Taking Care

An Alternative to Therapy

David Smail

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781782202868
• eBook ISBN: 9780429919770
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Taking Care established the author as an important social and political analyst whose background happened to be in clinical psychology. In this work the author develops the analysis of mental illness, and psychology in general, in the contexts of society, power and interest. People's experience is embodied in the world in which they exist. Notwithstanding the claims of some, psychology cannot, in the same way that magic cannot, change the nature of that experience fundamentally. At best, psychotherapy might provide a degree of understanding about that limitation. The historical relationship between psychology and magic is examined. The socio-political and economic structures of the society in which we live have the greatest influence on mental health, as on many other matters. Therefore, the individuation of focus in psychology on personal relationships, happiness, and sexuality can significantly miss the point. We need to develop political and social structures that 'take care' of people, to enable them to have meaningful 'public' lives.

1
Dreaming and Wishing: The Individual and Society

‘All life is a dream, and dreams are just dreams.’

What seemed to me as a schoolboy no more than a poetic affectation useful for quoting in exams, comes to mind thirty years later as a statement of the simple truth.

Perhaps all that signifies is that literature is wasted on some schoolboys; perhaps anyway Calderon^* meant something entirely different by his words from what I now understand by them. However that may be, it seems to me that we may be sunk more deeply into our dreams than at any previous time in our recorded history, and in any case more deeply than we can afford to be, for our dreams are full of a destructive rage and hatred, a frustrated craving for omnipotence, a desperation for satisfaction beyond the bounds of mere greed, through which we may dream ourselves to our own annihilation.

We can see the world only in the ways that human beings, with their own particular ways of sensing and experiencing (and interpreting sensation and experience) can see it. Whatever reality there may be beyond the ‘reality’ which filters to us through our individual, historical and cultural ways of seeing, we shall never be able to say what it ‘is’. We have, of course, a naive belief in a scientifically establishable, objective reality, but subscribing to that belief is in truth doing no more than taking, in a very grandiose way, what is merely our best guess so far about the nature of things as the nature of things. We have yet fully to accept that we can never get beyond guesswork.

So we are dreamers within a reality we cannot ever completely know, but which is nevertheless vulnerable to our conduct. Our lives are dreamt within a world, indeed a universe, which permits our dreaming and exists independently of it. Though we cannot know our world, we can certainly dream its destruction (and thereby put an end also to our dreaming).

That ‘primitive man’ lives in a dream is easy enough for most of us to grasp as we read of his nervous transactions with a world of ghostly ancestry and dangerous magic. What we find less easy to see is that our own world is to just about the same extent constructed out of superstitious fantasies, centring, in our case, mainly around images of conquest and wealth. Furthermore, our naive belief in a scientifically establishable objective reality renders us dangerously blind to the influence of our dreaming. Less wise than the Australian Aborgines, we do not acknowledge our origin in a ‘dream time’, and have not traced its contribution to our ‘scientifically established reality’. We mistakenly trust our reality, therefore, not to be affected by ‘primitive’ dreaming: we are not sufficiently on our guard against the influence of our dreams.

Dreams vary in the degree of their ‘primitiveness’, but this is to be judged more by the extent to which they are infused by wishful self-concern than by any lack of correspondence they may have with what we assume to be ‘objective reality’.

Human beings are, so to speak, engines of symbolism. We turn the reality we cannot finally know into a kind of endlessly enriching compost of symbols, of which our wide-awake, conscious words are only one, and by no means necessarily the most profound, aspect. Anyone who has ‘watched’ his or her thoughts (i.e. self-addressed speech) turn at the point of sleep into ‘pictures’ cannot fail to be astounded by the economy, complexity and beauty of the process of symbolic transformation. Since it tends not to have words attached to it, and since we find it very hard to ‘remember’ without the use of language, this process is an extremely difficult one to capture. Although I know I have experienced it quite frequently, I can only think of a couple of examples.

Sitting in a London underground train, for instance, I watch the cables writhe past along the tunnel wall. Some are thicker than others; they run neatly parallel, until suddenly they switch position, cross over, alter their height, branch unexpectedly, swerve a little. I just catch myself ‘realizing’ that the cables ‘are’ an argument; they are a complex logical discourse; in some absolutely direct way they display the nature of an intellectual thesis. Again, one hot afternoon, I look slightly sleepily out of the window down at the car park outside. Suddenly the car park – the arrangement of the cars, their colours, the way the sunlight reflects off them – is absolutely full of meaning (I cannot say what, for I am surprised into wakefulness and have no time to put words to the meaning before it has gone).

I suspect that our world – the world, that is, of ‘developed’ Western civilization – is as saturated with our dream-meanings as are the cave walls of any Stone Age hunters. We live with the world we cannot know (in the way we think we would like to) in a relation of symbolic reciprocity. We extract from the world meanings and metaphors which we then project back into it as objective characteristics, though of course there is nothing truly objective about them.

At any moment, waking or sleeping, experience reaches us through an accretion of meaning, all of it to some extent individually and culturally idiosyncratic, which has, as it were, become wired into our bodies from previous experience. This accretion of meaning thus gives form and colour to everything we experience in the present, providing a kind of symbolic background to what we take to be reality. In this sense, we dream all the time. Perhaps the underground cables have more in common with the caveman’s bison than we might suspect.^* More than just dreaming inside our own heads, we dream into as well as out of the world: our psychological relation to the world is one of continuous symbolic interchange. The depth, complexity and significance of that relation is quite awe-inspiring; symbolization of this kind, asleep or awake, is the very opposite of primitive. There is no shame in our being dreamers.

‘All life is a dream’, if true, seemed to my schoolboy self a potential reason for taking life less seriously than otherwise one might. However, the reverse now seems to me the case. If I dream you, and you dream me (and, of course, we do: how else explain the rapid shifts in perception of each other we undergo, the discovery in time that we are more separate than we thought, that wife is not mother, husband not knight?), then how careful we must be with each other. For if all there is for us is dreaming there is no possibility of waking to find that the harm we have done each other was just a dream. Over and over again, as a species, we ‘awake’ from our dreams to find our hands covered in blood.

There are all kinds of dreaming, and it is important not to get carried away by the metaphor of ‘life as a dream’ to the point where we lose a conception of reality. Even though we cannot directly know reality as something ‘in itself’, existing quite objectively apart from our symbolic understanding of it, we can attempt to ‘unwind’ it as far as possible from our wishful fantasies.

This, no doubt, is what science, at its best, achieves. But all too quickly science itself becomes enmeshed in our autistic reveries of power, so that we use it as a vehicle for our covert aims and borrow its authority to justify our ravaging of the world and each other.

The wishful fantasies we dream in our beds at night – the kind of which Freud began, at least, to articulate an understanding – present no great problem of themselves. (In fact, they need no articulate understanding since their whole meaning is inarticulate and in most respects quite sufficient unto itself.) As we sleep, we may fantasize any kind of satisfaction or horror with no more ill-effect than, perhaps, a slight feeling of unease or embarrassment for half the following day. But, awake, only a faithful respect for the unknowable reality of the world and the other people in it will prevent our enacting our dreams in potentially catastrophic ways. For what else is the man who takes an automatic rifle to mow down the shoppers in an American supermarket doing but dreaming?

If we are to unwind ourselves from the strands of base magic which are so thickly interwoven in our dreams we need to remind ourselves that we are not simply pictures, or shadows, or images, but bodies in a world. In the second half of this century there has been an increasing awareness of the dangerous seductiveness of the image, though interpreted differently by different writers.^* At times, even, it becomes unclear which is more important to us – the image or the actuality. In the political sphere particularly, though by no means solely, the explicit concern of the actors (some of them trained as such!) as well as the commentators is with the adequacy of their image, the effectiveness of the ‘P.R.’ battles which seek to present us with credibility as a higher value than truth. The awful danger, of course, is that enactment of the fantasies which such ‘images’ create can, and does, result in the mutilation of our bodies and our world.

Contributing to this state of affairs, no doubt, is the fact that our very experience of the world is becoming increasingly insubstantial and disconnected from any bodily involvement in it. For example, whether presenting ‘fact’ or ‘fantasy’, the television – on which most of us depend for any kind of understanding of world affairs – deals solely in images. It thus becomes increasingly difficult to differentiate the images of our dreaming sleep from those of our waking televisual experience, and gradually the laborious, uneditable nature of our bodily experience of the world seems to become a kind of irksome, obsolete burden. Our dreams are so much more attractive, and it seems that technology makes them attainable.

At no time in our previous history can it have been so possible for people to ‘experience’ death and destruction – the actual death and destruction of real people – on such a wide scale but in such a disembodied and dislocated form. The danger is that we get so used to them in this form that we think we know what they’re like and that they don’t really hurt. Hence perhaps the numbed amazement written on the face of people who discover that ‘it’ has indeed ‘happened to them’. Hence perhaps also the unhappy moral confusion and uncertainty surrounding the deaths of forty spectators at a televised football match – do we treat this as a real event demanding a flesh-and-blood response to the sensible agony of those involved, or do we sweep up the bodies like so many discarded cardboard containers of fried chicken and get on with the game? Our confusion is genuine – already our world is such that the values of embodied presence seem not necessarily to outweigh those of disembodied image.

And yet it is inconceivable that we shall ever be able to achieve what seems to be our covert aim – that is, to etherealize ourselves to the point where we become pure, disembodied images, as unencumbered as an electronic pulse. We are creatures of bone and tissue in a world upon which we depend for our bodily existence. If we persist in actually involving each other in the pursuit of our dream images, we shall discover that they are indeed dreams from which we cannot awake and that the sacrifices we make will be made not in pictures, but in tears and blood.

In our eagerness to escape the vulnerability to pain to which our nature as embodied beings exposes us, we construct a variety of technological and therapeutic ‘solutions’ which share a common origin in the wishful magic of dreaming. But no matter how hard we may try and how fervently we may believe in it, magic still does not work. The reluctant conclusion to which I have been driven after having worked for some years in the fields of psychology and psychotherapy – fields which are, as I shall argue later, deeply imbued with magic – is that human suffering arises from our embodied interaction with a world whose reality, though it cannot be known, cannot be wished away. A very significant part of the psychologist’s role is continuous with that of the ‘cunning man’ and the astrologer, and as such is a sham. The evil that we do each other cannot be undone, at least not so easily as we like to think, and the ravages of the world cannot be erased.

Not for nothing, I believe, are so many people these days oppressed and frightened by a sense they have that ‘things have got out of control’, that people are the powerless victims of impersonal forces which are experienced as a strange and barely analysable mixture of malignity and inevitability – even necessity. It is as if these forces are uninfluenceable: we wait for them to crush us and to destroy our environment with the kind of hopeless resignation one imagines prisoners awaiting execution to feel.

Fifteen or so years ago, it was quite common for people who expressed a sense of impending doom, and who perhaps coupled this with some kind of untutored critique of the societal or technological influences they took to be responsible, to be diagnosed as mentally unstable in some way. I have several times in the past observed at first hand the label ‘schizophrenic’ being attached to someone on no better grounds than that they accounted for their emotional unease in terms judged by their psychiatrists to be ‘pseudo-philosophical’. Nowadays, it seems, this sense of helplessness and threat has become much more general, and though the ‘pseudo-philosophical’ constructions of and reactions to it have become both more shared and more focused (e.g. in environmentalist movements and an upsurge of fundamentalist religious feeling) there are still many people who feel unable to formulate a clear idea of exactly what is wrong.

It is no longer plausible to suggest that people who feel this sort of unease are unstable or even mad (though this is a possibility that they themselves often consider with great trepidation). Our feelings seem rather to be indications of a social, not an individual, ‘disease’, and are to be taken absolutely seriously. ‘Ordinary people’, it seems, are swiftly becoming dislocated from any sense at all that they can influence or even identify those forces which shape their lives, and this both engenders a despair which is reflected in their relations with others and stimulates forms of defensiveness (such as denial, apathy, or ostrich-like optimism) which only serve to make things worse. The state of affairs, in any social community, in which people find themselves being carried along by forces which seem both destructive and out of reach of their influence, is a recipe for disaster.

‘There have always been prophets of doom,’ you may say, to which the answer must be that doom is prophesied only that it may be avoided. What I find much more chilling than prophecies of doom is the fact that doom has often enough already occurred with only one or two observers (out of millions) brave enough to say what they saw and to draw lessons for the future. The prophet of doom may indeed be an optimist alongside the observer of doom, who could under the circumstances scarcely be blamed for pessimism.

Take, for example, just one fragment of the experience of the psychoanalyst Wilfred Bion, who as a youth of barely twenty found himself blown into a shell-hole in a First World War battlefield, drenched in mud, water, and bits and pieces of other people’s bodies – ‘a kind of human soup’. It is surely not surprising that, having observed the ‘progress’ of humanity for the ensuing sixty years he should write:

When the super clever monkeys with their super clever tools have blown themselves into a fit and proper state to provide delicate feeding for the coming lords and ladies of creation, super microbe sapiens, then the humans who cumber the earth will achieve their crowning glory, the gorgeous colours of putrescent flesh to rot and stink and cradle the new aristocracy.^*

What is perhaps much more surprising is that so many people who have experienced similarly horrific circumstances to those Bion describes in his book, and so many of the rest of us who may in one way or another learn of them, continue, either by forgetting them, excusing them or even glorifying them, to believe in any future at all.

This may seem an unnecessarily drastic theme by which to illustrate our apparent inability to learn from our mistakes, and one far removed from the usual concerns of psychology. However, I make no apologies, since it seems to me that the everyday violence we do each other, the waste of human talent and squandering of human resources, the suspicion of and indifference toward each other which are such features of our alienated existence, all of which lead to a wreckage of human life which in its own way is quite bad enough, may eventually – perhaps quite soon – terminate in a frame of mind in which we really don’t care if we try to destroy ourselves outright. This is not fanciful; it has happened before. The difference now is that ‘we have the technology’ to guarantee success.

Perhaps the most tragic aspect of human nature lies in its vulnerability to wishful magic. Perhaps, ultimately, it will prove to be its fatal aspect. Over and over again we abandon a rational intuition of our embodiment in a real world for passionate belief in alternative modes of existence in worlds created out of our imagination. Our genius as symbolizers and as users of language enables us to disregard the lessons of our bodily experience, and to construct acceptable versions of all our lowest motives and actions, in ways that, fortunately for them, are not available to less ‘gifted’ species, which are by contrast firmly anchored in an ineffable reality from which no flight of fancy can release them. A dead cat is a dead cat, and could never become, for example, posthumous martyr to some warlike feline ...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Dedication
• New Preface
• Introduction
• 1 Dreaming and Wishing: The Individual and Society
• 2 The Pursuit of Happiness
• 3 Magic, Interest and Psychology
• 4 Faults and Reasons
• 5 Change: The Limits of Therapy
• 6 ‘Relationships’
• 7 Growing Up and Taking Care
• 8 Morality and Moralism
• Index