Sports, male identity, and waking up from ‘dreamland’

Posted on April 2, 2015 by Jules Evans

John-Henry Carter is the most successful captain of Oxford rugby team ever, the only captain to lead the team to three successive victories in the Varsity match. The former flanker attributes that success not to his speed or his 6ft 3 frame, but to his training in psychodynamic therapy and existentialist philosophy.

After graduating, John played professional rugby at Sale Sharks in 2004, but his brief career was plagued with injury and he had to retire in 2007, after five operations. He was physically battered, but also morally disillusioned by ‘the primitive belief that meaning and consequence transpired through a scoreline’. He hadn’t found what he was looking for in professional sports.

He went to Oxford University to do an MSt in psychodynamic psychotherapy. While there, he got drawn back into rugby, and was invited to become manager of the team in 2011, at the age of 30. He became captain as well. At that point, although Oxford were winning games, the team culture was “full of a misconceived idea of masculinity – sexism, homophobia.” He took on the challenge of leading the team because he thought he could change the culture and find that enigmatic thing he’d been looking for – spirit, being, soul.

At the same time, he worked on his PhD, about the mental struggles faced by professional rugby players when they retire. Based on in-depth interviews with six players, five of them internationals, it’s a fascinating insight into male identity and how it can find and lose itself in sports.

John uses the story of Peter Pan as an organizing myth for some of his insights in the PhD. He talks about how players live in ‘Neverland’ – a sort of dream-world of fantasy. The players he interviewed spoke of ‘living the dream’, ‘having to pinch myself’, ‘feeling high’, ‘like I’m on drugs’ when they’re playing at big matches. It sounds like ecstasy – or a sort of trance state. And in this dream-land, they will never lose, never get hurt, never got old.

They’re not just living out their own childhood dreams – they’re acting out the dreams of all the millions of spectators watching them too. The media like to say ‘the fans were in dreamland’. Well, that’s exactly right – fans use sport to enter trance-states, to regress to the fairy tale fantasies of childhood as they watch the game. The media feeds this fantasy, with language like ‘fairy tale’, ‘magic’, legend’, ‘talisman’, with every over-the-top slow-motion Wagnerian montage, and every ridiculously puffed-up publicity poster.

The spectators like to fetishize their sports’ heroes inner lives. ‘How are you feeling? This must be the best moment of your life, is it?’ The same thing happens when an actor wins an Oscar, and they go into dreamland – that ultimate valorisation of their external self. And the truth is, they might not know how they’re feeling. Winning – for all that we fetishize it as the ultimate goal in life – is more emotionally complex than we realize. Many Olympic gold-medallists, for example, speak of their ‘depression, mourning, emptiness’ after they win.

As in Hollywood, the immersion in dreamland leads to a sort of ego-splitting – on the one hand you have the external self, the persona, a fantasy-self of power, heroism and invincibility. But behind that, hidden from everyone else, is the shadow self, which is weak, afraid, hurt and confused. But that self can’t be shown, can’t even be admitted to oneself, amid a culture (John writes) ‘defined by positive thinking and positive action through omnipotent dreamlike beliefs and tag-lines such as ‘Just Do It’’.

One reason many men love sport is for the male bonding it allows – it enables them to be with each other and express love and physical intimacy, whether you’re a player or a fan. But men are often terrible at expressing that, and at being vulnerable and authentic with each other. So the vulnerability gets hidden behind a mask of machismo, sexism, homophobia, binge-drinking, ‘banter’ and the autistic exchange of sport stats and punditry. And beneath it all is a terror of losing the surrogate family of ‘the lads’, and being on your own.

How did John do it differently at Oxford? Firstly, he redefined what it meant to win. Victory was not primarily about the scoreline, he insisted. It was ‘a commitment to the potential experience of being’. He says: ‘This commitment to ‘being’ felt like a spiritual alchemy – We embarked upon a voyage to simultaneously create and discover our ‘spirit’.’ The team embraced honesty, authenticity, trust, relatedness, creativity and play – the conditions to allow this ‘spirit’ to emerge.

In practical terms, this meant being ‘player-led’ rather than led by top-down diktat. It also meant John spent a lot of time talking to the players one-on-one, and in group conversations, in which all 30 of the team would take part and learn to be open, trusting and vulnerable with each other. ‘The consequence of it was much greater than I could have ever imagined. It was a really ethereal sense of being. I got to taste that sense of being.’

Again, this may sound unlikely, but it’s exactly what I do with Saracens, where it’s incredibly refreshing to hear players express their fear of failure, or death, and to be able also to express their feelings of joy, hope and love. It’s a mature model of male identity, of male strength and courage. John says: ‘It takes more courage than anything I’ve experienced to look at the parts of yourself you don’t want to see and to let other people see your vulnerability. That’s ultimate courage.’

The Saracens philosophy club (I’m the slightly smaller one in the middle)

I imagine some of you might be groaning and thinking this is the ultimate triumph of the therapised, feminised male – but John’s leadership made the team stronger, not weaker. If you think it made them weak, watch the highlights of their routs of Cambridge.

John’s now retired from rugby, for the second time. It is not easy to retire from rugby, because you’re losing your surrogate family. He describes retired players as ‘lost boys’. Of the six players he interviewed for his PhD, all of them said they felt depressed after retiring, and a third of them felt suicidal. Team sports allow men to recreate the small tribe in which humans have existed for most of their existence. And then, at retirement, suddenly you are in the lonely atomised world of modern neoliberalism.

But, after a period of grief and mourning, John’s enjoying his new life as a psychodynamic therapist, working both with sports teams, and with schools and individuals. What I personally admire in his work is his ability to describe and live a better sort of male identity than we sometimes fall for – more complex, more open to love and to suffering. Imagine if sportsmen went from being poster-boys for infantile fantasies of invincibility, to becoming ambassadors for the messy and sometimes wonderful experience of being human.

Here’s a journal article John wrote about his work.

Jean-Martin Charcot and the pathologization of ecstasy

Posted on March 27, 2015 by Jules Evans

One of the things I want to argue in my next book is that ecstatic experiences have been pathologised in the secular west, to our detriment. People still experience ecstasy – by which I mean moments where we go beyond the self and feel connected to something bigger than us, usually a spirit but also sometimes another individual or group – but we lack the framework to make sense of such experiences. And, as Aldous Huxley said, ‘if you have these experiences, you keep your mouth shut for fear of being told to go to a psychoanalyst’ – or, in our day, a psychiatrist.

The medicalisation and pathologisation of ecstasy happened slowly over the last four centuries – it is a key shift in the emergence of secular society. Before the 17th century, if you had an ecstatic experience, you might either be canonized or demonized. Either way your experience was carefully defined and controlled by the Church, which has always been wary of unbridled ecstasy, particularly in women (see Monsignor Ronald Knox’s misogynistic Enthusiasm (1950) for a recent example – Knox writes ‘the history of enthusiasm is largely the history of female emancipation…and it is not a reassuring one’).

Then, from the 17th century on, cases of both ecstasy and possession were viewed not as spiritual encounters but as disorders of our mechanical body, the product of diseased nerves, or an over-heated brain, or ‘animal spirits’, or ‘the vapours’. In the 19th century, unstable women were increasingly diagnosed with ‘hysteria’, a disease which Egyptians suggested, back in 1900 BC, was caused by a ‘wandering womb’ (supposedly the womb could be lured back to its proper position by holding scented objects near the affected woman’s vagina).

The understanding of hysteria didn’t advance much in the 4000 years to 1856, when Charcot was made head of the Salpetriere hospital in Paris. Salpetriere was the biggest hospital for women in Europe, and a ‘grand asylum of human misery’, as Charcot put it. He and his team carried out ground-breaking research into several neurological conditions – Parkinson’s, Tourette’s, Multiple Sclerosis, Lou Gehrig’s syndrome – but it was his work on hysteria that made Charcot globally famous.

Hysteria was a notoriously loose and imprecise diagnosis, so Charcot attempted to classify it, and discover the physical cause of it. He insisted that hysterical fits followed four clearly-defined stages – 1) epileptoid fits, 2) ‘the period of contortions and grand movements’, 3) ‘passionate attitudes’, and 4) final delirium.

He claimed that, although hysteria was a physical disease caused by a lesion on the brain, one could artificially induce these four stages through hypnosis. To prove this, he used photography to capture the four stages of hysteria, and circulated the evidence through the Iconographie Photographique de la Salpetriere. Photography was still a new, somewhat magical science – rather like neuro-imaging today – and these photos ‘did much to fix the image of hysteria in the public mind’, according to the medical historian Andrew Scull.

Augustine vogue-ing in the Iconographie

Charcot also put on public displays, every Thursday, where he hypnotized female patients and provoked hysterical fits for the fascinated male public, which included everyone from Sigmund Freud to Emile Durkheim. Both in the photographs and in the public displays, Charcot had ‘star patients’ who were particularly good at performing the four stages of hysteria, including a pretty teenager called Augustine, and a devout woman called Genevieve.

A painting of Charcot with Blanche, a hypnotized patient

These ladies expertly performed religious poses which Charcot’s team defined as ‘ecstasy’. And the team insisted that their work proved that all the religious ecstatics and demoniacs of yesteryear were suffering from hysteria. Joan of Arc, St Theresa, St Paul, Jesus himself were all evidently hysterics. By a happy coincidence, Genevieve – who suffered from particularly violent fits – came from Loudun, the scene of a mass demonic possession of nuns in the 17th century. Charcot had an extensive gallery of religious art, and displayed the drawings and photos of his hysterics next to this art – were they not one and the same condition?

An illustration of a fit of Genevieve's (right) next to an illustration by Rubens

An illustration of a fit of Genevieve’s (right) next to an illustration of a demoniac by Rubens

This equation of ecstasy with degenerative hysteria served a political purpose. Charcot and his disciples (particularly his main disciple, Desire-Magloire Bourneville) were closely affiliated with the Third Republic, which was virulently anti-monarchist and anti-clerical. Charcot and Bourneville were involved in the campaign to secularize medicine, and to replace nun-nurses with secular nurses. Each proof of the hysterical pathology of religious ecstasy was a broadside in this wider war.

Yet the irony, as several historians of hysteria have noted, is that in many ways the secular diagnosis of hysteria recalled the medieval Inquisition. Of course, none of the hysterics were burned – although they could be subject to physical punishments including mustard baths and ‘ovarian compression’. But they were made to follow and perform a cultural script defined and directed by a male power system, for the prurient consumption of a fascinated male public.

Again and again, the women would be made to perform hysteria, just as the poor nuns of Loudun were wheeled out, over and over, to go through their demonic antics. They would literally be fixed into poses, like ‘automatons’ or ‘statues’ as Charcot’s disciples put it, and then the poses were used as evidence for the pathology of ecstasy. This script advanced the career ambitions and political agenda of the men in charge, as it did in the Inquisition.

As with the Inquisition, it sounds like a form of pornographic cabaret masquerading as a public service. The Iconographie looks like a porn catalogue, with the photos of the sexy teenager Augustine interspersed with accounts of her sexual reveries. And the Thursday shows sound like something from the Moulin Rouge – the women are hypnotized by a gong or a tom-tom drum, the approach of the hysterical fit announced by the shaking of the feathers in their hats, before they fall to the floor clutching their vaginas as the male audience applaud.

Indeed, one of the star-hysterics of the Salpetriere went on to become Jane Avril, a lead-dancer at the Moulin Rouge who was painted by Toulouse-Latrec. She claimed she was cured when she learned to dance, which goes back to the ancient Greek idea that the best cure for anxiety and phobia, particularly in women, is the ‘Dionysiac cure’ of dancing. Augustine, meanwhile, finally escaped from Salpetriere, dressed as a man, while Genevieve was offended one day by Charcot and refused to be hypnotized anymore.

Charcot’s search for a materialist cause for hysteria ultimately failed, and the consensus grew that his fantastic shows were merely the result of suggestion. It didn’t help that something like 500 hypnosis vaudeville shows sprang up around Paris in the 1880s, some featuring women fresh from their debut at the Salpetriere. But a few in the audience – including Sigmund Freud and Frederick Myers – still thought he had hit on something important.

If nothing else, Charcot’s use of hypnosis showed the profound connection between mind and body – his hypnotized patients felt no pain, and their physical symptoms could sometimes be cured by hypnosis and suggestion. His work suggested the existence of what Myers called a ‘subliminal self’, which could be brought to the surface under hypnosis. And it suggested a connection between spirituality, sexuality and subliminal or hypnotic states.

However, Charcot – and, later, Freud – defined hysteria purely as a symptom of female sexual disorder, when it could be argued it was just as much a product of male sexual disorder. Many of the hysterics had been raped as children or teenagers, and were struggling in a society dominated by men with few opportunities for female liberty. Performing sexual hysteria for a titillated male public was one opportunity for approval, expression and a sort of fame.

Frederick Myers, founder of the Society of Psychical Research and gifted writer on psychology (alas all his works are now out-of-print)

Frederick Myers and William James, meanwhile, accepted the idea that spirituality might be connected to sexuality, to hypnotic or subliminal states, and to nervous instability. But they insisted it wasn’t necessarily pathological or degenerative – many of the geniuses of human culture were ecstatics, much of our culture is the product of ecstasy. Perhaps, wrote Myers, ‘ecstasy is to hysteria somewhat as genius is to insanity’.

In fact, as Asti Hustvedt argues in her excellent Medical Muses: Hysteria in 19th Century Paris, in seeking to pathologize ecstasy, Charcot ended up spiritualizing medicine. He used the language of religion – ecstasy, stigmata, possession – and also some of the ritual and performance of religion. He and his disciples explored how hypnotized women seemed to exhibit miraculous powers of telepathy (a word Myers later coined).

By the end of his career, Charcot, like William James, came to recognize that religious ritual could be powerfully healing, even if the mechanism that healed was really ‘just’ suggestion. His last work, an article on ‘the faith cure’, suggests the miracle cures at Lourdes and elsewhere are real, but simply the result of suggestion. James and Myers went further, speculating that the hypnotized self might also be more open to spiritual forces.

We still don’t know. Hustvedt notes that, while ‘the hysterics of yesteryear’ have disappeared, a new batch of poorly-understood and possibly psychosomatic illnesses have proliferated – chronic fatigue syndrome, ME, post-viral fatigue, cutting, anorexia, conversion disorder, depression, psychogenic non-epileptic seizures, mass psychogenic illness – the prevalence of which is higher, sometimes much higher, in women than in men.

Are these real or invented? Physical or mental? Pathological or spiritual or both? We still don’t know. We don’t yet understand the relationship between mind and body, between mind and gender, between your mind and my mind, and between our minds and nature / God / Super-consciousness.

One last item in this bizarre and fascinating history: the vibrator was invented in the late 19th century as a result of the ancient theory that female orgasm (or ‘paroxysms’) helped to cure hysteria. Doctors would bring patients to paroxysm by manipulation, but complained their hands got cramp, so one bright spark invented an electric dildo. Meanwhile the first electrically-vibrating bed was actually developed as part of an 18th-century sexual-religious-health show called the Temple of Health and Hymen – where the star-performer was the delectable Emma Hamilton.

Don’t you think this would all make a brilliant musical?

Want to read more on this topic? Here’s a piece on mass psychogenic illness as depicted in the forthcoming film The Falling. And here’s a personal account on being diagnosed with Psychogenic Non-Epileptic Seizures by a friend of the Centre.

VIDEO: Interviews with Centre Members

Posted on March 25, 2015 by Thomas Dixon

We recently asked three of our early-career scholars – Sarah Crook, Richard Firth-Godbehere, and Chris Millard – to tell us what they thought about the history of emotions and how it connected with their research. Here’s what they told us about how they got into this area, some of their favourite books in the field, and their thoughts about the future…

These films were made by Dawn Firth-Godbehere, and are available on our YouTube channel.

Can governments create ‘collective effervescence’ in their citizens? And should they?

Posted on March 20, 2015 by Jules Evans

The physicist Lawrence Krauss recently argued that education should teach all children the central tenet of science – ‘nothing is sacred’. Not God, not human rights, not democracy, not the environment. Nothing.

Emile Durkheim, one of the founding fathers of sociology, would disagree. Durkheim argued in The Elementary Forms of Religious Life (1912) that, though no one should dispute ‘the authority of science’, we still need religion to bind us together and to renew our moral and social consciousness through what he called ‘collective effervescence’.

He used Aboriginal society as an example of religion in its purest and earliest form. Aboriginals would periodically gather together for festivals, and a sort of electricity arose between them, a ‘power’, ‘a charge’, a ‘potentiality’. They would eat together, dance together, cry, chant, self-intoxicate, perhaps even swap wives, and get into such a state of delirium that they were transported beyond their individual selves, and filled with the spirit of the tribe. The totemic symbols of their tribe reminded them, in calmer times, of this exalted state of collective consciousness.

We might call this exalted state of consciousness ‘ecstasy’, but that has supernatural connotations. Durkheim is at pains to show that this ‘collective effervescence’ (or group fizz, if you prefer) is actually perfectly rational, natural, and necessary to tribal functioning. Man is connected through such rituals not to God but actually to the tribe. Religions celebrate and perpetuate society – ‘the idea of society is the soul of religion’.

We may have lost touch with Jehovah, but we still need these periodic orgies of collective effervescence to rejuvenate our collective moral and tribal consciousness. Durkheim was a lapsed Jew and a devout citizen of France, and thought the French Revolution was a great example of secular effervescence. He wrote:

Society’s capacity to set itself up as a god, or to create gods, was nowhere more visible than in the first years of the Revolution. In the general enthusiasm of that period, things that were purely secular were transformed by public opinion into sacred things: homeland, liberty, and reason.

The Tennis Court Oath during the French Revolution

The Elementary Forms was published a few years after William James’ Varieties of Religious Experience, and the two books attempt a scientific analysis of religious ecstasy from opposite poles. For James, religious experience is the individual soul in commune with the divine – he has no interest in collective ecstasy. For Durkheim, religious experience is always social and tribal – he has no interest in individual ecstasy. The truth must be somewhere in between.

But both share the idea that in ecstatic moments, we somehow transcend material determinism and access what Durkheim calls the Ideal, from which we draw power and inspiration down into material reality. So ecstasy is a bridge between two worlds – the material-empirical, and the ideal or spiritual.

James is prepared to suggest that this ‘other world’ of the spiritual genuinely exists. Durkheim is more wary – he puts forward a sort of emergence theory of collective consciousness.

Every other species, he says, is biologically-determined, lacking in free will, and confined to the material realm. Only humans have the capacity to transcend the material realm and to access the Ideal. We have this capacity through the chemical fusion of ‘collective effervescence – all our individual consciousnesses come together and create such an electrical charge, such a fizz of effervescent bubbles, that we can leap into the Ideal, and bring back ideas and symbols which become actualized in the material world. This is all entirely natural and human – gods are just ideas, as real as any other idea, as long as we believe in them.

This is an interesting theory, and could be compatible with Giulio Tononi’s Integrated Information Theory of consciousness. But humans aren’t the only animals to gather together – why don’t bees or wildebeest also achieve transcendent consciousness when gathered together? Why do most great religious visions or scientific discoveries happen to individuals when they’re on their own? And why does collective effervescence sometimes lead not to moral advance but moral regression?

Durkheim thought Europe in 1912 was in a state of ‘moral mediocrity’ – ‘the ancient gods grow old or die, and others are not yet born’, he wrote, sounding like JRR Tolkien. But ‘a day will come when our societies will once again experience times of creative effervescence and new ideas will surge up’, new festivals, new symbols, new gods.

Well, be careful what you wish for. He noted in passing that effervescence can lead to barbarism, bloodshed and attacks on ‘scapegoats’, as in the Crusades, and this is just what happened a few decades later with the Nazis, an ecstatic new cult of the state, led by a man who was the embodiment of Durkheim’s description of the demagogue: ‘He is no longer a simple individual speaking, he is a group incarnate and personified’.

Since then, western thinkers have been understandably wary of looking for ways to ferment ‘collective effervescence’ for political means. But there has been a return to Durkheim’s ideas in the last few years, notably in philosophers like Martha Nussbaum and Simon Critchley, and the psychologist Jonathan Haidt, whose TED talk on ‘ecstasy and the hive-mind’ is a contemporary riff on Durkheim.

Durkheim’s ideas are a useful way of understanding some contemporary political problems. You can see the Charlie Hebdo attack as a clash of sacred narratives, for example. Muslim radicals see the cartoons of the Prophet as taboo, and therefore punishable, and they think the democratic state is a false god. For French Republicans, the Republic is sacred, and any attack on free speech is taboo.

Durkheim’s work also helps us understand the United States’ continued inability to control gun sales. The Constitution is sacred, the United States is sacred, its origins in private armed militia are sacred – therefore any pragmatic attempt to control arms sales in order to save lives is taboo.

More positively, Durkheim recognized that ‘games and major art forms have emerged from religion and long preserved a religious character’. Certainly, football is a collective ritual – the fans join together, chant the same songs, tattoo the sacred signs of the collective onto their bodies, applaud the players when they kiss the badge, and even, in some inarticulate way, see the team as transcending death. Individuals rise and fall, but as part of Liverpool FC, you’ll never walk alone.

Rock and roll is another modern ritual, a modern means to collective effervescence which arose from religious roots, and ‘every festival, even ones that are purely secular in origin, have certain features of the religious ceremony…Man is transported outside of himself.’ Rock n’ roll is a much less toxic form of collective effervescence than, say, fascism.

I’d suggest that the 2012 Olympics Opening Ceremony brought together all these modern rituals – the celebration of the state, the sacredness of the NHS and the monarchy, the sacredness of sport, and the sacredness of British rock and roll, all orchstrated with rare skill by Danny Boyle and Underworld. But the 2012 Olympics was a one-off for England. A genuine ‘new ritual’ needs to be repeated every few years. Is that possible, in a multicultural megapolis like London or the UK? Have we become too skeptical and rational to let ourselves be carried away en masse? And should politicians be dabbling in the Dionysiac, or is that playing with fire?

More broadly, is society sufficiently transcendent to satisfy our longing for transcendence? I’m not sure it is. I think human consciousness longs for something bigger than just the tribe, and I find Durkheim’s political conception of religion claustrophobic and potentially toxic.

When we immanentize our longing for expanded consciousness, project it onto the state, and yearn for a revolution to heal our pain and boredom, we risk making a false idol of the state. We then make blood-sacrifices to that false god, to try and perpetuate our state of ecstasy. That’s what the Crusades did, it’s what the Nazis did, and it’s what radical Muslims are doing with Islamic State. I’m all for fizz and effervescence, but that moonshine will kill you.

Sir Gus O’Donnell on the politics of well-being

Posted on March 16, 2015 by Jules Evans

Last month I interviewed Sir Gus O’Donnell for a forthcoming Radio 4 programme about the revival of Aristotle’s idea of flourishing in public policy. Sir Gus is one of the pioneers of a new movement called the politics of well-being, which agrees with Aristotle that the proper aim of government is the enhancing of citizens’ flourishing or eudaimonia.

Since 2010 (when Sir Gus was head of the civil service) the Office of National Statistics has started measuring our national hedonic and eudaimonic well-being, in the hope that the data will be used to guide public policy. After leaving public office last year, Sir Gus joined the economics consultancy Frontier Economics as non-executive chairman. It looked conducive to employee flourishing – it had an open plan office, a big kitchen, table-football, and the occasional poster offering well-being advice. Here are his thoughts on Aristotle, the politics of flourishing, and why he didn’t become a monk.

You’re still a passionate advocate for the politics of well-being. Why is it so important to you?

It seems to me if you think about what success is for individuals and governments, governments are trying to improve the quality of life for people. Now you can think about different ways of measuring the quality of life, but surely in a democratic society, part of it should be, how do people feel? Do they feel overall that their life is worthwhile, do they feel satisfied, are they happy? Those are really important things. And until recently we were not systematically measuring those factors.

Do you think the fact we weren’t previously measuring those things created a bit of a moral vacuum in government?

I’ve always said, if you treasure it, measure it. We place undue weight in the things we can measure precisely, even though they’re actually the wrong concepts. For example GDP – actually we don’t measure it that precisely. But we put out numbers that suggest we measure it to the last pound. And people place a lot of emphasis on that – is the economy growing, is GDP going up. When in fact, what we should be saying is, are we improving the quality of life for people in this country?

Do you think we can define well-being or flourishing for an entire country, and then measure it?

Source – ONS data for 2013/2014

We’ve gone round the country and asked a lot of people – what for you constitutes the good life. As a result of that, the ONS has come up with four questions: do you think your life is worthwhile, are you satisfied with your life, what’s your happiness level, and what’s your level of anxiety. The last two are ‘affect measures’. If you think of one thing the governments could do, it would be to get rid of misery. That’s why the well-being approach has an enormous policy implication: do more about mental health problems. At the moment we spend huge amounts on physical health, yet only one in four people with mental health problems get treatment. Imagine if one in four people with a broken leg got treatment and the other three were told ‘tough’.

No policies in the last 50 years seem to have made much difference to national well-being levels. Do you think if we do more for mental health policy it will eventually push up our national well-being level from a 7 to an 8, for example?

People talk all the time about inequality of income and wealth, but what we should really care about is inequality of well-being. And it’s that group at the bottom, the ones who are really desperately ill, they’re the ones I care about. And yes, that would affect the overall average level of well-being. But more importantly, it would help those in the worst state in our society improve their level of well-being, that’s what I care about.

If politicians got more onboard with this new politics of well-being, how would Britain look different in 30 years?

We’d start to think about what would make a difference to people’s well-being. We need to do more research, so we’ve launched a new What Works Centre on well-being. This isn’t just what governments can do, there’s lots individuals can do too. But if you’re saying what could governments do, at the macroeconomic level, it might mean trading a bit of economic growth for more economic stability, because job insecurity and unemployment has a negative well-being impact. Building resilience for people is also hugely important. People need to be able to withstand the ups and downs of a globalised society. And the best time to improve resilience is in childhood. Some of these resilience and mindfulness programmes in schools are in my view going to make a huge difference.

Sir Isaiah Berlin thought governments should protect citizens’ negative liberty, and not really be in the business of trying to enhance their positive liberty – their flourishing or moral freedom. He thought there was a danger of tyranny if governments say ‘we can make you happy, we can make you morally free’. Do you think this new politics of well-being embraces the idea governments can enhance our positive liberty?

I’ve never understood this ‘nanny state’ idea, because actually it’s one of the most democratic things known to man – this is asking individuals how they feel, so the power is with them. I am absolutely not for saying states should decide what it is that constitutes things which are the good life – I’m quite nervous about that. But allowing individuals to tell you if they feel their well-being is enhanced, I think that’s hugely important.

Are people’s self-reported feelings of happiness really a good guide to policy? A gangster might feel their life is full of meaning and value and happiness, but they might be wrong.

The government’s National Citizen Service encourages young people to volunteer for worthwhile causes

Absolutely. People can be wrong. Education is really important. So’s the law. You could have a serial killer who gets a kick out of killing people. We are thinking of the well-being of society. What you’re trying to teach, at school and throughout people’s lives, is that helping other people helps your well-being too. One of the interesting studies in Daniel Kahnemann’s book was they gave $20 to some experiment participants, and the people who gave some or all of it away reported feeling better than those that didn’t. And they didn’t expect that. Recently we’ve discovered that things like volunteering make a huge difference, not just for the people you help, but the individuals who volunteer report higher well-being. So there is something intrinsic in human nature that means you get a lot more benefit out of helping others – it gives you a real buzz.

You successfully introduced these ideas into public policy when you were head of the civil service. Was it a tough sell to politicians?

David Cameron had made a speech saying he wanted to measure well-being, that there was more to life than GDP, when he was leader of the opposition. So it was obvious when he came into office that he wanted to do that, and I was able to help him do so. This was very much led from the top, by the prime minister. Because it was such an obvious thing – why wouldn’t you want to improve the quality of life of the people in the country? It’s so blindingly obvious. The biggest obstacle is people thinking this is all fluffy. Getting the measurement out there and explaining that we’ve been using this idea in public policy for years. In health, for example, when you’re deciding whether to use this drug or that drug, how do you compare? You look at the impact on QALYs – quality-adjusted life years. That’s a way of making hard-nosed decisions.

To what extent do Aristotle’s ideas on flourishing feed into contemporary politics of well-being?

Sir Gus O’Donnell next to David Halpern, head of the nudge unit and another big advocate for the politics of well-being

Aristotle’s ideas are a part of it. My intellectual journey, starting as an academic economist, for us, standard economics was very much utilitarian – we thought every individual maximized their utility, subject to budget constraint and prices. You get some very elegant mathematical theories telling you markets are very good at delivering good outcomes. But there are lots of assumptions implied and a lot of them don’t work in the real world. So economists tend to start off as utilitarians. Then I was at Oxford, and had time to go and listen to a lot of philosophers. I realized there are plenty of criticisms of utilitarianism. Aristotle comes into that – his concept of flourishing is it’s not just utility, it goes beyond that. So as an economist, you come across people like Amartya Sen talking about enhancing capabilities. There’s a rich discussion between philosophy, economics and political science about how there’s more to life than the narrow utilitarianism of many economists. So now we’re trying to operationalize that into public policy.

Aristotle wrote his Nichomachean Ethics for his son. Has exploring this area influenced you as a father?

Yes, enormously. What did it for me was when I was talking to leaders in the private sector and public sector. And I was really impressed by private sector leaders who could really get their staff enthusiastic about their vision. And their vision was selling more cornflakes or pot noodles. And I thought, in the public sector it should be so much easier, because what we’re trying to do is enhance the quality of everybody’s lives, and help those who are most disadvantaged. I’m delighted to say my daughter has decided to go down the public sector route, and has embraced that.

Sir Thomas Cromwell, not a fan of monasteries

Right at the end of the Nichomachean Ethics, Aristotle says that the ultimate road to eudaimonia is contemplation. This idea of the importance of contemplation helped inspire the blossoming of monasteries for hundreds of years, until Thomas Cromwell intervened with the Dissolution. Now mindfulness is making a comeback, and is a big part of the politics of well-being. Do you think we should bring back institutions dedicated to contemplation – neo-monasteries, if you will?

Well, as you can imagine from some called Augustine O’Donnell, I was brought up in a quite strict Catholic background, and at times my parents were saying would one of the five of us should become a priest or a nun. I thought about this quite hard, since I was number five and the first four had let me down. In the end I decided it’s not for me – when you think about it, the monks going off to contemplate, they believed in the power of prayer to improve society. I find that difficult to swallow. I think it’s much more important that we don’t just look after ourselves. I find my well-being much more enhanced by helping other people. If it’s just about privately going away and feeling good about yourself, that’s too limited.

So there you go – no major monastic revival on the cards, but hopefully a lot more emphasis on mental health policy. You can also read an interview with Richard Layard, another key figure in the UK politics of well-being, here.

Reading Emotions: Love in Fiction 1750-1950

Posted on February 25, 2015 by Thomas Dixon

We’re excited to announce our new community book group:

‘READING EMOTIONS: LOVE IN FICTION 1750-1950’

It’s aimed at anyone who likes reading and would like to discuss the books they have read. We will be reading neglected works of fiction published by British women between c. 1750 and 1950, as part of the Read Women campaign.

The group is specifically aimed at members of the public so please invite your neighbours, friends and family members to take part. Men and women of all ages are welcome to join.

We will meet one Friday per month 6-7.30pm from April-September 2015. Meetings will take place in the café space at the Bromley by Bow Centre in east London overlooking ‘Bob’s Park’. Books, hot drinks and refreshments will be provided free of charge. We are able to subsidise transport for less able or elderly members.

‘Reading Emotions’ is run by Sally Holloway and Jane Mackelworth of the Queen Mary Centre for the History of the Emotions, funded by the Queen Mary Centre for Public Engagement and subsidised by Oxford University Press.

Our first book is Julia Strachey’s Cheerful Weather for the Wedding (1932), which can be posted to your home address. To join the group or find out more, please email Sally and Jane at communitybookgroup@outlook.com

Download a poster about the book group to print off and display.

Force-feeding suffragettes: Violation or medical care?

Posted on February 23, 2015 by Juan Zaragoza

Dr Juan M. Zaragoza is a Marie Curie Research Fellow at the Centre for the History of the Emotions, Queen Mary University of London. Here he writes about his current research into the material culture of medical care and the force-feeding of suffragettes.

Last month, The Independent published an article by Arifa Akbar, the paper’s literary editor, entitled “The year of the suffragette: women on the verge of a societal breakdown”. It started with the statement that “Suffragettes are currently having a moment”. To support her point, she provided several examples. The first was the release of Suffragette, the film starring Meryl Streep as Emmeline Pankhurst, Helena Bonham-Carter as Edith New, and Carey Mulligan as Maud – foot soldier suffragettes who become radicalized and turn to violence to achieve their objectives. Akbar also mentioned the release of a new edition of Emmeline Pankhurst’s memories “Suffragette: My own story”, also in January 2015, and the second series of Jessica Hynes’s BBC suffragette sitcom Up the Women. The clip below, from the first series in 2013, gives a flavour:

To Akbar’s list, we can add the forthcoming broadcast on BBC television of a three-part series presented by Amanda Vickery – ‘Suffragettes Forever! The Story of Women and Power‘. This re-emergence of the suffragist movement into the public sphere in 2015 is particularly interesting since, as far as I know, there is not any historical event with a significant anniversary this year, except perhaps for the Women’s March through London on 17 July 1915, sanctioned and paid by the Ministry of Ammunitions, in which the WSPU expressed their support for the war effort and reaffirmed the suspension of their own activities, announced the previous year. Here is a film of the event (without sound) from the British Pathé YouTube channel:

I made my own small contribution to the new ‘suffragette moment’ in early 2015 with a talk on force-feeding, given at the Postdoctoral Research Colloquium at Queen Mary School of History, on which this blog post is based.

As far as we know, Mary Leigh was the first suffragette to be force-fed. Mary and her fellow protesters were arrested and sent to Winson Green Prison, Birmingham, after an action against the prime minister in September 1909. That very same night, Mary Leigh and the other three women went on hunger strike. Four days later, on Sunday 16 September 1909, she was forcibly fed. She recalled that moment as follows:

On Saturday afternoon the wardress forced me onto the bed and two doctors came in. While I was held down a nasal tube was inserted. It is two yards long, with a funnel at the end; there is a glass junction in the middle to see if the liquid is passing. The end is put up the right and left nostril on alternative days. The sensation is most painful – the drums of the ears seem to be bursting and there is a horrible pain in the throat and the breast. The tube is pushed down 20 inches. I am on the bed pinned down by wardresses, one doctor holds the funnel end, and the other doctor forces the other end up the nostrils. The one holding the funnel end pours the liquid down – about a pint of milk… egg and milk is sometimes used.

We cannot help being moved and outraged by these lines. Suffragettes’ testimonies to this form of violation became a powerful tool in the movement towards their final victory. The public debate on the issue, and the critiques of doctors and civil servants involved in this form of violence against women, were fundamental for the change of social perceptions of their cause.

All of this is why what I am now going to ask you to do is difficult – namely to try to understand these shocking events from the point of view of the doctors and nurses involved. Why would I want to do such a thing? The main reason is the distance between doctors’ attitudes then and now – you can compare treatments of the topic in a BMJ item about suffragettes in 1909 and one about hunger-strikers at Guantanamo in the Lancet in 2013. Perhaps a better understanding of this historical attitudinal change can help us to know more about our present values and about the political attitudes towards the role played by medicine in our own culture.

Is it really a problem?

On 28 September 1872, The Lancet published an article entitled, ‘Feeding by the Nose in an Attempted Suicide by Starvation’, signed by a doctor, Anderson Moxey. The author related the death of a prisoner who was on hunger strike “in one of the county prisons”. The motive of his hunger strike was his being sentenced to death for the murder of his wife, of which he had been convicted fifteen days before his death. Dr Moxey said that this death could have been avoided, if only the method of feeding through the nose had been used, instead of through the mouth:

If anyone were to ask me the worst possible treatment for suicidal starvation, I should say unhesitatingly – “Forcible feeding by means of the stomach-pump”[1].

For Moxey, the problem with the forcible feeding of this prisoner was that an erroneous method had been used. If they had fed the prisoner through the nose, by using a funnel, instead of a stomach pump, the prisoner would have survived until his execution date, and justice would have been served.

Does this mean that Moxey avoided passing judgement on the moral problem that this case brought to light? On the contrary! Moxey says that the State should prevent the prisoner from escaping the hand of justice, by any means possible. And no, it is not enough to say that the “torture” produced by the chosen method to feed him was sufficient punishment. The State, says Moxey, should not torture its prisoners, but, again, should serve justice. Justice, in this case, would have been achieved by having chosen the technically correct option, which would have permitted the death sentence to be carried out as it should have been (p. 445).

For Moxey, therefore, the question of the force-feeding of prisoners was just a technical problem. Did other doctors share his opinion?

Moxey is completely wrong

On 30 November 1872, also in The Lancet, a new article was published entitled ‘Forcible Feeding’, signed by the alienist Thomas S. Clouston. He wrote that the method Moxey proposed (feeding through the nose) was “completely contrary to the experience of the majority of doctors who have had to force feed their patients”^[2]. Clouston’s attack was direct and devastating. He not only stripped Moxey of any authority to talk about this topic, but he also criticised Moxey’s methods as unprofessional, citing two specific examples: first when Moxey allows himself to quote from memory, and even worse, when he puts words into the mouth of Dr. John Hitchman “which can only astonish those who know him”. (At that time, Dr. Hitchman was the medical supervisor of the Derby county asylum.)

The harshness of Clouston’s attack must at the very least surprise us, given that, in the end, it was provoked by nothing more than a technical discrepancy in how the patient should be fed. And Clouston dedicates the rest of the letter to highlight this difference – as well as to demonstrate his own knowledge of the process. For Clouston, a doctor working in an asylum should carry certain things in his bag (as he will have to face this type of situation many times):

A common metallic spoon “made of German silver”;
The ingenious instrument designed by Dr. Stevens (whatever that may be);
The tube for nasal feeding (“problematic, disagreeable and normally useless”);
A small silver funnel, with a tube, for feeding through the mouth.

Each one of these objects could be useful, Clouston wrote, depending on the specific case which the doctor face. But the tools for nasal feeding, he wrote, were not to be recommended, for three reasons:

It is very easy for the patient to resist and to return the food, together with a large quantity of nasal mucus, onto the face and clothes of the physician, and this is disgusting;
As the tube is very small, the patient can only be fed with very liquid food, ruling out, for example “lamb mashed with a mortar”;
In cases of an acute manic seizure, portions of food can block the patient’s windpipe.

In other words, what Clouston tells us is that it is a method requiring instruments so badly designed, that it is a risk for the doctor who carries out the task as well as a risk for the patient’s health. Even more, its effect is limited, even when the food is successfully administered.

In comparison to this, Clouston says, we have the gastric pump, which, on the contrary, is widely used and which “has saved thousands of lives” in the simplest way. He describes the method as follows: seat the patient, restrain his hands, open the mouth using a simple and safe instrument, place a gag so that he cannot close his mouth and introduce the tube, without causing damage or pain, through the patient’s jaws.

Care as a technical issue

What we have just seen has not been the cold discussion which we normally associate with a technical debate, but instead a heated argument between supporters of two different methods who aim, it is evident, to show their effectiveness in carrying out the task, but, above all, and I believe this is fundamental, who agree that the vital factor to prove is the effect that it has on the patient. In other words, what these doctors defend, sometimes with such passion, is that the method that they use, “their” method, is that which has the least negative effects on the patient. Negative effects can be avoided thanks to the superiority of different designs, the improved quality of the materials, the use of more instruments.

All this technical debate about the methods of forcible feeding does not make any sense if it is not placed in the broader context of the care of patients within the material culture of the age. At the time – and this is the hypothesis behind my current research – it was understood that taking care of the patient consisted, specifically, in using the material objects that were the most suitable for the particular disease, that improved the patient’s wellbeing and made them the most comfortable during their illness.This is the background that allows the technical discussion to be understood as something that goes beyond the mere functionality of the instruments, beyond whether they are more or less effective.

Suffragists, doctors and politics

In 1914, Frank Moxon wrote what has gone down in history as probably the most effective attack on forcible feeding in English prisons – a 32-page pamphlet published by The Women’s Press, and available to read online via Bryn Mawr College Libary. Even though it is true that texts appeared prior to this, which denounced the practice against the imprisoned suffragettes, it was Moxon’s account (written while he was doctor in Moorfields), which made the case most effectively.In Moxon’s article we can see how the terms of debate had changed radically since the 1870s. Moxon begins his article by stating that he is going to avoid any “sentimental” approach to the problem, and that his intention is to present a “frank and complete report on the medical aspects of this treatment”. If you don’t want to read the book, I have the perfect audio-visual synopsis of it – an equally upsetting scene from the 2004 film about the struggle of American suffragists, Iron Jawed Angels:

Moxon does not make mention to plastic tubes lubricated with oil, stomach pumps, or funnels. Or, rather, he only does so to describe a violent procedure, which the victims describe as a violation. He does not question the effectiveness of the method (as it had previously been understood in earlier debates) because he is not interested in that issue. What Moxon aims to elucidate is whether the State has the right to force-feed the prisoners. He wants to know if by being imprisoned, as Dr Moxey had claimed, the prisoner is in the same situation as an insane person, having lost the right to decide for himself (p. 13). Moxon is placing the debate in the moment that precedes the problem of efficiency, by formulating a question that we could phrase in the following way: “Does the doctor have the right to decide on behalf of the patient, when the patient cannot?”

But we were already clear on this point, would say the supporters of force-feeding, Pinel gave us a protocol on which to act in the early nineteenth century: we have the adequate tools and our obligation is to look after our patient, to avoid him or her comeing to any harm, even if they are themselves the cause of the harm. Moxon’s reply would be: no, I don’t agree. Artificial feeding (note the subtle difference) is a simple and innocuous procedure, in the majority of cases. What I don’t allow is that we have the right to carry out it against the will of the patient (p. 15).

This change in the terms of the debate did not go unnoticed by the medical profession, and they reacted as a result, either supporting the article (and there were many that did) or, on the other hand, by denouncing it as inadmissible, as it tried to politicise the debate. The latter group, precisely, are those who aim to redirect the discussion back to what they consider to be the appropriate terms. One such example of this was the article published by William Morton Harman, in answer to Victor Horsley’s report published in the British Medical Journal in 1912. Harman placed the debate where he thought it should be, not in the political interpretation of Horsley (and Moxon), but in the technical questions discussed by Moxey, Clouston and others.

To conclude

The debates about forcible feeding at the end of the 19th century should be placed within the context in which the care of the sick was understood at the time, which paid special attention to the material elements. When you track the debates around the issue, you realize that these doctors never questioned if they did or didn’t have the right to feed someone who didn’t want to b fed. Or, rather, if they did, this only served to confirm that they did have this right, as only in this way would they prevent the death (by suicide) of their patients. Once this was decided, the remaining steps were to establish the protocol and to develop the most effective and the least harmful techniques possible. What Moxon and others proposed, therefore, was a total correction to how doctors understood their jobs, their relation with their patients and the primacy of “care” as the backbone of medical practice.Without a doubt, the suffragist movement pushed the medical profession to change, as it also pushed other institutions and forms of social organisation to change.

I know the topics of suffragists, violation and hunger strike are highly controversial. To avoid any ambiguity let me state my view that the suffragists, Moxon, Horsley and the others were right. Doctors didn’t have the right to choose for their patients whether or not they should be fed. Nor do doctors have that right today. Suffragists described forcible feeding as a violation because it was a violation, and the doctors were guilty of an attack on women. My goal is to understand how it was possible that a great part of medical profession supported the government, but not to justify them!

References

[1] D. Anderson Moxey, “FEEDING BY THE NOSE IN ATTEMPTED SUICIDE BY STARVATION.,” The Lancet, Originally published as Volume 2, Issue 2561, 100, no. 2561 (September 28, 1872): 445, doi:10.1016/S0140-6736(02)56483-7.

[2] T. S. Clouston, “FORCIBLE FEEDING.,” The Lancet, Originally published as Volume 2, Issue 2570, 100, no. 2570 (November 30, 1872): 797, doi:10.1016/S0140-6736(02)56739-8.

The love of a philosopher

Posted on February 14, 2015 by Katherine Angel

Katherine Angel (photograph by Pedro Koechlin).

Katherine Angel is a Leverhulme Research Fellow at the Centre of the History of the Emotions at Queen Mary University of London, where she works on the history of sexuality and psychiatry. She is the author of Unmastered: A Book On Desire, Most Difficult To Tell (Penguin, Farrar Straus & Giroux), and is currently writing a book on female sexual dysfunction and post-feminism. Her research has been published in History of the Human Sciences, Biosocieties and the Lancet, and her writing in the Independent, the New Statesman, and the Los Angeles Review of Books. She also reviews for the Times Literary Supplement and for the Poetry Review.

In this post, written for both the History of Emotions and Cultural History of Philosophy blogs, Katherine reviews one of the most recent additions to Oxford University Press’s series of Very Short Introductions, this one on the subject of love, by the philosopher of emotions Ronald de Sousa.

Why do we love a person we love? Is this the kind of thing we can know? These are recurring questions in Ronald de Sousa’s Love: A Very Short Introduction. Perhaps more accurately, the question is whether we in fact love for reasons at all. We enlist reasons for our love – he’s so playful, so accomplished – but it’s the location of qualities in someone’s particular personhood, with all its embodied wholeness, that enables love for them. What’s more, de Sousa notes, ‘an outside observer may detect causes of love that will always remain obscure to the lover’ (p. 57). These causes might include early attachment experiences, or strategies unconsciously deployed to keep particular anxieties – of abandonment, of rejection – at bay. And Freud’s psychoanalysis developed significantly from the insight that we can be wrong not just about why we love a person, but also about the fact that it is them we love: transference is precisely the direction of intense feelings (whether of love or hate) onto another target. There is always the possibility that a ghostly, unrecognised object of love is hovering behind the one we are apparently fixated on.

Much of de Sousa’s book is in a tone of accessible, chatty musing on some of the main questions about love. Why are some forms of love taboo? Is it a problem that love is subjective? Is love blind? Does love free or bind one? What is the relationship between love and sex? It also, rather self-consciously, introduces several pieces of philosophical terminology (‘explaining the significance of these two facts is going to be a little intricate, and will require me to introduce some philosophical jargon….if you bear with me, we should be able to gain some clarity’, p. 58) in a bid to make useful distinctions and gain purchase on a potentially unwieldy subject. (The terminology includes ‘intentional states’, ‘propositional object’, ‘focal property’.)

What quickly becomes clear, in particular in the insistence on the question of reasons versus causes of love, is the extent to which the book is framed by the conventions of a broadly analytic Anglo-American philosophy. The concerns of the book feel primarily determined by prior debates internal to the practice of that discipline. The question of whether we love for reasons, while an interesting one, begins to feel, as the book progresses, like a case study the author is using in order to articulate a particular position on a conventionally invoked debate about the distinction between reasons and causes. As such, the book feels less like an introduction to Love, or to thought on love, than an introduction to analytic philosophy’s commitment to an ahistorical, free-floating, unmoored conceptual analysis unencumbered by complicating details such as particularities of time and place. There’s nothing wrong with writing a book from within the conventions of one’s discipline. But here, the somewhat narrow and skewed take on the supposedly most universal concern of all turns this into a book curiously distorted by the techniques, language and methodology of a very particular and contingent way of conceiving of philosophy.

One of the problems with this way of doing philosophy is an unreflected-upon tendency to see the question of what philosophy might be as having already been resolved – and to reduce substantial questions about the discipline and its history to a vision of itself as a quasi-technical application of a method; a method which amounts more or less to a kind of sophisticated cleverness, an ability to see distinctions where others fail to, the application of intelligence and rigour. The roots of the much-discussed division between ‘analytic’ and ‘continental’ philosophy in differing responses to positivism, modernism and post-structuralism have been much written about. The point I want to make here is that the vision of inquiry that can emerge from a disciplinary commitment to philosophy as a thoughtful, common-sense, distinction-wielding clarity has substantial consequences.

In his chapter on desire, de Sousa digs into some interesting questions and dilemmas. What does the lover want? Can love be satisfied? Is love altruistic? Do we love for reasons? The question of whether love is altruistic naturally encounters problems – the ‘altruists’ dilemma’ – ‘if each wants only to do the other’s will, there is nothing either of them can do’; ‘even for sensibly imperfect altruists, the lover’s concern for the beloved can be hemmed in with small print’; provisos such as ‘I want your happiness above all things – providing only that I am the one to provide it’ (pp. 42-43).

Problems like the ‘altruists’ dilemma’ strike me as arising from a commitment to exploring a theme in a particular, disciplinary-bounded way; from trying to find a model that suits a phenomenon, rather than from starting with a fine-grained account of the phenomenon. (There are many models outlined in the book – those of the interlocutors in Plato’s Symposium; the puritan model; the Lawrentian model; the pansexual model). If you start by wondering if love is altruistic, you are going to encounter a lot of counter-evidence, and you are going to be left scratching your head, or adding provisos, qualifiers, and clauses to your model. But why the commitment in the first place to a model for love? Starting from a position which is rendered complicated by exceptions to a model is a prior intellectual and disciplinary decision that would usefully be let into the analysis.

Philosophy conceived of as a sort of chatty, insightful cleverness also inadvertently gives itself an additional burden: that of not sounding like a bore leaning against a pub bar. De Sousa avoids that, but his chattiness can become problematically gestural. Writing about jealousy, he claims that ‘someone who worked in a Scottish women’s prison related that when she heard inmates talking about love of their men, it transpired that the criterion appealed to was that a man loves you only if he beats you’ (p. 14) If you’re going to discuss something this thorny, then hovering vaguely in a non-committal space between citing research and reporting on a conversation had over a pint is intellectually and ethically lazy, to say the least.

Hannah Hoch, Coquette (1925). Picture credit: Polari Magazine/Whitechapel Gallery

It’s also notable that while de Sousa has some insightful things to say about constricting gender roles, he cites overwhelmingly male sources for his edifying citations on love. His citations are rather well-worn, too – Shakespeare, as usual, carries much of the burden. Moreover, women figure in the book as, variously, prisoners embracing the violent jealousy of their partners; creatures more concerned with their breast size than their IQ; as those ‘known to win a rape conviction when the wrong twin took advantage of dim light’ (p. 63); the muse of poets (Cyrano by Rostand); as ‘some feminists’ who have, for example, ‘disparaged love as a cruel hoax’ (p. 69); or as the anorexic or suicidal object of love whose own desires a lover should perhaps not encourage. The figuring of men as the proponents of theories of love, and women as love’s problematic objects, is, I’m sure, unintentional and unconscious – but it’s striking, and it reveals a kind of inattention to the wider contextual and structural questions around not simply love, but about the writing of philosophy. What sources and voices do we turn to when writing about such a large theme, and why?

De Sousa’s chapter on science is intriguingly ambivalent. He starts out discussing controversies about turning to science to answer questions about love – the allegation that scientific understanding of love (amongst other things) will disenchant the world for us, and ‘show our most cherished values to be illusions’ (p. 77). De Sousa counters this ‘bogey of reductionism’ by suggesting that understanding a phenomenon doesn’t necessarily mean ’the magic is gone’ (ibid.). But he doesn’t question the assumption that what passes for scientific understanding or explanation of love amounts to knowledge, rather than risking being a mere redescription. Veering rather close here to an epistemological reductionism, he then notes that we might be wrong in thinking that ‘one approach can capture everything we think or want to know’ (p. 78), and invokes the need not only for knowledge of biological processes, but for understanding of why such mechanisms exist in the first place and what role they play: the disciplines of evolutionary theory, anthropology, psychology, sociology.

De Sousa states, with apparent modesty on behalf of the scientific approach, that ‘no good scientist would be rash enough to claim that we can fully explain every nuance of feeling and experience in terms of the underlying state of our brains. At least not yet.’ (p. 78) The possibility of a complete scientific understanding of love, through the revered brain, is postponed rather than denied by de Sousa, and he toys with the idea that knowing more about ‘how love is implemented in the brain might help us to manage our love lives’ (ibid.). (It’s not quite clear how.) De Sousa’s flirtation with a scientific approach to love, however, is set aside as he sets out to unmask various spurious claims on his subject made in the name of science. Of the idea that both male and female jealousy can be explained by evolutionary psychology (men fear for their paternity, while women fear loss of parental cooperation), de Sousa notes that even if it is true that men are more distressed by a woman’s sexual infidelity, ‘that could be an effect of the stereotype rather than its justification’. Self-reports ‘that seem to confirm the hypothesis of the evolutionary psychologists rest on the spurious theory that is wheeled in to explain them’ (p. 95).

De Sousa’s last chapter, ‘Utopia’, is his most successful to my mind. He is at his best when he frees himself from the constraints of analytic philosophy and lets his observations and his prose operate more elegantly. ‘Nature is indifferent to us and to our happiness’, he writes. But ‘from the point of view of an individual human being, of course, the manner in which it is attained is everything’ (p. 96). Discussing questions of fidelity, lust, and polyamory, his writing feels like it originates more organically in a curiosity about the subjects at hand, rather than structured by prior philosophical conventions and debates applied to that subject. On the subject of erotic nonconformists such as the Marquis de Sade and the Earl of Rochester, de Sousa notes, wisely I think, that ‘not all the rebels of sex and love are immoralists. On the contrary, modern champions of “free love”… can moralize as tediously as popes’ (p. 101). And his discussion of the concerns at the root of polyamory feel sensitively attuned to the genuine philosophical, ethical and political questions that inevitably arise in partnerships with others. How do we love while accepting and embracing the autonomy of the other? Is loving someone giving them their freedom? This last chapter also conveys a sensibility cognizant of the authoritarian impulses always hovering near questions of love, marriage and gender. Writing of the expansion of possibilities in regards to these could, he writes, ‘lead to a flowering of modes of sexuality, love and relation – providing they exist in a political framework friendly to a multiculturalism of love’ – but at worst ‘we might be led not to a paradise of diversity but to a nightmare “brave new world” in which everyone is suitably programmed for the subjective satisfaction of a restricted range of desires determined by some arbitrary conception of what might be politically expedient – in other words, pretty much a variant of the present system’ (p. 112).

Aspects of this book may be somewhat hemmed in by formulaic philosophical conventions, but it’s in de Sousa’s alertness to the contemporary political quandaries of love, and in his scepticism about the impulse to rigidity and fixity underlying even the most liberatory rhetoric, that his sensibility feels most refreshing. As he puts it, ‘a world that leaves nothing to be desired would be a grim one; even in a utopia there must be desire’ (p. 112).

Follow Katherine Angel on Twitter: @KayEngels

Follow the History of Emotions Blog on Twitter: @EmotionsHistory

Read Chapter 1 of Ronald de Sousa’s Love: A Very Short Introduction
(via the Oxford University Press website)

Paul Dieppe on spirituality, ritual and the healing response

Posted on January 23, 2015 by Jules Evans

Paul Dieppe is professor of health and well-being at Exeter Medical School. Having spent a distinguished career researching rheumatism and specifically knee pain, he shifted his focus onto the placebo effect and, most recently, humans’ natural ability to heal themselves, which he calls ‘the healing response’.

Can you tell us about your research into ‘the healing response’?

I’ve been interviewing healers and people who think they’ve been healed, doing in depth qualitative interviews to get a sense of the experience of both parties, and the views of both parties as to how it works. I’ve also been doing sensory ethnography tests – I ask people to give pictorial representations of what healing represents to them. That’s been absolutely fascinating. They often surprise themselves by what they draw. One person burst into tears while drawing because he had an insight into what was going on in his life. Drawing seems to access a different part of our brain.

So how do the healers think healing works?

The dominant narrative is about energy flow. Some think in an externalised way of energy from outside being channelled through them. Others speak of rebalancing natural energy levels.

What about the healed?

I’ve talked to fewer of them than the healers. But I suspect they go along with whatever narrative or attribution the healer comes up with.

Have you come across many instances of actual healing?

Masses of cases. It’s anecdotal stuff, but it’s extremely impressive and extremely convincing. I’ve experienced it myself. A lot of this stuff happens completely under the radar, people just getting on with it in their back room, not part of any particular body or group, just doing their own thing. I went to see one such person, a little old lady in her front-room, and she said the best way to understand healing is to experience it yourself, and asked if I had anything I wanted working on. I told her I had a bad knee, so she said, OK let’s give it a go. And for what it’s worth, it’s been better since then. That was a couple of years ago.

What’s your explanation of what’s happening?

Ruth Kaye, a spiritual healer who works within the NHS in Leeds

There are many possible explanations, of course. I think the energy story has something to it, though I don’t understand it. But my main hypothesis is this is about switching on our own intrinsic ability to heal ourselves, which we evolved for powerful and important reasons. Healers are helping us to activate that mechanism which, for some reason, we have forgotten in our culture. Some call the process unconditional love. If that’s too difficult, my short-hand for it is ‘total attention with good intention’. It’s about having a totally unconditional desire for the other person to get better.

Do you have a sense of what happens in the brain, does it involves specific neural or nervous networks? What systems does it involve?

Life gets difficult when you talk like that. You’ve slipped into the assumption that our materialist knowledge is the appropriate framework for that. We assume our current materialist science can explain everything, so the default position is ‘how can I explain this physiologically within my own materialist framework?’ I’m not convinced that’s the right way to do it.

No, I don’t have a materialist worldview, but if there is a spiritual dimension (which I think there is) I’m curious as to how it interacts with the body. William James, for example, explored how spiritual experiences interacted with ‘the subliminal self’. I wonder if healing is connected to things like trance states, altered states of consciousness, and so on.

OK, well how might it happen in those terms? Certainly there’s a lot of evidence for our ability to alter things through the Autonomic Nervous System via hypnosis. That can give us clues to a lot of this stuff. Hypnosis certainly affects the ANS, it certainly affects the immune system…probably everything. The mind / body split is of course silly. Everything is connected, everything works together. Although it’s easiest to talk in terms of what we can observe physiologically…I think we can control pretty much all of it probably.

You spoke of ‘cultural forgetting’. How and when do you think we forgot the healing response?

It was perhaps something that followed from the invention of germ theory [in the 18th and 19th century], which allowed us to have a mechanistic concept of the cause of disease and the belief that we can isolate this factor and do something about it. It’s a result of that shift in thinking. Prior to that, there was a much more spiritual and pluralistic view of how things work, and what disease states might mean. It’s still an approach that’s prevalent in some parts of the world, other than our so-called developed world. If you talk to people in some parts of Africa, their view is more akin to where we were.

Witches Apprehended, 1613, from the Wellcome collection

Another factor was our rejection of witchcraft. A lot of the healers I meet are very strange people, who, in times of yore, would have been written off as witches. They possess an extraordinary sensitivity to others. One or two have said some really weird things, like they have blurred sense of the boundary of self – they’re not sure if what they’re feeling is their feeling or the person they’re with. They’re sometimes called ‘sensitives’. We might think of the capacity for human sensitivity as being on a spectrum – if autistic people are at one end, at the other end are these sensitives. I think that’s where the healers fit in the spectrum. When they focus their attention on others, remarkable things happen.

OK, so at the moment we’re at or near the peak of a biomedical conception of health and illness. You, by contrast, espouse what you describe as ‘a bio-psycho-socio-spiritual theory of the transcendence of suffering’. How does that go down in academic medical circles?

Most of my medical colleagues think I’ve gone completely barmy, and this is all absolute nonsense. The dominant model in which we work and teach rejects anything to do with spirituality. If you mention words like spirituality or love, you’re rejected. It’s not acceptable behaviour, you’re regarded as someone who should be quietly taken off to the funny farm. So it’s quite lonely. It doesn’t bother me, I’m at the end of my career, I don’t need a new job or a reference, I don’t need to toe the line. It’s irrelevant to me. But I can feel the group discomfort sometimes around this area. I think the medical profession is a bit out of kilter with the rest of society, which is probably more accepting of the link between spirituality and health. Can I tell you another story?

Sure!

I remember a comment my daughter made after my knee was healed. She’s a doctor. I used to hobble around with my bad knee, and then when my daughter could see it was much better, she asked me if I’d finally had a knee replacement. I said no, I’d gone to a healer. She gave me a look, then she stopped herself, and asked if I’d had it X-rayed to see if it was structurally better. I said I hadn’t. She said: ‘If an X-ray showed it really is better, we are all buggered, aren’t we?’ I think that nails it. There is a terrible fear among doctors that all our stuff is a castle built on sand. It’s a fear that we don’t have all the answers. We’re often completely stumped by patients’ conditions. There’s a fear that the power structure on which our professional identities are built will be destroyed.

But your daughter raises a good point – could one not try to amass empirical evidence for healing? Would that not help to convince skeptics?

I get my intellectual knickers in a twist about using the modern materialist approach to test other models. But a team at Northampton is about to release a systematic meta-analysis of healing, which clearly shows that it can work. [Here’s a meta-analysis already produced by that team].

You previously did research on the placebo effect?

That’s how I got into this whole area.

What drew you to that topic?

I always felt there was something seriously missing within medicine. I hated medical school. I thought it was about being human, and it wasn’t. I was convinced that caring was an important part of medicine, but my medical training taught me nothing about that. So, about half-way through my career, I started to research the placebo effect. Because the only way to explore the area I wanted to explore, while retaining one’s respectability, was to call it ‘the placebo effect’.

Australian medicine man with magic healing crystal. From the Wellcome Collection

There’s not much research being done on the placebo effect – it’s a pretty tiny field in comparison to, say, cancer research. There’s a team in Italy, led by Fabrizio Benedetti, which is doing good work, and another team in Germany, and a few others. Really, ‘the placebo effect’ is kind of a hopeless concept – it’s an idiotic way to talk about it, merely with reference to dummy effects in clinical trials. But it’s a gateway to explore this natural healing mechanism. So I did some systematic review work, to shut up the people who say it doesn’t exist.

But I became convinced that pursuing the effect as ‘placebo’ was unhelpful, because it spreads the myth that this effect is just to do with clinical trials. Then I began to look at what I called ‘context effects’ – the wider context in which medicine is given, and how that affects outcomes. I’m involved in trials of that. And then, finally, I said, let’s call it the healing response. It’s a reconceptualization of research into placebo, insisting that there’s more to this than just the placebo.

There’s now good evidence, isn’t there, that our mind affects our body, that our attention, beliefs, expectation and imagination can have a powerful impact on our emotions, our bodies and our immune systems. There’s evidence from research on the placebo effect, research on mindfulness and the relaxation response, research from Cognitive Behavioural Therapy. So I’d guess that a lot of the medical profession would go that far with you – our mind certainly affects our body. But you then take it a step further – suggesting that it’s not just our minds’ ability to heal ourselves, but that some people have the ability to heal other people, even at distance. That’s a bigger challenge to traditional physics!

Yes, it’s a leap beyond where placebo research can take us.

I wonder if any teams are looking at the role of imagination, and trance states in disease and healing. I’m interested in how the arts – performance, dance, poetry, rhythm, cinema – can take us into those hypnagogic or trance states, and how that can be healing. Is anyone researching that?

An engraving of Franz Mesmer

I’m very interested in that too. That’s a very exciting avenue to explore. In fact, I’m working with a performance studies scholar, Sarah Goldingay, on exactly that. Are you aware of Ted Kaptchuk’s work on ritual and healing? That’s highly relevant. He’s a leading scholar of the placebo effect, and he’s likened the healing ritual to other forms of ritual. He compared healing ceremonies among the Navajo to alternative medicine rituals in the west, and speculated that the healing power might be in the ritual. We’re very interested in that, and in developing healing rituals that are appropriate for contemporary times, which would involve performance.

That’s fascinating. It reminds me of Mesmer, who of course used performance and stagecraft to increase the hypnotic effect. And it also reminds me of the charismatic church I go to, partly out of belief and partly anthropological interest – the different parts of me all come along. The preacher tends to do a sermon, and then to invoke the Holy Spirit for healing. And often they go into a sort of hypnotic pattern, saying things like ‘you might be feeling this’ or ‘open yourself up to the spirit’ and so on. With the music, and 500 other people around you, it can be quite powerful. It’s a sort of collective hypnotic healing.

Sarah Goldingay and I actually went to Lourdes, and we had some similar impressions. I’d say it stops just short of hypnotic trance, but only just. It’s very intriguing. And of course, music is a big part of it there too. They make fabulous use of music in their ceremony.

My feeling is if we knew enough about how people in different cultures use ritual and performance to trigger the healing response, we’d find a common thread, and then we could operationalize it. That’s the dream.

Strangely enough, I wrote an article for The Times on spiritual healing within the NHS, back in 2008, when my aunt found it useful in her recovery from cancer. Here’s that article. And here’s a video that Paul and Sarah made of their trip to Lourdes:

Stoicism Today 2014 videos

Posted on January 20, 2015 by Jules Evans

Here are some of the videos from the Stoicism Today 2014 conference, held at Queen Mary, University of London on November 29 2014. Thanks very much to all the speakers, to the QMUL Public Engagement Fund and the Centre for funding the event and the videos, and thanks to Dino Jacovides for shooting and editing them. Here’s the playlist of all the talks. More info about the Stoicism Today project here.

The History of Emotions Blog

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