Dialogical Recovery of Life

Daniel Fisher, MD, PhD
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During a recent dialogue training, Dr. Peter Rober, from Belgium, said, “listening deeply, going beyond categories, creates dialogical space in which life can come… into this space will come life and super reality.” It seemed with those few words Peter unlocked a space of my own thinking about dialogue and recovery. The space in which new ideas breathe new life.

This understanding makes me wonder about the description of the anguish from which I recovered. A narrow medical description of my mental distress often interfered with my recovery.  Instead of opening new space, medicalizing my life’s woes closed down spaces by labeling them. This deadening effect of easy explanations of life’s challenges was captured by playwright Eugene Ionesco when he said, “Explanation separates us from astonishment, which is the only gateway to the incomprehensible.

By translating recovery into other languages we have learned more about the issues. We have found that the best translation of recovery in Spanish is “recobro de la vida,” or “recovery of [ones] life.” This translation, seems intuitively close to the truth of our experience. But what does it mean? I think it means that when we are disconnected and lose touch with our feelings, we die inside. Our heart may beat, but without enthusiasm or spirit, our life force seeps out.

It seems that all of us in this society need to recover from the constricting effect of isolation and the black and white thinking that separates us from our feelings.  Implementing recovery needs to occur beyond the clinical context. Recovery principles and culture needs to be adopted throughout society because every relationship we engage in has the capacity to enhance or degrade our recovery by nourishing or smothering our life force.

I think that a major aspect of bringing recovery to society is through understanding and practicing dialogical relationships in every day life. This might be considered a type of community dialogue. I have carried out several training programs here in Mass. based on six basic principles of dialogue (the first 4 come from Isaacs, 1999, the 5th from my own experience and the sixth from Yankolivich, 1999):

1. Listening deeply together

2. Suspending our own beliefs, going beyond categorical thinking

3. Respecting and valuing differences and the wholeness of each of us

4. Speaking from our deepest truth, from our heart

5. Connecting on a heart to heart level

6. Valuing each other’s humanity deeply enough to see we are all equals

But why are these principles of dialogue so important. Because they create a space that we all want and need. A psychological space in which we experience our life more fully. On the other hand, the top down monological world of everyday life in the present is killing our life forces within and between us. To this degree, the green movement, the recovery movement in mental health , and the dialogue movement have a common unifying goal: to create a society which nourishes the life force in each and every living being through dialogical relationships.

Rober cited an ideal of dialogical space in Jacque Derrida’s (http://en.wikipedia.org/wiki/Jacques_Derrida) concept of hospitality. According to Derrida, when meeting another person we need to show an interest. Before we ask any question we need to assume a position of yes. We need to welcome without words. In recovery language, we need to believe in the person.  We need to talk but words, according to Derrida,  are inherently violent. Hospitality is an ethical ideal never realized. When we fail to welcome all the dimensions , and all the voices of another in full polyphony, we are creating a condition of violence.

By this criteria, most of our day-to-day culture is violent.

It would seem that severe mental health issues are basically matters of life and death. We need to understand that the deepest meaning of life is much more profound than the vital signs of breathing and heart-beats. Just as surely as we know when our breathing is impaired or our circulation is compromised, at a more profound level we know when our wellspring of internal life is being poisoned or starved. Some of us are much more sensitive to compromises in our life force. When we experience a fading of that force we protest in a variety of ways that are called symptoms. Rather than symptoms of disease these protests are actually creative attempts to restore our life force. Alfred Adler described symptoms as attempts to solve problems.  It seems there are two major ways that we creatively seek to restore our life force and solve the problems of our life being extinguished:

1. Creating connections even if they don’t appear to exist: this is the creation of voices, imagining that the TV has special messages for you, and imagining that the CIA is following you. These waking dreams are all attempts to replace the most intolerable state of having no response with an imagined response, which the mental health system and much of society call hallucinations, ideas of reference, and delusions.

2. Severing connections which are violent, oppressive, or toxic or bring back such memories: withdrawal, refusal to speak or express emotions because human interactions are considered violent, or as David in David and Lisa said,”touch kills;” another way to distance oneself in through substances that reduce the intensity of one’s reactions to toxic influences of traumatic relationships

I gained more insight into my own recovery by interviewing my former therapist, Dr. S. George (as he was comfortable being addressed) still practices today as he did 40 years ago, in a very relaxed and accepting manner. I kept asking him how he used the approach he used and what was it. What did he think of me? You were always very earnest and determined [that has not changed.]  He told me of his childhood, which involved great privation while a refugee in Europe after WW II. He had also worked as a shrink in Vietnam. From that experience he learned that people can often rapidly, and completely recover from psychosis, when treated as directly and humanely as possible.  So at the end of the interview I commented that I felt I had learned nothing of what was most important in our 4 years of work together. In frustration I said, “All we did in these two hours was have a conversation.” To which George replied,” That was what we did then too.” Though I think he is selling short the importance of his experience as a therapist and his life experiences, I have since marveled at the power of the conversations I had with George. Perhaps most important, was the manner in which he approached me. It was very respectful and empowering. Whenever I was impressed by an insight he delivered, he would say, with great sincerity, that I had come up with the insight and he had merely delivered it. His approach was very close to Derrida’s ideal of hospitality.

In passing, George referred to the Santiago Theory, though that did not inform his practice. Instead, it merely reinforced instincts he had learned through life.

Here is Fritjof Capra’s description of the Santiago Theory of life from his book the Web of Life:

“The understanding of the process aspect of living systems…implies a new conception of mind, or cognition. This new conception was proposed by Gregory Bateson and elaborated more completely by Maturana and Varela, and it is known as the Santiago theory of cognition.

” The central insight of the Santiago theory is the identification of cognition, the process of knowing, with the process of life. Cognition, according to Maturana and Varela, is the activity involved in the self-generation and self-perpetuation of autopoietic networks [ autopoietic is the quality of the living cell or organism captured by the term: self-creation, self-making or self-producing]. In other words, cognition is the very process of life [and it depends on the living organism to form itself].

It is obvious that we are dealing here with a radical expansion of the concept of cognition and, implicitly, the concept of mind. In this new view, cognition involves the entire process of life – including perception, emotion, and behavior – and does not necessarily require a brain and a nervous system.

The Santiago theory of cognition, I believe, is the first scientific theory that overcomes the Cartesian division of mind and matter, and will thus have the most far-reaching implications. Mind and matter no longer appear to belong to two separate categories, but can be seen as representing two complementary aspects of the phenomenon of life – the process aspect and the structure aspect. At all levels of life, beginning with the simplest cell, mind and matter, process and structure, are inseparably connected. Mind is immanent in living matter as the process of self-organization. For the first time, we have a scientific theory that unifies mind, matter and life.”

From this beautiful description, we can see the mistake of narrowly defining mental distress as a form of biological illness just like diabetes and claiming that medication(s) will bring about mental health by balancing our chemistry.  It is short sighted to claim that a medication by itself will bring mental health.  I am not claiming mental illness is a myth, for I can clearly recall periods of terror and paranoia. Instead, I would say that for many people the medical model is too narrow a description. Mental distress can only be understood within the context of our social networks and in all the realms of our existence: mind, body, and spirit. Furthermore, the importance of self-creation of living systems supports the recovery movement’s central principle of self-determination. Recovery is what people do to create a new life, it can not be done to or for a person.

The process of thinking proposed by these scientists, I believe is mapped out in greater detail by the proponents of dialogical practice. For in the interplay of dialogue, new meanings are generated that neither person had previously dreamt of. They give life to new ideas, which can then inform their lives and others with renewed meaning. This weaving together of your world and my world goes beyond our own narrow world and opens new horizons. We are brought together by our shared anguish. We can through dialogue dream together. We share in new ways, as Ionesco stated: “Ideologies separate us, while dreams[through dialogue] and anguish bring us together.”

References:

Fritjof Capra (1996). The Web of Life: A New Scientific Understanding of Living Systems. New York: Anchor Books.

Isaacs,W. (1999).Dialogue: The Art of Thinking Together. New York: Doubleday.

Rober,P. (2012). Training Program in Open Dialogue, sponsored by Mary Olson, Mill River Institute, Haydenville, MA.

Rubin, T.I. (1960). David and Lisa.New York:Forge.

Yankelovich,D. (1999). Magic of Dialogue. New York:Simon and Shuster.

 

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10 COMMENTS

  1. Duane, Our inner spirit is the most profound aspect of who we are, it is our growing edge, and because it is so pervasive it is very difficult to describe in words or as the mystics say it is ineffable. Naming limits who we are and for that reason a branch of Buddhism always states Netti Netti, or not so, not so, after each word said or thought, meaning that any word needs to be invalidated, lest we mistake the word for that which it describes.That is especially true for persons.Diagnostic labels are, in this context, understood as limiting who we are as a fully evolving human being who is becoming even more.

  2. Thanks for your blog post Daniel – lots to think about – your description of the conversations with your therapist are enlightening and remind me of the importance of connecting with people, listening intently and reflecting back. For folk need to know they are not alone.

    It’s encouraging to hear that people can recover from psychosis when treated “directly and humanely” for there must be a better way than the drugging and labelling.

    To “know thyself” is a wise saying and a starting point when in dialogue with others. The journey becomes ever more interesting.

    Regards, Chrys

  3. Great post.

    I am reminded of a story a friend told me of her time in Africa where at nighttime the campfire was the meeting place where persons would come and tell their story to the people around the fire who would listen to their story, and then the person would eventually leave, having been heard, having shared their life experience with others.
    What a wonderful metaphor for the healing dynamic, wonderful metaphor for life itself !!

    I am also reminded of reading of Shaker community hospitals for those needing help or at the end of life —-the rooms were comforting, naturally lighted, quiet places where caregivers would be there to provide whatever the patient needed. There was no imposition of treatment….caregivers were chosen who particularly were loving and gentle people.

    Creating a space where sharing is possible, where healing can occur . . .it occurs to me that that space doesn’t require physical walls . . . it is the space we provide within ourselves for others:
    the fire in that African veldt is our heart fire;
    that Shaker convalescent facility is our own tenderness …wherever, whenever.

    Thank you, Dan, for that insightful, remarkable essay. One of the best.

  4. thank you dan………….. the non-words – the silent meaningfulness – sitting behind the words you speak – express something that, wordlessly, reaches out to me and conveys what your words, as only limited words, can only attempt to explain the loaded silence behind them so clearly.

    years ago, I had violent, worded arguments with my brother, a “Born again” Christian evangelical minister (and a true healer). He screamed (sounded like) at me that there is no other Word but that which is spoken in the “Holy Bible”. I kept saying to him, “How could something so Infinite be contained, minimized, diminished- made seemingly Finite- by restricting it to only One physical book? How could something Infinite be made so horribly Finite by restricting it to Limiting words? Seems something Infinite would be LimitLess in its expression–not ever having enough worded books in which it might be contained. To me, this is a sacrilege -to make something Infinite seem Finite by using Finite words. Again I say– Something Infinite cannot be described using Finite words.
    It can only be experienced and shared by the speechless feelings within its Energy as it moves between, within and through living beings engaged with each other and with “‘non-living’ ‘things'”. For this reason, it took me from my twenties, when I stopped talking about religion– even “spirtuality”– until two years ago, when I found others with whom I could connect, who also had come to this realization of Infinity without words…then, it became a way I could share this bond- even in speech -sometimes, with like-feeling-special-others.
    I cannot be overly redundant enough in my attempts to convey something that I don’t feel is a bearded man sitting up there that one could so easily describe with any words. Even now, words fail to express what I mean to say.

    Recovery, for me, in part, is the regaining of my awareness of the Energy that flows unspoken between All. It has been my attempts at grasping and regaining this Energy that have been catergorized as “symptoms” falling within a Classification that were/are employed in the use of a shorthand word to describe my unique,natural, broad and precious human journey along the pathway to my recovery of what is Wellness for me. How dare my own energetic being be restricted to limited, restrictive words!

  5. Upon re-reading your article, others posts, and my own post, I have to go back and examine my own harsh words and limits I put upon others.

    I could not see beyond the limits of the boxes I was put into against my will–including the ones I put myself into and did not realize I had my own power to leave, if I only saw that I had this power. I feel so much anger about this unfairness, these things that held me back from getting in touch with my own self-discovery.

    My anger has caused me to overlook the limits and categories I put others into too. I now see how I have thrown my brother and other like-minded people into their own boxed-in categories which I created in my own mind. I see that I categorize those that categorize–including myself who once (and still sometimes fall into) categorized people into mental illness slots for easy descriptions.

    My anger has blinded me from seeing how I use words to limit others by labeling them as being narrow and limited in their beliefs. I find myself guilty of doing the same in my own narrow categorizing of others that I hate to have done to myself!

    What words do I use to describe my own brother? And those that categorize in mental health descriptions–including using these terms myself during the years of being a provider in the mental health system, and still, the limiting jargon which still spills unintentionally from my lips from time to time–and very often, toward myself. So, I categorize the ones who categorize, including myself.

    Thank you, Dan, for being the vehicle that has brought me to this awareness of my own prejudice of others that puts a wall between their positive energy and mine!

    I need to return to your thoughts, Dan. The thoughts that capture the importance of respect, and lovingness toward all–very much including those that are not like us or have hurt our feelings and perhaps restricted our healing.

    I need to take responsibility for the harshness in my own judgment and treatment of others.

    I need to allow for a rapport within our agreement and a silence and respect in our differences.

    Thank you for helping me to see things I want to improve upon in myself and helping me to get in touch with humility in my dialogue with all others–not just those with similar thinking and beliefs.

  6. Hi Dan,
    To me, this is definitely the best article that you’ve written. Some day, maybe the two of us can carve out some time to sit down and have a fun intellectual discussion. I very much appreciate how much your thinking and insights continue to evolve….and of course the important work that you are doing.

    Best,
    Ron Bassman

  7. Thank you all for your supportive words. I am always wary of words as they can be so limiting. But your responses encourage me.
    I am particularly struck by the resonance that my experience of a loving space for life brought out. It helps me to further understand that the most relevant part of dialogue, at least to me, is the space it creates for others to enter into. A space described in Open Dialogue for new voices, new feelings, new languages to emerge and communicate with and within us. A space we all share unknowingly. Some call it intersubjectivity, Capra called it the web of life, Buddhists call it Atman, Bateson called it the language of artists, animals, and madmen or creatura. If we listen very deeply inside, beyond the buzz of our own sun we can hear the voices of the millions of other suns of living creatures, who each think their sun is central to their universe. Perhaps our job, as carriers of a new, transformed world of loving dialogue is to find the points of resonance, and life nurturing spaces.