17 Jun 2016 Leave a comment
12 Jun 2016 Leave a comment
Self-deception is the price that we pay for our sanity.
This self-deception holds us together by shielding us from truths that threaten to undermine our sense of self, or ego integrity. A person on the verge of ego disintegration makes frenzied use of self-deceptive ego defences. The resulting loss of perspective or change in function can in itself count as mental disorder, while the ultimate capitulation of the ego defences leads in particular into the depressive position.
By removing us from fearsome truths, ego defences not only blind us to those truths and thus to reality, but also confuse and constrict our thinking. Their partial or temporary failure can lead to a range of psychological disturbances including anxiety, anger, irritability, insomnia, and nightmares. The more they are challenged, the more exaggerated, compulsive, and inflexible they become. The person is reduced in scope and ability, with little left of the capacities for consciousness, spontaneity, and intimacy that define, elevate, and glorify the human condition.
A vicious cycle takes hold: the more constrained a person becomes, the less he is able to reason; and the less he is able to reason, the less he is able to overcome his constraints. For the philosopher Aristotle, the distinctive function of human beings is to reason, and, therefore, the happiness of human beings is to lead a life of reason. Reason begets freedom, and freedom begets reason, and both together beget knowledge of the truth, which is wisdom, which is the highest happiness.
Once, upon being asked to name the most beautiful of all things, the philosopher Diogenes the Cynic replied parrhesia, which means ‘free speech’ or ‘full expression’. Diogenes used to stroll through Athens in broad daylight brandishing an ignited lamp. Whenever curious people stopped to ask what he was doing, he would reply, ‘I am just looking for a human being.’
Self-deception, which is often rooted in the unconscious or semi-conscious fear of falling short of familial and societal standards, and in the fear of death, is a defining part of our human nature. By recognising its various forms in ourselves and reflecting upon them, we may be able to disarm them and, even, in some cases, to employ and enjoy them. This self-knowledge, which I call super- or hyper-sanity, opens up a whole new world before us, rich in beauty, subtlety, and connection, and frees us not only to take the best out of it, but also to give it back the best of ourselves, and, in so doing, to fulfil our potential as human beings.
Reasoning is but one route to self-knowledge or hyper-sanity. The other route—more painful, destructive, and uncertain—is mental disorder, or ‘madness’, which involves the failure or complete breakdown of the ego defences. Unlike medical, or physical, disorders, mental disorders are not just problems. If successfully navigated, they can also present opportunities. Simply acknowledging this can empower people to heal themselves and, much more than that, to grow from their experiences. At the same time, mental disorders should not be romanticised or left unattended simply because they may or may not predispose to problem solving, personal development, or creativity. Rather than being medicalised or romanticised, mental disorders, or mental dis-eases, should be understood as nothing less or more than what they are, a cry from our deepest human nature.
Both mental disorder and hyper-sanity place us outside society, making us seem ‘mad’ to the mainstream. Both attract scorn and derision, but whereas mental disorder is distressing and disabling, hyper-sanity is liberating and empowering.
Ultimately, standing out is the price we pay for being outstanding.
08 Jun 2016 Leave a comment
Phenomena derives from the Greek meaning ‘things that appear’, and phenomenology can be defined as the direct examination and description of phenomena as they are consciously experienced.
Pioneered by philosopher Edmund Husserl (1859-1938), phenomenology involves paying attention to objects and their relations so that they begin to reveal themselves, not as we take them to be, but as they truly appear to the naked human consciousness, shorn of superimposed theories, preconceptions, abstractions, interpretations, and emotional associations.
Unlike many other philosophical approaches, phenomenology is not a theory or set of theories, but a formal method for accessing bare human experience as it unfolds, moment by moment. It enables us to study not only the phenomena themselves, but also, by extension, the very structures of human experience and consciousness.
Phenomenology is not quite the same as mindfulness. Mindfulness, which derives from Buddhist spiritual practice, aims at increasing our awareness and acceptance of incoming thoughts and feelings, and so the flexibility or fluidity of our responses, which become less like unconscious reactions and more like conscious reflections. In contrast, phenomenology is more explicitly outward-looking.
In the early 20th century, psychiatrist and philosopher Karl Jaspers (1883-1969) brought the method of phenomenology into the field of clinical psychiatry to describe and delineate the symptoms of mental disorder. This so-called descriptive psychopathology created something of a scientific basis for the practice of psychiatry, with Jaspers emphasising that symptoms of mental disorder should be diagnosed according to their form rather than their content. This means, for example, that a belief is a delusion not because it is deemed implausible by a person in a position of authority, but because it conforms to the definition, or phenomenology, of a delusion, that is, ‘a strongly held belief that is not amenable to logic or persuasion and that is out of keeping with its holder’s background or culture.’
Unfortunately, Jaspers and others rather overlooked or underplayed phenomenology’s healing and protective potentials. Potentially phenomenological endeavours such as writing, drawing, gardening, bird watching, and wine tasting remove us from our tired and tortured heads and return us to the world that we came from, reconnecting us with something much greater and higher than our personal problems and preoccupations. Phenomenology can, quite literally, bring us back to life. In The Philosophy of Existence (1938), Jaspers himself described it as ‘a thinking that, in knowing, reminds me, awakens me, brings me to myself, transforms me’. To describe is to know, to know is to understand, and to understand is to own, to enjoy, and even, to some degree, control. Like mindfulness, phenomenology is a balm not only for depression and anxiety, but also for boredom, loneliness, greed. selfishness, apathy, alienations, and any number of human ills.
If that were not enough, phenomenological practice also offers a number of other benefits and advantages. Wine tasters, for example, often say that wine blind tasting enables them to:
- set a standard of objectivity,
- test, stretch, and develop their senses,
- apply their judgement,
- recall old memories,
- compare their analysis with that of their peers,
- discuss the wine and learn about it, and about wine in general,
- forge meaningful human relationships, and
- imbibe the wine with the respect and consideration that it deserves.
In refining their senses and aesthetic judgement, wine tasters become much more conscious of the richness not only of wine but also of other potentially complex beverages such as tea, coffee, and spirits, and, by extension, the aromas and flavours in food, the scents in the air, and the play of light in the world.
For life is consciousness, and consciousness is life.
22 Oct 2015 Leave a comment
Is the medicalization of human suffering doing more harm than good?
‘Mental disorder’ is difficult to define.
Generally speaking, mental disorders are conditions that involve either loss of contact with reality or distress and impairment. These experiences lie on a continuum of normal human experience, and so it is impossible to define the precise point at which they become pathological.
What’s more, concepts such as borderline personality disorder, schizophrenia, and depression listed in classifications of mental disorders may not map onto any real or distinct disease entities. Even if they do, the symptoms and clinical manifestations that define them are open to subjective judgement and interpretation.
In an attempt to address these problems, classifications of mental disorders such as DSM-5 and ICD-10 adopt a ‘menu of symptoms’ approach, and rigidly define each symptom in technical terms that are often far removed from a person’s felt experience. This encourages mental health professionals to focus too narrowly on validating and treating an abstract diagnosis, and not enough on the person’s distress, its context, and its significance or meaning.
Despite using complex aetiological models, mental health professionals tend to overlook that a person’s felt experience often has a meaning in and of itself, even if it is broad, complex, or hard to fathom. By being helped to discover this meaning, the person may be able to identify and address the source of his distress, and so to make a faster, more complete, and more durable recovery. Beyond even this, he may gain important insights into himself, and a more refined and nuanced perspective over his life and life in general. These are rare and precious opportunities, and not to be squandered.
A more fundamental problem with labelling human distress and deviance as mental disorder is that it reduces a complex, important, and distinct part of human life to nothing more than a biological illness or defect, not to be processed or understood, or in some cases even embraced, but to be ‘treated’ and ‘cured’ by any means possible—often with drugs that may be doing much more harm than good. This biological reductiveness, along with the stigma that it attracts, shapes the person’s interpretation and experience of his distress or deviance, and, ultimately, his relation to himself, to others, and to the world.
Moreover, to call out every difference and deviance as mental disorder is also to circumscribe normality and define sanity, not as tranquillity or possibility, which are the products of the wisdom that is being denied, but as conformity, placidity, and a kind of mediocrity.
The evolution of the status of homosexuality in the classifications of mental disorders highlights that concepts of mental disorder can be little more than social constructs that change as society changes. PTSD, anorexia nervosa, bulimia nervosa, depression, and deliberate self-harm (non-suicidal self-injury) can all be understood as cultural syndromes. Yet, for being in the DSM and ICD, they are usually seen, and largely legitimized, as biological and therefore universal expressions of human distress.
Other pressing problems with the prevalent medical model is that it encourages false epidemics, most glaringly in depression, bipolar disorder, and ADHD. Data from the US National Health Interview Survey indicate that, in 2012, 13.5% (about 1 in 7) of boys aged 3-17 had been diagnosed with ADHD, up from 8.3% in 1997. It also encourages the wholesale exportation of Western mental disorders and Western accounts of mental disorder. Taken together, this is leading to a pandemic of Western disease categories and treatments, while undermining the variety and richness of the human experience.
For example, in her recent book, Depression in Japan, anthropologist Junko Kitanaka writes that, until relatively recently, depression (utsubyō) had remained largely unknown to the lay population of Japan. Between 1999 and 2008, the number of people diagnosed with depression more than doubled as psychiatrists and pharmaceutical companies urged people to re-interpret their distress in terms of depression. Depression, says Kitanaka, is now one of the most frequently cited reasons for taking sick leave, and has been ‘transformed from a rare disease to one of the most talked about illnesses in recent Japanese history’.
Many critics question the scientific evidence underpinning such a robust biological paradigm and call for a radical rethink of mental disorders, not as detached disease processes that can be cut up into diagnostic labels, but as subjective and meaningful experiences grounded in personal and larger sociocultural narratives.
Unlike ‘mere’ medical or physical disorders, mental disorders are not just problems. If successfully navigated, they can also present opportunities. Simply acknowledging this can empower people to heal themselves and, much more than that, to grow from their experiences.
17 Oct 2015 Leave a comment
Generally speaking, culture-specific, or culture-bound, syndromes are mental disturbances that only find expression in certain cultures or ethnic groups, and that are not comfortably accommodated by Western psychiatric classifications such as the DSM and ICD. DSM-IV defined them as ‘recurrent, locality-specific patterns of aberrant behavior and troubling experience…’
One example of a culture-bound syndrome is dhat, which is seen in men from South Asia, and involves sudden anxiety about loss of semen in the urine, whitish discoloration of the urine, and sexual dysfunction, combined with feelings of weakness and exhaustion. The syndrome may originate in the Hindu belief that it takes forty drops of blood to create a drop of bone marrow, and forty drops of bone marrow to create a drop of semen, and thus that semen is a concentrated essence of life.
DSM-5, published in 2013, replaces the notion of culture-bound syndromes with three ‘cultural concepts of distress’: cultural syndromes, cultural idioms of distress, and cultural explanations for distress. Rather than merely listing specific cultural syndromes, DSM-5 adopts a broader approach to cultural issues, and acknowledges that all mental disorders, including DSM disorders, can be culturally shaped.
However, some DSM disorders are, it seems, much more culturally shaped than others. For instance, PTSD, anorexia nervosa, bulimia nervosa, depression, and deliberate self-harm (non-suicidal self-injury) can all be understood as cultural syndromes. Yet, for being in the DSM, they are usually seen, and largely legitimized, as biological and therefore universal expressions of human distress.
Thus, one criticism of classifications of mental disorders such as DSM and ICD is that, arm in arm with pharmaceutical companies, they encourage the wholesale exportation of Western mental disorders, and, more than that, the wholesale exportation of Western accounts of mental disorder, Western approaches to mental disorder, and, ultimately, Western values such as biologism, individualism, and the medicalization of distress and deviance.
In her recent book, Depression in Japan, anthropologist Junko Kitanaka writes that, until relatively recently, depression (utsubyō) had remained largely unknown to the lay population of Japan. Between 1999 and 2008, the number of people diagnosed with depression more than doubled as psychiatrists and pharmaceutical companies urged people to re-interpret their distress in terms of depression. Depression, says Kitanaka, is now one of the most frequently cited reasons for taking sick leave, and has been ‘transformed from a rare disease to one of the most talked about illnesses in recent Japanese history’.
In Crazy Like Us: The Globalization of the American Psyche, journalist Ethan Watters shows how psychiatric imperialism is leading to a pandemic of Western disease categories and treatments. Watters argues that changing a culture’s ideas about mental disorder actually changes that culture’s disorders, and depletes the store of local beliefs and customs which, in many cases, provided better answers to people’s problems than antidepressants and anti-psychotics. For Watters, the most devastating consequence of our impact on other cultures is not our golden arches, but the bulldozing of the human psyche itself.
Looking at ourselves through the eyes of those living in places where human tragedy is still embedded in complex religious and cultural narratives, we get a glimpse of our modern selves as a deeply insecure and fearful people. We are investing our great wealth in researching and treating this disorder because we have rather suddenly lost other belief systems that once gave meaning and context to our suffering.
Distressed people are subconsciously driven to externalize their suffering, partly to make it more manageable, and partly so that it can be recognized and legitimized. According to medical historian Edward Shorter, our culture’s beliefs and narratives about illness provide us with a limited number of templates or models of illness by which to externalize our distress. If authorities such as psychiatrists and celebrities appear to endorse or condone a new template such as ADHD or deliberate self-harm, the template enters into our culture’s ‘symptom pool’ and the condition starts to spread. At the same time, tired templates seep out of the symptom pool, which may explain why conditions such as ‘hysteria’ and catatonic schizophrenia (schizophrenia dominated by extreme agitation or immobility and odd mannerisms and posturing) have become so rare.
The incidence of bulimia nervosa rose in 1992, the year in which journalist Andrew Morton exposed Princess Diana’s ‘secret disease’, and peaked in 1995, when she revealed her eating disorder to the public. It began to decline in 1997, the year of her tragic death. This synchronology suggests that Princess Diana’s status and glamour combined with intense press coverage of her bulimia and bulimia in general led to an increase in the incidence of the disorder.
An alternative explanation is that Princess Diana’s example encouraged people to come forward and admit to their eating disorder. By the same token, it could have been that the Japanese had always suffered from depression, but had been hiding it, or had not had a template by which to recognize or externalize it. The danger for us psychiatrists and health professionals when treating people with mental disorder is to treat the template without addressing or even acknowledging the very real distress that lies beneath.
Adapted from the new edition of The Meaning of Madness.
01 Oct 2015 Leave a comment
In his paper of 1943, A Theory of Human Motivation, psychologist Abraham Maslow proposed that healthy human beings had a certain number of needs, and that these needs are arranged in a hierarchy, with some needs (such as physiological and safety needs) being more primitive or basic than others (such as social and ego needs). Maslow’s so-called ‘hierarchy of needs’ is often presented as a five-level pyramid, with higher needs coming into focus only once lower, more basic needs have been met.
Maslow called the bottom four levels of the pyramid ‘deficiency needs’ because we do not feel anything if they are met, but become anxious or distressed if they are not. Thus, physiological needs such as eating, drinking, and sleeping are deficiency needs, as are safety needs, social needs such as friendship and sexual intimacy, and ego needs such as self-esteem and recognition. On the other hand, he called the fifth, top level of the pyramid a ‘growth need’ because our need to self-actualize enables us to fulfill our true and highest potential as human beings.
Once we have met our deficiency needs, the focus of our anxiety shifts to self-actualization, and we begin, even if only at a sub- or semi-conscious level, to contemplate our bigger picture. However, only a small minority of people is able to self- actualize because self-actualization requires uncommon qualities such as honesty, independence, awareness, objectivity, creativity, and originality.
Maslow’s hierarchy of needs has been criticized for being overly schematic and lacking in scientific grounding, but it presents an intuitive and potentially useful theory of human motivation. After all, there is surely some truth in the popular saying that one cannot philosophize on an empty stomach, or in Aristotle’s observation that, ‘all paid work absorbs and degrades the mind’.
Many people who have met all their deficiency needs do not self-actualize, instead inventing more deficiency needs for themselves, because to contemplate the meaning of their life and of life in general would lead them to entertain the possibility of their meaninglessness and the prospect of their own death and annihilation.
A person who begins to contemplate his bigger picture may come to fear that life is meaningless and death inevitable, but at the same time cling on to the cherished belief that his life is eternal or important or at least significant. This gives rise to an inner conflict that is sometimes referred to as ‘existential anxiety’ or, more colourfully, ‘the trauma of non-being’.
While fear and anxiety and their pathological forms (such as agoraphobia, panic disorder, or PTSD) are grounded in threats to life, existential anxiety is rooted in the brevity and apparent meaninglessness or absurdity of life. Existential anxiety is so disturbing and unsettling that most people avoid it at all costs, constructing a false reality out of goals, ambitions, habits, customs, values, culture, and religion so as to deceive themselves that their lives are special and meaningful and that death is distant or delusory.
However, such self-deception comes at a heavy price. According to Jean-Paul Sartre, people who refuse to face up to ‘non-being’ are acting in ‘bad faith’, and living out a life that is inauthentic and unfulfilling. Facing up to non-being can bring insecurity, loneliness, responsibility, and consequently anxiety, but it can also bring a sense of calm, freedom, and even nobility. Far from being pathological, existential anxiety is a sign of health, strength, and courage, and a harbinger of bigger and better things to come.
For theologian Paul Tillich (1886-1965), refusing to face up to non-being leads not only to a life that is inauthentic but also to pathological (or neurotic) anxiety.
In The Courage to Be, Tillich asserts:
He who does not succeed in taking his anxiety courageously upon himself can succeed in avoiding the extreme situation of despair by escaping into neurosis. He still affirms himself but on a limited scale. Neurosis is the way of avoiding nonbeing by avoiding being.
According to this outlook, pathological anxiety, though seemingly grounded in threats to life, in fact arises from repressed existential anxiety, which itself arises from our uniquely human capacity for self-consciousness.
Facing up to non-being enables us to put our life into perspective, see it in its entirety, and thereby lend it a sense of direction and unity. If the ultimate source of anxiety is fear of the future, the future ends in death; and if the ultimate source of anxiety is uncertainty, death is the only certainty. It is only by facing up to death, accepting its inevitability, and integrating it into life that we can escape from the pettiness and paralysis of anxiety, and, in so doing, free ourselves to make the most out of our lives and out of ourselves.
Adapted from the new edition of The Meaning of Madness
04 Sep 2015 Leave a comment
A short, sharp look into some of our most important ego defenses.
In psychoanalytic theory, ego defenses are unconscious processes that we deploy to diffuse the fear and anxiety that arise when who we think we are or who we think we should be (our conscious ‘superego’) comes into conflict with who we really are (our unconscious ‘id’).
For instance, at an unconscious level a man may find himself attracted to another man, but at a conscious level he may find this attraction flatly unacceptable. To diffuse the anxiety that arises from this conflict, he may deploy one or several ego defenses. For example, (1) he might refuse to admit to himself that he is attracted to this man. Or (2) he might superficially adopt ideas and behaviours that are diametrically opposed to those of a stereotypical homosexual, such as going out for several pints with the lads, banging his fists on the counter, and peppering his speech with loud profanities. Or (3) he might transfer his attraction onto someone else and then berate him for being gay (young children can teach us much through playground retorts such as ‘mirror, mirror’ and ‘what you say is what you are’). In each case, the man has used a common ego defense, respectively, repression, reaction formation, and projection.
Repression can be thought of as ‘motivated forgetting’: the active, albeit unconscious, ‘forgetting’ of unacceptable drives, emotions, ideas, or memories. Repression is often confused with denial, which is the refusal to admit to certain unacceptable or unmanageable aspects of reality. Whereas repression relates to mental or internal stimuli, denial relates to external stimuli. That said, repression and denial often work together, and can be difficult to disentangle.
Repression can also be confused with distortion, which is the reshaping of reality to suit one’s inner needs. For instance, a person who has been beaten black and blue by his father no longer recalls these traumatic events (repression), and instead sees his father as a gentle and loving man (distortion). In this example, there is a clear sense of the distortion not only building upon but also reinforcing the repression.
Reaction formation is the superficial adoption—and, often, exaggeration—of emotions and impulses that are diametrically opposed to one’s own. A possible high-profile case of reaction formation is that of a particular US congressman, who, as chairman of the Missing and Exploited Children’s Caucus, introduced legislation to protect children from exploitation by adults over the Internet. The congressman resigned when it later emerged that he had been exchanging sexually explicit electronic messages with a teenage boy. Other, classic, examples of reaction formation include the alcoholic who extolls the virtues of abstinence and the rich student who attends and even organizes anti-capitalist rallies.
Projection is the attribution of one’s unacceptable thoughts and feelings to others. Like distortion, projection necessarily involves repression as a first step, since unacceptable thoughts and feelings need to be repudiated before they can be attributed to others. Classic examples of projection include the envious person who believes that everyone envies him, the covetous person who lives in constant fear of being dispossessed, and the person with fantasies of infidelity who suspects that his partner is cheating on him.
Just as common is splitting, which can be defined as the division or polarization of beliefs, actions, objects, or people into good and bad by selectively focusing on either their positive or negative attributes. This is often seen in politics, for instance, when left-wingers caricature right-wingers as selfish and narrow-minded, and right-wingers caricature left-wingers as irresponsible and self-serving hypocrites. Other classic examples of splitting are the religious zealot who divides people into blessed and damned, and the child of divorcees who idolizes one parent while shunning the other. Splitting diffuses the anxiety that arises from our inability to grasp a complex and nuanced state of affairs by simplifying and schematizing it so that it can more readily be processed or accepted.
Splitting also arises in groups, with people inside the group being seen in a positive light, and people outside the group in a negative light. Another phenomenon that occurs in groups is groupthink, which is not strictly speaking an ego defense, but which is so important as to be worthy of mention. Groupthink arises when members of a group unconsciously seek to minimize conflict by failing to critically test, analyse, and evaluate ideas. As a result, decisions reached by the group tend to be more irrational than those that would have been reached by any one member of the group acting alone. Even married couples can fall into groupthink, for instance, when they decide to take their holidays in places that neither wanted, but thought that the other wanted. Groupthink arises because members of a group are afraid both of criticizing and of being criticized, and also because of the hubristic sense of confidence and invulnerability that arises from being in a group. Philosopher Ludwig Wittgenstein once remarked, ‘It is a good thing that I did not let myself be influenced.’ In a similar vein, historian Edward Gibbon wrote that ‘…solitude is the school of genius … and the uniformity of a work denotes the hand of a single artist’. In short, a camel is a horse designed by a committee.
An ego defense similar to splitting is idealization. Like the positive end of splitting, idealization involves overestimating the positive attributes of a person, object, or idea while underestimating its negative attributes. More fundamentally, it involves the projection of our needs and desires onto that person, object, or idea. A paradigm of idealization is infatuation, when love is confused with the need to love, and the idealized person’s negative attributes are glossed over or even imagined as positive. Although this can make for a rude awakening, there are few better ways of relieving our existential anxiety than by manufacturing something that is ‘perfect’ for us, be it a piece of equipment, a place, country, person, or god.
If in love with someone inaccessible, it might be more convenient to intellectualize our love, perhaps by thinking of it in terms of idealization! In intellectualization, uncomfortable feelings associated with a problem are repressed by thinking about the problem in cold and abstract terms. I once received a phone call from a junior doctor in psychiatry in which he described a recent in-patient admission as ‘a 47-year-old mother of two who attempted to cessate her life as a result of being diagnosed with a metastatic mitotic lesion’. A formulation such as ‘…who tried to kill herself after being told that she is dying of cancer’ would have been better English, but all too effective at evoking the full horror of this poor lady’s predicament.
Intellectualization should not be confused with rationalization, which is the use of feeble but seemingly plausible arguments either to justify something that is painful to accept (‘sour grapes’) or to make it seem ‘not so bad after all’ (‘sweet lemons’). For instance, a person who has been rejected by a love interest convinces himself that she rejected him because she did not share in his ideal of happiness (sour grapes), and also that her rejection is a blessing in disguise in that it has freed him to find a more suitable partner (sweet lemons).
While no one can altogether avoid deploying ego defenses, some ego defenses are thought to be more ‘mature’ than others, not only because they involve some degree of insight, but also because they can be adaptive or useful. If a person is angry at his boss, he may go home and kick the dog, or he may instead go out and play a good game of tennis. The first instance (kicking the dog) is an example of displacement, the redirection of uncomfortable feelings towards someone or something less important, which is an immature ego defense. The second instance (playing a good game of tennis) is an example of sublimation, the channelling of uncomfortable feelings into socially condoned and often productive activities, which is a much more mature ego defense.
There are a number of mature ego defenses like sublimation that can be substituted for the more primitive ones. Altruism, for instance, can in some cases be a form of sublimation in which a person copes with his anxiety by stepping outside himself and helping others. By concentrating on the needs of others, people in altruistic vocations such as medicine or teaching may be able to permanently push their own needs into the background. Conversely, people who care for a disabled or elderly person may experience profound anxiety and distress when this role is suddenly removed from them.
Another mature ego defense is humour. By seeing the absurd or ridiculous aspect of an emotion, event, or situation, a person is able to put it into a less threatening context and thereby diffuse the anxiety that it gives rise to. In addition, he is able to share, and test, his insight with others in the benign and gratifying form of a joke. If man laughs so much, it is no doubt because he has the most developed unconscious in the animal kingdom. The things that people laugh about most are their errors and inadequacies; the difficult challenges that they face around personal identity, social standing, sexual relationships, and death; and incongruity, absurdity, and meaninglessness. These are all deeply human concerns: just as no one has ever seen a laughing dog, so no one has ever heard of a laughing god.
Further up the maturity scale is asceticism, which is the denial of the importance of that which most people fear or strive for, and so of the very grounds for anxiety and disappointment. If fear is, ultimately, for oneself, then the denial of the self removes the very grounds for fear. People in modern societies are more anxious than people in traditional or historical societies, no doubt because of the strong emphasis that modern societies place on the self as an independent and autonomous agent.
In the Hindu Bhagavad Gita, the god Krishna appears to Arjuna in the midst of the Battle of Kurukshetra, and advises him not to succumb to his scruples but to do his duty and fight on. In either case, all the men on the battlefield are one day condemned to die, as are all men. Their deaths are trivial, because the spirit in them, their human essence, does not depend on their particular incarnations for its continued existence. Krishna says, ‘When one sees eternity in things that pass away and infinity in finite things, then one has pure knowledge.’
There has never been a time when you and I have not existed, nor will there be a time when we will cease to exist … the wise are not deluded by these changes.
There are a great number of ego defenses, and the combinations and circumstances in which we use them reflect on our personality. Indeed, one could go so far as to argue that the self is nothing but the sum of its ego defenses, which are constantly shaping, upholding, protecting, and repairing it.
The self is like a cracked mask that is in constant need of being pieced together. But behind the mask there is nobody at home.
While we cannot entirely escape from ego defenses, we can gain some insight into how we use them. This self-knowledge, if we have the courage for it, can awaken us to ourselves, to others, and to the world around us, and free us to express our full potential as human beings.
The greatest oracle of the ancient world was the oracle at Delphi, and inscribed on the forecourt of the temple of Apollo at Delphi was a simple two-word command:
Adapted from Hide and Seek: The Psychology of Self-Deception.