Tuesday, November 10, 2009

Talking the Walk (2)

In Praise of Puzzlement

It’s time to sing of puzzlement as a desired, and desirable, state of mind. It’s time to paint in lush, layered grays. Living grays.

A friend wrote me the other day of G.E. Moore saying, of the young Wittgenstein, “I have a very good opinion of him. He is the only student who looks puzzled in my lectures.”

In brutish schools of thought (often among the most powerful and influential schools of thought), puzzlement is typically derided as a sign of the infirm or timid mind. It can be. Just as it can be sign of the strongest and bravest. Do you have what it takes to live with–live in–“maybe...maybe not”?

I see you’re critical of the mental health system. Yes...to a point.

You think you know a better way. Yes...to a point.

I don’t have a one-treatment-fits-all program to suggest. I’m left with–left in–puzzlement, but out of puzzlement I do have a couple of questions to pose.

1) Why has one of the oldest and most low-tech approaches to mental illness fallen so out of favour? I’m talking here of the “rest cure” as it used to be called, making use of the healing power of time and quiet as the wounded psyche sorts itself out. I think of this sometimes as I walk around the now-disused grounds of the old Ontario Hospital, a place I was almost sent to for the long-term care that we patients called “bagging.” I find those lawns and chestnut trees restful and restorative now...I suspect I would find them even more so in a time of acute illness. Not, certainly, as a “bagged” person, a warehoused shell of myself–but as a broken soul in need of sanctuary, of asylum, in need of the long, slow time necessary to reknit brokenness. No matter how successfully it is managed, trauma takes time. Time to occur (since it occurs in waves, even if one event precipitates it)...and a long time to come back from.

2) Now, I know that part of the answer to my first question is that we have other treatments now. More focused ones, usually pharmacological but also psychotherapeutic. The “rest cure” was partly because the ones prescribing it had nothing else to prescribe. But that’s only part of the answer. Another part has to do with our haste these days to restore a patient to functioning. “Time heals,” we say, but do we act as if we believe it? It takes courage to trust time–the courage to wait and see. And I have absolutely nothing against functioning. At my best, I juggle a full-time job with serious reading and writing, seeing family and friends, other hobbies and interests–I like being active and productive, as only someone who has spent months and even years out of commission, can. But I think we all fall into the trap of defining functioning too narrowly. And of making it a kind of idol. Functioning can’t really be understood in abstract or absolute or general terms, but only in individual terms, as part of a larger concept of overall mental health. It’s likely that, after the onset of illness, a person’s means of functioning will change, temporarily or permanently; it may also fluctuate, which is certainly true for me. I’ve had to develop–and this is something I’m still doing–a new model of functioning...one that fits the person I am now.

Can there be any person for whom this is not true? That is, anyone who, to answer the question What can I do today? must not first ask the question Who am I today?

“Who decides what functioning is?” I asked Dr. George in one of our first sessions.

She looked puzzled. At last! I’d seen psychiatrists furrow their brows in anger, in disbelief, in impatience...in any one of the rainbow hues of pique. When had I last seen a brow furrowed in honest perplexity?

“You do,” she said. “Who else?”

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