Foundations for peace of mind.

Dont look for the differences,I started working in prisons with addicted prisoners and found much of this work released the addicts from emotional pain

, Foundations for peace of mind.

“Listen to the patient, s/he is telling you the diagnosis” – this again comes from William Osler, the sharpest clinician in the early twentieth century. Certainly this is the best medical aphorism I ever heard. It is not difficult to see why diagnosis is the single most crucial aspect of medical practice. Obviously where there are problems which you want to sort out, you will wish to apply the most efficacious solution. So the key is to find out what is the root of the problem – namely the diagnosis – for if you miss this, then any remedies you apply will not work, indeed risk doing additional harm, while the original disease carries on in its merry way, untrammelled, wreaking the havoc it threatened in the first place.

Needing to know what is going on, is also the first requirement for exercising adequate responsibility – if you respond to the wrong signal, or miss an important sense-data, then you reduce your adaptability by precisely the same degree. I recommend applying the same approach to wider social, indeed political problems – there are various social and global ‘diseases’ which need far better diagnoses than they currently receive – only thereafter are available remedies likely to work.
The triad of Truth, Trust and Consent arose directly from my work with the most violent prisoners in the UK prison system. I listened to them, as Osler advised, and they listened to me – and the violence which characterised their earlier behaviour, evaporated, proven by the total absence of alarm bells for three years, a unique record of any maximum security wing worldwide. Truth here, measures how closely reality correlates with your mental picture of it.

Trust, in clinical terms, is the sovereign remedy for fear. Fear gives warning, on the individual scale, of a threat to health, or indeed to life (very much as pain does on the physical scale). If you were not fearful of walking across busy motorways, then your contemplation of this philosophical nicety would be short-lived. Trust is another amorphous term, which needs to be earned rather than defined. Its relationship to fear is easily demonstrated. Suppose you were frightened of walking over a rickety bridge – your fear of being dashed to pieces on the rocks below would be entirely appropriate and realistic. However, if I could persuade you to trust me that the bridge was safe – your fear of it would disappear, and realistically so.

So here we have two of the three components that are indispensable for any stability or peace of mind.

The first is Truth – how closely does your picture of reality reflect that reality itself? Secondly, Trust – how much do you accept my reassurances that your current fears are groundless? The third and final component is Consent – do you accept what I say, not through coercion, but because it makes sense to you and you agree to accept it voluntarily. Make it your own – join your intent with mine. Here we touch again on the ‘spiritual ping-pong ball’, if I may term it thus, which our joint intents can keep aloft despite the incessant ravages of an unfriendly world.
Now while these three are indispensable to peace of mind on the individual level, they are also crucial to social stability at the community, national or global level – after all, the chief component of such communities are human beings, rather similar to ourselves, and they too require adequate supplies of Truth, Trust and Consent to maintain a dynamic security amid an ever changing and not necessarily cooperative world.
Truth is a commodity which needs to be valued far more highly. If it is in short supply globally, we all lose. Promoting Truth actively assists our social health. The less there is and the more irresponsible our media and our politicians become, then the poorer our social health is likely to be. We need calls for greater responsibility being exercised nationally and globally, else we will misdiagnose the very real problems which face us, and therefore fail to adapt – a penalty we as living organisms should rightly fear. As I write this, I’ve just received a letter from a prisoner I know who complained that the tabloid press keeps repeating a myth regarding what occurred in one of the crimes he witnessed. It is an especially gory myth. It is quite untrue. It continues in circulation, untrammelled, because it sells more papers. If we are concerned about social stabilities and social well being then Truth is certainly a commodity we must value more highly. What we need is a better apparatus for ensuring more responsibility in the media, at all levels. For this we need an adequate rationale to support it, and a clearer perception of the damage we all suffer when deceit is so widely tolerated. Weapons of mass destruction, 45 minute warnings – these are just the latest in an ongoing political tradition which is socially unhealthy in the extreme.
Trust has been so widely corrupted in the current financial credit crunch that its vital social value hardly needs further emphasis. Consent is perhaps the least well understood. It has been found in democracies, to be the most stable form of government – my view on this is that every citizen has the responsibility to ensure that the policies being propounded centrally, are True, and more likely to improve our adaptation to our environment, than otherwise.

Consent empowers – a critical feature, whether among massively deprived prisoners, or more widely across the globe.
Discussing emotions closely with 100 long term prisoners, including 60 murderers and 6 serial killers taught me a great deal. I taught them that their irrationality, including their violence, had been learnt in their appalling childhoods, and that it could be unlearnt. They taught me that all crime is revenge, a topic we need to defer at this point. They also taught me that they had been born Lovable, Sociable and Non-Violent

– just as Ethan was, and just as we all have been. Of course this contradicts certain religious dogmas that we are fundamentally born evil, or that we have in some awesome way ‘fallen’ – I find no place for this in my clinical work, and do not commend it to those who wish to make an impact in this field. On the contrary, I take great delight in resting back on the assurance that we were indeed all born Lovable, Sociable and Non-Violent – and further, that we wish to return there. Not only wish, but are fully capable of so doing, given enough insightful emotional support.
I cannot resist inserting here a paragraph from a book review by the geneticist Steven Rose which he recently wrote for a Sunday newspaper, since it rather complements the points put forward.
On the contrary, brains are not primarily cognitive devices designed to solve chess problems, but evolved organs adapted to enhance the survival chances of the organisms they inhabit. Their primary role is to respond to the challenges the environment presents by providing the cellular apparatus enabling the brain's owner to assess current situations, compare them with past experience, and generate the appropriate emotions and hence actions. It is this evolutionary imperative within the particular line of descent leading to Homo sapiens that has resulted in our large and complex brains. As feminist sociologist Hilary Rose points out, Descartes’ famous "cogito ergo sum" should be replaced by "amo, ergo sum."



The reference to Descartes indicates just how deep is the need to go back to philosophical fundamentals which have so lead us astray in the last 100 years, ever since Kaiser Wilhelm set out to leapfrog the British Empire. In that conflagration, which continued in various scenarios for the rest of that century, much in the way of idealism, and the inherent nature of human values was smashed to pieces in the abominable trenches. I have not the least doubt that without this human cataclysm, we would never have suffered from the Wittgenstein Fallacy to the extent we have. I have taken Wittgenstein as the paradigm – he was responding to the current ethos – hopefully we can now do better.



in closing
In closing, I’d like to offer a brief glimpse as to why human beings are so prone to irrationality. There is no doubt in my mind that we developed as the aquatic ape. This accounts for so many of our physiological features as to be irrefutable in my view. We are hairless because hair gets waterlogged. We are bipedal because that way we can wade deeper, avoid more predators, and seek more fish. We are sensitive to subtle changes in pressure sensors in our skin which work in water, but not so well in air. And crucially for our infantile development, we arrive at birth better equipped with subcutaneous fat than other primates, and cling to parental head hair, which thickens during pregnancy to allow the automatic clinging which politicians find newborn infants are so good at. This simple adaptation prevents us floating away from parental support.
However this evolutionary development has two serious adverse consequences. The first is that being bipeds we cannot run as fast as quadrupeds – either towards our prey or away from predators. Accordingly in order to survive, indeed to flourish, we needed a different evolutionary strategy than our speedier quadrupedal associates. And this, it turns out is our ability to socialise. We work together. We communicate, we plan, we socialise. This way we can exterminate all the mega-fauna in the Americas and elsewhere, which otherwise would have had no difficulty exterminating us. Thus, any infringement of our ability to socialise, diminishes our evolutionary advantage (as per irresponsibility), and reduces our chances of surviving. Bipedalism entails socialising – it’s what our minds are for, it’s what we most enjoy, and it is the principal loss when irrationality reigns.
The second serious consequence is our complete inability to support ourselves at birth. Other primate neonates can cling to maternal or paternal body fur – our parents have none, so we cannot. We were evolved to float neonatally – so becoming terrestrial animals opens the possibility of being dropped on hard ground – hence the vital importance of early, reliable, and comprehensive parental attachment. Where this goes awry, for whatever reason, there the roots of irrationality are to be found – indeed by honing in on this central emotional discrepancy, these roots can be cut most efficaciously, allowing mature, emotionally self-confident adults to emerge.
Irrationality therefore arises simply because every human infant is born 100% dependent. Thus every one of us in infancy, requires a sound parental attachment – vital to future mental stability. It is well established that all children, when faced with threats to this attachment, resort to ‘denial’ – “this isn’t happening to me.” Unexpectedly, many cannot then in later life, say “this has stopped happening to me”. Most of course can, especially given adequate support, but for those who cannot, the consequences can be dire. For when fear persists in this pathological manner, the threat may go, but the terror does not. The afflicted individual then becomes too fearful of reality to double-check the validity or truth of their mental picture of it. And here is the root of irrationality – afflicted individuals continue to deploy a perfectly logical reason, but one that is based on a reality that no longer obtains, significantly one in which parents were three times your size and infinitely more powerful. Irrationality occurs when reason is based on a past reality – viewed in this way, all that is required to restore rationality, is to bring that internal reality up-to-date. Again this is easier done than said, and to accept once experienced.
Are you feeling strong? If so, we can venture deeper here and talk of life’s purpose, normally an unforgiving minefield. For myself, I find I have no need to believe in the supernatural – the natural is quite awesome enough for me. So what’s the purpose of life, and why is life worth living ? Well, for me it’s all a question of being Lovable, Sociable and Non-Violent. Life’s purpose, certainly as far as humanity is concerned is to interact socially so as to regain what some of us lost in difficult childhoods. Sociability, social interchange is what we have been aiming for since we developed our unique knee joints 3 million years ago. The point can easily be proved by interacting with other people, by joining your intent with theirs, by battling the threats of the world which assail us cooperatively, together, using our minds for what they were meant. This way, it seems to me, we can gain the height of positive emotions – joy, cheerfulness, optimism. It is a positive delight to know that anyone can do it. Sublime. Sex and drugs don’t even come close.
in sum – the good, the bad and the future.
In sum, I have just drawn an astonishing, hugely optimistic and glorious picture of the human being. Our species can now claim to have intent, by virtue of being alive, and to have more of it than any other living organism. This is enormously enhanced by verbal communication – but we overlook the pitfalls inherent in that communication at our peril. Released from the ineradicable rigidities of words, we can expand our view of what life processes actually do – they organise – only when dead, does their entropy increase. But to stay alive, we need to respond and adapt to changes in our surroundings. From this emerges a new moral precept, which can counter our current moral illiteracy (and indeed our rampant nihilism). This moral does not hang in the air like a wish to be good, nor depend on the religious veneration of any god or gods. If you or any of us fails to act responsibly, being primarily living organisms ourselves, the penalty is not a nasty glance from aunty, it’s death. Or in our highly socially-dependent species, on various forms of partial social death and isolation up to and including dying itself.
If we can release our intent from its current verbal shackles, and apply our reason as the Enlightenment fervently hoped, we also need a clear, obvious, utterly reliable and repeatable account of irrationality – since that is what scuppered earlier expeditions in this area. Irrationality is the application of reason from infantile environs to today’s adult reality. The roof is falling in, you need to escape – the rational cries “where’s the exit?”, the irrational, “where’s mum?”. Irrationality, including violence, and of course war, is essentially infantile. Violence is a learned disease and can be unlearned.

We are born sociable, we need to develop dynamic social security, based on consent, on trust and on the truth of the situation. Then we, as a social species can flourish. Given enough resources it is not difficult to persuade the irrational individual to grow up emotionally – but you’ve got to put in the effort. This offers a 100% guaranteed cure for all psychiatric morbidity – provided you finish the course.

It is fear that corrupts rational thought – hence the significance of Frank Furedi’s work. If you abate the fear, with trustworthy, non-authoritarian consent-dependent support, then rationality blossoms. This again is easier done than said, easier seen than described in cold print – but if this approach survived, as it did, in the bowels of the British prison system, among the most violent and disturbed in the nation – then it augurs well for its success elsewhere.

Now for the bad. The worst thing about this view, is that it is unbelievable. It runs counter to so many contemporary shibboleths, so much conventional wisdom. This accounts for why it has made so little progress since I first excavated it, way back in 1960. I needed to keep away from the sterile teachings of the day – but when I attempted to bring my findings back, I found I had no standing. Politically too, the notion that violence can be cured is unacceptable. The Home Secretary of the day closed the Special Unit in Parkhurst Prison on political grounds, while the prison press office of the time stated “it is quite wrong for Dr Johnson to claim he did any good in the Special Unit in Parkhurst Prison”. Only last autumn the present Home Secretary chose to suppress the fact that no alarm bells had been rung in that maximum security wing for three years. In 1998, the then Prime Minister explicitly vetoed my attempts to reform psychiatry.

Medieval feudalism is alive and flourishing in Britain today.

As for the future, this depends, as with all living organism on what we do next. A global nuclear holocaust is still available, still supported by our infantile (and horrendously costly) political strategies. Why cooperation should be so much harder to implement than confrontation needs a rational explanation – in my view, we need to examine its appalling provenance, starting in 1914. But the evidence that we are all born sociable is confirmed by every positive trustworthy communication with like minds. When you or I exercise our sociability faculty, and overcome the childhood prejudices we learnt so deeply, we enter upon a glorious win-win situation.

Being living human beings, we are all licensed to dip our tongues into the great soul of humanity – sunny emotions then come bubbling up, all by themselves, for all of us – whatever our sect, colour, gender, age, wealth or outlook. What fun.

Dr Bob Johnson Tuesday, 13 January 2009