I think that our mind and our capacity to use it to think clearly depends on our inner and outer dialogue. When we become too narrow in our thinking, which can be intensified by emotional disconnection from others and ourselves, we lose our minds. Makhail Bakhtin, a Russian philosopher, calls this form of narrow thinking, finalized and monological. Here is my understanding of this concept from my own life experience with altered thought.
In a previous blog, “Dialogical Recovery of Life,” I described six principles of dialogue. I asked Belgian psychotherapist, Dr. Peter Rober, one of my Dialogical Practice teachers, to comment on the blog. He said overall he liked it, but the idea of principles of dialogue troubled him. He said that principles can lead to ideals, which lead to ideology, which lead to violence because most people can never fulfill the expected level of compliance to ideology. At first, I was taken aback by the intensity of his response. But knowing that the inspiration for dialogical practice, Bakhtin, said there is nothing more distressing than no response, I responded. I told Peter I thought his critique was not a dialogical one. Instead of opening a place for new life and new thoughts, I felt closed down. Then I read what Bakhtin had said about these matters and more deeply understood Peter’s utterance. I am finding that indeed Bakhtin was very suspicious of theories and ideology. Theories have a way of closing down dialogue by concluding that there are answers when only possibilities exist. He argued for the concept that thoughts should not have a final conclusion, but instead need to be “unfinalizable.” He believed that there is, in life, a greater importance of the little details than in the grand scale generalizations such as of science. He called this “the prose of everyday life.” In explaining unfinalizability, he states, ” Nothing conclusive has yet taken place in the world, the ultimate word of the world and about the world has not yet been spoken, the world is open and free, everything is still in the future and will always be in the future.” He uses the term unfinalizability to mean openness, creativity and surpringness. I can give three examples of the dangers of some finalizable thoughts based on past monological thinking of my own. In the first example, I failed to pull out my monological thinking, and was hospitalized, while in the other two instances I found my way out once by self-help and once by peer support:
In my first episode of altered thinking, I had a meal with my roommates, which did not settle well with my stomach. I tried to sleep, but my stomach discomfort kept me awake. Then I started to feel weak and my heart started to beat faster and faster. My mind raced searching for an explanation. Ah ha, I reached a conclusion,” My roommates had actually poisoned me.” This thought was terrifying. I felt I couldn’t ask them because I could not trust them. They wouldn’t tell the truth. I had come to a final, irrefutable conclusion because of my monological thinking. Unfortunately there were no peers for me to share my fears with and I had not gained the experience of re-establishing my inner dialogue on my own. So my family, being helpless to do anything, took me to a psychiatric hospital where I was given an injection of Thorazine. It did stop the pattern of thought but did little for my habit of withdrawal at times of fear.
Five years later, when I was in my darkest hour, I felt I had to face my demons alone and without sleep. I was freshly out of my third hospitalization. I returned to my apartment and was greeted by my cat Nosey (who somehow survived the 2 weeks I was away), the stray cat who had adopted me. Night fell hard. My muscles were twitching from withdrawal from Thorazine. After all I had left the hospital without meds or a script. I had no intention to start the meds again. My mind was twitching too.
I spent 6 painful days not sleeping and not sure of the future. One night I became all too sure of my future. I could see no way out of the psychic pain I fallen into. I was sure I needed to end my life to end the pain. I lay in the tub in despair. I thought to myself, “What possible reason do I have to continue living? ” Two thoughts kept me alive. First I was curious what would happen next. It still seemed that something new and unexpected might happen. Then even more fervently I said to myself, “I can’t kill myself, who would take care of Nosey?” I couldn’t think of anyone else. So I decided I had to go one living to take care of the cat who had adopted me. I then said to myself, “I am going to say yes to life.” Later I realized I must have been saying no to life for a long time prior to that. “Yes, life was worth living,” I affirmed to myself. I think a large part of experiencing my humanity, since that moment, has been saying yes to life. Freud would say I went from Thanatos to Eros. I was experiencing my deepest spirit. It had left me and now was back. It seems I had to reach deep inside to my most essential level of life and death to rediscover my deepest spirit. That seems to be the moment when my maelstrom of despair turned into a tornado of hope. I felt like Dorothy, kicking the heels of her ruby red slippers and saying “there is no place like home,” to return myself to the home inside myself. The home of my spirit. And the whole sequence of leading back to life started with my letting go of the finalizability of my thinking. My future opened up when I re-experienced my curiosity. Saying yes to life is welcoming in new experiences and new people.
Five more years later, just after I had returned from an exciting trip to California, I felt freer and more buoyant than usual. Then I became frightened as the feeling was so unfamiliar. I started to believe that I was experiencing less of the force of gravity. This thought led to worries that actually gravity was much more variable than we had been taught. I thought, “Gravity must be pushing up on me, not pulling down. O my all the scientists have been lying to us!” Then my whole belief structure started to crumble. If “the men of science” had lied to us about gravity, what else had they lied about. My fear was growing to terror, as my mind fell into a narrow, familiar groove of linear thinking, if A was true then B then… leading to a state of extreme suspiciousness, some call paranoia. This extreme was allowing my thoughts to become finalized with one conclusion, i.e. that there was no real pull of gravity, only a pushing up by the earth. However, this time was different. Instead of letting my thoughts merely consumer themselves by twirling into a whirlpool of monologue and fear, I had learned the value of peer support. So I called a reserved, thoughtful practitioner of the Alexander technique. I felt I could trust him, as he seemed very accepting of unusual thoughts. I told him of my experience with traveling, lightness etc. and concluded with my worst fear, “Richard, I am worried that there may be no gravity!” I fairly screamed. Richard remained calm, acknowledged my agitation and then thoughtfully, and believably replied, “Well no one really knows what gravity is, but it is a useful hypothesis.” With those few words and his caring attitude, my mind became freed from that deadly death spiral groove it was careening into. ” Hypothesis, of course, not absolute reality, but a human construct to describe reality for our convenience,” I thought to myself.
So upon reflecting on these three pivotal events in my recovery of my life, I now can frame them with an understanding that feels very satisfying. In all cases, my thinking had become calcified. I had become trapped in the certainty that I could explain my life and all of life around me by linear logic. I was looking for a set of laws to explain all of life. This attitude worked well in the Lab. of Neurochemistry of NIMH where my boss said he only believed the reality that could be written as a chemical formula. My thoughts had become finalized and my thinking monological. They had become as final as a chemical formula. Thank heavens in the last two cases there was a part of me that refused to believe that I had all the answers in my immediate conscious conclusions. How exciting it is now to have discovered Open Dialogue and its inspiration Makhail Bakhtin. It explains to me how overly certain thoughts, combined with monological thinking which result from emotional isolation lead to the altered thinking called psychosis. It makes sense then to understand recovery as the combination of an inner and outer capacity to reestablish dialogue, especially on an emotional level.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.