Thursday, April 7, 2011

Illness and Symptoms

One
Illness and Symptoms

Human understanding
Cannot grasp true instruction.
But if you are in doubt
And do not understand
You may happily discuss things
With me.

Yoka Daishi: `Shodoka`

  We are living at a time when modern medicine constantly presents the marvelling layman with fresh evidence of its almost miraculous skills and powers. At the same time, though, those who have a basic mistrust of modern medicine and its near omnipotence are raising their voices ever more loudly. An evergrowing number of people place a good deal more confidence in natural healing methods (be they very ancient or quite modern) or in homoeopathic therapies than in today`s highly scientific orthodox medicine, which offers a whole range of targets for critisicm – side-effects, symptom-shifts, lack of humanity, rocketing costs and much else besides. Yet what is a good deal more interesting than the details of the criticism is the fact that it occurs at all. For even before a criticism can be reduced to rational form it emerges as a vague feeling that something is no longer as it should be, and that the chosen way, despite – or even directly because of – its thorough-going application, is not leading to the hoped-for goal. This uneasiness about medical practice is an experience common to large numbers of people, including many younger doctors. Yet the concensus quickly disappears as soon as it comes to proposing new, alternative solutions. Some see salvation in the socialization of medicine, others in replacing chemotherapy with natural and plant-based remedies. While some see research into earthly radiations as the key to solving all the problems, others swear by homoeopathy. Acupuncturists and reflexologists do their best to turn our medical gaze from mere morphological phenomena towards a more energy-orientated view of the overall body process. Perhaps the best way of summing up all the alternative methods and initiatives is to speak of a `holistic` form of medicine – thus bearing witness to the endeavour not only to remain open to all the various approaches, but above all not to lose sight of the whole person as a psychosomatic unity. The fact that academic medicine has lost sight of it has in the meantime become obvious to nearly everybody. Its high specialization and reliance on analysis as the basic principle of its research has inevitably resulted not only in an ever-greater and more exact knowledge of detail but also, at one and the same time, in its losing sight of detail but also, at one and the same time, in its losing sight of the picture as a whole.
  If we consider the immensely refreshing discussion and movement that is currently going on within medicine, it soon becomes clear that the talk is largely confined to the various methods and their effects, while little is so far being said about the theory or philosophy of medicine itself. Admittedly medicine lives in large measure by concrete, practical procedures, yet every procedure is –consciously or unconsciously – an expression of the philosophy on which it is based. The rock on which the ship of modern medicine is foundering is in no sense the efficacy of its procedures, but the view of life on which it has based those procedures, often without either discussion or reflection. It is in philosophy that it is failing – or rather lacking. Medical procedures have been founded up to now upon considerations of practicality and effectiveness, but medicine`s inner `lack of soul` has in the end brought down upon itself the accusation of inhumanity. True, this inhumanity expresses itself in many concrete, exterior forms, but the problem is not to be resolved by further changes of procedure. Many symptoms bear witness to the fact that medicine, too, is sick. The `patient` that is medicine itself cannot be cured by tinkering around with the symptoms, any more than can any other patient. Notwithstanding this, most of those who criticise academic medicine and who champion alternative therapies take on board as a matter of course the philosophy and goals of academic medicine, and so apply their energies purely to changing its forms and methods.
  It is the aim of this book to get to grips all over again with the problem of illness and healing. In no way, though, shall we be taking on board the familiar, received basic values that are universally held in this field to be so irrefutable. To be sure, this attitude will make our enterprise difficult and dangerous, for we cannot help but probe deeply and mercilessly into areas which are taboo even to the public at large. We are fully aware that we are undertaking a step which is certainly not the next one on medicine`s planned developmental agenda. Indeed, it would be more accurate to say that there are a whole range of steps which have yet to be undertaken by established medical practice, yet whose deep understanding is a vital precondition for realising the concept that is basic to this book. Therefore we shall be addressing our presentation not so much towards the development of medicine in general, as to individual people whose powers of personal insight place them somewhat in advance of the rather sluggish general trend.
  What goes on at the practical level has any meaning in itself. The meaning of an event only emerges as a result of interpreting it, since it is the interpretation which alone enbles us to experience it as meaning-ful. Thus, for example, the rising of a mercury column in a glass tube is, by itself, absolutely meaningless: only when we have interpreted the event as the expression of a change in temperature does the process become meaningful. The moment people cease to interpret world events and the outworkings of their own personal destiny, their existence sinks into meaninglessness and senselessness. But in order to interpret anything, we need a frame of reference which lies beyond the level at which whatever we are trying to interpret is manifesting itself. Consequently the events and initiatives of the material world – the world of forms – can be interpreted only by bringing in some metaphysical reference-system. Only when the visible world of forms `becomes like an allegory`, as Goethe puts it, does it acquire sense and meaning for people. Just as letters and numbers are formal vehicles for the ideas which underlie them, so everything visible, everything concrete and functional, is purely an expression of an idea, and thus a mediator of the invisible. In short, we can equally well refer to these two spheres as `form` and `content`. It is through form that content expresses itself, and it is in this way that forms become meaning-ful. Written signs or letters that convey no ideas and no meaning remain for us senseless and void. Even the most detailed analysis of them cannot alter the fact. The relationship between form and content is just as universally clear and understandable in the artistic context. The quality of a painting does not reside in the quality of the canvas or paints: the mediators of an idea which is the artist`s inner picture. The function of the canvas and paints is thus to make it possible for the otherwise invisible to become visible, and so they are physical expressions of a metaphysical content.
  These simple examples represent our attempt to bridge any gap in understanding which may surround the method applied in this book, a move to consider the themes of illness and healing in a meaning-ful way. But in the process we are quite deliberately and unequivocally leaving the sphere of `scientific medicine` behind. We make no claim to be `scientific` for the simple reason that our point of departure is a quite different one – a fact which means that scientific discussion or criticism of our approach is bound to miss the mark. Consequently it is with all due deliberation that we shall be abandoning the scientific framework, since this confines itself specifically to the functional level and thus makes it impossible for sense or meaning to become clear. Such an approach is not designed for inveterate rationalists and materialists: it is designed, though for people who are ready to follow the inticrate and by no means always logical paths of human consciousness. Among the most helpful companions on such a journey through the human soul are pictorial thinking, fantasy, association, irony and an ear for the linguistic background. And our chosen way demands not least the ability to tolerate paradox and ambivalence without immediately feeling obliged to destroy one pole or the other for the sake of imposing clarity.
  In medicine, as in common speech, people refer to a whole variety of ìllnesses`. This is an example of linguisti slovenliness which reveals very clearly the widespread misunderstanding which surrounds the concept of illness. Ìllness` is a term which can in fact only be used in the singular. The plural, ìllnesses`, is just as meaningless as the plural of `health`- `healths`. Illness and health are singular concepts, since they refer to a human state or condition and not, as is fashionable in today`s usage, to organ or parts of the body. The body is never ill or healthy, for it does no more than express messages from our consciousness. The body does nothing of itself, as anybody can confirm for himself by looking at a corpse. For its operation the body of a living person has two immaterial entities to thank – precisely those to which we generally refer as consciousness (soul) and life (spirit). It is consciousness which presents us with the messages that are manifested in the body and so eventually made visible. Consciousness is to the body as a radio programme is to the receiver. Since consciousness represents a non-material, self-sufficient quality in its own right, it is naturally neither a product of the body nor dependent on its existence.
  Everything that happens within the body of a living being is the expression of a corresponding information pattern, or a condensation of a corresponding image (the Greek for ìmage`is eidolon, which is also related to the concept ìdea`). When pulse and heart are following a particular rhythm, when the body temperature is being maintanied at a constant level, when the glands are pumping out hormones, or when antibodies are being formed, these functions cannot be explained purely in material terms. Instead, each is dependent on a corresponding information pattern whose source is consciousness itself. When the multifarious bodily functions are chiming together in a particular way an overall pattern emerges which we feel to be harmonious and so refer to as health. If a particular function goes wrong, it compromises the overall harmony to a greater or lesser extent, and we call the result illness.
  Illness, then, means the abandonment of harmony or the throwing into question of a hitherto balanced regime (we shall be seeing later that – seen from another angle – illness, too, is actually the creation of a kind of balance). But the disturbance of this harmony takes place within consciousness, at the informational level, and merely manifests itself in the body. In this way the body is the representational or realisational aspect of consciousness, as well as of all the processes and changes that go on within consciousness. Thus, just as the entire material world is merely the stage on which the play of the achetypes takes on form and so becomes `like a metaphor`, so by the same token the material body is the stage on which the images of consciousness force their way into expression. Hence, if a person`s consciousness falls into imbalance, the fact becomes visible and tangible in the form of bodily symptoms. That is why it is misleading to say that the body is ever ill – only people can be ill – even though the illness does show up in symptomatic form within the body. (When a tragedy is performed, after all, it is not the stage, but the play that is tragic!)
  Sypmtoms are many and various, yet they are all expressions of one and the same event which we call ìllness`, and which always occurs within a person`s consciousness. Just as the body cannot live without consciousness, so it cannot become ìll` without consciousness either.
  At this point, meanwhile, it should be understood that we do not accept the nowadays customary division between somatic, psychosomatic and mental conditions. Such a concept is more likely to hinder the understanding of illness than to help it. True, our viewpoint does correspond somewhat to the psychosomatic model, yet with the difference that we take such a view of all symptoms without exception. The disctinction between `somatic` (i.e. bodily) and `psychic` (i.e. psychological) can at best be applied to the level at which a symptom appears – but cannot be used to locate illness itself. The age-old concept of mental illness is completely misleading, since the mind (that is, the consciousness) can never become ill. Rather is it a case here of symptoms which manifest themselves on the psychological level – that is, which show up within a person`s consciousness.
  Consequently we shall be endeavouring here to develop a unitary view of illness which uses the distinction between `somatic` and `psychological` at most to refer to the primary level on which a symptom appears.
  Given the conceptual distinction between illness (consciousness-level) and symptom (body-level), the focus of our consideration of illness will necessarily shift away from the familiar analysis of what is going on in the body to something which has hitherto been far from familiar, at least in this context – namely a thorough-going look at the psychological level. Thus, we shall be acting rather like a critic who, instead of panning a bad play in analytical terms or proposing changes of scenery, props or actors, turns his attention directly to the play itself.
  When a symptom manifests itself in a person`s body, it draws attention to itself to a greater or lesser degree and thus interrupts, often quite abruptly, life`s former continuity. A symptom is a signal which directs our awareness, interest and energy to itself and in the process upsets the usual smooth flow of things. Willy nilly, a symptom demands our attention. We regard this interruption form òut there`as a disturbance and therefore we generally have only one aim – to make what is troubling us (the `trouble`) go away again. People hate to be disturbed – and so the battle against the symptom begins. Even a battle, meanwhile, implies concern and attention – and so it is that the symptom always manages to ensure that we concern ourselves with it.
  Ever since the time of Hippocrates, academic medicine has been trying to convince patients that a symptom is a more or less accidental phenomenon whose cause is to be sought in mechanical processes, and so everybody is eager to research those processes. Academic medicine carefully avoids interpreting the symptoms, and so condemns both symptom and illness to meaninglessness. Yet this deprives the signal of its true function – for in the absence of symptoms the signals lose all significance.
  By way of clarification, let us take an analogy. On its instrument panel a car has a whole range of warning-lights, which come on only when one of the car`s vital functions is no longer operating properly. Yet in the actual event of one of them lighting up during the journey, we are far from happy about it. We feel obliged by this signal to interrupt our trip. In spite of our understandable disquiet, however, it would be stupid to get annoyed at the light itself. It is, after all, telling us about some happening which we otherwise would have taken much longer to find out about, since it lies in what for us is an ìnvisible` zone. Consequently, we treat the fact that the light has come on as the cue to call a mechanic, with the object of ensuring that after he has done his job the light will no longer be on and we can happily resume our journey. Nevertheless, we should be pretty indignant if the mechanic were to achieve this end simply by taking out the light-bulb. True, the light would no longer be on – which would indeed be what we had wanted – but the way in which this had been achieved would appear to us to be far too superficial. Rather than stop the light coming on at all, we would regard it as far more sensible to make it unnecessary for it to light up in the first place. But for this to happen, we should need to shift our attention from the light itself and turn to what lies behind it, so as to find out what is actually out of order. The light`s real function, in other words, is and was simply to act as an indicator and make us ask questions.
  As is the warning-light to our example, so is the symptom to our subject. That which constantly reveals itself as a series of bodily symptoms is the visible expression of an invisible process; it is designed as a signal whose function is to stop us in our tracks, reveal that something is no longer in order and make us ask questions about what lies behind it all. Here, once again, it is silly to get upset about the symptom, and downright absurd to try switch it off simply by preventing it from appearing. The symptom has to be made superfluous, not prevented. But in order to do this it is just as necessary as before for us to avert our gaze from the symptom itself and examine things more deeply, if we are to understand what the symptom is really pointing to.
      It is in its incompetence to undertake this step, however that the main problem of academic medicine lies: it is far too mesmerised by the symptoms themselves. Consequently it equates symptom with illness – in other words it is unable to distinguish form from content. It then goes on to apply enormous resources and skills to the treatment of organs and parts of the body – but never of the actual person who is ill. It chases after the goal of one day being able to do away with symptoms altogether, without for a moment looking more deeply into the sense of feasibility of the idea. It is astonishing how impotent even plain facts are to bring this euphoric wild-goose-chase back down to earth. Since the advent of so-called modern, scientific medicine the number of patients has not gone down even by the smallest fraction of one per cent. True, efforts are made to mask this sobering fact with the aid of statistics that refer only to particular groups of symptoms. Thus, victory is proundly proclaimed over the infectious diseases, for example, without a word about what other symptoms have increased in intensity and frequency over the same period.
  No honest view can emerge until people start to look not at the symptoms, but at illness as such – and this has not declined, and will assuredly not decline in the future. Illness is as deeply rooted in human nature as death itself, and is not to be eradicated from the world by a few mere mechanical gimmicks. Were we to appreciate illness and death in all their awesome greatness, we should realise in the light of that appreciation how laughable our ill-begotten efforts are to pit our powers against them. But then, of course, we can always shield ourselves from any such disillusionment by explaining away illness and death as mere physical processes, so making it possible at the same time still to believe in our own greatness and authority.
  To sum up thus far, then: illness is a human condition which indicates that the patient is no longer in order or in harmony at the level of consciousness. This loss of inner balance manifests itself in the body as a symptom. The symptom is at one and the same time a signal and a vehicle of information, for its appearance interrupts our life`s familiar flow and forces us to give the symptom our attention. The symptom alerts us to the fact that we are sick people or sick souls – that is, we have lost our inner, psychological balance. The symptom tells us so: it says that something is missing. `What`s amiss?`, people used at one time to ask those who were ill – though the latter always replied by saying what they had: Ì`ve got a pain.` (To this day sufferers in Scotland are routinely asked, `What are you lacking?`- tr.) Nowadays we have taken to asking straight out, `What have you got?` On closer consideration, the mutual polarity of these two questions - `What`s amiss?`and `What have you got?`- is very revealing. Both are entirely appropriate from the patient`s point of view. Anybody who is ill is lacking something, and specifically at the consciousness level: if they were not lacking something they would be whole – both healthy and complete. On the other hand, once that wholeness is compromised in some respect, then they are ùn-whole`- that is, unwell or ill. This ìll-ness`shows up in the body as a symptom, which is something that one has. And so it comes about that what one has is an expression of what one lacks. One lacks some aspect of consciousness, and therefore has a symptom.
  Once people have grasped the difference between illness and symptom, their basic attitude and approach to illness becomes transformed at a stroke. No longer do they see the symptom as the great enemy which it is their highest goal to resist and destroy. Instead they discover in the symptom a partner capable of helping them to discover what they lack and so to overcome their current illness. At this point the symptom becomes a kind of teacher, helping us take responsibility for our own development and the growth of our consciousness – a teacher, though, who can show great severtity and harshness should we fail to respect what is in fact our highest law. Illness knows only one goal: to make us become whole.
  In the course of this quest the symptom can tell us what we are lacking thus far. This presupposes, however, that we understand the language of symptoms. It is the re-learning of this language of symptoms that is the purpose of this book – re-learning, because this language has existed from the earliest times, and is therefore not to be discovered, but re-discovered. Our whole language is psychosomatic – which is to say that it knows all about the connections between body and psyche. If we can learn once again to appreciate our language`s capacity for double entendre, to listen in to its ulterior meanings, then we shall very soon be able to hear what our symptoms have to say and learn to understand them. Our symptoms have more – and more important – things to say to us even than our fellow human beings do, for they are far more intimate associates, pertain to us alone and are unique in really knowing us from the inside.
   The result, however, is a degree of honesty that is not all that easy to put up with. Even our best friends would never dare tell us the truth about ourselves to our face in the honest, unvarnished way that our symptoms always do. No wonder, then, that we have allowed ourselves to forget the language of symptoms: it is, after all, always easier to be dishonest. Yet merely refusing to listen or understand will not make the symptoms go away. We are constantly forced to come to terms with them in one way or another. If only we can dare to listen to them and enter into communication with them, they will become incorruptible teachers and guides along our way towards true healing. By telling us what we are currently lacking, by making us aware of whatever themes we still have to integrate consciously within ourselves, they give us the opportunity, through a process of learning and inner awakening, to render the symptoms superfluous.
  It is here that the difference lies between fighting illness and transmuting illness. Healing arises exclusively from the transmutation of illness, never from conquering symptoms. For, as the linguistic wisdom reveals, healing presupposes that the patient has become `healthier`- which is to say `more whole` or `more complete` (our use of the ùngrammatical` comparative form of whole simply implies nearer to wholeness: the comparative is actually no more legitime where health is concerned, either!) Healing always means a closer approach to the whole – to that wholeness of consciousness which is also known as enlightenment. Healing occurs through the incorporation of that which is missing, and thus is not possible without an expansion of consciousness. Illness and healing are twin concepts which have relevance only to consciousness and are not applicable to the body, since a body itself can neither ill nor healthy. All that it can do is reflect the corresponding states and conditions of consciousness itself.
  But it is precisely over this point that academic medicine is most liable to criticism. It talks of `healing`without paying due heed to the one level on which healing is actually possible. True, it is not our intention here to criticise how medicine goes about its job when it is making no specific claim to healing as such. Medical practice confines claim to healing as such. Medical practice confines itself to purely practical measures which in themselves are neither `good` nor `bad` but are simply available forms of intervention on the material level. On this level medicine is often extraordinarily effective, and so turning its methodology into a kind of general bogeyman is something which is best reserved for oneself, not imposed on other people. It all depends, after all, on just how prone one is to try and change the world by brute force, or on whether one has managed to unmask such an approach – for oneself, at least – as the illusion it is. Those who have seen through the game have absolutely no obligationto go on playing it (even though there is absolutely nothing to stop them either!), but nevertheless they have no right to deny it to others merely because they themselves no longer need it. Even learning to cope with an illusion can in the event have its benefits too.
  Thus, we are less concerned here with what people do, than with their awareness of what they do. Readers who have understood our viewpoint thus far will note at this point that our criticism naturally applies just as much to `natural` healing methods as to academic medicine itself. Natural methods, after all, likewise attempt to bring about `healing`and to prevent illness through practical intervention, as well as talking about a `healthy lifestyle`. The underlying philosophy is thus identical to that of academic medicine, but for the fact that the methods involved are somewhat less noxious and more natural. (Homeopathy, which belongs strictly neither to academic medicine nor to naturopathy, may be seen as an exception to this.)
  Humanity`s path is one that leads from the unhealthy to the healthy, from illness to that true healing which is also wholeness and even holi-ness. Illness is not some accidental, and therefore disagreeable upset along the way, but the very way itself along which people can progress towards wholeness. The more consciously we can think about that way, the more likely is it to lead us to the goal. Our purpose is not to resist illness but to use it. Nevertheless, if we are to succeed in doing so, we are now going to need to go into things somewhat more deeply.