different angles. but if we insist that our own window is the only one worth looking through, we shall not get very far”

I like that. I like it a lot.

Here’s to an understanding of the value of different viewpoints, and different methods in diverse circumstances. I think we could advance the lot of humankind so much more if we attempted to engage with, and understand, each other, rather than bashing each other about the heads! In particular, less arrogance and conceit would be good!

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In his Choice Theory, William Glasser make the point that we are all born “genetically programmed” to have five basic needs. However, we don’t all have each particular need to the same degree as another person. Our personal mix of these five needs will tell us a lot about our personal motivations and what lies behind the choices we make in life. The five needs are

  1. Survival
  2. Belonging (love and loving sex)
  3. Power
  4. Freedom
  5. Fun

He makes suggestions to help you figure out the strengths of these various needs in your own life.

If you have found that you are less willing to take risks than most people, you have a high need for survival.

The key to assessing the strength of your need for love and belonging is how much you are willing to give.

To assess the strength of your need for power, ask yourself if you always want to have your own way, to have the last word, to own people, and to be seen as right in most of what you do or say.

If you can’t stand the idea of following rules, conforming, or even staying in one place or with one group of people for very long, you have a high need for freedom.

If you enjoy learning and laugh a lot when you do, you have a high need for fun.

You get the idea? Of course, you could say that ALL of us have ALL of these needs. The point is to understand which of these resonate most strongly with you. Because that’ll be your prime motivator.

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William Glasser, in his Choice Theory, says this –

I disagree with the usual psychiatric thinking that you can learn from past misery. When you focus on the past, all you are doing is revisiting the misery. One trip through the misery is more than enough for most people. The more you stay in the past, the more you avoid facing the present unhappy relationships that are always the problem.

I’m with him on that – “One trip through the misery is more than enough for most people” – what a great quote! Whilst telling the story of the past can be important part of making sense of an experience and of understanding something of another person’s life, the solutions to the present suffering or distress don’t lie in revisiting. It’s not enough to just “get it out”. What matters is what you are choosing to DO today. How are you coping with life NOW as you are living it. That’s an empowering point of view because you can’t change the past, but you sure can change something about what you are doing today. Glasser believes that “present unhappy relationships that are always the problem”. Well, I’m always wary when I see that word “always”! It’s unlikely that there is a single cause, or type of cause, for all problems. He says –

What I will teach him is that he is not satisfied with a present relationship, the problem that always brings people to counselling. His past could have contributed to the problem, but even though most current psychotherapies initially focus on it, the past is never the problem.

I do think he’s onto something here, even if he’s pushing  things a bit with his “always” and “never”. There are, of course, a number of psychological approaches which focus on the present as opposed to spending hours digging through the past but not all so explicitly attempt to uncover the present unsatisfying relationship as the thing to focus on. The following three quotes make this very clear –

There is no need to probe at length for the problem. It is always an unsatisfying present relationship.

Since the problem is always in the present, there is no need to make a long intensive investigation of the client’s past. Tell him the truth: The past is over; He cannot change what he or anyone else did. All he can do now is, with my help, build a more effective present.

In traditional counselling, a lot of time is spent both enquiring into and listening to the clients complain about their symptoms [which makes it harder to get to the real problem]……..what the client is choosing to do now.

I remember the first time I realised I was on the wrong path when counselling a patient with postnatal depression who had been sexually abused as a child. On one of the one hour sessions she said to me “Look, I really do appreciate you taking all this time to listen to me, but every time I spend an hour talking to you about the past abuse I feel worse. I think I need a break from this. I think I need to live now.” Well, that woman taught me an important lesson about counselling – that it wasn’t enough to just let someone talk about the past, and that the present is where we live now so we all need better tools to live now, not better tools to remember the last miseries. I also realised at that point that different people had different needs and there was no one model of counselling which would fit everyone.

As I’ve learned from patients and learned from further reading and training, I’ve discovered I’ve a great affinity for focusing on what’s in life NOW and what coping strategies we’re using NOW. But I haven’t had the thought before that the problem ALWAYS lies in a current unsatisfying relationship. Maybe that’s worth exploring a bit more, but, what has made sense for me so far is that there are different areas of focus (and therefore different priorities) for different people. Sure, for many people, the most significant area is relationships, emotions and feelings. But for others the most significant area is something physical, practical, maybe work-oriented. And for yet others, the focus is on something spiritual, their disconnectedness to whatever is greater than themselves, or their search for meaning.

What do you think? Do these theories ring true for you?

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I can’t remember how I stumbled over William Glasser’s Choice Theory or his Reality Therapy, but when I did I was interested enough to buy his “Choice Theory. A New Psychology of Personal Freedom” ISBN 978-0-06-093014-1.

I really enjoyed reading this book. It appeals to my personal philosophy in relation to psychology. One of the basic tenets of this book is that digging over the past to recount and relive old wounds and hurts is not helpful. Instead, the author claims, it is better to focus on your current relationships, your current thoughts and actions. His idea of “total behaviour” is holistic and highlights the connections between aspects of mind and aspects of body which enables us to make a better understanding of illness. It’s a psychology of hope because it rails against the dominant stance of “external control theory” – this is what most people do, most of the time – when things go wrong, people who use an “external control theory” feel like victims. This paralyses, disempowers and demotivates, and seeks to blame others for personal experiences.

I see parallels between this Choice Theory/Reality Therapy and Existential Psychology, Solution-Focussed Approach, Logotherapy and Positive Psychology. Together, these approaches build a framework of understanding behaviour and the mind which I find both useful and appealing.

Here’s the summary from the last chapter of Glasser’s book –

  1. The only person whose behaviour we can control is our own.
  2. All we can give or get from other people is information.
  3. All long-lasting psychological problems are relationship problems.
  4. The problem relationship is always part of our present lives.
  5. What happened in the past that was painful has a great deal to do with what we are today, but revisiting this painful past can contribute little or nothing to what we need to do now: improve an important, present relationship.
  6. We are driven by five genetic needs: survival, love and belonging, power, freedom and fun.
  7. We can satisfy these needs only by satisfying a picture or pictures in our quality worlds.
  8. All we can do from birth to death is behave. All behaviour is total behaviour and is made up of four inseparable components: acting, thinking, feeling and physiology.
  9. All total behaviour is designated by verbs, usually infinitives and gerunds, and named by the component that is most recognisable.
  10. All total behaviour is chosen, but we have direct control over only the acting and thinking components.

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