“Parity of Esteem for Mental Health”: why we need a critical history

Posted on May 19, 2016 by Helen Stark

This is a guest post by Chris Millard. Chris is a Wellcome Trust-funded postdoctoral researcher with interests in the histories of psychological categories, the welfare state, the emotions and the idea of ‘parity of esteem for mental heath’. His book, A History of Self-Harm in Britain, was published (open access) by Palgrave Macmillan in 2015. Chris’s previous post about parity of esteem for mental health is available on this blog.

This post is part of a series we’ll be posting this week for Mental Health Awareness Week. In 2015 the Centre for the History of the Emotions was awarded a grant of £1.6m by the Wellcome Trust for a five-year inter-disciplinary research project entitled ‘Living With Feeling: Emotional Health in History, Philosophy, and Experience’. The project, one of the first to receive a Wellcome Trust Humanities and Social Science Collaborative Award, will connect the history and philosophy of medicine and emotions with contemporary science, medical practice, phenomenology, and public policy, exploring the many varied and overlapping meanings of emotional health, past and present. You can find out more on the project website.

“Parity of Esteem” is in the news again. On Monday (9th May), NHS Providers and the Healthcare Financial Management Association revealed that only half of mental health trusts that they surveyed had received a ‘real-terms increase’ in funding, even though the overall budget for clinical commissioning groups (CCGs) rose 3.4% this year.[1] Barely a week goes by without another story about ‘parity of esteem’ targets being missed, warnings about them not being met,[2] or detailing policies that have an indirect effect that undercuts parity between mental and physical health.[3]

In 2014 it was announced that mental health therapies would be subject to the same waiting time targets as physical ailments.[4] This was quite rightly touted as a great step forward by mental health campaigners and charities.[5] These targets were supposed to come into force at the beginning of May. However, the Department of Health has yet to work out how much this will cost, and it is known that the majority of the cost for implementing these new standards will have to be met out of existing budgets.[6]

This has a familiar ring to it. (This could be my cue to go on another rant about the new junior doctors’ contract, and how an increase in service is supposed to be achieved with no extra money and a cap on locum expenditure.) However, I’m wary of going on an impassioned rant outside my specific area of expertise. My area is the history of mental health and psychiatry, especially the history of psychiatry and mental health within the National Health Service. The ‘familiar ring’ this story has for me is one of a more historical nature.

In 1959, a Mental Health Act was passed [pdf],[7] based upon the Report of the Royal Commission on the Law Relating to Mental Illness and Mental Deficiency (the Percy Commission).[8] In this report it was claimed that ‘most people are coming to regard mental illness and disability in much the same way as physical illness and disability’. The Mental Health Act 1959 had at its heart this commitment to treat mental any physical health in equivalent ways. Part of this involved the running down of the nineteenth-century system of remote psychiatric hospitals (‘lunatic asylums’), and prioritizing caring for people in the community.[9] The catch was that no new money was to be provided. It was to be up to each locality to fund these services. So we get a big, progressive statement about the value of mental health provision, and how it must be taken seriously. Even better for Harold Macmillan’s government of the late 1950s, ‘taking it seriously’ meant reducing expenditure on very costly psychiatric hospitals. This money was then not channeled into new ‘community’ provision.

One of the things I remember most clearly from working in Parliament for three months (in 2014), writing a briefing on Parity of Esteem for mental health,[10] was how enthusiastic everybody was about ‘parity of esteem’. Mention money, and those who might have been able to pledge it started backing slowly out of the room with murmurs of ‘we’ll see what we can do…’. One of the reasons that ‘parity of esteem’ has such broad appeal is that ‘esteem’ costs nothing, is not easily measured, and can thus be easily shunted to the bottom of the priority list.

History is important here. Articles talk about the ‘historic underfunding of mental health services’[11] or ‘decades of underinvestment’[12] yet there is little sense of what that history is specifically. Critical history is necessary in order to find out more about that history, what it means, and the rationales (both explicit and unspoken) by which mental health has been downgraded, marginalized and underfunded, whilst at the same time being front and centre in a field of unfunded pledges and cost-free grand gestures.

[1] http://www.theguardian.com/society/2016/may/09/nhs-mental-health-funding-is-still-lagging-behind-says-report

[2] http://www.nationalhealthexecutive.com/Health-Care-News/government-warned-mental-health-targets-could-be-missed

[3] http://www.nationalhealthexecutive.com/Health-Care-News/lords-perplexed-by-removal-of-incentives-for-mental-health-treatment

[4] https://www.gov.uk/government/news/first-ever-nhs-waiting-time-standards-for-mental-health-announced

[5] http://www.mind.org.uk/news-campaigns/news/mind-hails-landmark-announcement-of-first-ever-mental-health-waiting-times-standards/#.VzHe36u-qng

[6] http://www.nationalhealthexecutive.com/Health-Service-Focus/why-are-we-still-waiting-for-progress-on-waiting-times-in-mental-health

[7] http://www.legislation.gov.uk/ukpga/1959/72/pdfs/ukpga_19590072_en.pdf

[8] http://discovery.nationalarchives.gov.uk/details/r/C10964

[9] http://studymore.org.uk/xpowell.htm

[10] http://researchbriefings.parliament.uk/ResearchBriefing/Summary/POST-PN-485/

[11] http://www.theguardian.com/healthcare-network/2016/may/09/mental-health-services-must-get-the-funding-they-need

[12] http://www.theguardian.com/society/2016/may/09/nhs-mental-health-funding-is-still-lagging-behind-says-report

Connecting NHS mental health with Islamic ruqyah healing in East London

Posted on May 16, 2016 by Jules Evans

A Ruqyah healer in Indonesia

In 2010, a tense, clandestine meeting took place in a coffeeshop behind a mosque in Whitechapel. On one side of the table sat a handful of practitioners of Islamic spiritual healing (which is known as ruqyah). On the other side sat psychiatrists from the East London NHS Foundation Trust. There was a certain amount of suspicion on both sides – psychiatry has a long history of pathologizing religious belief, while British Muslims are less likely than non-Muslims to seek mental health support from the NHS, and more likely to report dissatisfaction with mental health services (see page 12 of this report). So ruqyah healers and NHS psychiatrists have been in competition for the care of souls. But could they work together?

Bringing the two sides together were two men – Dr Nigel Copsey, a former priest and Team Leader for Spiritual and Cultural Care within the East London and City Mental Health Trust, and Imam Qamruzzman, a Bangladeshi Muslim Imam. Copsey has spent the last 20 years improving spiritual care in East London mental health services, engaging with the rich variety of spiritual groups within East London, including Pentecostal, Catholic, Muslim, and African healers.

At a recent presentation at Queen Mary, University of London’s psychiatry department, Dr Copsey said: ‘The spiritual has always been marginalized by psychiatry. Psychiatrists operate from a frame which excludes the spiritual most of the time, while our community includes it. The default for Bangladeshis is to go to a traditional healer first, and faith groups also often have a frame that exclude NHS mental health services. I would love a true dialogue between mental health services and religious and spiritual groups, to help the person as best we can.’

Of course, a dialogue involves challenges. NHS mental health services operate from a secular framework, which ruqyah healers may attribute emotional disturbances to possession by a djinn, or demon. Both frameworks can be harmful for a person – psychiatry can insist on a narrow biomedical explanation for a person’s suffering which denies their experience has any non-physical meaning; while religious healers can insist on demonic possession as the cause of everything from depression to homosexual desires. The unskilled application of either of these frameworks can exacerbate a person’s suffering.

An advert for Ruqyah healing in London

Dr Angela Byrne of the East London NHS Foundation Trust says: ‘Therapists often feel anxious and unskilled when patients talk about their spirituality. We get asked a lot about ruqyah and had a prejudice towards it – we saw them as charlatans. It’s been an incredible journey working with them, and quite mind-blowing for someone like me with a secular framework.’ She was struck by some similarities between ruqyah counselling and Cognitive Behavioural Therapy – an emphasis on a person’s values, beliefs, attitudes, meaning, on hope, equanimity, endurance.

Imam Qamruzzman says: ‘We had to distinguish between genuine ruqyah healers, who are gifted and experienced at counselling, and charlatans charging high prices for amulets. Genuine healers offer counselling which helps people to receive illnesses with patience, prayers and community support – the Prophet went through suffering too.’

Professor Simon Dein, honorary professor at QMUL’s psychiatry department, is one of the UK’s leading researchers into religious healing. He also spoke at the presentation. He said: ‘Thirty years ago, religion was a taboo subject in medical schools. It was called a ‘non-tenure factor’ – you were at risk of losing your job if you researched it. It only became fairly respectable in the last 20 years. Now there’s much better understanding that religious faith is not bad for your mental health, on the contrary. For example, there’s a significant inverse relationship between heart disease and levels of religiosity. There’s a lot of research into the health benefits of meditation, including better cardiovascular functioning.’

What about the healing effects of prayer? Professor Dein says that meta-analyses have found little differences in physical outcomes for people being prayed for versus people who are not. However, in his own research into spiritual healing in Pentecostal communities, he’s concluded that ‘spiritual healing can have a great effect in psychological well-being’. He adds: ‘there’s an emphasis on the healing of memories, which is analogous to psychotherapy’. Many types of religious healing incorporate trance or hypnotic states, which can unlock the placebo response. Dein says: ‘Trance is essential to spiritual healing, but it hasn’t been much studied by psychiatry, it’s more a focus of anthropology.’

Can religious groups work together with mental health services? This project, and others like it, suggest it is possible. After all, Cognitive Behavioural Therapy came from the spiritual tradition of Stoicism, which deeply influenced both Christianity, Judaism and Islam, while Mindfulness-CBT is influenced by Buddhism and Hinduism. Professor Dein noted that some forms of CBT have emerged which tailor their approach to particular religious sensibilities, such as Christian psychotherapy and Muslim CBT, and there is some evidence that these have slightly better outcomes for their target groups than secular CBT. More importantly, a better dialogue can help encourage British Muslims to access psycotherapy without seeing it as a threat to their religious faith.

Here is a report by the Tavistock Institute on working with traditional African healers in East London.

Emotions in the Wild

Posted on May 13, 2016 by Thomas Dixon

A Conversation With Charles Foster

Charles Foster’s Being a Beast (Profile, 2016) is an extraordinary book about the author’s life-long fascination with the minds of animals and his attempts to see the world through their eyes – to feel their sensations, perhaps even think their thoughts. He tries to enter – physically and imaginatively – the worlds of the badger, the otter, the fox, the red deer and the swift. His experiments include living for weeks in a specially made human-sized sett dug into the Welsh hillside; trying to catch fish in his mouth in a Devon stream; scavenging for food among the refuse of East London; being hunted by a blood-hound across Exmoor; and undertaking something between a migration and an ornithological pilgrimage to West Africa.

Being a Beast doesn’t fit into any standard genre. It is part memoir, part natural history, part metaphysics. It is written with incredible intensity, and humour, and ends with an epilogue tackling philosophical questions about identity, agency, authenticity, and otherness. One of the themes of the book is the nature of consciousness, in humans and other animals, and the related question of whether animals experience anything like human emotions.

Charles, whom I heard speak about his book earlier this year, very kindly agreed to answer some questions about it for the History of Emotions Blog.

Thomas Dixon: Your experiments in becoming a beast seem to have been motivated by something like E. M. Forster’s motto “Only connect” – but applied to non-human animals. Did you end up feeling that you had connected and, if so, with what?

Charles Foster: I would prefer to say that I ended up acknowledging that I was connected. The opening line of the book is: ‘I want to know what it is like to be a wild thing’. That is a woefully misconceived line. For, whether I like it or not, I am a wild thing. That’s the (trite) Darwinian truth. My DNA wasn’t forged in a factory. The shape of my psyche was determined by wood, wind and water. Why do we like sitting next to a fire in the winter? It’s not because we see a Dickensian parlour in our sentimental mind’s eye. It’s because our subconscious is happy to know that when the wolf crouched just beyond the light makes its move, we can grab a burning branch and shove it in the wolf’s face.

David Abram points out that there are no non-wild places – just places of relative unwildness. Leave a piece of pie in an inner-city office for a few days, and it’ll be covered with exuberantly wild mould. Your gut is a mass of entirely wild organisms over which you have no control. You depend on their wild fecundity for your thriving and your survival.

So: I am connected to non-human species, whether I like it or not. Many of my defining relationships are with non-human species. We’re much better off noting and accepting the relationships that make us. Nasty things happen if we don’t. Ask Freud.

We have systematically, brutally and disastrously unlearned the languages we need in order to articulate properly our relationships with the non-natural world. The relationships are still there: we’re just painfully constipated when we try to discuss them.

I suspect that all worthwhile knowledge is acquired by anamnesis. And that’s certainly what I was about on the moors and in the woods. I started to unforget my fellowship with the natural world, and unforgot a few words in which to describe that fellowship.

There were moments when old memories flooded in particularly fast. I looked into the eyes of an urban fox. I knew that it knew something about me that I didn’t know, and that it was changed by the encounter. You asked me about connection. Connection entails reciprocity, and that meeting stank muskily of reciprocity.

TD: Was I right in sensing in your book a dissatisfaction with prevailing attitudes in the scientific study of animal behaviour – especially those which refuse to countenance the possibility of animal emotion?

CF: Absolutely. I see lots of scientism, and very little science. The Academy is awash with scientific fundamentalism – offensive mainly because it is fundamentally unscientific. The scientific zeitgeist assumes (just as inflexibly as the Creationists it rightly derides) that there are many non-negotiable axioms. The proper scientific standpoint is that nothing is unthinkable except that one should think something unthinkable. Look at how Rupert Sheldrake has been lynched. It’s like the hounding of Galileo by the Church. This has happened because scientism has become the new Church. Power, of whatever kind, seems to cause sclerosis, and sclerosed brains aren’t good at bending round the contours of a world that is splendidly curvy.

“Chimpanzee disappointed and sulky” – an illustration from Darwin’s Expression of the Emotions in Man and Animals (1872). Image credit: US National Library of Medicine.

When you look at the history of the scientific study of animal emotion, you see irony piled on irony. The militant neo-Darwinists are the mockers-in-chief – yet Darwin himself wrote the foundational monograph on emotions in animals. And the main objection to the proposition that animals may have emotions is the blatantly Creationist one – contrary to all that Darwin told us – that man is fundamentally, unbridgeably different from non-human animals. Of course in many important respects humans are different, but there’s no evidence to suggest that animals don’t have emotions, and a large amount of evidence that they do.

One factor that’s important in the unsceptical scepticism of modern scientists about animal emotions is the tyranny of the metaphor of the computer. It’s the only metaphor that most biologists have, and any idea that can’t be shoehorned into it is assumed to have no place in the natural world. The reasoning therefore goes: ‘1. Animals are like computers. 2. Computers don’t have emotions. 3. Therefore animals don’t have emotions.’ The argument is beyond parody.

TD: So, do you think that animals experience emotions like ours?

CF: I don’t know. But my non-knowledge is of the same kind that would force me to say that I don’t know whether you experience emotions like mine. Of course I have rather less doubt about my knowledge of your emotions than about my knowledge of a badger’s, but the epistemological worries relating to both enquiries are substantively the same. What a tortured academic answer! Sorry. I expect they do. I would be less surprised if they did than if they didn’t.

TD: I know that you trained as a veterinary surgeon before branching out into law and ethics. Did that experience give you insights into the emotional and sensory worlds of animals too?

CF: Quite the opposite, I think. I’d have written a much better book had I not been marinated in science. Jonathan Sacks observes that science takes things apart to find out how they work, and religion puts things together to find out what they mean. An inquiry (or at least a readable inquiry) into the emotional worlds of animals is much more like a religious than a scientific quest.

Children don’t have categories like ‘scientific’ or ‘religious’. They’re much better integrated than we are. For them, how something works and what something means are not two different categories. As I describe in the book, I started wondering, as a very young child, how animals perceive and relate emotionally to the world. I thought that one way of trying to find out was to take animals apart. So I did. I cut up animals I found dead on the roads. I pickled their brains, put them in jars, and clutched them as I went to sleep, hoping that something of their understanding would seep into me. It sounds perverted, but any shaman would mutter: ‘Yes, yes: a standard technique.’ If I’d continued along that path I’d have taken fewer wrong turnings. But I grew up, up, up and away from the land on which the creatures crawled, and away from sensation, and away from the mind-body-spirit unities in the hutch in the back garden, and into an adult world where ‘how something works’ and ‘what something means’ were very different, and had to be approached using very different tools. The tool of intuition was denigrated: that was for the thick kids who did art. If you could, you did science: you dissected, and so lost sight of the whole, and of the whole idea of meaning.

I’ve never recovered. I never will. It meant that I had to start my journey into the heads of the various animals not in the rivers and forests, but in the library. I had to start with abstractions such as ‘nerve membrane depolarization’, and argue towards real things like dung and dislocated necks. It was the wrong way round. Good science and good literature and good ethics all start on the ground and justify their abstractions and their generalisations laboriously and apologetically.

TD: Your children feature in several places in the book and took part in some of your experiments. Do you think that children are closer to animal nature than adults, and if so is that anything to do with having shared emotions?

CF: They are certainly closer. There are some obvious ways in which this is true. They are physically closer to the ground. The distance between their eyes, noses and ears and the ground is much closer than mine to that of a fox. Their senses are less atrophied than ours – and hence closer to the senses of animals. They don’t have our arrogant anthropocentrism: they talk to animals as if they are their peers rather than their prey. Children are much less in thrall to cognition – and hence abstraction – than I am. When I walk through a wood I can’t see the leaves or hear the birdsong. I see only the abstraction of the leaves: I hear only the hiss of cognitive tinnitus. And those are far, far less interesting than the real leaves and the real birdsong. My wilderness is achingly self-reverential. My descriptions of the wild are essentially onanistic. But children see the leaves and hear the birdsong. And there is plainly some connection between some physical sensations and some emotions.

Having said that I can’t be sure about the nature or content of animal emotions, I need to be consistent and say that it follows that I can’t say that children share emotions with animals. But it seems to me to be highly likely. For animals too (I presume) see the real leaves and hear the real birdsong. It’s only 30 million years or so since my children shared a common ancestor with badgers. They share most of their neurological hardware with badgers now. If both experience emotions, and both are sensing the same thing, surely it’s more likely than not that they both children and animals react in a similar emotional way to their perception of those same things? Of course there will be many very important differences: the smell of an earthworm means something very, very different to a badger than to my son Tom, who’ll get pasta in the evening from his adoring parents. But I’d have thought that there would be some convergence of emotions on at least some things in the wood.

TD: One recurring theme of the book is the idea that animals live in closer proximity to death than we do, and you write about how that might feel, including your own sensations when lying in your sett, imagining being returned to the cold, wormy earth after death. I was put in mind of the book of Ecclesiastes: “For the fate of the sons of men and the fate of the beasts is the same; as one dies, so dies the other. They all have the same breath, and man has no advantage over the beasts; for all is vanity. All go to one place; all are from the dust, and all turn to dust again.” Did your experiments in living like a beast change your thoughts or feelings about death?

CF: They should have done, shouldn’t they? Other people say that as they’ve got more ecological – recognised their own place in the wheel of life (including their role as a piece of food) – they’ve become reconciled to their own deaths. I understand and admire that position, but I can’t share it. Perhaps that’s because my ego is pathologically inflated, and the thought of it being dissolved, or reallocated, or at best having to exist in new circumstances, is uncomfortable. There is, though, some comfort in the thought of solidarity with all the other doomed creatures on earth. Partly this is the thought that nothing has any lasting advantage over me – that the most vibrantly alive swift will join me in the darkness, or the light, or wherever. I suppose that this is the same sort of comfort that some people get from the notion of the communion of the saints.

Black swifts. Image: Glen Tepke/VIREO.

TD: Before we finish I have to ask you whether you’re a fan of The Island of Dr Moreau by H. G. Wells. It’s a favourite of mine, and I thought about Moreau (a mad scientist figure who also personifies the cruel process of evolution) and his “beast folk”, when I was reading your book. In particular I remembered Moreau’s haunting fear that as soon as his work in creating his beast people is done, they begin to “revert” and the beast to creep back in. Then, when the narrator, Prendick, returns from the bizarre world of Moreau to England, he sees everywhere the beast-like behaviour of his compatriots, and devotes himself to the intellectual study of chemistry and astronomy, partly to get as far away as possible from the animal within:

The Island of Dr Moreau (1895). Image: British Library.

“There is, though I do not know how there is or why there is, a sense of infinite peace and protection in the glittering hosts of heaven. There it must be, I think, in the vast and eternal laws of matter, and not in the daily cares and sins and troubles of men, that whatever is more than animal within us must find it solace and its hope.”

But I suspect your own conclusions on returning from the world of the beast folk might be different.

CF: I used to read a lot of H.G. Wells, and know Dr. Moreau well. But Wells now seems to me to be suffocatingly metropolitan. None of his ideas works outside Bloomsbury. Your citation is a case in point. He’s really, despite his vaunted secularism, an enthusiastic Genesis 1 subduer of the things that creep and crawl on the face on the earth. For him, the more a man subdues the wild, the more of a man he (and it always is he) is. We’re back where we came in: Wells and you and I are wild creatures, and we’re better off if we learn to live with it. You can’t subdue it either out there or in you. It doesn’t need to be subdued: it is kind.

Representing emotion in the doctor-patient encounter in Victorian medical writing

Posted on April 29, 2016 by Sarah Chaney

Photograph of Alison Moulds

This is a guest blog by Alison Moulds, second-year DPhil student at St Anne’s College, University of Oxford. Her thesis examines the construction of the doctor-patient relationship, and the formation of a professional identity, in nineteenth-century medical writing and fiction by doctors. She is part of the AHRC-funded project Constructing Scientific Communities.

Working in partnership with the Hunterian Museum of the Royal College of Surgeons of England, the project has guest curated an exhibition on the history of vaccination and will be running several events, including “People-Powered Medicine” (7 May 2016), a symposium about public participation in medicine and healthcare from 1800-present. More details can be found here.

[I]f you are not a keen observer of men and things, if you cannot read the book of human nature correctly, and unite knowledge of physic with an intelligent comprehension of the thoughts, feelings, and desires of mankind, […] you will be sadly deficient, even after twenty years’ experience.[i]

In the opening pages of The Young Practitioner (1890) – an advice guide for aspiring medical men – Jukes de Styrap proposes that what we might now refer to as emotional intelligence is a fundamental component of the general practitioner’s ‘bedside manner’.

The extent of his interest in the relationship between the “thoughts, feelings, and desires of mankind” and medical practice at the century’s close may surprise modern-day readers. The nineteenth century has traditionally been seen as a period in which the emotions became increasingly alienated or divorced from the practice of medicine. The era is often associated with a shift from the bedside to the clinic or laboratory; the introduction of medical and surgical instruments instituting more distance (both physical and emotional) between doctor and patient; and the ascendancy of more objective, ‘scientific’ ways of thinking and working.[ii] One might think of Francis Galton’s claim in 1874 that “[t]he man of science is deficient in the purely emotional element”.[iii]

In recent years, however, scholars working at the nexus of history, literature and medicine have challenged or revised this supposed trajectory from subjectivity to scientificity. They have pointed towards the way in which general practice in the Victorian period continued to privilege the role of interpersonal skills.[iv]

In this blog post, I will consider the ways in which the Victorian doctor was conceived as a reader or interpreter of the patient’s emotions before looking at how his or her own emotional life was conceptualised. While much can be said about emotions-as-etiology in medical discourse at this time, this post is primarily interested in how emotions figured in writing about the social aspects of medical practice, such as the doctor-patient relationship. It also largely focuses on models of general practice as opposed to hospital-based medicine.

This notion of the doctor as an interpreter of the patient’s inner emotional life has been identified and problematised in a raft of writing about historical and contemporary medical practice. For instance, in Somatic Fictions (1995), Athena Vrettos explains how

the idea that a body contained stories about an individual’s life, habits, heredity or emotions, and that doctors served as privileged interpreters of those stories provided the medical profession with a narrative structure for the revelation of social and scientific “truths”.[v]

In the history of medicine, this model of the doctor-as-reader is often associated with the profession’s rising claims to scientific authority. Yet in the opening of The Young Practitioner, de Styrap perceives an “intelligent comprehension” of emotions as something which must be yoked with “knowledge of physic”. The latter is not seen as granting immediate or unfettered access to the former.

‘The Doctor’ – Luke Fildes (1891) © Tate, CC-BY-NC-ND 3.0

During the Victorian period, medicine was conceived by many to be an art as much as a science. Medical writing often acknowledged an underlying empirical uncertainty to diagnosis and prognosis. The Young Practitioner cautions its young readers against over-reliance on “scientific ‘extras’, and modern instrumental and other aids to diagnosis”. It suggests that, by favouring these over “rational, subjective symptoms”, they risk ignoring the fact that “the art of curing disease is more indebted to sound judgment and common-sense bedside observation and experience than to aught else”. [vi] In “Behind the Times” (1894), a short story by Arthur Conan Doyle (himself a medical practitioner until 1890), two “young, energetic, and up-to-date” GPs find that the local community far prefers the attendance of the ageing Dr Winter. For “[h]e has the healing touch – that magnetic thing which defies explanation or analysis”.[vii] In texts such as these, the patient’s subjective experience is privileged over scientific knowledge, which is seen to be fraught and provisional.

The doctor was not merely supposed to discern or intuit his patients’ emotions. In some instances he was also expected to respond actively to their needs and preferences. De Styrap suggests that the young medical man “[s]eek to penetrate the character of each [patient], and to become an adept in adapting [his] manner and language to the case before [him]”.[viii] He feels that each patient should be able to “find in [the doctor] his ideal”. [ix] Undoubtedly there is a significant strain of romanticism in de Styrap’s writing. Reviewing his book, the BMJ notes that, “[t]he standards which he sets up for our conduct towards the public and towards each other is perhaps almost too high”, though it emphasises that “it is well that the standard should be put high”.[x]

The possible gap between rhetoric and practice should be acknowledged. In a 2007 article for Health and History, Sally Wilde suggests that much of the discourse surrounding the doctor-patient relationship was anathema to patient experience in the late nineteenth century. She describes how medical encounters in general practice and surgery involved many individuals. Patients may have included friends or family in their healthcare decisions and consulted multiple doctors. In hospital, they would have been treated by surgical teams and seen by an assortment of nurses. Wilde argues that the doctor-patient relationship was a myth perpetuated by the profession: “Doctors were concerned to establish that they had a special relationship with their patients in private practice, because their livelihoods were directly related to that relationship”.[xi] She suggests that doctors policed or regulated ideas of patient ‘ownership’ in the interests of remuneration and forming professional relationships with one another.[xii] While acknowledging a possible lacuna between medical discourse and the actual delivery of healthcare, I think it is important to emphasise medical writing’s vital role in shaping ideas about professional identity and the relationship between practitioner and patient.

Not all medical writing propounded an idealised doctor-patient encounter, moreover. While the patient’s emotional state was sometimes represented as a neatly stable and legible text waiting to be read or ‘diagnosed’, it was also understood that emotions could play a much more dynamic or even slippery role in the doctor-patient encounter. One might think of myriad instances in popular literature in which patient opinion towards the doctor and his practices is shown to be in flux. Examples include Harriet Martineau’s Deerbrook (1838), Anthony Trollope’s Doctor Thorne (1858), and George Eliot’s Middlemarch (1871-2). In these novels, patients form affective relationships with their family doctor but also move between practitioners in accordance with their thoughts and feelings about local rumour and innuendo. Ultimately, emotional responses to a doctor or medical procedure may have engendered compliance (even enthusiastic adherence) or resistance. Our exhibition on the history of vaccination at the Hunterian Museum explores public reactions to the introduction of compulsory vaccination in 1853. It shows how campaign material produced by anti-vaccinationists was often highly charged, gesturing towards the power of emotions in acts of public protest.

Furthermore, it was not only the patients who displayed unhappiness, frustration or anger towards their medical encounters in this period. Medical writing also illustrates less positive responses from the practitioners themselves. An article entitled “The Questions of Patients” – which appeared in the Midland Medical Miscellany in 1882 – amounts almost to a bitter invective against the public. It rails against “the ignorance and stupidity of patients” – particularly those from the poorer classes – including those who are “very anxious to render themselves objects of interest and pity”.[xii] The attitude displayed here is somewhat extreme, though hostility towards patients who were perceived as wasting the practitioner’s time was fairly commonplace. Prime examples of ‘nuisance’ patients included hypochondriacs, the garrulous, and those who summoned the doctor in the middle of the night for non-urgent cases.

Whether hagiographic or cynical, medical writing often tackled the role played by doctors’ own emotional lives. De Styrap instructs young men to manage and modulate their emotions in order to maintain their professionalism, while openly acknowledging that this may be challenging:

If you possess the power to control your temper, and to maintain a cool, philosophic composure under the thousand provocations given to doctors, it will confer upon you a signal advantage over those who cannot […][xiv]

In discussing the doctor’s emotional responsiveness, medical writing often emphasised the importance of qualities such as composure and authority. A satirical take on this can be found in Conan Doyle’s The Stark Munro Letters (1895) which depicts an irascible and unorthodox practitioner named Cullingworth. He tells the narrator (a more conventional young doctor) to “[b]reak your patients in early, and keep them well to heel. Never make the fatal mistake of being polite to them”.[xv] He contends that his patients have an appetite for his hot-headed and bullish demeanour – indeed they flock to his door, crowding his practice. In this extended parody, a medical character conceptualises a very different kind of bedside manner which is nevertheless somehow decidedly popular and remunerative.

Debates about the more subjective skills needed for medical practice often figured in discussions about whether women could or should work as doctors, which gathered pace from the 1860s onwards. At times, medicine was characterised as a distinctly masculine profession. In an editorial in 1870, the Medical Press and Circular describes how it requires “the highest qualities of scientific intellect” and “the knowledge of the world, the downright nerve, that have always distinguished the masculine temperament and character”. The writer contends that there are “an abundance of cases” in which the physician cures purely through “being able to ‘put his foot down’; in one word, by being a – man”.[xvi] Writers such as this implied that women would be emotionally ill-equipped to deal with the pressure of serious and emergency cases. Those in support of the medical-woman movement countered these claims, with some commentators championing the role that stereotypically ‘feminine’ characteristics could play in medical encounters. In Medical Women: A Thesis and a History (1886), Sophia Jex-Blake suggests that a male doctor may be ignorant of the “more sensitive and delicately organized feelings of his [female] patient” and that female practitioners would be better placed to respond to this.[xvii] These debates illustrate how ideas about women’s inherent emotionality could be used to either exclude them from, or embed them in, prevalent ideas about medical practice.

The emotions inhabited a fraught place in medical discourse during the Victorian period. They could be seen as antithetical or complementary to scientific attitudes. To be emotionally attuned was seen as a powerful tool for diagnosing the patient and winning his or her trust. However, excessive or uncontrollable emotionality could render both the doctor and the patient temperamental and unreliable. For a medical practitioner, learning to exercise control over one’s emotions was often seen as important in the formation of a professional identity and in relationships with one’s patients. However, this did not necessitate detachment or aloofness. Some argued that the doctor needed to be engaged with his patients, and highly adaptable, almost mercurial in his own moods and behaviour. It is significant that a good bedside manner – whether one interpreted this in terms of compassion and sympathy, or authority and command (or indeed both) – was associated with successful and remunerative practice. In a crowded medical marketplace, doctors needed to court prospective patients (at least those with money), tapping into their preferences and gaining their loyalty. Cultivating good interpersonal skills was seen to be in the interests of the patient and therefore the practitioner him/herself, a harbinger (if not guarantor) of professional and financial success. This demonstrates the reciprocity of the doctor-patient relationship, the way in which the patient’s values and priorities may have shaped writing about, and understandings of, medical interactions.

[i] Jukes de Styrap, The Young Practitioner (London: H.K. Lewis, 1890), pp. 1-2.

[ii] These histories have often been influenced by Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (1963) (London: Routledge, 2003).

[iii] Francis Galton, English Men of Science: Their Nature and Nurture (1874), 2^nd edn (London: Frank Cass, 1970), p. 207.

[iv] Anne Digby, Making a Medical Living: Doctors and patients in the English market for medicine, 1720-1911 (Cambridge: Cambridge University Press, 1994).

[v] Athena Vrettos, Somatic Fictions: Imagining Illness in Victorian Culture (Stanford, California: Stanford University Press, 1995), p. 8.

[vi] De Styrap, pp. 76-7.

[vii] Arthur Conan Doyle, “Behind the Times,” in Round the Red Lamp, ed. by Robert Darby (Kansas City: Valancourt Books, 2007), pp. 3-7 (p. 5-6).

[viii] De Styrap, p. 32.

[ix] De Styrap, p. 32.

[x] “Review: The Young Practitioner”, British Medical Journal, 13 September 1890, pp. 632-3 (p. 633).

[xi] Sally Wilde, “The Elephants in the Doctor-Patient Relationship: Patients’ Clinical Interactions and the Changing Surgical Landscape of the 1890s”, Health and History, 9.1 (2007), pp. 2-27 (p. 17).

[xii] Wilde, p. 20.

[xiii] “The Questions of Patients”, Midland Medical Miscellany, February 1882, pp. 21-4 (pp. 23-4).

[xiv] De Styrap, p. 32.

[xv] Conan Doyle, The Stark Munro Letters (1895) (London: Amalgamated Press, 1907), p. 64.

[xvi] “Lady Doctors”, Medical Press and Circular, 23 February 1870, pp. 146-7 (p. 147).

[xvii] Sophia Jex-Blake, Medical Woman: A Thesis and a History, 2nd edn (Edinburgh: Oliphant, Anderson, & Ferrier, 1886), p.7-8.

A 10-day Vipassana retreat taught me the meaning of pain

Posted on March 24, 2016 by Jules Evans

Last Sunday I finished a 10-day Vipassana retreat, at a monastery in Sweden. This was my third attempt to do a monastic retreat – I’d done a runner from both previous efforts, from a Rusian monastery in Lent 2006 (the head monk kept trying to convert me to Orthodox Christianity) and from a Benedictine monastery on the Isle of Wight in January 2013 (I was bored). This time, I vowed not to do a runner. To make sure, I chose a Vipassana centre in the middle of the Swedish countryside. Further to run.

The Odeshog Vipassana centre, in the south of Sweden near Lake Vattern, offers 10-day, 20-day and three-month retreats as taught by a Burmese teacher called SG Goenka, who died in 2013. The courses are all free, you offer whatever donation you want at the end of the course.

Let me sketch a brief history of Vipassana. At the beginning of the 20th century, a Burmese monk called Ledi Sayadaw made the unusual move of entrusting his teachings to a farmer called Saya Thetgyi, telling him that his mission was to teach Vipassana to laypeople. Saya Thetgi’s students included a civil servant called U Ba Khin, who was a leading figure in the post-independence Burmese government. When he wasn’t running five departments (at the same time), U Ba Khin also taught a 10-day intensive course in Vipassana to a select handful of laypeople.

In 1955, a rich Hindu businessman called SG Goenka was looking for relief from debilitating migraines. He had tried many different medical solutions, at one point living in Switzerland to consult the doctors there, and become addicted to morphine in the process. A friend suggested he try U Ba Khin’s 10-day course, but U Ba Khin told him the aim of the path taught by Buddha was not migraine relief but liberation from the ego. Goenka had his own doubts – he was a devout Hindu, and feared ‘taking refuge in the Buddha’ might be sacrilege. But eventually he was convinced that the Buddha taught a non-sectarian approach to wisdom, and he started the course. He almost did a runner on day two, but stayed, and became a great disciple. In 1971, U Ba Khin passed the lineage to him, with a mission to expand it globally. Goenka left his business, moved to India, and began setting up Vipassana centres – there are now around 170 globally – offering 10-day introduction courses and longer retreats. He was clear he wasn’t seeking to be worshipped as a guru or to convert anyone to Buddhism, but was rather teaching an ‘art of living’.

Bringing Vipassana to lay-people: Saya Thetgyi, U Ba Khin and SG Goenka, from left to right

His courses attracted several young westerners who went on to be leading figures in western Buddhism, including Daniel Goleman, Ram Dass, Sharon Salzberg, Jack Kornfield and Joseph Goldstein. Kornfield and Goldstein set up the Insight Meditation Centre in Massachussets in the 1970s, offering similar 10-day and two-week retreats partly inspired by Goenka’s structure. In the spring of 1979, a researcher at U-Mass medical school, Jon Kabat-Zinn, attended a two-week retreat at the Insight Meditation Centre. He writes:

while sitting in my room one afternoon about Day 10 of the retreat, I had a ‘vision’ that lasted maybe 10 seconds…I saw in a flash not only a model that could be put in place, but also the long-term implications of what might happen if the basic idea was sound and could be implemented in one test environment—namely that it would spark new fields of scientific and clinical investigation, and would spread to hospitals and medical centres and clinics across the country and around the world, and provide right livelihood for thousands of practitioners.

Kabat-Zinn (who was also influenced by other approaches like Zen and Tibetan Buddhism) established what became known as the mindfulness-based stress-reduction programme (MBSR), an eight-week programme drawing on Vipassana breathing awareness and body-scan techniques and also on yoga. That in turn inspired mindfulness-based cognitive therapy (MBCT) and other mindfulness therapeutic interventions. There are now mindfulness centres in over 35 medical schools in the US, mindfulness CBT is provided by the NHS, it’s offered at many companies from Google to the US Army, there are mindfulness apps like Headspace, and courses in everything from mindful eating to mindful colouring. Time magazine has called it ‘the mindfulness revolution’ -it’s also a $1 billion-a-year industry. All this fits in to a prophecy which Ledi Sayadaw liked to quote, that 2,500 years after the Buddha’s death Vipassana would return from Burma to India, and then spread round the world. ‘The clock of Vipassana has struck!’, he would say (along with the clock of yoga and Tibetan Buddhism).

Military discipline

Many people also still go on Goenka’s 10-day courses. Although he died in 2013, you still hear his instructions and chanting by audio at the beginning and end of every meditation session (his baritone chanting is something to hear) and watch an hour-long dharma talk by him every evening. For 10-days, he’s pretty much the only voice you hear, besides the brief interjections from the assistant teacher, which are usually confined to ‘keep working’.

https://www.youtube.com/watch?v=m41Mb_Mdm2w

There were 60 people on the course, 30 men, 30 women, who slept in different buildings, ate in different halls, and meditated on different sides of the dharma hall. We all agreed to follow certain rules for the 10-days: a vow of ‘noble silence’ (no talking or communicating except with the assistant teacher), no booze, no sexual misbehaviour, no phones, books or writing, and no other religious practices in order to ‘give the technique a fair trial’. We also agreed to follow the meditation schedule, getting up at 4.30am and going to bed at 9.30pm. The Buddha taught that there are three parts to the path – sila, samadhi and panya, or morality, concentration and wisdom. The vows were sila – the moral foundation without which the practice does not bear fruit. Goenka said: ’Many teachers, both in the Buddha’s time and now, offer samadhi meditation without any sila. They say it doesn’t matter what you do or how you live, just follow this practice and you’ll get the benefits. That’s not true.’ I wondered what he’d make of the mindfulness boom today.

The vows try to strengthen the 10 paramitas or virtues – Buddhism is a virtue ethics which trains people in moral habits like equanimity, tolerance and loving-kindness. The vows were hard – I missed the internet, and missed books and writing even more. The silence I could handle, but I realized I am very intolerant – a few times, I muttered at my room-mate when he disturbed my sleep.

And then there was the meditation. On the first evening, I saw the schedule of meditation, and my heart sank.

The longest I’d ever meditated before was half an hour, and I thought that was a heroic achievement. Ten hours a day? How would I ever get through it? Initially there was a lot of clock-watching and day-counting, like a prisoner trying to get through a long stretch. Ten days felt like a very long stretch.

The first three days are focused on teaching samadhi, or concentration, through anapanasati, or concentration on the breath. We practiced focusing on our breath going in and out of our nostrils, noticing which nostril it’s going in and out of, whether it feels cold or warm etc. On Day Two, we focused on the nose area, to see if we felt any sensations there, then on Day Three, we focus just on our upper lip. Mind kept running away, of course, into the past and future – you realize how closely memory and imagination are intertwined. Often I wouldn’t realize for 10 or 20 minutes that I’d become lost in an inner movie, then I’d wake up, and bring the mind back.

Your problem-solving, outward-focused, ego-driven mind has been in charge for so long, and it keeps bringing you fascinating insights, like a wagging dog bringing you sticks, and you want to remember and preserve the insights (particularly if you’re a writer), but you don’t have pen or paper, and in any case these ‘insights’ are just a ploy by the ego-mind not to sit still, so you keep gently bringing mind back to the breath. And the strange thing is, it gets easier. By Day Three I could concentrate for a whole hour on the breath without losing focus for more than a minute or two. And I became fascinated by the sensations on the nose or the lip – there’s a whole world going on there!

Torture camp

On the evening of Day Three, Goenka told us that all this samadhi practice was to prepare us for Vipassana proper, which would begin on Day Four. We would ‘make a deep surgical incision’ into the unconscious, in order to lance the pus and begin the healing. It would be painful, it would be difficult, some weak-minded people might even do a runner (not me!). So we should prepare ourselves. On Day Four, we gathered nervously in the hall for the Vipassana ceremony. Goenka (on tape) led us through the 90-minute meditation – we should concentrate on our head, then our face, then our shoulders and arms, then our throat, then our stomach, then….It was a big let-down – firstly, he went quite quickly, so it was difficult to be aware of any sensations in one body part before he’d moved on to the next one. And secondly, wasn’t this just a ‘body-scan’? Where was this deep dive into the unconscious we’d been promised? I was pissed off after that session, annoyed with this overweight burping Burmese businessman, and all these western sheep who chanted ‘sadhu’ (agreed) after his Pali singing, even though they’d no idea what they were agreeing to.

Things got harder in the next session. We were told there was a ‘new rule’ – the three hour-long group meditations each day were henceforth ‘sittings of great determination’, in which we should try not to move for the whole hour. For some masochistic reason, I decided to do these sittings cross-legged, even though I could barely sit cross-legged for ten minutes (because of a skiing injury in my left leg). For all of us, these sessions were intensely uncomfortable and painful. We were told to simply be aware of whatever sensations arose – whether gross (painful) or subtle (pleasurable) – and observe without attachment or aversion. This would overcome our deep-seated ego-habit to react to physical sensations with craving or aversion, which was at the root of all our suffering.

So you would sit there, doing these circuits round the body, from head to toe and toe to head. I’d do roughly four circuits in an hour. The pain in my legs, thigh and buttocks would start around mid-way through circuit two, at the 20 minute mark. By 30 minutes it was quite painful. By 45 minutes it was agony. During the last five minutes, my body would be shaking from the pain, there’d be tears in my eyes, a feeling of nausea, I’d only be conscious of the pain, in my knee or feet or buttock or thigh, stabbing, awful, unbearable pain. So I’d give up, unlock my legs, and the pain would vanish. We went through three of these torture-sessions a day.

Since the development of anaesthetics, we have lost the idea of pain as educative or ennobling, as Ariel Glucklich explores in ‘Sacred Pain’

Why put myself through this pain? Surely there was nothing ennobling about it, it was just my body warning me I’d injure myself. We were told that observing gross sensations without aversion ‘purified’ the accumulated sankharas (habits of craving and aversion) of the past. We would also learn that both gross, solidified sensations and subtle sensations were anicca, or impermanent – they arose and passed away. The sensations might be fast pleasant treble vibrations or slow painful bass vibrations, but they were all part of the same cosmic song of anicca. This realization would liberate us. Really? Or was I just doing permanent damage to my legs?

Transcending aversion

On Day Six, I managed to get to the hour-mark without moving, dragging myself grimly round four body-circuits, my body quivering with the effort, until Goenka’s chanting comes in to mark the hour point, you praise the Lord for the end, and go to your room feeling sick. And then, on Day Seven, something strange happened, in the first ‘sitting of great determination’, about 40 minutes in. The pain was building up, I was observing it and reminding myself it was impermanent, and then something shifted. It was like a light dawned within me, literally, and a cool breeze spread over the top half of my body. It felt like cool vibrations went all through the top half of my body, which were sufficiently pleasant that I no longer felt bothered by the pain in my legs. And then, when I observed the ‘gross sensations’ of pain in my legs, which seemed so solid and permanent, they dissolved too, into subtler sensations. My left foot, which had been totally asleep in a deep freeze, also woke up. Everything in my body dissolved – everything except my left buttock, which remained stubbornly clenched. I observed it, willing its dissolution, but it wouldn’t dissolve, it held out.

Still, it was a breakthrough. It felt like the chemical creation of some new substance through transcending pain. GI Gurdjieff, from the Pythagorean-Platonic tradition (supposedly inspired by Pythagoras’ journey to India), also talks about purifying oneself through the alchemical process of ‘intentional suffering’: ‘One needs fire. Without fire, there will never be anything. This fire is suffering, voluntary suffering’. After this, the sessions became easier, though it was not linear progress – sometimes I’d have a great session, and decide I’d become a very wise and advanced being, and then the next session I’d wipe out after thirty minutes. It was constantly humbling and humiliating. But I learned three main things.

The physical unconscious

Firstly, I learned that pain is intimately connected to aversion. When I’d briefly overcome aversion and find an attitude of acceptance or equanimity, it transformed the pain. When a strong aversion-thought came back, like ‘you’re not going to make it!’, the pain would spike instantly. Insight also transformed the pain – if I reminded myself that the pain was not permanent, not solid, that it rose and fell, shifted, was transient, this helped to dissolve a very solid concrete feeling into a subtler sensation. One particularly noticed this with some of the solid habitual muscular tension we carry around – insight would dissolve these muscular knots, in a fascinating way. The body and mind are intimately connected in a way we don’t yet fully appreciate. States of deep absorption connect to our muscles, autonomic nervous system and immune system in ways that can be profoundly physically healing.

Secondly, I realized the importance of working with what Goenka called ‘the unconscious’, by which he meant our semi-conscious physical sensations. Greek philosophy and CBT also talk about overcoming our attachment and aversion to externals, and cultivating acceptance and equanimity of the endless flux of the cosmos, but the therapy of Greek philosophy / CBT is mainly focused on becoming mindful of one’s thoughts. The focus is mainly cognitive. Vipassana, by contrast, teaches mindfulness mainly through the body – we become aware of our physical sensations and their impermanence, thereby transcending aversion and attachment at the physical level. I think that’s transformative at a much deeper level than Stoicism – many Stoics, including me, might be quite rational at the thought-level, but still basically stuck in attachment and aversion at the subconscious physical level. Vipassana also introduces the idea of karma – sometimes, we may have a sudden physical sensation of, say, pain or anxiety or heaviness, and it may not be related to a present situation, but may rather be a manifestation of a past craving or aversion. So sometimes depression or anxiety simply manifests from the past, and there’s no point looking for the event that triggered it, one just has to note it, and note it won’t last forever. Belief in reincarnation means Buddhism (like Pythagorean-Platonism) is more optimistic than Stoicism – we don’t just endure suffering out of acceptance of the Logos, we endure it and purify it bringing us the promise of liberation in future lives.

Transcending attachment to ecstasy

Finally, I glimpsed a new attitude towards ecstatic or altered state experiences. I wouldn’t say I had an ecstatic experience on the course, it was harder than that. But some of my fellow students did – one girl, who gave me a lift back to Gothenberg, told me about her first retreat, where she felt really high the entire 10 days. Another man told me he felt a sudden shift into a sort of vast inner hall of light. A 1979 phenomenological study by Jack Kornfield found that 95% of students on a three-month retreat and 40% of students on a two-week retreat reported experiences of rapture or bliss (described as piti in the Pali texts). But students also reported painful experiences: the return of difficult emotions and traumatic memories, autonomic disfunction in breathing, shaking, insomnia, nightmarish visions of violence or orgies. Participants on my course also found it very tough at times – my room-mate said he faced the return of deeply anxious thoughts and sensations from his teenage years, and felt ‘almost psychotic’ at times. Another participant told me he’d been beset by violent visions on his first retreat.

Traditional psychiatry would tend to pathologize such experiences, good or bad. But this is a mistake, as Kornfield writes:

Unusual experiences….are the norm among practiced meditation students. Over 80% of our three-month students reported such experiences as part of their normal meditation process. From our data it seems clear that the modern psychiatric dismissal of these so-called ‘mystical’ and altered states as psychopathology – referred to as ego-regression to an infantile state or labeled as psychic disorder – is simply due to the limitations of the traditional Western psychiatric mental-illnesses oriented model of the mind.

We shouldn’t be averse to, afraid of or embarrassed by such experiences, as western psychiatry has taught us to be. At the same time, we shouldn’t become attached to them either. Goenka repeatedly warned that blissful or rapturous experiences were dangerous, because they could lead to craving. People end up playing ‘the sensation game’, chasing the rapture, expecting it, craving it. Laura, the girl who gave me a lift, told me her second retreat was harder than the first, because she’d been expecting the bliss, and instead there was pain. Equanimity towards both painful and rapturous experiences seems to me a much healthier attitude than one sometimes finds in, say, Transcendental Meditation, Romanticism, the New Age, or charismatic Christianity, where the sensation of transcendent bliss, rapture, shakti or kundalini can easily become fetishized as the high-point or goal. For example, in 2013 I had an ecstatic experience in a Christian context, and it was immediately seized on, turned into a ‘testimony’, and telegraphed around the church network. I was told there was a great vocation on my life, and I naturally felt very special and blessed, then confused when the rapture dried up. For 18th century Methodists and Pentecostalists, such rapture is proof that they are the justified elect, proof of God’s favour, of a great awakening, perhaps even the coming End Times. How could you not end up craving such an experience, when such a high value is put upon it?

We need to overcome our cultural aversion to ecstatic experiences, but we equally need to overcome the strong attachment to ecstasy often found in Romanticism, the New Age or charismatic Christianity. Otherwise we become spiritual thrill-seekers, denigrating the everyday and unprepared for the pain. As Kornfield puts it, ‘after the ecstasy, the laundry’.

So I’m back in the world now, and not sure what will survive of my practice in these less propitious circumstances. But I hope I’ll keep on sitting and observing whatever comes up. Goenka advises us to meditate two hours a day, and renounce booze and meat. We’ll see. Meanwhile, at the Odeshog centre, a new batch of students have just arrived, and are sitting down to begin the practice.

Review: Cure, by Jo Marchant

Posted on March 21, 2016 by Jules Evans

Cure: A Journey into the Science of Mind Over Body, is an excellent new book by science journalist Jo Marchant, which explores the healing (and harming) power of the mind and emotions over the body. It succintly brings together a lot of recent evidence in areas sometimes dismissed as ‘pseudoscience’, such as the placebo response and hypnotherapy, to argue for their medical efficacy and the need for a medical model which better incoporates the mind.

Marchant argues: ‘Conventional science and medicine tend to ignore or downplay the effect of the mind on the body. It’s accepted that negative mental states such as stress or anxiety can damage health long-term…But the idea that the opposite might happen, that our emotional state might be important in warding off disease, or that our minds might have ‘healing powers’, is seen as flaky in the extreme.’ Her book succeeds in its aim of rescuing this area ‘from the clutches of pseudoscience’.

The book is very much in line with a new research project I’m involved with at the Centre for the History of Emotions, calling Living with Feeling, which also explores the interaction between emotions and health. I’m going to summarise the main points from each chapter of Marchant’s book.

Brain scans from Benedetti’s research

Chapter One looks at the placebo response, in which fake or dummy medicine still has real healing effects on patients. Mainstream science has tended to dismiss the placebo effect as a trick or mental anomaly that mainly works for ‘unintelligent or inadequate patients’, as The Lancet put it in 1954. In fact, the placebo response has been shown by researchers such as Fabrizio Benedetti to have powerful physiological effects. For example, Jan Stoessl, a neurologist at the University of British Columbia, found that dopamine levels tripled when patients with Parkinson’s were given placebo pills. Fabrizio Benedetti has used brain scans to identify the effect of placebo – the effect of belief – on motor neuron cells, which fire more slowly in Parkinson’s sufferers following a placebo. The power of belief and suggestion appears to release natural healing chemicals in the brain such as endorphins, which help counteract some illnesses like Parkinson’s and MS, as well as psychiatric illnesses like depression. Indeed, another placebo researcher, Irving Kirsch, has suggested wonderdrugs like Prozac work mainly through the placebo effect – his book The Emperor’s New Drugs explores this. Benedetti has also found that valium ‘has no effect unless patients know they are taking it’, which surprised me.

Chapter Two explores how placebos even work when patients know they are taking a placebo. A 2010 study by Harvard’s Ted Kaptchuk – a leading researcher in this field – gave placebos to patients with Irritable Bowel Syndrome (which affects 10-15% of the population) and told them ‘that although the capsules contained no active ingredient, they might work through mind-body self-healing processes’. They did significantly better than those who received no treatment. Marchant highlights the market in ‘open-label placebos’ like Placebo World, Universal Placebos and Aplacebo – the latter set up by Simon Bolingbroke, who manages his own pain from Lyme disease using placebos. ‘It sort of started as a joke’, Bolingbroke says. ‘But it’s a joke that’s real.’

Marchant deepens her analysis of the placebo effect in this chapter, exploring the power of ‘feeling cared for’ – patients who receive their drugs when their doctor is present apparently get 50% more pain relief. She suggests that placebos tap into ‘ancient evolved pathways’ in our brain which persuade our brain ‘that we are loved, safe and getting well’. She also begins to explore the connection between placebo, ritual and symbols – bigger placebo do better than smaller ones, two pills work better than one, coloured pills work better than white, blue helps us sleep, red is better at relieving pain, green is better for anxiety. ‘We are symbolic animals’, says Benedetti. We’re also ritualized animals, and the ritual interaction between healer and patient affects the placebo response. ‘Words, gaze, silence, body language, all are important’, says Kaptchuk.

In Chapter Three, Marchant explores another mechanism for the placebo effect – physiological conditioning. She writes about the relatively new field of psychoimmuneology (which includes QMUL’s Fulvio D’Aquisto), which has proved that our autonomic nervous system is connected to our immune system, and that the placebo effect (or beliefs) can impact immune cells through neurotransmitters. She writes about a new medical intervention called Placebo Controlled Drug Reduction, where patients are given a drug in combination with a placebo, and then subsequently the drug is reduced while the placebo remains. The physiological association between the drug’s effects and the placebo’s effects means the placebo keeps working – a 2010 study by Adrian Sandler found PCDR to be effective in treating children with ADHD.

Chapter Four covers the highly contentious area of fatigue and Chronic Fatigue Syndrome. Marchant explores how fatigue used to be understood as an automatic physiological response, but which some researchers argue is actually more like an emotion. Sports psychologist Tim Noakes of the University of Cape Town has ‘proposed that the feeling of fatigue is imposed centrally, by the brain’. A ‘central governor’ in the brain makes us feel tired before our body gets damaged, as an early-warning system, Noakes argues. However, the central governor can get it wrong, and can be modulated through training, and through belief – Chris Beedie at Aberystwyth University found cyclists given a pill they believed was performance-enhancing could cycle 2-3% faster.

Marchant then highlights the research of QMUL’s Peter White on Chronic Fatigue Syndrome. White’s research argues that CFS can be treated with a combination of Cognitive Behavioural Therapy and Graded Exercise Therapy. A 2011 study found that 22% of patients recovered after a year of CBT and GET, while patients trying ‘adaptive pacing therapy’ (in which you adapt to the new circumstances of having CFS) did no better. CBT and GET appears to be a way to re-train the ‘central governor’ of your brain when it gives you the false information that your body has reached its fatigue limit. The suggestion that CFS involves the mind is, however, hugely unpopular with some sufferers of ME (Myalgic Encephalopathy, patients’ preferred name for the condition) , who have been stigmatized for decades as suffering from ‘yuppie flu’ or ‘Raggedy Ann syndrome’. A Guardian article by Marchant on CFS has already attracted the ire of ME groups. Perhaps it’s the mind / body paradigm that’s at fault – it’s rarely just the mind or just the body, but a complex interaction between the two.

Franz Mesmer

Chapter Five looks at hypnosis, a medical intervention with a chequered history ever since Benjamin Franklin’s 1784 trial of Mesmer’s animal magnetism dismissed it as ‘imagination’. The Lancet was initially a fan of John Elliotson’s early research into animal magnetism in the mid-19th century, but then rapidly and publicly dismissed it as mere ‘suggestion’. But can suggestion still be very healing? Part of the problem is there is still argument over what hypnosis actually is and what it does. On one side are those who argue it induces a hypnotic ‘state’ in the brain – a trance or altered state. On the other side are those who argue it is simply role-play, people going along with suggestions, particularly if given by a high-status figure. It’s probably both. In support of the ‘state’ theory, neuroscientist David Spiegel has found that brain scans of people hypnotized to see black and white as colour show the colour-processing parts of their brain are activated – if this is just ‘make-believe’, then it’s make-believe at a neurological level.

Marchant highlights the research into the healing power of hypnotherapy visualization for sufferers of Irritable Bowel Syndrome, which helps 70-80% of IBS sufferers, according to the research of Peter Whorwell. Visualizing and imagining apparently affects our physiology – a study by Karen Olness found that children who imagined heat going to their hands really did heat up their hands. I find that fascinating, considering the importance of ‘warm healing hands’ in charismatic Christianity and alternative medicine. It also reminds me of how people using Tibetan Tummo meditation manage to heat up their body, and even endure ice baths for long periods, by visualizing a candle burning in their chest.

Chapter Six takes this idea of the healing power of visualization into the realm of virtual reality, by exploring a VR programme called Snow World, which has been found to help burn victims to cope with pain, apparently by distracting them with an interesting immersive world. VR can also be used to manipulate people’s body awareness, mitigating the symptoms of phantom limb syndrome, and even inducing out-of-body experiences. Below is a video on Snow World:

Chaper Seven deepens the analysis into the importance of caring relationships in healing, showing how mothers giving birth who have the same care-giver helping them throughout the birthing process tend to have less complications and easier births – an important finding when one third of women feel traumatized by birth. Marchant also looks at the use of Comfort Talk by medical practitioners. She takes up the importance of caring relationships in Chapter Ten as well, highlighting the Tecumseh research project, which explored the importance of social connections to the immune system.

Chapter Eight looks at how stress is bad for our immune systems and even ages us, and how growing up in poor, rough neighbourhoods affects our bodies. Stress is apparently connected to our imaginations too – we remember past adverse events and expect them in the future, so our bodies are stuck in defense mode. Chapter Nine looks at how we can counteract this with mindfulness, bringing our mind back to the present moment rather than worrying about the past and future. Marchant also discusses the Relaxation Response, first highlighted by Herbert Benson, who looked at how chanting a mantra (or any word, it doesn’t have to be Hindu) helps kick in the parasympathetic nervous system response, enabling our bodies to relax and heal.

In Chapter Eleven, Marchant looks at the role of the vagus nerve as an important transmitter between our mind and body, particularly through Heart-Rate Variability (HRV). Those with higher HRVs are apparently better able to adapt and respond to adverse events. We can modulate the HRV through techniques like meditation, and train our response through biofeedback mechanisms – in one app, for example, as your HRV goes up, you see on an image change and the sun rise over a tree! That kind of live feedback makes training much easier. Marchant also looks at the ground-breaking research of Kevin Tracey into Vagal Nerve Stimulation, using implanted electric nerve stimulators which are controlled via iPad. It’s been found to be helpful in treating arthitis, MS, depression and other disorders. Is electric healing the future? One more device to charge!

The faithful at Lourdes

Finally, Chapter Twelve brings these various strands together to look at the role of ritual, care, belief and faith in healing at Lourdes. Marchant visits Lourdes and takes part in the healing ceremonies. Despite her atheism and skepticism, she is struck by the physical power of the ritual, and the deep caring connections that visitors feel. ‘Quite unexpectedly, I feel a powerful sense of connectedness, as if I’m at the centre of something much, much bigger’, she writes. Exeter’s Paul Dieppe, another key researcher in this field, has also studied the Lourdes effect – I interview him here.

But do visitors to Lourdes experience ‘miracles’? Maybe, maybe not, but it certainly unlocks many of the healing responses Marchant’s explored throughout the book. She also highlights the healing power of spiritual beliefs in HIV patients – a 2006 study of HIV patients found 50% throught their religion / spirituality was helping them live longer. Another study found that 45% of HIV patients became more religious after their diagnosis, and those who did ‘lost CD4 cells much more slowly’ over the four years of the study than those who didn’t. Religious belief isn’t always healing – those who believe in an angry or judgemental God are more stressed and heal less well.

Marchant concludes by noting the scientific community’s ‘ingrained resistance’ to much of the research she has explored, how difficult it is for the researchers to get funding, how the NHS website still says ‘there is no strong evidence’ for hypnotherapy’s effectiveness for IBS, when there actually is. She puts this down to the success of the materialist paradigm in giving rise to modern medicine, in which the physical is taken as real and measurable, while the mental / emotional / subjective is seen as slippery, hard to measure, and best ignored. As a result, we put much more faith and funding into surgical or chemical interventions than mental ones, despite the huge cost of drugs which may work mainly through the placebo effect, and despite the sad fact that half a million people die each year in the western world accidentally through psychiatric drugs. We have replaced spiritual healing with chemical healing, even though the latter is still, to some extent, a faith-system.

We need to go beyond the mind / body split and find new terms, like ‘psyche’, or mind-body continuum, or even the dreaded ‘holistic medicine’, particularly in the treatment of chronic conditions like IBS, CFS, MS, and depression. It reminds me of meeting Professor Qasim Aziz, head of QMUL’s gastroenterology unit and an expert on IBS, last month. He told me that, although it is now official NHS policy to combine mental and physical care within hospitals, in reality this isn’t yet the case at all, and many IBS sufferers are passed from department to department without proper treatment, until around 40% contemplate suicide, and some go through with it. I hope this changes, and we can reincoporate the mind into medical care. This excellent book is a hopeful step towards that change, and essential reading for those interested in the medical humanities and the fascinating interplay between belief, meaning, imagination, emotion, ritual, relationships, and our material bodies.

Egypt, Laughter, and the History of Emotions

Posted on March 7, 2016 by Jules Evans

This is a guest post by Anny Gaul, graduate student in Arabic literature at Georgetown University

Five years ago, Egyptian president Hosni Mubarak resigned after facing 18 days of mass popular protest. In following years, a succession of regime changes, elections, more protests, and fierce crackdowns unfolded. These events can hardly be narrated without evoking emotions––ranging from joy and hope to fear and pain. But one of the most striking aspects of the Arab uprisings in Egypt is laughter: alongside the generals, revolutionaries, presidents, and martyrs of the Egyptian revolution of 2011, one of its most prominent faces was that of a comedian.

Albernameg Sketch.jpg

Among the many medical professionals who came to the aid of the protestors in Cairo’s Tahrir Square was Bassem Youssef, a cardiac surgeon who soon rocketed to national fame––not for his medical skills, but for his comic timing. Shortly after the uprisings started, Youssef began broadcasting a satirical news show on YouTube loosely modeled on Jon Stewart’s The Daily Show. It was soon picked up by a major Egyptian television network and became one of the singular cultural phenomena of post-revolution Egypt, narrating and poking fun at its many twists and turns. The show, Bernameg Albernameg (whose glibly redundant title translates to something like “The Show Show”), pushed the envelope not only by lampooning political figures but by performing edgy humor and sexual innuendo in the process. While never technically censored by the state, the show was nevertheless forced to switch networks multiple times, and Youssef announced he was ending production for good in June 2014. Youssef began a fellowship at Harvard soon thereafter, and he will soon host a new digital comedy series from the United States. Here he is on the Daily Show:

What is interesting for the historian, and particularly for the historian of emotions, is that while aspects of Albernameg are unprecedented, the importance of humor to politics is not a new story in Egyptian revolutionary history. Many of the nationalist and literary periodicals that flourished amidst the political and cultural revivals surrounding the country’s 1882 revolt and its 1919 revolution also described themselves as humorous publications. And it’s a well-worn stereotype across the Arab world (and, I should point out, among the people who study it) that Egyptians are just funny people. This is likely attributable in part to the fact that Egypt has long been the Arab world’s cinema powerhouse, producing countless comedy films familiar throughout the Arabic-speaking world; but Egypt also has a long and storied tradition of political cartooning, puppetry, and satire.

I wish to focus a critical eye on the perception of Egyptians as inherently funny, and argue that a particular reading of humor and laughter in the context of Bassem Youssef’s show and the 2011 revolution can offer a rereading of how humor functions in Egyptian history and society in a broader sense.

*****

Often, the story of Albernameg is told as a narrative of resistance––satirists speaking truth to power in a revolutionary context and providing some much-needed laughs along the way. This is certainly one valid telling of the story: the pushback that Youssef and his team faced was nothing to sniff at, ranging from lawsuits to protests to harsh criticism in the media and resistance from the networks. At one point a citizen-instigated lawsuit was brought against Youssef for insulting both the president and Islam (after being detained and interrogated, he was released and let off with a fine).

As a foreigner living in Egypt in 2013 and 2014, I found Albernameg essential to my understanding of what was going on around me. But the more I began to grasp what role the program was playing in Egypt, the less satisfied I was with the narrative of satire as resistance. To begin with, Youssef’s position in Egyptian society, his material, and his reception were far more complex than a power-resistance dialectic might suggest. But my misgivings also stemmed from the fact that this narrative fit so neatly into the widespread notion that Egyptians are funny.

I certainly don’t contest the well-documented tradition of Egyptian humor, nor do I intend to write off its practice as ineffective or misappraised. But I do want to delve into why, and how, this ongoing historical and cultural tradition can so easily slide into a static, reductive stereotype of Egyptians as genetically programmed to resort to jokes as a safety valve in reaction to the (equally reductive) notion that their leaders have always been, by nature, oppressive. Besides being ahistorical and totalizing, such a conception is less than useful for describing how what humor and laughter are actually doing in a revolutionary (or counterrevolutionary) context. The more I thought about it, the more it seemed the notion of Egyptian humor as a safety valve was deployed as a form of “othering,” not unlike the misconception that Arabs are autocratic by nature. It did little to humanize Egyptians and their cultural production or to explain what had changed since the 2011 uprisings. In short, describing Egyptian political humor in terms of either resistance or as a safety-valve produced inadequate explanations of Albernameg as a historical and political phenomenon.

Moving past a hydraulic model of humor

The history of emotions offers useful insights for rereading contemporary Egyptian satire. The notion of the safety-valve corresponds neatly to what Barbara Rosenwein (following Robert Solomon) has termed a “hydraulic” model of emotion.[1] Such a framework assumes that emotions are reflexive and inherently “unreasoning,” leaving little room for individual agency and assuming a division between embodied emotions and cognitive reason. It is by thinking critically about emotion that historians of emotion have come up with conceptual tools that work against this divide.

William Reddy’s emotive is one concept that opens up possibilities for thinking through what Egyptian humor might be enabling alongside or beyond the straightforward categories of resistance and domination. Because emotives involve not only social codes but linguistic and sensory ones, they produce meaning in a way that must be understood in terms of their “self-altering” effects; that is to say, emotives “do something to the world.”[2] Thinking about laughter and humor according to a model of emotives thus accommodates––even requires––consideration of how a joke is working not only in terms of the discursive logic and choices of the satirist, but also in terms of the physical, sensory, and emotional experiences it triggers or registers in those who consume the material.

This point is particularly relatable when thinking about humor: early on, the creators of Albernameg convinced their TV network to cover the considerable expense of filming the show in front of a studio audience, in part because laughter is the true test of whether a joke is working. But getting a laugh is not merely an indication that a joke was well-written and executed: it’s a way to move your audience, literally and figuratively. The transformations it provokes may be fleeting or ephemeral, but they create a realm of political possibility––something that was very much on the forefront of everyone’s minds in Egypt in the years following a revolution that removed a dictator with the movement of people in mass protest.

Emotion, embodied: revisiting data

With emotives in mind, I went back to notes that I’d jotted down while watching an episode of Albernameg in a local sidewalk ahwa, or café, in the spring of 2014. Such cafés nearly always feature large televisions, which usually broadcast football games or Arab pop music videos.[3] Watching the program surrounded by a group of young local men offered a glimpse into the complex dynamics of the show’s reception.

The level of noise and attentiveness in the café varied widely during the show’s different segments: it was always obvious how well the jokes were working because if they weren’t, they could barely be heard over the din of conversation. Once a segment got a laugh or two, however, the room fell progressively quieter. This offers a small example of how emotives––in this case, laughter––might structure social and political reality: until Youssef’s speech triggered enough laughter, his message couldn’t get through because people literally couldn’t hear it. Laughter may have been a way for the audience to let out steam at the end of a long week, true, but in the context of an hour-long satirical news show it was also a signal to listen, a call to sustained attention.

Two of the show’s primary segments provided an intriguing comparison: first was a comedy sketch based almost entirely on bodily humor. A commentary on natural gas as a form of energy, it featured wearable machine designed to capture human farts (“natural gas”) for the benefit of the nation (which was experiencing frequent power cuts and blackouts at the time, prompting debates in the Egyptian media on questions of using and importing coal). Laughter in the café during this sketch could only be called contagious. Guys actually stood up and high-fived one another after a joke they particularly liked––a physical acknowledgement and extension of a shared emotional experience.

Next was an interview with an environmental activist from Egyptians Against Coal––a segment that was in ways, similar (or at least related) in content to the flatulence sketch, but completely different in form and tone. In what was essentially a twelve-minute policy discussion, only a handful of jokes were cracked before Youssef unambiguously took the same (anti-coal) political stance as his guest. In the café, there were no more guffaws or high-fives, but the audience sat quietly, at rapt attention, for the entire segment. I have no way of knowing whether these men had an opinion about coal before the segment began, or whether the show changed their mind. But I know that political discussions of this sort were not typically shown, let alone listened to, in our ahwa except in this specific situation.

Thinking about humor in this way––in terms of emotives and emotional experience––points to how we might begin to understand laughter and humor as a political practice without glossing it as a mechanical reflex or confining it to the realm of resistance. I’ve described just one group of Egyptians on one night, but stories abound of families who were divided by politics but watched Albernameg together anyway, or of men who disagreed with Youssef’s politics but would watch the show and use it as an entry point into political conversations. Tracking how laughter as an emotive is embodied in experience and observing the changes it effects raises all kinds of new questions. What does it mean to laugh at a joke you disapprove of, or to chastise someone else for their laughter? What does it mean to consume satire and not laugh? What does laughter structure, and what experiences does it enable? When we think of laughter “bringing people together,” which people are we talking about, and in which ways are they “together”?

These questions are essential to moving beyond an understanding of humor as simply a safety-valve for a repressed or oppressed society––and consequently, returning emotive responses like laughter (and for that matter, outrage and grief) to the realm of what is cognitively consequential and significant. At they same time they help track the potential and limits of the political possibilities that humor enables.

It is at the moment of laughter, an embodied emotional experience, that the political potential of satirical material may begin to materialize. Lisa Wedeen, who has written about comedy and ideology in contemporary Syria, elucidates humor’s bearing on power. While acknowledging that humor might both reinforce the “conditions of oppression” it depicts and “operate as safety valves, providing both citizens and officials relief,” Wedeen argues that it also works to “dramatize what we already know but may not be recognizing, thereby inviting us to detach from aspects of ordinary life that no longer do affirming work for us.”[4] In other words, the experience of laughter can move us just enough to be open to a new possibility.

Wedeen also emphasizes that humor’s capacity for political change is contingent: just because it might summon a new community or political consciousness into being does not mean that it inevitably does––that is to say, it is possible to recognize the space that laughter might create for political change or resistance without qualifying laughter or humor necessarily in terms of direct opposition or resistance itself. An emotive-influenced understanding of humor thus preserves the possibilities of historical contingency, a particularly important issue in writing histories of Middle Eastern societies from the perspective of the Western academy. Emotives can help us avoid both reducing laughter to an unthinking reflex and equating political humor with resistance, expanding our notion of what counts as political practice and its possibilities––however contingent they may be.

[1] Jan Plamper, “The History of Emotions: An Interview with William Reddy, Barbara Rosenwein, and Peter Stearns,” History & Theory 49 (2010): 237-265. [p.251]

[2] William Reddy, The Navigation of Feeling: A Framework for the History of Emotions (Cambridge, UK: Cambridge University Press, 2001).

[3] The motivation behind this approach to understanding Albernameg was inspired by the work of Dwight Reynolds, who has studied Arabic folk epics through a performance studies approach, and Lila Abu-Lughod, who conducted a media ethnography examining reception of Egypt’s popular soap operas, Dramas of Nationhood: The Politics of Television in Egypt (Chicago: University of Chicago Press, 2004).

[4] Lisa Wedeen, “Ideology and Humor in Dark Times: Notes from Syria,” Critical Inquiry 6 (2013): 863-5 [865]

Reading Emotions Book Group: Charlotte Dacre’s Zofloya, or The Moor (1806)

Posted on February 29, 2016 by Helen Stark

Dr Sally Holloway and Jane Mackelworth report on the third meeting of their community book group, exploring love and its history through literature…

The third meeting of our book group focused on one of the lesser-known Gothic writers of the early nineteenth century, Charlotte Dacre (c. 1772-1825), and her second novel Zofloya, or The Moor (1806). Born Charlotte King, Dacre was the daughter of the moneylender John ‘Jew’ King (c. 1753-1824), who famously engaged in an adulterous affair with the actress Mary Robinson in 1773. Dacre’s writing career began with the publication of several poems in the Morning Post, before she moved on to write four novels, of which the other three were: Confessions of the Nun of St. Omer (1805), The Libertine (1807) and The Passions (1811).

Until recent years, Zofloya, and Dacre’s work more generally, has been relatively unknown both in scholarship, and also by the reading public. None of our members had previously heard of the novel or its author. Kim Michasiw argues that this lack of awareness is in part because the book’s heroine is ‘a mother-hating triple murderess who dreams of sexual congress with a demon of colour.’[1] Yet this contrasts with Dacre’s relative success at the time.[2]

Zofloya is a novel in the gothic tradition, begun by Horace Walpole’s Castle of Otranto (1764), and developed by Matthew Lewis’ The Monk (1796), and Ann Radcliffe’s The Mysteries of Udolpho (1794) and The Italian (1797), among others. Dacre was clearly influenced by Lewis, whose visceral and shocking style was designed to invoke horror and disgust.[3] One of her pseudonyms was Rosa Matilda, which is directly taken from the name of the demon lover in The Monk, known alternately as Rosita or Matilda. Scholars have argued that Dacre deliberately placed her novel in this male tradition of ‘pornographic and sensationalist literature’, seeking to trump The Monk for ‘salaciousness and horror.’[4] Yet Dacre’s work was also unique in its portrayal of gender and race, and explicit exploration of women’s sexual desire and subjectivity. This was unprecedented in both gothic literature, and wider literature of the time. These themes were discussed at length by our group.

The novel (spoiler alert!) tells the story of the Loredani family, primarily the daughter Victoria. We follow Victoria as she leaves home and marries Count Berenza, who she quickly becomes unhappy with, largely because he is unable to satisfy her sexually. She then falls in love with his brother Henrique and sets out to make Henrique return her love, with the help of Zofloya, a Moor, who is Berenza’s servant. Aided by Zofloya, Victoria poisons her husband, then takes Henrique’s fiancée Lilla to the mountains and holds her captive. Victoria then gives a love potion to Henrique and consummates her relationship with him. Shortly after this he commits suicide, and Victoria kills Lilla before partnering up with Zofloya in some nearby caves. At the end, readers learn that Zofloya is the Devil, who sends Victoria to her death in the mountains.

Our members found Victoria a fascinating anti-heroine, an observation also made in scholarship, with Emma Clery referring to her as ‘a remarkable creation’ with ‘no concessions … made to the stereotype of the sentimental heroine.’[5] We particularly revelled in her juxtaposition against Lilla, who most of the group found to be a deliberately dull character, representing a passive and helpless feminine stereotype, much more typical of women throughout Gothic novels, who find themselves in need of rescue. Diane Long Hoeveler has described Lilla as emblematic of the new feminine type emerging at the start of the nineteenth century, a gender ideal which became strengthened during the nineteenth century and featured in later Romantic poetry.[6] Victoria is a refreshing contrast, able to escape brief imprisonment through her own resources, and later capturing, imprisoning and killing Lilla. Victoria’s emotional state is marked by pride, envy, hatred and revenge, compared to the usual emotions felt by gothic heroines, such as love, fear, joy and grief.[7] The group relished the way that Victoria was a transgressive, even evil, character, finding her wickedness refreshing.

We admired Victoria because she followed her own desires, particularly in her pursuit of men.[8] The novel therefore represented women’s sexual subjectivity in a new way, with Clery suggesting that ‘Victoria’s passions are unlike anything else in the women’s Gothic writing of the period.’[9] It is also interesting to consider the impact on readers at the time. Mellor argues that the text would have ‘enabled Dacre’s readers to explore a far wider range of sexual options…than did the other writing of her day.’[10] The group also debated what Dacre’s overarching message, or moral framework, might be concerning women seeking autonomy, particularly sexual autonomy. Victoria ultimately meets her end through following her desires, and this in itself is seen as being the fault of her mother previously doing the same. The novel opens with Victoria’s mother being seduced and deserting her family. It is the mother’s pursuit of her own desires and the impact on her family honour, which is clearly indicated in the novel as the cause of Victoria’s downfall, and that of her brother who falls in with a gang of bandits. On the whole, the group concluded that Dacre was giving a negative impression of women who indulged their lust. Our debate concerning Dacre’s overarching message mirrors that in the wider historiography. For example, Nayar argues that the novel suggests that a woman pursuing her own sexual agency threatens English domesticity, the family and ultimately the boundaries of England.[11] Pramrod Nayar suggests that Dacre is therefore ambivalent about the issue of women’s agency and that it is unclear where her loyalties lay.[12] However, Clery suggests that Dacre was simply doing ‘cursory moralizing’ noting that she went on to create several other female monsters in her work.[13] And so it is possible that the inclusion of an overarching Christian message allowed her to get away with the themes that she portrays in the novel.

Our readers were intrigued by Dacre’s controversial portrayal of a white woman desiring a black man. Victoria’s partnership, and particularly her longing and desire for Zofloya, a black man, was an unusual and unprecedented representation in literature at this time. Anne Mellor has described this as perhaps ‘the most taboo of all human sexual desires in Romantic-era England.’[14] The novel was published the year before the slave trade (not slavery itself) was abolished by parliament. Dacre’s choice of pairing between Victoria and Zofloya can therefore be seen as a bold move, which challenged wider social norms.[15] Discussions around the abolition of slavery had opened up the possibility of interracial relationships, yet where these had been represented in literature beforehand this was almost exclusively through the eyes of the male and his desire; whether the white man desiring the black woman or the black man desiring the white woman.[16]

Illustration from the pirated chapbook of Zofloya, The Dæmon of Venice (1810)

We discussed Dacre’s motivations for this and where her political sensibilities may have lain, although were unable to reach consensus. Scholars have also debated this point. Long Hoeveler highlights the ‘racist’ and ‘xenophobic’ themes of the novel, arguing that it should be seen as part of a wider Colonial project.[17] For example, the novel can be read as highlighting the perceived threat to England from outsiders through the devastation caused by Zofloya. However, as Nayar asserts, the real threat to English domesticity in the novel comes not from Zofloya but from both Victoria, and her mother, because they followed their own desires. And Nayar is keen to highlight that Victoria is not merely seduced by the Moor, rather she is following her own ‘quest for sexual agency.’[18]

The black character’s representation of the Devil also seems to highlight the racist context in which the novel was written, with Dacre once more tapping into wider concerns that Englishness was being lost or threatened by outsiders. However, the use of the demon lover was a wider trope in literature at this time and can be understood in this light. For example, this was also employed by Lewis in The Monk. However, Dacre reimagines the trope of the demon lover by making him a man that is actively desired by a woman.[19]

The group also discussed the role of the Devil in the novel. We debated whether Victoria could be considered evil, or whether she was merely enticed to evil by the Devil. The group was divided on this issue. Some felt that Victoria was already set on a destructive course before the involvement of the Devil. Others felt that she was manipulated by Zofloya to commit evil acts. To this extent, the novel ties into wider cultural debates in the late-Enlightenment which focused on the nature of free choice or free will.

On the whole, the group enjoyed the novel and found it an interesting and entertaining read. A few members said that they found it to be something of a page-turner. A related free exhibition ‘Black Georgians: The Shock of the Familiar’ has opened at the Black Cultural Archives in Brixton and runs until April 2016: http://bcaheritage.org.uk/programme/exhibitions/black-georgians-the-shock-of-the-familiar/

Follow Sally Holloway on Twitter: @sally_holloway

Follow Jane Mackelworth on Twitter: @jane__victoria

[1] Kim Ian Michasiw, ‘Introduction’ (1997) in Charlotte Dacre, Zofloya, or The Moor, (Oxford: Oxford University Press), (1997), (2000), 2008, p. x.

[2] Michasiw, ‘Introduction’, p. xiii.

[3] Michasiw, Introduction, pp. xiv-xv.

[4] Adriana Craciun, Fatal Women of Romanticism, (Cambridge: Cambridge University Press, 2003), p. 111; E.J. Clery, Women’s Gothic from Clara Reeve to Mary Shelley, (Devon: Northcote House), (2000) 2004, p. 107;.

[5] Clery, Women’s Gothic, pp. 108; 111.

[6] Diane Long Hoeveler, ‘Charlotte Dacre’s Zofloya: A Case Study in Miscegenation as Sexual and Racial Nausea.’, European Romantic Review, Volume 8, No.2, Spring 1997, pp.185-199, p.188.

[7] Clery, Women’s Gothic, p. 111.

[8] On the importance of desire in Dacre’s work see Clery, Women’s Gothic, James A. Dunn, ‘Charlotte Dacre and the Feminization of Violence.’, Nineteenth-Century Literature, Volume 53, No.3, December 1998, pp.307-327; Anne Mellor, ‘Interracial Sexual Desire in Charlotte Dacre’s Zofloya’, European Romantic Review, Vol. 13, No.2, June 2002, pp.169-173 and Pramod K. Nayar ‘The interracial Sublime: Gender and Race in Charlotte Dacre’s Zofloya. Multidisciplinary Journal of Gender Studies, 2 (3), 2013, 233-254.

[9] Clery, Women’s Gothic, p.110.

[10] Anne Mellor, ‘Interracial Sexual Desire in Charlotte Dacre’s Zofloya’, European Romantic Review, Vol. 13, No.2, June 2002, pp.169-173, p.173.

[11] Nayar, ‘The Interracial Sublime’, p.250.

[12] Nayar, ‘The Interracial Sublime’, pp.250-1.

[13] Clery, 116.

[14] Mellor, ‘Interracial Sexual Desire’, p. 169.

[15] Michasiw, ‘Introduction, Xxiv

[16] Mellor, ‘Interracial Sexual Desire,’ pp. 169-170.

[17] Long Hoeveler, ‘Charlotte Dacre’s Zofloya’ p. 189.

[18] Nayar, ‘The Interracial Sublime’, p.249-50.

[19] Adriana Craciun, ‘”I hasten to be disembodied”: Charlotte Dacre, the Demon Lover, and Representations of the Body, Volume 6, No.1, Summer 1995, pp. 75-97, p.75.

Why Science Needs “Passion”

Posted on February 26, 2016 by Helen Stark

Louis C. Charland is Professor in the Department of Philosophy, the Department of Psychiatry, the School of Health Studies, as well as member of the Rotman Institute of Philosophy, at the University of Western Ontario in London, Ontario, Canada. Professor Charland has published widely on the history and philosophy of psychiatry and the theoretical foundations of the affective sciences. Professor Charland is currently International Partner Investigator with the Australian Research Council Centre of Excellence on the History of Emotion in Perth, Australia, and affiliated research scholar with the Centre for History of the Emotions, at Queen Mary University of London. Dr. Charland is also author and co-author of several public policy reports concerned with research ethics, mental health, and program evaluation.

This post originally appeared on the blog of the Australian Research Council Centre of Excellence for the History of Emotions (Europe 1100-1800). You can read the original posting here.

In this blog post, I briefly share some results of research undertaken in my role as Partner Investigator with the Australian Research Council Centre of Excellence for the History of Emotions, based at The University of Western Australia in Perth, Australia. In honor of National Science Week in Australia, I argue that science needs “passion” and that for this we must turn to the history of emotions.

The term and concept “passion” no longer figures in contemporary scientific efforts to understand emotion or other related phenomena in the affective domain. “Emotion” now is the keyword and paradigm theoretical posit of the affective sciences, although “feeling,” “mood,” and “affect” also play a significant role. The verdict appears to be that “passion” is now a matter of historical interest only, and can otherwise be ignored, although admittedly, the term is sometimes still employed in everyday discourse and some academic research, to refer to very intense and powerful emotional states. Note that even the history of “passion” now falls under the rubric of “emotion.” For example, this blog entry is meant to be a contribution to the dissemination efforts of the Australian Research Council Centre for Excellence for the History of Emotions. Again, the keyword here is “emotion,” even though the topic is “passion.”

In general, situating the historical study of “passion” under the general rubric of “emotion” does not pose major problems. In many cases, older usages of the term “passion” can, with appropriate provisions, even be rendered using the term “emotion,” a common practice. However, there is at least one particular context where this practice proves to be misleading. This is the case where both the terms “passion” and “emotion” and their associated concepts are intended as distinct, but mutually complementary, posits in an overall theory of the affective domain. There are in fact several pivotal milestones in the history of affective terms and concepts where this occurs. In such cases, rendering the term “passion” as “emotion” is misleading. The reason is that it obscures an important lexical and conceptual distinction in the original texts under study. Yet, there are cases where “passion” has been uncritically rendered as “emotion” in the study of such texts. As a result, the importance of the distinction is lost on readers, especially when the original texts are not present or easily available. This makes it appear as if we can dispense with “passion” in the translation and interpretation of such texts – as if “emotion” can do all the work that “passion” used to do. But this is not so.

The primary thesis of this short essay is that this relegation of “passion” to the proverbial ‘dustbin’ of history represents an important loss, not only for the history of “emotion,” but also for contemporary science; in particular, scientific efforts to explain the nature of “emotion” and other related phenomena in the affective domain. In particular, this omission leaves us without adequate conceptual resources to properly describe and explain the nature and organization of long term affective states and processes. We must therefore reinstate “passion” into science. No doubt, this is a call for reform on a grand scale. It is also a telling lesson on the importance of historical studies for present day science, philosophy, and even public life and our common sense understanding of “emotion”.

All of this, of course, requires stipulating an appropriate sense of “passion,” which admittedly is a term with a long and variegated history of conceptual change. As we shall see, though it is certainly complex, the history of “passion” and its relation to “emotion” is still vibrant and full of promise for those who wish to study it. This is no ‘dustbin.’ On the contrary, it is an historical domain with important lessons for how we should understand the function and limitations of our current term “emotion.”

In the sense intended here, “passions” are complex long term affective states and processes that differ from “emotions,” which are affective states and processes of shorter duration and lesser complexity. Moreover, properly understood, passions often serve to organize emotions and so must therefore be carefully distinguished from these. So, for example, think of jealousy over time, perhaps months or years. The jealous individual in the throes of such a passion will respond with very specific emotions – suspicion, anger, rage, and revenge, or maybe forgiveness – during the course of that passion. They will also experience very specific associated feelings – despair, resentment, and maybe, we hope, eventually relief. Eliminate the passion, and you eliminate the specific, rule-governed, course of emotional dispositions and responses that typically accompany and issue from that passion. In contrast, an individual who is not in the throes of such a passion will not respond, or be disposed to respond, in the same way as the person who is.

Cover of 'From Passions to Emotions' by Thomas Dixon. — Cover of ‘From Passions to Emotions’ by Thomas Dixon.

Now for some history. Before we go any further, it is important to be reminded of the fact – and it is an historical fact – that the term “emotion” is a relatively recent arrival on the contemporary philosophical and scientific stage. Prior to the arrival of “emotion,” “passion” and its various lexical cognates in various languages was the primary term of art in matters that concerned the affective domain. Since its emergence, both the denotation and connotations of the term “emotion” have changed dramatically, although the term itself, as a lexical item, has remained mostly the same. In the 16^th and 17^th centuries, it was common to refer to ‘emotions of the pulse’, or ‘emotions of the clouds’, a physical usage that has changed as the term has acquired more psychological connotations. Historian Thomas Dixon gives a wonderful, very comprehensive account of these developments from “passion” to “emotion” in his classic work, ‘From Passion to Emotion: The Creation of a Secular Category’. The bulk of Dixon’s discussion focusses on this transition in English texts, but it also occurs – to some degree, sometimes rather differently – in French, Spanish, Italian, and German texts of the same period.

A key figure whose influence is notable across much of this history is the French philosopher-scientist, Rene Descartes (1596-1650). He argued that it would be better (mieux) for science if we started referring to ‘emotions’ of the soul, rather than ‘passions’ of the soul.

Yet, at the same time, in keeping with tradition, Descartes decided to title his 1649 book on the topic ‘The Passions of the Soul’ (Les Passions de L’ame).

Descartes wrote in French, which like Spanish and Italian, has easily recognizable lexical equivalents for the English words “passion” and “emotion.” His suggestion that it would ultimately be better for us to speak of “emotion” rather than “passion” in scientific efforts to understand the affective domain, is tantamount to a conceptual revolution. He introduced a new, emerging, psychological meaning of the term “emotion” to the scientific world, setting in motion a larger transition in which “emotion” eventually came to replace “passion” as the keyword of the affective sciences. In doing so, he also refocused the scientific study of affective states and processes on episodes of relatively short duration, in keeping with the methodological orientation of current inquiries into the heart and nervous system. It was hard to find a place for affective states and processes of long duration in this new explanatory paradigm that focussed on direct observation and measurement in the here and now. That had been an important characteristic of the older passions, from which a person could suffer chronically for months, or even years. The new emotions were more sudden, transient, motions of the soul, now ‘active’ determinants of action and behavior that moved individuals to act. This made them quite different from the more ‘passive’ passions of the soul of ancient times, which the soul was said to suffer (Gr. pathé).

Front page of of 'Della Pazzia' by Vincenzo Chiarugi. — Front page of of ‘Della Pazzia’ by Vincenzo Chiarugi.

Another, later, medical writer who also used both the terms “passion” and “emotion” is the Florentine medical doctor, Vincenzo Chiarugi (1759-1829). His views on “passion” and “emotion” are contained in his 1793-5 classic work on insanity, Della Pazzia. He referred to these concepts in his native Italian, as “passioni” and “emozioni.”

Crucially, unlike Descartes, who argued that ultimately it would be better (mieux) to use the term “émotion” instead of “passion,” Chiarugi forcefully demonstrated that we must retain and use both terms, because they serve different purposes.

Chiarugi therefore apparently disagrees with Descartes on the relationship between “passion” and “emotion.” While the French scientist suggests that we can replace “passion” with “emotion,” the Italian doctor asserts that we need both, which means that we cannot replace the former with the latter, as Descartes had suggested.

Chiarugi’s work constitutes an important example of our thesis that “passion” and “emotion” are distinct, but mutually complementary, theoretical terms and concepts in the affective sciences. Other, different versions of the distinction, and the reasons for making it, can be found in the work of medical writers like Philippe Pinel (1745-1826), Sir Alexander Crichton (1763-1856), Jean-Étienne Dominique Esquirol (1772-1840), as well as the philosopher Immanuel Kant (1724-1804). What is curious about all this is that, although they are all major figure in their respective fields, this aspect of these major thinkers’ work has been almost entirely overlooked, not only in the history of affective terms and concepts, but also the history of “emotion” more generally. Likewise, there appears to be little or no appreciation of the importance of the distinction between “passion” and “emotion” for science, or indeed the ‘philosophy of emotion’, today.

How did this happen? The answer is too long for this blog and constitutes a major research project of its own. Suffice it to say that, in the end, Descartes’ strategy proved to be the more compelling, and numerous philosophers and scientists across Europe began to adopt the term “emotion” as their primary theoretical term of art in their studies of what used to be called the “passions.” Interest in long term affective states and processes diminished as the study of short term affective states and processes increased. The development of new experimental methods and paradigms in the sciences probably played a major role in this change. In any case, by the 19^th century, “emotion” was firmly in place and “passion” had largely disappeared from the theoretical vocabulary of science and philosophy.

As indicated above, there are some famous exceptions to this trend which takes us from “passions” to “emotions.” Together those exceptions form part of a distinct development, namely, the history of “passion” and “emotion,” which must be contrasted with the wider and far more influential history from “passion” to “emotion,” which is the received view. The key figure in this alternate history where “emotion” does not displace or eradicate “passion,” but both coexist together alongside each other, is somebody we have not mentioned yet. It is the French pioneer of experimental psychology, the philosopher Théodule-Armand Ribot (1839-1916).

Théodule-Armand Ribot. Image Courtesy of Wikimedia Commons.

Ribot’s overall position with respect to these issues is set out in his 1907 ‘Essay on the Passions’ (Essai sur les passions). There, he argues very clearly and forcefully, that we must retain – and reinstate, where necessary – the term “passion” in science and philosophy. The strongest argument that can be marshalled in defense of Ribot’s thesis is that there are theoretical tasks in philosophy and the affective sciences that can only properly be accomplished with “passion” working alongside “emotion.” Ribot’s work on this topic is, by intention, very schematic and structural, as he is primarily concerned with the general form of psychological concepts at this stage, treating the more specific psychological study of those states as a separate task that must inquire into their place in culture and history. According to him, so far as their form is concerned, passions are complex and dynamic long term affective syndromes, or tendencies (tendances), that emanate from and are centered around a fixed idea (idée fixe). It is important to stress that, for Ribot, passions are thoroughly embodied. In a psychophysical monism that is reminiscent of Spinoza, he views the mental and physical aspects of the passions as two sides of a common coin.

A key aspect of the above definition is how it straddles the distinction between psychopathology and normality. Passions may begin innocently, and when they progress and develop within healthy limits, they can fill life with meaningful activities and purpose. However, when they evolve to extremes, passions can become obsessional, or even delusional, and they begin to suck all of an individual’s activities and energy into a single, all-encompassing, downward spiral – a process Ribot likens to an avalanche. When they get to these extremes, passions can also severely limit a person’s agency and capacity to make decisions, much like an addiction. Tragically, sometimes passions reach a point of no return and the individual in question is caught in the grip of a powerful affective syndrome from which they are unable to escape. They have lost control and are now ruled by the passion – by the ‘heart’ rather than by ‘reason’. Therefore, passions can lead to mental disorder, as well as physical illness and even death, although this is not always, nor necessarily, the case since, within limits, passions can also fill life with healthy, purposeful activities and meaning.

Note that cognitive, or thinking-based, therapies are unlikely to vanquish such powerful affective syndromes once they get entrenched, although they might be of limited help in preventing or slowing them. Commonly, only new, alternate passions can reverse, block, or divert pathological passions. Bursts of shorter affective interventions that employ the elicitation of short-term feelings and emotions can also be helpful in weakening the hold of a morbid passion on an individual’s thinking and behavior. Recent empirical research on Anorexia Nervosa undertaken by the present writer in association with clinical collaborators in psychiatry, has shown that the concept of “passion” has much to offer contemporary psychiatry in this area. Likewise with the study of emotion regulation and intelligence, which are substantially ‘blind’ without the contribution of passions that often serve to direct and organize emotions. In effect, passions connect the emotional dots that are typically associated with the different passions at various stages of their development. You need the construct “passion” to properly connect the dots – scientifically, in law-like, rule-governed, ways. Finally, the distinction between “passion” and “emotion” has also proven helpful in solving several vexing interpretive problems in the exegesis of some of Shakespeare’s plays, revealing his masterly psychological insight and erudition in a manner that is more perspicuous than before.

All of this adds up to a very respectable, and indeed a very promising legacy for a concept that has until now been largely relegated to the ‘dustbin’ of history. Scientists should be reminded that it is possible to make ‘discoveries’ in history that are not only of importance to contemporary historical studies, but even to contemporary science itself. This shared mission is certainly something to celebrate during Australian National Science Week.

Most of the material from which this discussion is drawn is cited on my personal website and many of the articles themselves are accessible through Research Gate. Some of the research is unpublished and some of it is still ‘in the twinkle of my eye’. I wish to dedicate this blog to Philippa Maddern (1952-2014) whose untiring encouragement and support gave me faith and confidence in this project when I was in need of it.

Jesus Wept: On Umberto Eco and John Donne

Posted on February 25, 2016 by Thomas Dixon

Is weeping more Christ-like than laughing? Dr Lucy Allen is a medievalist working on the literature and culture of late-medieval England, and as a teaching associate of the English Faculty at the University of Cambridge. In this post, re-published with kind permission from Lucy’s ‘Jeanne de Montbaston’ blog, she explores the histories of tears and laughter, through the writings of John Donne and Umberto Eco.

East Window, King’s College Cambridge

At 5.30pm on Monday this week (22 February 2016), I was sitting in King’s College Chapel, looking up at the stained glass, which – from where I was – was mostly shades of blue, with the afternoon light behind it. We were waiting for the beginning of a service, a service for Lent, on the theme of tears. As we waited, candles were lit, and by the time the choir began to sing, the fading light outside made the stained glass darken almost to black.

I was noticing these details, because I’d got there early. I was running over the passages from a sermon by John Donne, which I was going to read. Donne’s sermon is based on the text from John’s Gospel, in which Jesus responds to the death of Lazarus by weeping. All week, I’d been enjoying getting emails from the chaplain of King’s with the faintly blasphemous-sounding subject line Jesus Wept. But Donne takes a predictably serious approach, and he makes a characteristically perceptive point that, while the Bible describes God in terms of human body parts (hands and feet, eyes and ears) as well as human emotions:

I do not remember that ever God is said to have wept. It is for man. And when God shall come to that last act in the glorifying of man, when he promises ‘to wipe all tears from his eyes’, what shall God have to do with that eye that never wept?

I enjoyed this point, and this rhetoric, but while I was enjoying it, I was also figuring out how to negotiate one of those lines you can’t read without raising an irritated feminist eyebrow. Discussing the idea of Jesus weeping, Donne comments on contemporary attitudes towards tears:

We call it a childish thing to weep, and a womanish; and perchance we mean worse in that than in the childish; for therein we mean falsehood to be mingled with weakness.

Donne glides over the idea of duplicitous feminine tears so quickly you don’t have time to explore the implications of the claim, nor what it says about the visibility of emotion and the sincerity of feeling. Donne would not be the only writer to see tears as something that should be contained, repressed, controlled, kept within the limits of the body. But Dr Thomas Dixon – who’s a historian at Queen Mary – gave the fascinating and wide-ranging address during this service, and he pointed out that Donne was writing at a time of rapidly-shifting ideas about the acceptability of emotion, a time of post-Reformation perceptions of medieval emotional display as a form of excess or insincerity. Dixon also notes that Donne is one of a very few sermon writers to discuss Christ’s tears, and I admit that this surprised me.

I was thinking back to the conversation about another kind of emotion Christ may – or may not – have displayed, which is notoriously central to the plot of Umberto Eco’s Name of the Rose. Eco died this week, and I was reading obituaries and reviews of his books.

The Name of the Rose is a classic detective story, transplanted to the early fourteenth century, and told from the perspective of a wet-behind-the-ears young monk, Adso, and his preternaturally observant, cynical, and jaded mentor, the evocatively-named William of Baskerville. Both men are visitors to a monastery in which mysterious and gruesome events are occurring, in best murder mystery tradition. But if William of Baskerville is a composite of Sherlock Holmes and of the stagey trickery that created one of his most famous cases, he’s also a skilled theologian, and early on in the novel he and Adso become dragged into what seems to be an absurdly dry argument over whether or not Christ ever laughed.

William and Adso in the Library. Still from The Name of the Rose (1986)

Looking over the comical and carnivalesque illuminations in a manuscript in the scriptorium, William is amused by scenes of abbot-monkeys and pope-foxes. Jorge of Burgos, an impeccably pious, irascible and deeply misogynistic scholar, declares that it is blasphemous to imagine that Christ – in full knowledge of human sin and sorrow – could ever have engaged in something as carnal and trivial as laughter. Amongst the thorns in his side is the charismatic dilettante and – whisper it – possibly not entirely heterosexual Berengar, the assistant librarian, who, it turns out, has been attempting to probe the hidden secrets of the monastery library. When William refers learnedly to Aristotle’s famous, lost treatise on Comedy, Jorge responds with rage, insisting that such a book could never have been written.

The Pope as a fox. London, BL MS 10 E. IV, f. 49v (detail)

Their argument is, as you’ll see, based on real theological points of view. I’ll quote from the film script, since I enjoy imaging Sean Connery’s accent as William:

Jorge: Laughter is a devilish wind which deforms the lineaments of the face, and makes men look like monkeys.

William: Monkeys do not laugh. Laughter is particular to man.

And you can watch a fuller clip here:

https://www.youtube.com/watch?v=jUUB96c6EpY

You can see that the outline of the debate is the same one that Donne presses into service in his discussion of Christ’s tears. While William (and Eco) describe laughter as particular to man, as opposed to animals, Donne describes tears as particular to man, as opposed to God. Together, they form a theory of emotion that determines the ordained place of humankind in the scheme of things. But gender doesn’t seem to come into it – at least, until I came across this old review of The Name of the Rose, written in 1983. It’s spiky praise, given grudgingly:

Filled with the good-natured polyglot banter of the superfluously learned, “The Name of the Rose” might be seen only as a effete “Canterbury Tales” except for tell-tale markings on the walls of its medieval monastic library, markings declaring that this records of those walls’ destruction is itself a labyrinth in the library’s image.

It’s that word ‘effete’ that caught my attention. It’s a rarely-used term today: our vocabulary of habitual and ingrained misogyny is fashionably up to date. I have my suspicions about what the author might have considered ‘effete’ – from Eco’s choosing a genre usually dominated by women, to the portrayals of monastic homosexuality, to his poncey in-joke academic pastiches of language – but, as I was thinking about emotion, its containment and its display, it made me reassess a crucial scene in the novel, and the understated way it plays with gendered expectations.

As William and Adso become dragged further and further into the disturbing events of the monastery, they find themselves investigating a series of gruesome murders that seem somehow to relate to the highly secret portions of the monastery’s impressive and labyrinthine library. Racing through that library with suspicions mounting in their minds, William and Adso discover the seemingly Stoical, dispassionate and authoritative Jorge, the monk who has spoken out so harshly against the idea of a laughing Christ, desperately cramming the poisoned pages of a book into his mouth in an act of destruction that will also kill him. It transpires that the fabled Aristotelian treatise on Comedy does indeed exist – hidden within the depths of the library – and that Jorge, having failed to suppress rumours of its existence, had daubed the pages in poison to trick any reader who licked his fingers as he leafed through the forbidden accounts of laughter.

William and Adso confront Jorge. Still from The Name of the Rose (1986)

This frenzied activity is, to a medieval eye, not simply bizarre and desperate. It’s also gendered. In medieval religious literature, there’s a huge and long-standing tradition of imagining readers who devour their books. But – crucially – they are women. Religious writers approvingly described how holy women, from St Cecilia to the Virgin Mary herself, devoured the words of the Bible as if chewing, eating, and enjoying the sweet taste of the book; instructional works directed to women described how a female reader should feel and imagine each word in her mouth as she shaped its syllables with her lips. The root of this image is a quintessentially feminine experience, that of pregnancy: as Mary read the words of the Bible, she became aware of the angel Gabriel, come to tell her that she was to bear the Word of God.

The Annunciation, attrib. Rogier van der Weyden, c. 1465-75 (Metropolitan Museum of Art)

So, when Eco has an elderly male monk – a fanatic, opposed to laughter and display of emotion – cram the pages of a book into his mouth, he’s participating in this tradition of gendering the internalisation and the display of emotion. The eating of the book feminises Jorge, even as he attempts to destroy the evidence of Christ displaying an emotion that later writers would see as suspiciously human, even suspiciously feminine. But Eco also participates in a process of aligning the medieval – as represented by Jorge and his ilk, and challenged by the proto-Humanist and rational William – with the crazed repression of emotion, the distorted and dishonest response to religion, that post-Reformation writers would seize upon for polemical purposes, like Donne’s.

Follow Lucy on Twitter: @LucyAllenFWR

The History of Emotions Blog

Conversations about the history of feeling from www.qmul.ac.uk/emotions