John Marzillier – To Hell and Back

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Book Review, John Marzillier, Psychiatry, Psychological Therapies, Psychology, Psychotherapy, PTSD, To Hell and Back, Trauma

A wise, thoughtful, compassionate and skillful book about PTSD revealed through the words of those who have experienced this.

It’s funny how synchronicity works. Because I read Noel Hawley’s highly recommended Before The Fall, which I highly recommend, and which features a small boy who suffers a profound traumatic event, and clearly would be diagnosed with PTSD, and because I have a professional interest in the subject, I was reminded that John Marzillier, a British clinical psychologist and later, psychotherapist had written a book on the subject.

I had been moved and beautifully taught much in another book by him, The Gossamer Thread, where he explored his wide journey of development as a practitioner, and the deep exploration, refining, and ambiguity in human relationships that happen throughout all our lives, within and without any kind of formal therapeutic setting, simply because human beings are complex, and so each and every encounter between self and other is fraught with – an endless possibility.

Duke and Duchess of Cambridge and Prince Harry: Promoting the charity Heads Together to open up discussion of mental health issues

So, I started to read the in some ways, more geared towards the practitioner, slightly more left brain, slightly less poetical/metaphorical To Hell and Back: Personal Experiences of Trauma and How We Recover and Move on. And during my reading and reflecting period, mental health, particularly linked to the experience of dealing with psychological trauma, suddenly became positive news, due to Prince Harry, and also Prince William, speaking openly about the deep, hidden effects caused by their mother’s death. Public figures speaking out in such a way, honestly, – particularly public figures who are, not being rude, part of the Establishment rather than famous for flashier, sex-and-drugs-and-rock-and-roll lifestyles, not to mention ‘reality TV’ famous only for being famous ‘stars’, will be listened to more seriously.

Expression of emotion is more common, and I would say, generally a good thing, with the exception of the artificial stimulation of emotion in reality TV shows!

But, he also cautions against those who assume it always IS the right approach to bare the suffering soul:

Is avoiding talking about feelings always wrong? I do not think that one can or should make such a categorical statement. So much depends on the context and the person, not to mention their relationships with family and close friends and on timing

Focusing on a wide range of traumatic single events – Marzillier in this book is exploring the kind of ‘out of a moderately clear blue sky’ unexpected and traumatic event, rather than, say the trauma of repeated brutal events from early childhood – the author looks both at the unpredictable horrors caused by acts of deliberate chosen malevolence, and the impersonal ‘being in the wrong place at the wrong time’ of major accidents like train crashes due to mechanical failures. Marzillier was, for many years, employed by Thames Valley Police, working with those who have to deal with traumatic events, which arise out of the nature of their work – police, firefighters, army personnel, ambulance personnel. The professionals have to maintain a distance from their own natural ‘alert! Danger! I am under threat! autonomic nervous system response of flight, fight, freeze or dissociation which is our physiological survival response. The fact that they are trained to do this, and have techniques to use, cannot ever completely over-ride that ancient animal response, and this kind of ‘trauma is my 9-5, day in-day out worker’ may well find health problems which arise out of the continual overriding of the normal response to danger – get out of here!

How people feel and behave once they are out of danger and the traumatic event is over is a product of the intensity of the experience itself, the nature of the person and the context – that is, what their life is after the event

As in his previous book, what most blazes out, necessarily and importantly, is Marzillier’s artistry, his compassion, his flexibility and his open-ness to meet each individual he interviews for this book, making space for a joint exploration of their stories. Time and again he cautions against the single fix-it approach to PTSD – and, indeed, to the single, fashionable diagnosis of the condition. There may be other mental and emotional health issues experienced by someone who has been in a ‘traumatic’ situation, and other approaches, other diagnoses may need to be made. Don’t jump to a PTSD conclusion, he cautions.

It is a mistake to sweep all post-trauma psychological reactions into one simple category, or to assume that if someone shows PTSD symptoms then nothing needs to be done but treat the person’s PTSD

At the heart of this book, is the often stated central idea that whatever ‘the diagnosis’ says, that it is a unique individual with all their individual personality, history, belief systems and social networks who is receiving the diagnosis, and there CAN be no ‘one way’ of treatment. As in Gossamer Thread, Marzillier stresses it is the relationship between practitioner/clinician and patient/client which actually matters MORE than any ‘specific’ method. Sure, the practitioner must have relevant skills which can work in this field, and preferably, the flexibility and skill to acknowledge that ‘their’ skillset may not be the right one for THIS client at this point. Marzillier even acknowledges that treatment approaches which lie outside his particular belief system and training, DO work for some people, – with the right practitioner. He is extremely open-minded, whilst being at the same time, a scientist by training.

This book has a lot, highly relevant, to say to both the clinical psychologist and the ‘energy worker’ working in this field.

It is a marvellous book, serious, analytical, warm, open minded and hearted – and, always important, beautifully written, and authentic – he has allowed the individual voices of the many people he interviewed in this book – those who had experienced events, and been diagnosed with PTSD – to recount their stories, and the different treatments and outcomes. These are not, in the main, ‘his clients or former clients’ . They are people who chose to respond to a general request made ‘public’ when he was planning on writing a book on this subject.

To Hell and Back Amazon UK
To Hell and Back Amazon USA

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Chris Mackey – Synchronicity

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Book Review, Chris Mackey, Positive Psychology, Psychiatry, Psychology, Synchronicity

An interesting book which might not quite reach its deserved audience

Chris Mackey’s Synchronicity is a fascinating look at this phenomenon, which is at the same time not completely satisfying, as, for this reader, its tone means it may well be more likely to appeal to the New Age converted (of which, to a large extent I can surely count myself a member) but fail to appeal to those who could or might be converted by the well argued theory and research to take this book as seriously as it deserves to be.

Some of the information, and, perhaps more, the at times ‘Wow!’ ‘Awesome!’ tone, makes the book appear to come from the scientific equivalent of what might be thought of as the ‘loony left of psychology’ When in fact, the focus is much more grounded and pertinent.

Mackey is clearly a respected and experienced psychologist and therapist. He is a Fellow of the Australian Psychology Society. Fellowships are an honour bestowed on those who are influential and have made positive contribution in their field. An honour, moreover, bestowed by one’s peers. He has worked within a public setting in hospitals, and has his own private psychology practice, and has been working in the field for over 35 years.

He is a passionate, thoughtful, persuasively articulate advocate of what might be called Positive Psychology. Mainstream pharmaceutically based psychology and psychiatry has increasingly become focused on what might be thought of as ‘lesion management’ rather than health recognition. In other words, the identification of the illness, the syndrome, the abnormality of dis-ease. And this generally means a reductionist and biochemical approach to management. The complex politics and organisation of this has been brilliantly explained in James Davies’ Cracked – Why Psychiatry Is Doing More Harm Than Good.

Holistic/Positive Psychology recognises that in every living organism forces of health/wholeness/stability – or the potential to achieve this always exists, as well as the opposite potential to entropy and disorganisation.

Western medicine has a focus around rectifying symptomatic dis-ease – and this is of course a very useful and productive paradigm, but it is not the only useful and productive approach. Other medical systems such as Ayurveda and Traditional Chinese Medicine focus less on the symptomatic analysis of the specific ‘wrong’ and more on what is the whole pattern of imbalance that symptoms are only a reflection of. This does represent a different approach as the pattern indicates the direction of ‘wholeness’ which still exists. A movement away from balance still indicates that relationship with the balance point. In TCM (Traditional Chinese Medicine) deficiency in flow of Qi has corresponding stagnation, excess, blockage.

In the field of Western psychology there are practitioners and theoreticians, and methods, where the emphasis is on understanding that the ‘lesion’, the wound, can be in fact the pointer to the direction in which health and wholeness lie, and that psychic wounds in fact show not only the potential for health and wholeness which is always present, but is the means by which healing manifests. This may sound barking, but, considered simply, it is the breaking of a bone, the wound to the skin, the being laid low by infection which galvanises the complex responses to repair and remodel tissue or to fight infection. Similarly those woundings to the psyche are also calls to where repair, remodelling and maintaining integrity will arise from. Unsurprisingly Mackey, an advocate of Positive psychology, explores the legacy of Jung, Maslow, Ken Wilbur and others, whose approaches have been around the psychology of health, individuation, peak experience and the like. Giving the psyche its weight and place.

Jung’s snappily titled (!) Synchronicity : An A-causal Connecting Principle, defined synchronicity as the connection of two or more, seemingly random occurrences, as not being ‘random’ or ‘chance’ but as meaningful, and common. These could vary from the experience many have, of having the thought of someone enter your head, someone you may not have thought about or had connection with, for some time, and an instant later, the phone rings, you pick up, and it is that person. Or it could be something more symbolic – Jung’s interest in the phenomenon initially being sparked from this direction – a patient told him about a dream in which she had been given a golden scarab (the dream was one which was a highly charged, meaningful one, full of symbols which were potent for the dreamer and the analyst) At the moment the analysand was describing her dream, came a tapping on the closed window in the room. Jung opened the window and an insect flew in – a scarab type of beetle, greeny gold in colour.

“Cetonia-aurata” by I, Chrumps. Licensed under CC BY-SA 3.0 via Commons.

Jung’s developing idea about synchronicity, which is seen as something of a pointer, something encouraging us towards a noticing, a kind of indication that you are in-the-flow, which Mackay describes as ‘ticks from the universe’ were formed in part out of discussions he had had with Einstein, and had encouragement from another ‘father of quantum theory’, Wolfgang Pauli.

Mackey also explores these connections, and provides some welcome, unflaky breaking the phenomenon away from the ‘spooky-woo’ dismissable. It is specifically ‘entanglement’ which interests him – on a quantum level:

The term ‘entanglement’ describes a relationship between two or more particles, or other objects, that have interacted with each other and then been separated. Bell’s Theorem (physicist John Stewart Bell) hypothesized that two or more such objects would somehow remain connected with each other, functioning as a single system. This mean that any induced change in one twinned particle, such as an electron, would lead to an instantaneous and complementary change in the other, regardless of how vast the distance that separated them

Easy-peasy, eh!

These kinds of ideas and reflections, though echoing many writings found in the New Age section of bookstores – or in long ago written texts on Eastern mystical thinking – are coming from that strange place called quantum physics, and from quantum physicists, trying to find ways to understand some of the phenomena happening at this level

And I must say, that describing all this through the perspectives of rationalising, without the kind of ‘Wow! Awesome!!’ wide-eyedness which often permeates ‘New Age’ books and makes the sceptical, unsurprisingly, dismiss the whole idea as something arising from the relicts of old hippies who dropped too much suspect chemistry in their dim and distant, is very very welcome indeed.

But……….there is ‘stuff’ in this book which troubles, however much I admire Mackay’s honesty about his own experiences. Which are thus : Synchronicity has been something which he has been aware of, in his own life, and usefully stayed open to. He has also, inevitably, in his professional life, attracted patients who noticed synchronicity, or synchronicity became a kind of tool which could be helpfully used in sessions. So there are examples and underlinings which Mackey gives, in clear, and understandable fashion.

What there also is, which increasingly creeps in, is precisely that tone of ‘Wow! Awesome!’ which begins to seem a little off-kilter, a little out-of-balance. And Mackey himself has had experience of ‘breakdown’ – a diagnosis of a hypomanic episode. During this, he was dizzyingly ‘synchronicitous’, and it is the reading of the chapters where he honestly recounts his ‘Wow!’ ‘Awesome’ and the recounting voice (to my mind) has a kind of ferociously over-bright, over-loud ‘Wow!’ ‘Wow!’ ‘Wow!’ quality to it that makes it a little hard to read. He is honest enough to let us know that during this period some of his colleagues thought (and told him) that he was psychotic.

Later, Mackey analyses his own experiences, and concludes he may have fallen into a kind of enlightenment trap – that of ‘psychic inflation’ a sense of grandiosity, specialness (which of course also happens in the ‘manic’ stages of bipolar disorder)

A writer Mackey met on a retreat, very broadly in sympathy with what Mackey has really spent his professional life involved in – furthering Positive Psychology, working with that impulse to wholeness within living organisms, embracing what might be called our spiritual nature, rather than reducing everything about a person to ‘dysfunctional chemistry’ and medication – warned Mackey not to get so focused and caught up in synchronicity. He felt Mackey had become so over-excited by it that he might overlook the ‘fundamental spiritual principles’

Translating that to my experience reading this book, it seems to me that however laudable his honesty about his own experience has been, that it is precisely the over-emphasis on his personal story, told in such a different voice from the rest of the book, which may end up side-lining what is surely an important book which has much to say about the ‘fundamental principles’ of bringing Positive Psychology, humanity, and meaningful, unreductionist ways of treating mental illness, and, perhaps more importantly, fostering and growing human wellness, into wider use. I do feel that it is the over-emphasised weight of that personal story which may lose Mackey a far more useful audience – the unconverted, the sceptical, than this book really deserves. It may not travel much beyond those New Age Shelves. Which will be a shame.

I do recommend it. The fully converted are unlikely to find it controversial, but I hope those less convinced might read it for the well-argued stuff.

I received this as an ARC for review from the publishers, Watkins, via NetGalley. It will be published in the UK next month, and in the States also, though with a much expanded title, which rather suggests its self-help market – nothing wrong with that, I just think it might have had a more professionally influential appeal. And perhaps some of the earlier, cooler stuff might not be sufficiently grab-able for those wanting more instructional self-help ‘how to’

Synchronicity Amazon UK
Synchronicity: Empower Your Life With The Gift Of Coincidence Amazon USA

Jon Ronson – The Psychopath Test

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Book Review, Jon Ronson, Psychology, Sociology, The Psychopath Test

Well written and engaging; could have gone so much further

Jon Ronson is one of those investigative journalists who gets down and dirty with his subject matter, rather than taking himself out of the equation and writing with a overview, an all-seeing eye which suggests ‘objective truth’ Of course, the writer will always have an opinion, and be part of what is being observed, whether they make that subjectivity overt or keep it covert.

The initial premise of this well-written book starts out looking like something far-fetched from The Celestine Prophecy – a mysterious manuscript which has been sent to various academics, one of whom asks Ronson to investigate where it came from and what it means. These investigations lead him into looking at the sort of personality which might be inclined to want to manipulate others, and quite quickly he gets drawn into that journey, looking particularly at psychopathic behaviour, what a psychopath is. Most of us probably consider psychopaths to be people who commit horrific crimes such as rape and murder, but as Ronson discovers, there is a continuum in reaching the diagnosis, and there are many ‘normal’ people in society, who do not rape and murder, but nonetheless have certain character traits and behaviours which may be part of the check-list of a clinician who is trying to ascertain ‘is this person a psychopath?’ Ronson’s journey takes a look at some of the history of psychiatric medicine – including some of the excesses of the anti-psychiatry movement of the 60s and 70s, and the backlash of overdiagnosis and that checklist of the DSM – Diagnostic and Statistical Manual of Mental Disorders. There is also the teasing throwaway that though psychopathic tendencies may exist in about 1% of the population at large, there are a statistically larger number of these ‘members of the general population’ with psychopathic tendencies to be found as CEOs of major organisations. Makes a horrid kind of sense really, given the cultivation of ruthlessness which seems to be required, fostered and encouraged in programmes like ‘The Apprentice’

Ronson making his own journey a central part of this exploration of mental health and psychopathy in particular, has both great strength – but also weaknesses. The strengths are an immediacy of having an engaging, articulate, witty companion as your guide, as you read the book, who asks some of the questions which you, the reader might have, as you try to gain some understanding of what a psychopathic personality might be. The weaknesses are that there are interesting questions raised,which don’t really go anywhere, and he doesn’t really follow through with them. Such questions as: what ‘normal’ is; why both ’empathy’ and its lack, might exist; the strengths and the weaknesses of having an ‘artist’s’ view of mental health (analysis, therapy, allowing the story/the gestalt of a person to happen ) versus the scientific/statistical ‘observed’ presentations of the DSM. There’s a teasing nod to this in his account of a partial conversation with his friend Adam Curtis, the documentary film maker, who is critical of the direction Ronson is taking in his investigations for this book – looking at how inevitably the investigator gets drawn into investigating the ‘on the edge’ peculiarities, the weirdly extreme, so that the investigator (and the reader/viewer) can feel safely superior, without really looking at aspects within oneself. I probably wanted Ronson to be closer to Curtis, and to look more at what all this means for society at large – how the attempt to over-diagnose mental illness has led to a flattening of what it means to be human, a tighter and smoother and more conformist view of ‘normal’, and mass medication, via the pharmaceutical industry, of normal, human variation. Perhaps the difference is that Curtis is a man with an agenda, and Ronson may not be. Curtis’s libertarian stance may give him a certain blinkered vision, but it also brings focus and cohesion. Ronson is more scattergun, not quite following through.

I also would have liked to have seen something about where cultivating ‘lack of empathy’ may work to society’s advantage – for example, within certain branches of medicine. It strikes me that the surgeon, if he or she allowed themselves to really engage with the pain and suffering of the patient, might be too overwhelmed to make that healing incision. There are professions where the fostering of empathy is crucial – nursing for example, and professions, like surgery, where it is most helpful if a certain ability to ringfence, or even inhibit, empathy is present

The Psychopath Test Amazon UK
The Psychopath Test Amazon USA

Erich Fromm – The Art Of Loving

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Book Review, Erich Fromm, Philosophy, Psychology, Sociology, The Art Of Loving

Love: equals care, responsibility, respect, knowledge

This is a quite extraordinary slim little volume. I started to underline certain sentences and paragraphs as being particularly potent and insightful, (or particularly open to fierce debate) and soon realised I might as well annotate the whole book

Inevitably, in the West we have come to focus more and more upon erotic love, the dizzying though often illusory experience of falling in love, which Fromm contrasts with the maturity of loving itself, in a sexual relationship – which he calls ‘standing in love’.

However this book goes way way beyond erotic love. He looks at love itself as an expression of life itself, and the act of giving, rather than taking.

The mother-child relationship is paradoxical and, in a sense, tragic. It requires the most intense love of the mother’s side, yet this very love must help the child to grow away from the mother, and to become fully independent.

The development of love is traced through key, primal experiences, firstly , that which he calls Motherly love – this is unconditional love, and if we are lucky, an experience which we have, that of being loved completely, for all we are, and taken care of. We need to do no more than BE, to inspire this kind of love. The second primal love is what he calls Fatherly love, which he sees as conditional. We earn father’s love by pleasing him, by being most like him, by accepting, therefore, responsibility. The third love is Brotherly love – this is an equal love, recognising you as similar to me. It respects your autonomy as well as my autonomy, and that respect prevents ‘Fatherly Love’ from becoming about domination – its the recognition of the individuality of other. This ‘brotherly love’ also tempers the blissful but unearned experience of maternal love. Mother and child will separate, and the child needs to have their autonomy recognised. We cannot respect without the fourth part of loving – knowledge. This requires self-knowledge, in order to see the other (and ourselves,) deeply and clearly. And that knowledge of the other needs still to come from that place of care (‘Motherly Love’)

Fromm’s background was in sociology, so he also looks at ‘love’ not just as it plays out in individual encounters, sexual love, parents and children, ‘brothers’ – peers and equals – but he looks at that idea of equality in societies, and condemns both Western Capitalism and Soviet Communism as equally, though differently, dehumanising our relationships. His own thinking is influenced by both Marx, and his own Jewish, Talmudic inheritance – he came from a rabbinical family. Although he was not, in the end, a theist, he traces, clearly, the positive (as well as the problematic) role that the development of religion had on society and on philiosophy and ethics, looking specifically at Old Testament stories, and unpicking them to find deeper meanings. He is in the end, most drawn to Buddhist thought, seeing this as a highly mature system, which properly incorporates the ‘all is connectedness’ bliss stage of motherly love (and falling in love, come to that!) the taking responsibility for oneself which is ‘Fatherly’ the respect for other and oneself and a deepening awareness of knowledge which can contain paradox.

Just as love for one individual which excludes the love for others, is not love, love for one’s country which is not part of one’s love for humanity is not love, but idolatrous worship

He talks about the importance of practicing ‘the art of loving’ examining our own attitudes, actions and relationships scrupulously, as an on-going discipline. Like many psychotherapists, he is also aware of the importance of self-love – not narcissistic self-regard which paradoxically often leads to behaviour which is destructive, both to oneself and others, because that sort of self love is often a veneer for self-loathing, hence the desire to make everyone else serve MY will, because I cannot bear to look upon my ‘wrongness’. Proper self love, a pre-requisite for proper love of other, involves being able to own one’s shadow, shame, guilt, and be compassionate, but not self-indulgent towards oneself. (Internalising ‘mother’ unconditional love and ‘father’ earned love) The theory is clear and even simple, the practice, of course, a struggle. But a vital one, for the individual and for the way society as a whole functions.

I feel I’ve barely scratched the surface of this tremendous book, and no doubt re-readings will yield more rich fruit.

There is, however, one cavil, and it is major. Fromm was born in the very early part of the 20th century. His thinking about gender and sexuality may well have been much more enlightened than many, at the time. (written in 1957) But his view of homosexuality as the result of a ‘flaw’ – inadequate relationship mainly with mother – and a certain rigidity in the roles of ‘Mother’ and ‘Father’ is disturbing, and flawed, with the hindsight of half a century on. I found I had to read some sections tempering my twenty-first century awareness, and trying instead to see through the lens of half a century earlier. Reading in context, in other words.

If you can set this aside, the rest, I think, is gold.

The Art Of Loving Amazon UK
The Art Of Loving Amazon USA