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Perspectives - Vol. 4, No. 4 - Sketch of a Theory of Loneliness - Page 2 of 3

Brian Davey: Mon, Nov 1st 1999

Continued from Page 1

Relationship Skills - Difficulties in establishing and sustaining relationships

To these difficulties that arise in the economic, social and physical environment must be added the influence of what might be termed people's emotional skills. The use of the term skills I do not particularly like since it makes having relationships too much like work - it says something about the times in which we live. Perhaps it would be better to describe this as people's levels of emotional awareness. In this respect one will often find that people who have had mental health problems and who have then experienced therapy, or read books about therapeutic issues, are, paradoxically, far more aware of emotional dynamics than the supposedly healthy. This does not, however, mean that their lives are necessarily any happier. Indeed the contrary is likely to be the case. People who have been through emotionally incapacitating times, will often evolve better and better coping skills and greater and greater self awareness - but the problems that they have to cope with tend to grow more than disproportionately to their coping skills. Once they have had a breakdown then, to whatever problems may have caused their original breakdown, they are likely to have to cope in the future with many additional stresses. They are likely to find it difficult to get a job, accommodation and new relationships. Not for nothing do many people call themselves 'survivors' - for they have been through assault courses that plumb the fundamentals of human existence. They are often thus a lot more mature than those for whom life has been easy. The reason that such people still sometimes breakdown again is often that their burdens accumulate faster than their coping strategies. There are so many sources of stress that they rpeatedly come back to points of disintegration in their personal worlds where the even the best coping strategies will not hold one together. (In this respect the ministrations of psychiatrists and social workers are irrelevant. They have never been there - their salary levels cushion them). Needless to say, however, as one falls to pieces again, one again reduces one's chances of every being seen as a suitable friend or sexual partner.

In short, merely understanding the dynamics of human relationships and one's inner emotional life close up, merely being emotionally aware, does not solve the economic, social and spatial problems already referred to. These problems are magnified once one has a record. One can only start again from an inferior starting point. Users of mental health services say time and again that their main problems are getting accommodation and jobs but few mental health workers listen because they have no skills in providing these and cannot hear a message that would disempower them. They prefer to hand out medication or psychotherapy. In psychotherapy the assumption, in this respect is that one's emotional misery is something that has arisen out of personal inadequacy.

The limits of psychotherapy as a response to loneliness

Within the psychotherapy model, to be sure, this is an inadequacy that it is assumed can be worked on and resolved. The assumption within psychotherapy is that people's problems arise in their early emotional relationships and life experiences - these are assumed to have been damaging, or not adequate, so that people have evolved life strategies and ways of coping that are self-defeating. By becoming aware of these self defeating responses it then becomes possible, within the assumptions of psychotherapy, to live life differently. The principle assumption in this respect regard to the causes of loneliness and isolation is that people are reticent about revealing their feelings and needs to other people, they live defensively because their upbringings will have made them suspicious, paranoid, defensive. They close themselves off from relationships because their previous experience of relationships has been one in which they will have been used, abused, and their feelings overridden. In the therapy view these earlier experiences will have made people assume that negativity is a feature of all relationships, keeping their distance from other people. They may not be fully aware of this but therapy will help them remember how they evolved personal strategies in relationships which are no longer appropriate, if they ever were. In the therapy model the way is then opened up to other kinds of relationships.In these more healthy relationships they are not carrying over the sorrows, fears, unmet longings or angers from their past relationships into their new ones.

This is all very convincing but it only takes us so far - it fails to address all those social, economic and environmental causes of loneliness mentioned earlier. It also assumes that in society as a whole your average person is reasonably emotionally healthy - psychotherapy is seen as being to bring people up the level of everyone else, a level that is emotionally mature. The implicit idea of a general emotional maturity allows one to believe that people who have been through a curative process in therapy will now find acceptance by everyone else. Alas there are reasons to believe just the opposite. It is true, of course, that some people are more emotionally healthy than others - because they have had a more positive upbringing and also because they have endured hardship themselves and so have empathy. However it would be over simplistic to see mass psychology, the psychology of the population at large, as simply being healthy as against the unhealthy people who cannot cope or form relationships. In mass psychology lots of people are coping because they are using other people in an emotionally destructive way. In society as a whole unhappiness exists everywhere .The people who break down often do so because they have access to less of the respectable (or better hidden) addictions, defences and emotional displacement that everyone else has ( e.g. a weekly visit to buy more toys from Rumbelows; the purchase of cocaine; the opportunity of offloading of frustrations onto others through a job in managing them, treating them, social working them, policing them etc.; self distraction through workaholism; visits to a brothel etc.).

Psychotherapy is a powerfully attractive ideology because it does say real and relevant things about people's behaviour. It aids self understanding. It introduces people to a language with which they can begin to make sense of their past, it provides the words that people can use, perhaps for the first time, to understand their emotional life. But it has limits. Very often the people most in need of therapy are not society's emotional victims but the people whose power sets the context of the lives of these emotional victims.

In society as a whole virtually everyone has been made to feel small when they were small. In later life virtually all those who possess roles of social authority protect themselves against feeling small (powerless) again by feeling big in relation to someone else - their children, their pupils, their clients, those 'under their protection'. In this situation many individuals or social groups are regarded or treated as inferiors. This enables many people to maintain their mental balance. Self esteem can be found in regarding others as inferiors. These inferiors can be bullied - thus offloading feelings of anger and frustration. Such bullying can take a completely respectable form where it is done by professional as treatment or punishment or various forms of official help. As the psychiatrist drives away from work in the evening he feels responsible, adult, emotionally secure at having to force a disturbed patient to take a tranquilliser injection, or using his expertise on the ECT machine. These feelings are the reassurance that he really is grown up and has been sanctioned to take control over the life of another. These are the feelings that banish self doubt, the inferiority complex that would otherwise be felt, bequeathed by overbearing, interfering parents.

There are great limits to therapy as a cure for loneliness. The implication here is that the casusers of loneliness lie in the inadequate relationship skills of the lonely person. The limits lie in the assumption that therapy only or mainly applies to this sickness. Through therapy the sick can rejoin the company of the healthy. It ignores the fact that plenty of people are only appear well because they are making others sick - and the medical profession of psychiatry contains a good few examples. (This viewpoint has occasionally been acknowledged in the mental health services by brave critics. For example a psychoanalytical study has been done of ECT doctors which revealed high levels of hostility and hatred to their patients. This article, by David Abse and John Ewing, called Transference and Counter Transference in Somatic Therapies, in the Journal of Nervous and Mental Disease, January 1956, includes the following kinds of comments from doctors, "Why don't we put him on the assembly line", "Hit him with all we've got")

To conclude, it would be wrong to assume that psychotherapy can cure loneliness except as part of a much broader process of social transformation that touches every aspect of life - and which touches and transforms the mental health services themselves, the ideology that they transmit socially, and the very personalities of their practitioners. Until this happens no one is ever going to be able to issue convincing certificates of emotional 'cure' that can function as useful references for potential sexual partners.(By writing convincing explanations for my own past emotional traumas and their context I try to do the best I can to write my own but......).

Medical psychiatry and loneliness

If psychotherapy has grave limits as a response to loneliness medical psychiatry is positively iatrogenic. Many of the supposed symptons of mental illness are easily understood as the result of loneliness and isolation. For example, one of the most common psychiatric symptoms, hearing voices, is probably most simply explained, as arising in the need for feedback, for friendships, for relationships, for someone with whom to share emotions, in times of stress. (This theme comes out clearly several times in the collection of writings in Hearing Voices edited by Marius Rome and Sandra Esher published by MIND in 1993. For example, it is very common for desperately lonely bereaved people to hear the voices of their loved ones.) Another common feature of madness is fantasy. But fantasy is an almost inevitable feature of isolation and loneliness. Loneliness generates powerful emotions and a desperate desire to communicate these strong feelings. At the same time there is no way for an isolated person to reality check how other people see or feel about him or her. The lonely person may indeed be being used a a moral leper, a scapegoat for emotional displacements in their family or some other social network. They have no way of judging the results of their desperate attempts to communicate with those from whom they are separated, who may have ostracised them. It is inevitable that this isolation and ostracisation will create fantasies of other people's responses to them because other people are not communicating. The hypothesis of other people's attitude to themslves that the desperately lonely person makes cannot be merely objective guesses. They are forced to think in hypotheses which are inevitably saturated with their hopes (for acceptance ) or fears (of their continued isolation, of dying unfulfilled, alone).

Within the medical model of mental health problems, one of the most pernicious and vicious effects of the medical theories which keep doctors in salaries, is that these entirely obvious things are falsely explained by reference to the allegedly different genetic and biological make up of people who are suffering in this way. They can do nothing about these problems other than to rely on these doctors for medication or voltage through the brain. Whereas psychotherapy, in principle, allows for the possibility of cure, the medical model even more reinforces loneliness as it undermines any possibility that people will be able to rebuild their economic or relationship futures. Within the medical model one is only ever 'in remission' - all attempts to start again are thus undermined in principle. The medical system therefore functions as a structure of parasitism that effectively renders impossible any chance of getting a second chance at employment, relationships or any valuable social role. Its principle means of intervention, medication, creates very noticeable disturbances of physical functioning, movement disorders, distant and slurred communication and facial expression that reduces possibilities for healthy emotional expression on the body level - we must remember that emotional expression occurs through facial expression, speech, body contact, making love etc. Many people think they know what the symptoms of mental illness are - when in fact they are witnessing the effects of drug use on people. In a sense they are right - mental illness is real. It exists as an iatrogenic (doctor caused) disease. The real mental illness is what doctors have created through their physical treatments of people who are suffering from incapacitating emotional distress caused, in reality, by a complex pattern of social, economic and environmental processes that impact on the inadequate coping strategies of individuals. (In the Third World, where the psychiatric system is less developed, and psychiatric drugs used less, non-normal states of mind and distress are repeated less recurrent - in the psychiatric jargon, relapses are less frequent most probably of all because psychiatry does not exist with all its iatrogenic effects). questions asked here are part of that new way of looking at society that will provide the asnwers. We must find the means through projects and initiatives in the restructuring of our living spaces for social and environmental goals that challenge narrow minded money rationality. Not that we must see finding our friends and lovers through earnest activity - rather we must turn earnest activity, as Ivan Illich has put it, into occasions for conviviality, for festivals and pleasurable celebrations which break down the barriers between work and leisure between colleagues and friends and which seek to draw in excluded people into positive and healing social processes that follow..

Continued on Page 3

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