CENTER FOR THERAPIST DEVELOPMENT
 

CINQUE TERRE, ITALY

SANTA CRUZ, CALIFORNIA

Table Talk by David Hoban, MD

The Edifice Complex

July 23rd, 2011

An elaborate construction of interconnected rationalizations housing Self-esteem.

The builder is not subject to housing codes or regulation.

Any attempts to gain entrance to the completed structure are strongly opposed by the dweller.

Reflection on the Metro

June 28th, 2011

I noticed, taking the train in early morning Paris, women who were half-dressed, getting dressed and made up. It was as if the jam packed car was a private boudoir. Ordinarily I would think that making up the face is done in private until the face in the mirror matches the mask one wants to present to the public. Not true. I watched a woman put on lipstick, lip-liner, powder, eye shadow, and eye-liner then, replacing sandals with high heals, she tied a scarf around her neck and pulled her tight, tapered pants over her heals. She was not alone. It seemed possible to me that these women had, in fact, placed themselves in an autistic shell awaiting their emergence into the world of offices or professionalism, in such a way that the masses did not exist at all.

Added to this is the sight of nine in ten people texting and stroking their I-pods in a ‘different,’ solipsistic world. Perhaps there is no difference since almost everyone who was not making up was sharing a distinctive posture, neck bent forward, chin down, eyes fixed, both thumbs moving rapidly. There is hardly a person to be seen reading a newspaper so the opportunity to offend by glancing at someone’s open page seems forever lost. The obsessive, addictive quality is hard to ignore.

All of this leads me to think, although people generally believe they are connected, and that this constitutes something beneficial for society, that the autistic shell is the next evolving organ. What people are doing in reality is not ‘connecting’ but putting themselves in a state of consciousness which involves, at best, being in contact with a machine and symbols. Symbols, of course stand for something, but are not the thing. What is transmitted is quantitative bits of information, even if that information is “I love you.” Information is not understanding. The multiplication of information is the tower of Babel. People might be exchanging the getting of attention and the giving of attention through these media but absent is the intangible yet vitally essential, qualitative, dynamic living exchange that exists only through direct human contact.

So, while we are priding ourselves in the revolutionary impact of the information age, perhaps we should take pause before another ‘hope’ for humanity turns into the next (mysterious) problem to be solved.

Aphorisms

May 17th, 2011

Aphorisms often have unnoticed inner content. We tend to be satified with nodding knowingly at their wisdom. Beyond cleverness and humor they can serve as framworks that help to reveal understanding, layer by layer in experience. Here are a few I have created, overheard in everyday speach, or read, often by isolating lines from fiction or poetry.

Hell is being one millionth of an inch from what you think you should be.

The dressmaker doesn’t have problems unless the dress has to hide rather than reveal.

You can want to do anything but you don’t have to.

Time belongs to you.

Tumble off the roof of your dreams.

There is no evil, only error

You can see the meaning of what is seen but can you see the meaning which is what is seen?

The facts are always the same. Change the way of seeing them and they will change.

Change is to decline to be in the present what you were in the past

Abjure the why and seek the how

Hope deferred injures the heart

If we are both transformed and changed what then becomes of me and thee?

Ignorance of your ignorance is your fiercest enemy

The deadliest sin is ignorance

Remember not to believe

Conscience is fear which is a shadow of justice

Pity is the shadow of love

Conscience must be applied to acts that will be done, not to deeds that have been done

Happiness and misery are equally distributed in the World

Facts, the idlest of superstitions

He knows not how to know who knows not how to unknow

We meet to part. Do we part to meet?

The yoke of Must

Do you labor at the letter I

If you scale a mountain you must face many a slip and fall

Who but madmen say, “I am right. You are wrong?”

Love of self makes the mine excel the thine

Death has an extra key to your safe.

A liar must have a good memory

Vanity always seeks a great love to its credit

The mendacity of social relations

When dignity does not give, Humor cannot live

To find a short way by a long wandering

People who like downey peaches are apt not to think of the stone

Principles

January 28th, 2011

A person of principle is much admired in our society. Political choice is an example. People vote for the candidate who is firm; unwavering; determined; strong; hard-working; has a heart of gold; is heroic; tough; loyal; faithful; well-mannered; Christian; visionary; willing to buck the tide; entrepreneurial; a calculated risk-taker; independent; a family man; patriotic; chaste; redeemed; a softy inside; knows what he likes and what he doesn’t; simple; competitive; underrated, and destined to succeed. The majority sees its own principles mirrored in its candidate.

It is impossible to oppose principles assumed by all to be virtues so the electorate votes on the perception of who possesses them in greatest quantity. No matter the party affiliation, no matter what their policy differences, a candidate must be perceived to possess theses socially trained characteristics.

Principles are a substitute for a greater capacity to understand. They reflect an early and important stage of development when we lack the capacity to understand. When one understands, he or she has no need for principles because he or she is in possession of a skill developed from within.

Principles are a product of environment, inculcated from without. They are unwavering because they are inexorably linked with identity and self-esteem. They serve as wings and stabilizers of one’s sense of who one is regardless of who one actually is. .Once principles are established and reified as opposed to being seen as elements of an earlier stage of development, any contradictory experience is perceived as threat and rationalized.

Only recently has there emerged an understanding, little known to most, which demonstrates that when an experience violates a principle with which one is identified, we tend to discard the experience rather than change our principle. History is replete with centuries of examples of prevailing belief systems overriding simple truths. In psychiatry, demonic possession as an explanation for mental illness has only recently, so to speak, been supplanted and still holds sway in many parts of the world.

We have been acculturated to judge people on their outward characteristics. When exercising judgment, the person who understands appears no different outwardly than the person of principle. However, he possesses an additional capacity to change his mind when circumstances alter cases. In the same way that Pygmies do not develop depth perception because living in dense forest precludes the necessity to see in the distance, our culture lacks the ability to perceive this inner capacity. We are exposed only to the belief that people’s outward behavior reflects his inward development.

One might object that it is impossible to know anyone’s inwardness and that outward characteristics are all we have to go on. This is akin to an earlier time when people, ignorant of microscopes, said that it is impossible to see or even know the existence of something called bacteria. Something is invisible to the conventional eye does not mean it has no existence. No matter how much people in the past focused on exorcising demons, knowledge of microbiology ultimately brought about solutions to infectious disease.

One who understands has the appropriate “instrumentation” to perceive the realities inherent in time, place, or circumstances. He or she does not need to rely on whether these realities match a preexistent model or principle to guide his actions. The content of one’s principles is less important than a knowledge that one is acting on them. This knowledge can provide the space for understanding to enter

Below is an account from the book, Thinkers of the East that more than hints at the development and continuous transmission of such knowledge. Baahaudin lived more than a thousand years ago.

A Morning’s Marketing

Bahaudin Naqshband one morning went into the great market of Bokhara with a long pole. He started to shout hoarsely until a crowd gathered, amazed at such behavior from a man of his fame and dignity.

When hundreds of people had assembled, uncertain of what to think or do, Bahaudin took up his pole and started to overturn stalls until he was surrounded by piles of fruit and vegetables.

The Emir of Bokhara sent a representative to Bahaudin’s house, to ask him to attend court immediately, to explain himself.

Bahaudin said:

“Let the doctors of the law be present, the chief courtiers, the senior administrators, commanders of the army and the most important merchants of the town.”

The Emir, together with his advisors, concluded that Bahaudin had gone mad. Deciding to humor him until they could have him committed to the Abode of Health, the Emir and his court summoned the people named by Bahaudin.

When all were assembled, Bahaudin entered the audience hall.

“You are no doubt aware, Your Presence Bahaudin,” said the Emir, “Why you are here. And you know why the rest of us are here. Please therefore say anything which you have to say.”

“Sublime Gateway to Wisdom! It is known to all that a man’s behavior is always taken as the index of his value. This has reached such a stage with us that a man has to do no more to gain acclaim and approval than to behave in a certain manner, no matter what his inner state may be. Conversely, if a man merely does something considered objectionable, he is regarded as being objectionable.”

The king said, “We do not yet understand what you are attempting to teach.”

Bahaudin said, “Every day, every hour, in every man, there are thoughts and inadequacies which, given vent to, would be illustrated by actions as damaging as my actions in the market-place. My teaching is that these thoughts and shortcomings, due to insufficient understanding, are as damaging to the community and to the individual as if he were to behave in a riotous manner – and more so.”

“What,” said the king, “is the solution to this problem?”

“The solution,” said Bahaudin, “is to realize that people must be improved inwardly, not just prevented by custom from showing their coarseness and destructivity, and applauded if they do not.”

The entire court was so impressed by this remarkable teaching, says the chronicler, that a public holiday of three days was announced, to enable the people to celebrate the receiving of such wisdom.

Bahaudin Naqshband lived in Fourteenth Century Afghanistan, in a Muslim culture. His message has been continuously in circulation since then, in both Muslim and Christian cultures. It has yet to penetrate. Whether legend or fact, this story serves to illustrate the existence of a capacity to perceive inwardness that contradicts our assumption that it has no existence at all, thus exposing us as the primitives.

If we can learn from this I believe we will have gone far toward understanding why it is we continuously elect lying politicians who do things we see as betraying us. In fact, we are electing mirrors of ourselves.

References:

Shah, Idries Thinkers of the East
Tavis and Aronson: Mistakes Were Made (but not by me)

Inmate Qustionaire

January 3rd, 2011

1) Is your authoritarian Warden hidden in his or her office?
2) Are there structural limitations in your institution outside of your control?
3) How does your penchant for order obscure your amorphousness and an understanding of your institution?
4) What provisions have you secured for your escape and for what duration?
5) How does your macho or dignity stand in the way of a need for guidance in the unknown territory outside?
6) How will you hide from pursuing guards when they learn of your
escape?
7) Who is “them?” Who is “us?”
8) What activities you oppose in prison could be used for the purposes of escape?
9) Is ruminating over your fate prison food? What is food like outside of prison?
10)What communication have you established with the outside?
11)Does your self-esteem make prison walls look like open space?
12) What is the nature of the cruelty of your guards? Their kindness? Can you recruit them to assist in your escape.
13) What satisfactions do you consume in prison that you would be hard-put to relinquish on the outside?
14) How does sequestering anger prevent you from gaining access to the outside?
15) What materials do you possess or can you find to fashion keys? What is the design of the locks?
16) Do you imagine that you know what the outside is?
17) For what crimes does the institution hold you accountable? What crimes of which you are innocent? Guilty?
18) Is your judgment final or are you under continuous prosecution?
19)Is your sentence indeterminate?
20) Can you trust the other inmates in your prison? Do you know what trust is?
21) How can you use all that is in prison to your advantage in an escape?
22)To what in prison life are you habituated or dependent upon?
23) What form does inhumane treatment take within your prison?
24) How do your warders exercise power from above? How do you exercise power from below?
25) Does a desire to do or be good stand in the way of necessary actions?
26) How has the institution trained you to be blind to potential escape routes?
27) Do you lack information? Do you lack knowledge of a lack?
28) How do visitors collude in supporting prison life? How would you use them to cooperate in an escape?
29)What is the relationship of your prison to the rest of society?
30) How do you get messages to the outside world?
31) Are you self-assured living among inmates that you are not one of them?

Impossible

December 19th, 2010

I spoke to a man in prison. He complained about the food, the callousness of the guards, his lack of choice, his loneliness, feeling coerced, the system, his losses, his longings, his lack of comfort, his poverty. “I’m a junkie,” he said, in the same way I might say I am a doctor. “Junk is beautiful. If only I could have my junk without all this shit.” “Yes,” I said, “wouldn’t it be great. There’s only one problem with it.” “What’s that?,” he asked. “You can’t have your junk without all this shit. The only thing standing in your way is that it’s impossible.” He bolted from the room, angrily exclaiming to the guards, “This motherfucker is sicker than I am!”

Watching him leave the room, I at least felt reassured that such an attitude does not exist outside of prisons.

Incurable

December 3rd, 2010

I heard from a colleague awhile back, about a woman who had had longstanding, unremitting symptoms of anxiety and depression. Along with these she had some vague experiences of dizziness and loss of balance. She had been treated by psychiatrists for years with antidepressants, which are used for both anxiety and depression. My colleague friend was quite astute and referred her to a neurologist, who diagnosed multiple sclerosis, a degenerative disease with no cure. The story might end here, with most physicians nodding in agreement that it is most important to first rule out physical causes for emotional symptoms. However, there’s a twist.

The patient breathed a sigh of relief when informed that she had an incurable degenerative neurological disease. “Thank God,” she said, “all the other doctors have told me it’s in my head.”

What is Knowledge not used?

November 23rd, 2010

While at the conference in London I found myself in the men’s room standing behind a distinguished-looking gentleman. The room was narrow and he moved to the sink to wash his hands, Unable to pass him, I waited for him to finish but didn’t wash my own hands. As we walked out he turned to me and told me that he was an anthropologist, an emeritus professor no less, and had recently read of a study done at Parliament. MPs were observed in a men’s room as to whether they washed their hands after urinating. The findings were striking. If someone was in the room they all washed their hands. If no one was in the room, none washed their hands. I recounted that I learned years ago in medical school that urine was sterile and that it was not necessary to wash one’s hands. He responded that he had recently seen his doctor who told him the same thing. So I asked him why he washed his hands, His answer? “Because you were there.” I often wonder why we don’t use the knowledge we have. Or is it that knowledge not used is really ignorance in disguise.

Heard at the Dentist’ Office

October 17th, 2010

“Shall we make an appointment for next week now?”

“Doctor, you know I am afraid of dentists. Can I make one when I feel pain?”

“You can do that, but by the time you feel pain you will lose the tooth”

“I’ll call you next week to make an appointment.”

Texas Tall Story

August 29th, 2010

Back in the day, there was a businessman from out East Texas named B.J. Williamson. He was about a pure bred a Texan as they come. He knew a little ‘bout a lot; he could run you clear off a straight with a pair of deuces; when it came to making a deal with him, it felt like he put a snake in your pocket and then asked you for a match. Didn’t drink no beer but Lonestar. I could right well say, without exaggerating, if BJ Williamson was in the pot, he dam sure always had the best of it.

So, as I was sayin’, he was on the top of his game when he gets an offer from one o’ those A-rab oil companies. They ask him to come over to one o’ them places where they just as soon buy a new Cadillac as wash one when it was dirty. He knew if he swung that one he’d be fixed for life. But, beings it would take a few years, and knowin’ anything could happen, he figured it was even up that he could go busted as well.

Now BJ wasn’t nobody’s pigeon, so he figured if he did tap out, he’d keep a stake back home just in case. That way he could start over if he had to. Thought about what he would do for a while ‘cause ‘round them times the banks weren’t worth two for five or half of that. Finally he came up with the idea that he’d hide it right out in the open. He fancied the price of iron never changed much and he figured he could buy a few tons of it and store it at Jim Preston’s shed ‘till he got back. Even if the price went down, he reckoned it wouldn’t go down so much that he couldn’t start over for what he paid if he sold it. Jim was a old poker playin’ buddy and he told BJ he didn’t care one way or the other if he stored it at his place. ‘Bout a week later a big rig pulled up at Jim’s place and dropped its load.

BJ went of to Arabia to work with them rag-heads for close on to two years. He didn’t have one single drink the whole time and he damn sure didn’t touch one o’ their women. But that wasn’t the half of it, ‘cause even though he raked a few pots, in the end he went broke. So he came back to Texas figurin’ he could count on his stake.

When he got there, Jim’s shed was as empty as county stadium on a Tuesday mornin’ in July. Seems Jim ran into some financial problems a year before and he went and sold that iron thinkin’ when he got out o’ hot water he’d put it back in his shed and nobody would be none the wiser for it. It didn’t work out that way though. When BJ showed up he‘bout split a gut when he saw the shed empty.

Jim drove up in his pickup and when he sees BJ he just about shit. He knew he better have a damn good story and bein’ scared as he was sure didn’t stand in the way of commin’ up with one. He’ says to BJ, ‘We been havin’ a real vicious problem with ants ‘round here lately and this bein’ Texas they aint no ordinary ants. Now you might find it hard to believe, but last year, we had such a load o’ mean ants here that ate all your iron and I couldn’t do a thing to stop ‘em. Poison didn’t touch ‘em, fact they thrived on it.”

BJ smelled a rat right off and he wasn’t ‘bout to be conned out o’ his case money. So he plays along and says, “Goddamn, that was dumb o’ me. Y’ know, before I left, I coated that iron with rust stopper and I’ll bet that made that iron tasty t’ them little devils. Must have ate it like candy.” Jim started to breathe easy thinkin’ he was home free so he invites BJ over for a Barbeque that night. BJ comes and acts likes he’s havin’ a good old time while the whole time he’s thinkin’ up a storm tryin’ to come up with a plan.

Finally he gets the idea to snatch Jim’s son and hide ‘im in his cellar. Next day BJ sees Jim downtown all bent out o’ shape. ‘What’s wrong with you?” BJ asks, actin’ like he donn’t know what’s goin’ on. Jim breaks down and tells him his son is gone. BJ rocks back on his heels and asks, “Is he ‘bout ten year old?” “Yeh,” says Jim. “And does he have blond hair and come up to about here on me?” Jim was getting’ real excited and says, “Sure enough.” So BJ says, “I saw a redtail swoop down on ‘im yesterday and carry ‘im off by the hair. Jim gets red in the face and hotter than a pistol. He calls BJ a cock sucker every which way sayin’ “That aint no thing to be jokin’ ‘bout.”

BJ looks ‘im square in the eye and says, “In a place where ants can eat thirty ton o’ iron, wouldn’t surprise me if a red tail carried off a ten year old boy.” Jim knew he couldn’t go no further so he spills the beans and tells BJ the whole truth ‘bout how he sold the iron. He says, “Don’t be mad now, I’ll pay you for the iron and then some.” BJ says, “Don’t be cryin’ for your boy cause I got him.” BJ got his money back and Jim got his son back. But, y’ know, no matter how many times they crossed paths after that, they never looked at or talked to each other again.