In an earlier blogpost I wrote about the potential for culture to both create mental illness and label normal illness as mental illness. I thought it would be useful to delve a little bit more into this cultural effect in this blog entry. The phenomenon of Hikikomoris or those who withdraw socially is worthy of further examination.
Andy Furlong talks about the phenomenon in a 2008 article of the Sociological review. The phenomenon presents us with, first of all, an example of a culturally created form of mental illness and, secondly, with an example of normal experience being recolonized by mental ill health.
Normal experience recolonized by mental illness
Looking at the second claim first one can see that the focus on hikikomori as an exclusively psychological phenomenon within a homogeneous group of people. Furlong points out that Hikikomori covers a number of subgroups of people including Otaku and another subgroup characterized as the alternative scene. The first Otaku are seen as ‘nerds’ and ‘geeks’ but they don’t seem to suffer from any recognizable psychiatric condition or peculiar individual psychological malaise. The group forming the alternative scene do not even fit the criteria for Hikikomori but they are still lumped in with the others even though they do leave their homes, form relationships with people and take the freelance work that is the market provides for youths.
When a young person exhibits detachment and lethargy in Japan Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (CFS) are not used as diagnoses. They have a very popular syndrome which they like to call ‘Student Apathy Syndrome’. Perhaps they could add to that a syndrome called ‘I’m sad because my dog is sick syndrome’ or possibly a ‘human condition syndrome.’ The Chinese attitude towards mental health similarly recolonizes normal experience as mental illness. The stigma that is attached to conditions in China definitely adds to the problem. Seeking help from therapists or psychiatrists is a method of last resort coming only after the stage of family, friends and religious healers have been passed. It represents the giving up stage of the family. Additionally the Chinese experience is shaped by the very long periods required and culturally sanctioned by families learning to cope with the difficulties of one of their members.
The Culture in China establishes the individual’s thoughts and feelings as something to be kept within the family. The culture of shame in turn then has created a culture and phenomenon of the somatization of mental difficulties. This is following the pattern of traditional Chinese emotions which sees each of the major emotions as having a corresponding organ which it effects. Tsung-Yi Lin, MD, discussing it says that heart was supposed to be the site of happiness, anger the liver, worry the lung, fear the kidney and desire the spleen.
Cultural creation of psychological problems
It might seem somewhat contradictory to argue that normal experience is being transformed into mental illness and then argue that the culture is creating mental illness. There is psychological difficulty and there is mental illness and I am not trying to suggest otherwise but the creation of this ‘mental illness’ is in large part created by the culture. It is the attitude of mislabelling and mishandling normal psychological difficulty that turns it into mental illness. The exclusively taxonomical approach to the phenomenon is belied by the job market in Japan.
There used to be a system called ‘Jisseki-Kankei’ which involved teachers taking on job placement functions and featured strong links between schools and employers. This system imploded with the recession in the 1990’s. In 1992 1 million job offers were made to Japanese High School Graduates. That number fell to 0.6 million in 1995 and then to 0.2 million in 2003. In a culture that attaches self-esteem to regular jobs and makes no room for second chances it is not surprising that suicides peeks the around March which is the end of the fiscal year and the time when people are let go from their jobs. In terms of the mishandling of the symptom I would give the following example. One approach is for a team of workers to forcibly enter the room of the hikkimoris and scold them for their sloth before removing them to their institution where they would be forced to see the error of their ways.
This, unsurprisingly, does not work. The Japanese public remains sympathetic to these institutions even after one died detainee after being chained to a pillar for four days. Apparently though that’s cool and the public evinced sympathy for the Director because Hikikomori are of course free riding deviants who should be brutally killed. It wouldn’t cross anyone’s mind that perhaps the problem is symptomatic of a wider societal dysfunction perhaps the one that thinks its cool to torture culturally created outcasts as free riders (To death!).
Returning to the Chinese example again one sees a number of culture-bound syndromes described by Tsung-Yi Lin, MD. All of the syndromes he mentions have an important feature in common and that is the somatization of anxiety and fear. To that extent they are culturally created difficulties. There is, for example, Koro which is characterized by panic that the penis will shrink into the abdomen and the person will die.
Then there is frigophobia where patients suffer from an excessive fear and intolerance of cold in terms of temperatures and foods of cold or ‘yin’ nature. Finally, I will mention Shen-k’uei which is characterized by weakness, fatigability, insomnia, anxiety and hypochondria. This of course if not dysphoria in China but of course caused by excessive masturbation, nocturnal emission or intercourse and for this reason is often called sexual neurasthenia. The regressive features within Japanese and Chinese mental health cultures might seem to be easy pickings. One could easily say it’s not that bad in Ireland for example. Yes it is not that bad but it is a bit that bad. While the hikkimori problem is not our problem the issues it raises are issues in Ireland even if less pronounced. The same with the Chinese example we may not have a culture that’s as obsessed with somatization but we still talk in terms of controlling symptoms. We will still conflate symptoms with the illness rather than recognise that everyone has their own unique symbolic world or umwelt. If we were to look at people, and by extension societies, in terms of their symbols we might learn of the great mass of societal dysfunction or insanity.
One book that always intrigued me was An American Dream by Norman Mailer. The book came to me at a time when I was unsurprisingly depressed. I know that Norman Mailer's writing has a horrible mysogynist bent to it but it was the central idea that caught my attention. In the book, according to Wiki's summary - 'Stephen Rojack, is a decorated war-hero and former congressman, a sensationalist talk-show host, and is the embodiment of the American Dream. In an alcoholic rage, Rojack murders his estranged wife, a high society woman, and descends into a lurid underworld of Manhattan jazz clubs, bars, and Mafia intrigue after meeting Cherry McMahan, a night-club singer and the girlfriend of a highly placed mobster.' Rojack is liberated by the experience of throwing it all away and it is only after this that he is able to get into the experience of life.Watching the film Pearl Harbour though I experience the opposite feeling. Each still from that film could be on the front of a post card or some sort of pin up. I am left with the feeling that perhaps the film's makers should have turned their hand to making softcore pornography instead. Or even hardcore pornography. At least that would have been a bit more real!
Watching Vanilla Sky with Tom Cruise recently I took a similar message that people crave real experience. Complete experience. As we are repeatedly told throughout the film the sweet is not as sweet without the sour. In the later part of the film Tom Cruise’s character lives in a lucid dream when he is in a frozen state. He is given the opportunity to forget the negative experiences of his life. He chooses the moment of his rejection by Penelope Cruz’s character as the moment for his memory splice. This is not good enough though. He insists on finding out the truth later on and he is presented with a choice of whether to continue living the dream of to live the imperfect ‘real’ life. He chooses the ‘real’ life even though he is told that his finances will soon run out. Even before this though his mind rejected the perfection that he could have experienced in this dream world. He instead plagues himself with guilt about the way he treated Cameron Diaz’s character. He confronts himself with the consequences of his actions. There is another element to Vanilla Sky that is interesting. That is the idea of the importance of actions and their consequences. This idea also ties into the idea of ‘real experience’. At a point in the film Tom Cruise’s character makes a decision to sit into Cameron Diaz’s car after she proposes having sex that nobody will know about. In the scene just previous Tom Cruise has fallen love with Penelope Cruz’s character. She represents the 'real' woman. She is not taken in by Tom Cruise’s money and charm and holds an additional job as a dental assistant just to support herself. This 'reality' causes Cruise to decide to be vulnerable with her and he reveals that his nickname in the company is ‘Citizen Dildo’. Penelope Cruz reproaches Cruise’s character on the meaning and importance of friendship. She knows that it was his friend who was interested in her first and he tells her that she is more right about this than she knows. The feeling of love is present with Cruise but the feeling is not enough. He is still not the sort of man whose actions follow through with the love. He gets into the car and sets in train a series of actions that lead to his disfigurement and Cruz leaving him. This reflection on the film reminds me of a section in John Finnis’ book, Natural Law and Natural Rights.
In that section Finnis wonders whether pleasure is the whole point of the human endeavour and concludes that is not. He points to Nozick’s experience machine and offers us a choice. He asks us to suppose that we could be plunged into an ‘experience machine’ which, by stimulating your brain while you lay floating in the tank, would afford you all of the experiences you choose, with all the variety (if any) you could want: but you must plug in for a lifetime or not at all. Finnis wonders is it not clear that one would choose the experiences of discovering an important theorem, or of winning an exciting game, or of reading or writing a great novel, or even of seeing God...or any combination of such experiences?
It seems to connect with Cruise’s experience in Vanilla Sky for as Nozick rightly concludes, one wants to do certain things (not just have the experience of doing them - and this applies to Cruise one wants to do love not just to have the experience of doing love); one wants to be a certain sort of person,through one’s own authentic, free self-determination and self-realization; one wants to live (in the active sense), oneself, making a real world through that real pursuit of values that inevitably involves making one’s personality in and through one’s commitment to those values. (as again amply demonstrated by Cruise whose self-examination comes to dominate his lucid dream).
(Here Cypher’s choice to plug himself in to such an ‘experience machine’ is hollow. He wants to be someone rich and important and then he adds ‘like an actor’ but isn’t that exactly what he is? - An actor. He is not the sort of person who does these things but the sort of person who wants to experience these things. He also includes that term that he does not want to remember anything outside of the Matrix perhaps wisely noting that his mind would reject the ‘unreal’.
21 Grams
In 21 Grams we are dealing with the stories of three lives that are brought together by tragic car accident. Jack Jordan, an Ex-Con, who has found Jesus rounds a corner too fast and hits the husband and two little daughters of Cristina Peck. Cristina Peck authorizes the transplant of a heart from her dying husband. Paul Rivers, a dying mathematics professor receives the heart. Each of these characters is in some way being pressured to accept a different reality to their own. Peck’s father urges her to move, like he did with his wife (Peck’s mother), after her death. Peck rejects this entreaty to accept a different version of life to her own as does Paul Rivers.This rejection reminds me of Kevin Spacey’s character’s similar rejection in the film shrink.
Paul Rivers rejects the pretence of a happy relationship with his partner and the ‘bandaid’ of an artificial insemination pregnancy being placed over a wound that has already bled dry. He wants to find out where his heart came from. The hospital staff and his partner inform him that the family remains anonymous but that he can write to the family if he wants. Paul hires a private detective and finds out who authorized the transplant. He demands the real from his life - becoming involved in her life, getting embroiled in her struggles, trying to stop her taking drugs and buying a gun to avenge her husband’s death. The gun we are told by the private detective who sources it is known in the trade as ‘an orphan’.
This is symbolically interesting to me because the gun a symbol of potency, action and aggression is a gun without a history. It is free from pretence but it can do the most damage and it can perform the most action. Later when Paul's body is rejecting the transplanted heart he chooses a terrible death in lieu of going back to the hospital because it is a death on his own terms out in the world of experience. Finally, the Ex-con, who’s pick-up truck hit the father and two daughter’s resists his wife’s appeals that he not turn himself in. She suggests that the family needs him and nobody witnessed his involvement with the ‘Hit and Run’. He needs to follow his own logic and experience his own relationship with God. He resists any attempt to alter the message and his experience by either his wife of the reverend when he meets him in prison. When Paul Rivers shoots beside him and tells him he needs to disappear he comes to Paul's hotel room and demands that he shoot him if he is going to shoot him. This is him putting his life in God's hands and following the trend of his experience.
Like Jaubert in Les Miserables he must face the totality of his experience. The guilt and the responsibilities represented by the reality of his experience. He tries to live in a motel and reject his experience but this ends with bloody confrontation with the consequences he tried to run from following him to his motel room. He then becomes involved in Paul and Peck’s story and after Paul turns the gun he brought on himself. He brings Paul to the hospital and he says that he shot Paul but he is let off for lack of evidence. This is God letting him go and telling him to go back to his family presumably. It is in line with his own experience though and this is the important point.
Diane Arbus
Diane Arbus was a woman who lead a sheltered life but then went on to take photos of the marginalized. She seemed to experience something of the real in the psychic danger she experienced in her work. Susan Sontag seems to be suggesting that Arbus' suicide could be viewed as a sort of combat death. Having trespassed certain limits, she fell in a psychic ambush, a casualty of her own candor and curiosity. She photographed people who were referred to as freaks at the time. She said that we all have a trauma in our lives and since freaks are born with theirs that makes them aristocrats. How original a way of looking at the world? Sontag's words relating to the unreality of experience for Arbus seem to capture the essence of my point exactly and for that reason are worth quoting in full. 'One of the things I felt I suffered as a kid' Arbus wrote ' was that I never felt adversity. I was confined in a sense of unreality...And the sense of being immune was, ludicrous as it seems, a painful one.' Sontag also relates the example of Nathanel West, another artist interested in the deformed, who feeling much the same as Arbus took a job as a night clerk in a seedy Manhattan hotel. Sontag suggests that for Arbus her method 'of procuring experience, and thereby acquiring a sense of reality was the camera. By experience was meant, if not material adversity, at least psychological adversity - the shock of immersion in experiences that cannot be beautified, the encounter with what is perverse, taboo, evil.
Instead of people whose appearance pleases, representative folk doing their human thing, the Arbus show lined up assorted monsters and borderline cases - most of them ugly; wearing grotesque or unflattering clothing; in dismal or barren surroundings - who have paused to pose and, often, to gaze frankly, confidentially at the viewer. Sontag writing of her work says that the photographs of deviates and the real freaks do not accent their pain but, rather, their detachment and autonomy. The female impersonators in their dressing rooms, the Mexican dwarf in his Manhattan Hotel Room, the Russian midgets in a living room on 100th Street, and their kin are shown as mostly cheerful, self-accepting, matter-of-fact. Pain is more legible in the portraits of the normals: the quarreling elderly couple on a park bench, the New Orleans Lady bartender at home with a souvenir dog, the boy in Central Park clenching his toy hand grenade. Norms (So called)
'Freaks' - (So called)
The connection between Kubrick and Arbus is another I would like to find out more about. A still from the Shining seems inspired by Arbus' photo of identical twins. There is an interesting article on the idea of duality in the Shining and the point it makes about the image of the twins is that the forced symmetry is even more unnatural than the natural symmetry. The blog notes that it was a brilliant decision to cast to girls who are not identical and actually probably of different ages. It does seem to capture an the Arbus photo and suggest that the attempts to beautify and order experience actually can make something quite unnatural. http://www.flickr.com/groups/31766670@N00/discuss/72157594384287718/ http://www.latimes.com/entertainment/movies/moviesnow/lat-lacmaku420121024173024,0,264309.photo
The DSM-IV, in its introduction identified as one of the components of the definition of mental disorder the fact that ‘the syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one.’ Now bereavement is a no brainer to me. I don’t think it was too big of them to say it is ok to be sad after a loved one dies. It’s the reasoning that gets me though. The bereavement sadness is not a mental disorder because it is (a) ‘expectable’ and a ‘culturally sanctioned response to a particular event’. This seems to capture the essence of the DSM and of the approach to madness more generally.Madness is an arbitrary, politically constructed entity, designed to suit the prevailing culture.
Richard Bentall also notes that there were a series of landmark studies carried out in the 1970’s demonstrated that psychiatrists in the United States and Russia were almost twice as likely to diagnose their patients with schizophrenia than their counterparts in Britain or elsewhere in Europe. In China there is no depression just lots of people with somatic disorders featuring lethargy and other physical complaints. The diagnoses are made to suit the culture. It suits the the United States and Russia to have more schizophrenia. It suits the Chinese to place no focus on the subjective mental state of depressed people and create a physical condition in its place. The culture is characterized by a marked focus on the group to the exclusion of the individual. The Japanese seem to do away with the idea of mental illness altogether.
There is an interesting blog post entitled - ‘Can Culture create Mental Disease? The Rise of ‘Hikikomoris’ in the wake of the Economic downturn in Japan.’ It deals with the social withdrawal of young adults in the wake of waning job security and the linkage of self-esteem. This to my mind is very much a problem that has been manufactured by the culture. Further equating having a job to self-worth another cultural invention has resulted in a special location, the sea of trees, for committing suicide. Rather than dealing with the problems created by a cultural insanity it is ignored and people Aokigahara to kill themselves.
Culture then can not only distort the mental life of the individual but it can also create problems where otherwise there would be none. The illusion of rigid separation between the different categories of diagnoses is reinforced by the arbitrary exclusion rules inserted in the DSM. Taking DSM-IV as the example it states that patients may not be diagnosed as suffering from schizophrenia if they also meet the criteria for schizoaffective disorder, major depression or mania. The DSM’s makers have not adequately addressed the issue of false positives that arise under their system. They ignore the issue of diagnoses being comorbid by arbitrary exclusion. The DSM provides the following gem of a disorder to illustrate the cultural point- Oppositional defiant disorder. I would like to thank Gareth Stack for discussing this in his Open Learning talk. This disorder is characterized defiant behaviour towards authority figures and refusals to comply with the requests of the majority. So madness could theoretically just be the result of thinking for yourself and trying to be an individual. Conduct disorder similarly manufactures an illness out of not following the rules. Culture then not only creates real problems where would otherwise be none but if creates fake problems where there are none. Perhaps being 'mad' is the sanest response. Breaking the rules in societies where politicians are corrupt and venal, groups regressive in the pressures they exert on the individual and rules patently absurd, counterproductive and odds with one another seems understandable. Also at least when we are feeling our feelings our experience is our own. This seems superior to the position in the modern capitalist society - a fragmented life lived for the approval of others. This clip below from network captures some of the feelings that we might experience in today's fragmented society. In that film Howard talks about the feeling of just wanting to be left alone in our living rooms or being told of horrible events that occur on the news as though that is the way things are supposed to be.
Sanity in this society is supposed to be represented by what Richard Sennett described as the new ‘flexible character’ in an ever accelerating, globalized capitalistic society by using terms that very much resemble the features of the narcissism or borderline pathology. There is an acceleration of momentary events, mobility of work life, futility of communication, fragility of relationships, receding loyalty and commitment. The symptoms of a growing fragmentation of society as a whole. This trend is only mirrored by the individuals who more and more tend to ‘compartmentalize’ their lives, their relationships and their attitudes, without striving for coherence. People today live in worlds, simultaneously or successively, that are not related to one another. Society then is stark raving mad even on the terms of the DSM.
The colonization of normal life experience by madness
The problem with this taxonomical approach to mental health is that everyone is different. It is all about individual context. Mental health is a lot more than just psychomotor retardation and disturbed sleep. Our experience is our own. Our feelings and our reactions to things are our own personal things. In fact if we were to take a book like Irvin Yalom’s Existential psychotherapy to heart we may be accused of imbibing depression. Yalom suggests, here and in his other writings, that we should take heed of Thomas Hardy’s proposition that ‘If a way to the better there be, it exacts a full look at the worst.’ He discusses the fundamental isolation which each person is forced to bear. He also deals with the idea of the meaninglessness of life and the ever present spectre of death. Were he not a world famous Stanford psychotherapist he might be accused of having a morbid preoccupation with death. We might suggest that he feels worthless or that because his life has no inherent meaning he must have a disorder of some sort.
R D Laing, in The Divided Self, says that he ‘is quite sure that a good number of ‘cures’ of psychotics consist on the fact that the patient has decided, for one reason or another, to play at being sane. At another point in that book talking about the onset of psychosis that in many cases there is no such qualitative change, but a transition extending over years, at no single point in which it may be clear whether any critical point has been passed. What this tells us is that the outward signs and behaviours may bear no relationship between the underlying ‘sanity’ or insanity. Additionally there seems to be a closer relationship between the so called signs of mental ill health and positive mental health than might be expected. But then society may actually have no interested in improving the internal world of individuals but merely in manufacturing passive consumers, who work and don't disrupt things. In a society where market research and media elements are trying to find out and sell our patterns of behaviour. Maybe I am a woman falling into such and such a socio-economic category and am on my way home from work. There are a half-dozen companies that 'know' what I think and will that information or exploit it to sell me something I don't know. The division of labour is such that, as discussed in Alain de Botton's book, the Pleasures and Sorrows of Work, there are people whose only job it is is to write the copy for the 'moment' chocolate biscuit angled at women from a lower socio-economic background. Their break from the pressures of life is the angled exploitation of a biscuit company's cynical marketing department. When confronted this sort of world it is hard not to sympathize with characters like that played by Michael Douglas in falling down. One feels that my life experience is my own and perhaps I need to do something destructive or out of the ordinary so that my experience cannot be packaged and sold back to me. The two clips should capture some of my feeling here.
The first clip captures the idea of our experience being fabricated just to sell things to us in Mad Men. The second clip captures a bit of insanity from michael Douglas that seems on one level to be a thouroughly sane reaction to an insane society. Symptoms then can come from a rational place. This argument is twofold. First of all ‘symptoms’ can come from a rational place. Richard Bentall in his book Doctoring the mind offers the following link between victimization and paranoia. He points to a population survey conducted by sociologists in El Paso in the United States, and Juarez in Mexico, that found that ordinary people who are highly paranoid tend to live in socially marginalized circumstances that left them powerless and prone to victimization. This reminds one of the joke that just because you are paranoid doesn’t mean they aren’t after you. So a ‘symptom’ could be an understandable response to life experiences. More than that the ‘symptom’ might possess a greater inherent rationality. R D Laing talks about psychotics delusions capturing an existential truth.He mentions Julie, the Schizophrenic, and says that we can see existential truth in her statements that she is not a person, that she is unreal, and we can understand what she was getting at when she said that she was trying to become a person, and how it may have come about that she felt at once so empty and so powerfully destructive. Laing suggests that even when what the patient is striving to tell us is told in as clear and straightforward a way as he knows how, the nature of his anxieties and his experiences, structured as they are in a radically different way from ours make the speech content necessarily difficult to follow.
So what we have said first of all is that sanity is a political and cultural construction. We have said that the human condition presents us with a number of human givens that it is perfectly reasonable to think about. We have then argued that symptoms can come from a rational place or have a rational purpose as their driving force. Advancing this what we are now going on to say is that the good and the bad reside closely together.
In Carl Rogers’ book Client Centred Therapy he talks about change occurring when people are feeling at their bleakest. This he suggests is because the process of therapy involves a painful process of letting our guard down and reorganizing our personality. The self, as Hegel suggested, depends on an internal dialectic for its intrapsychic structures and operations. Any meaningful interaction with a person involves an engagement with the way they choose to represent and symbolize their experience. Two examples can be furnished from Yalom’s writings. The first of Carlos, a man who suggested that he would enjoy rape if it were legal. It was not from first principles that these abhorrent views were changed but from following the dialectical logic of his own representations and logic to their conclusions. The second is a woman who viewed her anger as a black ooze which caused all those who touched her either to abandon her or to die. Again it was only by engaging this patently irrational symbolization of experience that Yalom was able to communicate in a meaningful way with this patient. He was able to show her that he was able to come into contact with this ‘black ooze’ without becoming ‘tarred’ by it. Taking the argument one step further we could view one’s ‘madness’ and unique symbolizations as representative of our unique specialness.
The symptom of mental ill health is also the creative impulse that spurs someone to paint a picture or create a beautiful piece of music. It is the vulnerabilities and the flaws that to a large extent make the person special. Yalom talks about the myth of specialness which is shattered by an awareness of mortality in his terminal patients.Our lives will be forgotten by all but a few who are close to us and our life purposes are our own artificial constructions. If we accept this and that we will never be the strongest or the most special we have to look somewhere else we have to look somewhere else for our individual specialness. We have to find our specialness in the unique and even skewed way in which we perceive the world. If we take Alfred Hitchcock we can make this point. Alfred Hitchcock is described as a brilliant director and as a great ‘auteur director’.
The reason he is seen as this great auteur director is because there is no question of his authorship. With other directors they can produce perfectly good films but they are not bringing anything of themselves to the films. The auteur on the other hand has a creative vision. His creative voice is distinctive enough to shine through the collective process. Hitchcock’s voyeurism, his paranoia, his preoccupation with guilt and his chauvinism towards women are unmistakably imprinted on each of his films. Here they are not evidence of a mental disorder but evidence of high art. One does not have to be a famous director to be special or to see the world uniquely. Your experience is your own and you life is your own.Any sort of thoughtful interaction with life’s existential questions or preoccupation with the fact of death does not have to be symptomatic of depression. These elements should be treated as highly individual natural ways of responding to human experience. However, even if we were to treat these as symptoms of a disorder we would still need a highly individualized inquiry. Markova and Berrios suggest that the structures underlying mental symptoms and subjective complaints should be primarily seen as unstable, and as dissimilar to structures underlying tables and trees. In their view, the structure of a mental state such as ‘depressed mood’ is fuzzy because it depends on the individual judgment of the person experiencing the state. In their view mental symptoms are above all personal constructs: ‘They are constructs in the sense that subjects create sense or construct a meaning out of an inchoate preconceptual and preverbal experience. They are personal in that although social and cultural influences will aid in their articulation,the experiences themselves are unique to the individual and inaccessible to anyone else’. So a preoccupation with death, being an outward manifestation, does not necessarily relate to the inchoate preconceptual and preverbal experience upon which things like depression are based. Arnold H Modell talks about metaphor as being a link with this internal preconceptual and preverbal experience. In his book metaphor and the meaningful brain he points to Giambattista Vico, his Descartes, in support of the idea that 'metaphor is not simply a figure of speech but primarily a mode of thought. Trying to get in touch with the psychic turbulence of the unconscious may the root of masses of art. Modell suggests that it clear that metaphor exists apart from language because we have gestures, visual images, feelings and bodily sensations which can all function as metaphors. Art and creativity often comes from this metaphoric process. We take something base and we convert it into something and higher with aesthetic quality. We are able to transfer meaning from one area to another, make comparisons and elevate ordinary painful experience to art like in the Greek tragedy and all of its variants. Striving after the painful raw fucking experience of sensations gives us the material to produce. Giambattista Vico says that it is noteworthy that in all languages the greater part of the expressions relating to inanimate things are formed by metaphor from the human body and its parts and from the senses and the passions'. Could it be that a large chunk of our art is as a result of trying to get in touch with the very experience that the establishment would label as a symptom of mental disorder. In Yalom's books he refers to himself and his feelings as his instrument of therapy. His Stradivarius of therapy. He included a lengthy and toxic rant about fat people and his countertransference towards fat controlling women like his mother for a reason. That reason is the same reason Maroda pays such attention to her initial feelings with a patient. Their feelings are a useful source of information and a part of their experience that is not be denied. Some people call it madness I call it being a human being. I will leave you with this clip to enjoy.
