Songs from the throats of the old gods

I am preparing materials for a workshop on Saturday on Poetry and Mindfulness  at Trebah Gardens in Cornwall (pictured) – details here.  One of the poems I want to share is by David Wagoner, called The Silence of the Stars.  You can read it here.

This poem elicits all kinds of reactions, mostly a sense of reverence but also loss.  The practice of mindfulness, with its roots in meditation and other contemplative traditions, takes us away from the world of ‘getting and spending’ and reminds us that the only reality is the present moment.  That realisation (which of course doesn’t last long), puts the past in perspective -it’s over – and reminds us that the future is essentially a fantasy.  As the joke goes, if you want to make God laugh, tell him your plans.  Mindfulness, though, doesn’t lead to living in a permanent la-la land but rather heightens experience. Worldly concerns weigh less heavily, but paradoxically, practitioners report improved efficiency, creativity and performance.  David Wagoner’s poem, both in its content and slow, breathlike construction, encourages a mindful engagement with the world.

Most of us, sadly, don’t ‘hear the stars’ but when we look at them, we do see patterns. There’s Orion with his studded belt, Castor and Pollux holding hands, the Plough – or the Big Dipper or the Great Bear, depending on who is looking.  The human brain seems to have an innate tendency to impose patterns, to group them meaningfully, to impose meaning.

A few weeks ago, I attended a lecture given by James Davies for SITE (an organization concerned with contemporary psychoanalysis).  He was talking about his book, Cracked which looks at the state of modern psychiatry.  He identifed three main areas of concern – that psychiatric drugs are often dangerous or ineffectual, that psychiatry and the pharmaceutical industry are hand-in-glove, and finally, there’s a growing trend towards medicalising any human behaviour or experience that might entail suffering, be inconvenient, or curtail personal productivity.

Most interesting though, was his investigation into the research basis for DSM-III – the ‘bible’ for categorising human psychiatric disorders.  James used the analogy of constellations as a way of thinking about human behaviour – DSM sees Schizophrenia, Depression and, until 1973, Homosexuality.  Another culture might see Religious Mysticism, Grief and one of the ways human beings express their sexual selves.  In 1950, DSM listed 106 disorders.  The latest version, V, lists 374, including, worryingly, something called Self-Defeating Personality Disorder which apparently is the medical basis for women staying with violent partners.  Do these psychiatrists simply have better telescopes now?  Or are they determined to join the dots across the whole of the night sky so that every human disorder is labelled and medicalised?

James Davies interviewed several of the, now elderly members of the committee responsible for DSM-III, asking what the research base was for categorising these disorders. Their candid replies were, essentially, ‘none’, that decisions weren’t based on data, but on voting round the table (one is quoted as saying it was like friends deciding where to go for dinner) and one symptom was dismissed by a member of the committee as not possibly being pathological because ‘I do that’.

It’s long struck me that psychiatry, like theology, is a science based on essentially hypothetical or inferred constructs – when did anyone ever have their serotonin levels checked before a prescription of antidepressants?  The only clear biological evidence for behavioural disorders are in the cases of Alzheimers, Huntingtons and substance abuse.

Of course, these things are complex and often people welcome a diagnosis as it can open the door to treatment.  A programme today on R4 explored this dilemma using Borderline Personality Disorder as an example – many think it doesn’t exist – and the presenter, who was given the diagnosis, questions whether it can be transient – as most human states are.

There’s been a backlash since the publication of DSM-V with articles such as this querying the medicalisation of normal human suffering and the British Psychological Society questioning the theoretical basis.  Apparently 21 of the 29 strong committee who agreed it have close links with pharmaceutical companies.  There’s disquiet at so many children being on medication. Of course, in extreme cases, powerful drugs save lives and make it more bearable for millions – and most of us self-medicate our moods and behavior  in a variety of ways –  with caffeine, alcohol or even reading poetry.

My sense, as a lay-person, is that human behaviour is dimensional rather than categorical, multi-faceted, mysterious and meaningful, and that many who exhibit ‘mental distress’ are in fact offering a sane reaction to a sick environment. Unlike the DSM committee with its powerful chairman sweeping aside objections, mindfulness and poetry offer an attentiveness that’s personal and specific but connects us to the world.  As David Wagoner writes,

I can still hear what I thought
At the edge of silence where the inside jokes
Of my heartbeat, my arterial traffic,
The C above high C of my inner ear, myself …
Tunelessly humming, but now I know what they are:
My fair share of the music of the spheres ..