Dementia, fears, & mirrors

Dementia: the very idea raises fears about the loss of control, loss of beloved memories, loss of self. Is a person who is deep into dementia still sentient, still conscious? If we lose our ability to connect with who we are–let alone with other people–have we misplaced whatever it is we call consciousness, or mind?

Yet no one who has interacted with a person who has dementia would say the person has no consciousness. It is, instead, an altered consciousness: sometimes a loss of ego or sense of self in the world, or the disintegration of social or emotional “filters,” or a series of cognitive gaps that collapse into fugue, fears, or blankness. There are people who lose everything but the distant past, and people who lose everything but the present moment. Dementia has many causes and takes many forms. We do not understand it, and that creates fear.

Of the things I fear that are actually not unlikely to occur, dementia–more than death–unsettles my equilibrium. I have watched it unfold among a number of people, uniquely and inexorably each time, devastating to the loved ones of the person who has become ill and frustrating beyond measure to the victim.

I try to avoid the word victim when describing illness, but there it appears.

Personhood, consciousness, rationality, emotionality, familiarity, habits and the framework of the person’s life erode while the person goes through the usual day; nothing stays usual. Sometimes all that remains are useless habits, physical tics, fragmented phrases that no longer convey social information.

Because I struggle with the concept of mind, because I read philosophy concerning mind and neuro-psychological texts about human consciousness, because I am a writer and feel passionate about human expression and interconnectedness and how we originated the tools of speech, metaphor, storytelling narrative and writing, the loss of sentience that dementia seems to bring represents the deepest kind of loss.

How do you face your fear?

~

How about in a mirror? Through a glass, darkly…*

Through some sort of glass–of which there are so many varieties, a huge number of which I encountered recently at the Corning Museum of Glass in Corning, NY. It is worth the trip to western New York state to experience this gallery of art glass, collection of glassware spanning 35 centuries, interactive exhibits on the development of such commercial and scientific glass innovations such as Pyrex, tempered glass, shatterproof and mirrored and flexible glass, fiber-optic glass, telescope mirrors and lenses, silicon chips, and bottle-making equipment. The huge museum, established as an in-house exhibit in the Corning Glass headquarters in 1951, has had several major architectural upgrades and expansions from 1980 to 2015 (and suffered a disastrous flood in 1972).

We can face fear through changes in our perspective, I think.

inverted

photo by David Sloan

~

*1 Corinthians 13:12, King James Version:For now we see through a glass, darkly; but then face to face: now I know in part; but then shall I know even as also I am known.”

 

Love & reflection

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We express love because the gratification of love is enormous, and we continue to express love and to act protectively because the loss of love is traumatic. If we did not experience pain on the demise of those we love, if we had the pleasure of love but felt nothing when the object of our love is destroyed, we would be considerably less protective than we are.

It may also be that the very structure if consciousness opens the pathway to depression…To give up the essential conflict between what we feel like doing and what we do, to end the dark moods that reflect that conflict and its difficulties–this is to give up what it is to be human, of what is good in being human.

–Andrew Solomon, The Noonday Demon: An Atlas of Depression.

Reflection is a sign of consciousness, the ability to take in information and observe how it feels to be oneself in the face of that information, and to assess the impact of behaviors and actions and catastrophes and deaths. Socrates, the irritating questioner, required of human beings that capacity of reflectiveness. Solomon suggests this reflective ability is natural to people who undergo a depressive episode: “The unexamined life is unavailable to the depressed.” (italics mine)

Yet it is also this reflective consciousness which permits recovery among those who’ve been in the abyss, and sometimes a kind of bounce into remission/relief. Solomon adds that “[p]eople who have been through a depression and stabilized often have a heightened awareness of the joyfulness of everyday existence. They have a capacity for a kind of ready ecstasy and for an intense appreciation of all that is good in their life.”

That sense of “ready ecstasy” often acts as the impetus for poetry, in my experience. I am not sure that joyful awareness was worth the pain and despair–couldn’t I have just achieved heightened awareness through, say, meditation, song, or religion? Nonetheless, if I can craft a relationship with depression that is not a destabilizing battle, that’s enough for me. The recognition of joy and the critical thinking that reflection deepens in my consciousness keep me striving.

Yesterday morning, early, in the long grass, the three-legged doe gave birth to a fawn. I watched as they emerged from the meadow and headed for the woodlot together, mama still licking the little one.

Earth delivers ecstasies readily, if only we will observe.

ann e michael

Depression & friendship

When I mentioned to an acquaintance that I am reading Andrew Solomon’s The Noonday Demon: An Atlas of Depression, the look on her face pretty much summed up how most people feel about the topic–why would I want to read about something so upsetting?

A few sections of Solomon’s book are hard to read but, surprisingly, some of it is laugh-out-loud funny. Humor definitely acts as a leveler for the challenges life brings us; Solomon admits to “being afraid of a lamb chop” and other anecdotes that are not merely self-deprecating–they are somehow universal, at least they are if you are a person who has had a relationship with the Noonday Demon. His descriptions of how his friends bore with him and supported him through his deepest katabasis are hilarious, humiliating, sad, and unbelievably moving.

Simultaneously, I’m reading The Five Invitations: Discovering What Death Can Teach Us about Living Fully, by Frank Ostaseski. Obviously, that text is on the reading list of “the morbid book group.” The approach is mostly Buddhist, but Ostaseski does a good job of gently suggesting that bringing more moment-by-moment, alert compassion into our lives daily can ease many of the burdens of human suffering by making us aware that all of us suffer and that suffering, shared, becomes less of a weight or stressor in our lives.

Friendship keeps us sane. It does so partly through that sense of community in which many hands make light work. And it brings us back to sanity, sometimes (not always–there is no “always” in the human sphere). For many persons, relatives are friends. Other people have no friendships within their families but have friend-relationships that act as similar, or even more powerful, support. The luckiest people have both.

I am one of the lucky ones. Today, while thinking about consciousness and suffering and depression in the human condition, I want to acknowledge the loving, sane difference a friend made in my life: David Dunn, poet, jazz aficionado, baseball fan, Trekkie, fellow laborer in the mines of the abyss, 1955-1999.

Reading these books while navigating the recent loss of an elderly long-time friend has unleashed a reflective current that, while a bit sorrowful, does not feel like depression. There’s gratitude in this rivulet, happy memories and rueful ones–more like inspiration than desperation. That may be because the friendships are still supportive. Relationships don’t die when the friends die; a powerful relationship lasts far longer.

Depressed people feel unlovable and, unable to accept the clear evidence that they are indeed loved and valued, manage to behave in ways that make themselves and others miserable. They don’t mean to hurt others; in their pain, they think that they deserve to be abandoned and their crazy words and actions create a self-fulfilling prophecy of isolation. It takes a surprising amount of strength to be a person who undergoes depressive episodes (they are so exhausting, physically and mentally–see Solomon’s book). And it takes incredible strength to love and stand with a deeply depressed person.

David Dunn, who experienced depressions far more debilitating than my own, acted as my tether when I started to drift too far. In my younger days, that drifting often led me toward Charybdis. In turn, I helped David when he was low; we shared poems of others and poems of our own, shared books, fears, and insomnia tales. We held one another upright in the throes of some pretty miserable days.

I miss him. Though I am much, much better now, I do not think I could have survived those years unscathed without his quiet acknowledgment of my pain and the presence of his friendship. The idea that we can accept what life brings us without bitterness or anger or blame, yet without resignation or helplessness, seems a tough task for the people in my culture. David Dunn could not always attain that balance for himself, but his acceptance of me taught me more than I ever realized at the time.

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~

“There is something brazen about depression. Most demons–those forms of anguish–rely on the cover of night. To see them clearly is to defeat them. Depression stands in the full glare of the sun. You can know all the why and wherefore and suffer just as much as if you were shrouded in ignorance. There is almost no other mental state of which the same can be said.” ~Andrew Solomon

 

Depression narratives

I have been an avid and interested reader of books, usually memoirs, describing the authors’ experiences with depression, unmanageable grief, or depressive episodes. There are a number of reasons for my interest, one being that I have an interior depression narrative of my own and the other because of my passion for delving into concepts of consciousness. Consciousness and depression must be intimately linked, of course; a person cannot feel depressed if he or she lacks a reflective sense of self or Mind. Sorrow differs, but some grief is so deep that depression enters in and squeezes the soul dry. Each narrative contains parallels to other narratives, and yet each is as unique as the author. We are “storytelling animals,” and the impetus to tell the story of depression may be to help others or to assist in re-knitting the disjunctions depression creates in consciousness.

For example: This Close to Happy, Darkness Visible, An Unquiet Mind, H is for Hawk, Hyperbole and a Half, The Year of Magical Thinking, The Solace of Open Spaces…even in the relatively brief Chapter 75 of Bruce Springsteen’s memoir Born to Run–there are dozens of such memoirs on my bookshelves, and this list does not even mention the books by poets, psychologists, and philosophers who have explored the human challenges of depression. [I have not yet read Andrew Solomon’s Noonday Demon; but it is on my list.]

Porcelain doll, “Rain,” by Alexandra Koukinova of “Alexandra” Company.

Because I am a writer, these narratives, and the lyric inventions crafted by poets, teach me much about how to explain the un-nameable, to describe–in words–the kind of numb grip that a depressive crash or a monumental grief exerts on a person’s sense of self, or even of language (which fails); the way depression shrinks into nothingness a person’s feeling of shared community/communion/communication with others, even with beloved others. There’s a story there, the story of how the story itself gets subsumed by stasis.

In these cases, metaphor: the person is the story; the story loses its narrative, tapers off, stands still. No longer interesting, expressive, alive.

Unfortunately, I know that feeling. I know how it arrests creativity and savages my ability to write.

~

Why do we “get” depressed? What does depression do to the brain? Does the brain itself cause depression? Despite the insights medical researchers have gleaned about neurological networks, cells, synapses, the anatomy of the organ we call “the brain,” there are no answers to these questions; the former can be tracked through scans to some extent, but there is seldom a “before” MRI or PET scan with which to compare “normal” and “depressed” in a unique individual. A New York Times Health & Science article from 2005 puts things pretty succinctly:

” ‘I think that, with some notable exceptions, the community of scientists was excessively optimistic about how quickly imaging would have an impact on psychiatry,’ said Dr. Steven Hyman, a professor of neurobiology at Harvard and the former director of the National Institute of Mental Health. ‘In their enthusiasm, people forgot that the human brain is the most complex object in the history of human inquiry, and it’s not at all easy to see what’s going wrong.’

For one thing, brains are as variable as personalities.”

brainOne of the problems is determining causation: which was first, the disease or a perceived (and possibly inaccurate) difference in brain structure or function? Is it chemical or hereditary, or is it traumatically-induced? Or are we not really seeing a difference in brain structure? Why do medications work for some people but not others? And why and how do medications work, exactly? Twelve years after Carey’s NYT article, psycho-neuro-biologist folks still do not know any definitive facts, though there is slow movement toward progress. [For a quite up-to-date and thorough but readable article about the complexities involved in depression, I recommend Harvard Health Publication’s online pamphlet “What Causes Depression?”]

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From the standpoint of a person who has had a lifelong relationship with depression, I’m not sure I need a cure at this point. My depression narrative includes taking a pill that seems to help considerably; but that has not been the magic bullet that alleviated a chronic, possibly chemical, condition. What has balanced my conscious mind with my chemistry is at least as likely to be related to support, friendship, talk therapy, cognitive behavioral changes, personal motivation, love, reflection, experience, information, aging, writing, spiritual study, Zen, nature, environment, valuable work, art, and tai chi.

The Nautilus article (cited below–do consider reading it) suggests there may be an “up” side to depression:

In a study of 61 depressed subjects, 4 out of 5 reported at least one upside to their rumination, including self-insight, problem solving, and the prevention of future mistakes.

“It may be best to let depression work its miserable magic, under protective supervision.”

“Most episodes of depression end on their own—something known as spontaneous remission…” says Steven Hollon, a professor of psychology at Vanderbilt University.

The Nautilus article cites several researchers who use the evolutionary model of fitness and bargaining, concepts that Marjorie Grene might caution us away from relying too heavily upon. Drake Baer of The Science of Us, whose article was certainly titled by editors, not scientists, writes “that, in some circumstances, depression may be, in the arc of a life, yielding of insights and personal meaning. All of this is in no way meant to minimize the suffering that depression can cause — but to suggest the uses that it may serve.”

Baer’s article dwells upon the idea that there are structural and cultural concepts at work in the identification of, experience of, and healing of depression; that the “illness” or disease resides in the subjective, non-empirical, non-testable world of human consciousness (interiority). I’m on board with that suggestion. Baer closes by relating depression to katabasis, an ancient Greek word that refers to the inexorable downhill slide, the descent into the underworld, the sinking down into darkness.

Baer writes that “Katabasis leads to catharsis; not coincidentally, there’s a shared theme in the personal narratives of people who reach midlife with a sense of well-being and generativity toward others: redemption.”

My personal depression narrative, just past mid-life (by some reckoning), suggests redemption. Which is to say there’s hope.

~

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Totally cheesy rainbow photo.

See also: http://psycnet.apa.org/journals/rev/116/3/620/

http://nautil.us/issue/45/power/does-depression-have-an-evolutionary-purpose

http://nymag.com/scienceofus/2017/02/a-new-way-to-understand-and-treat-depression.html

Please, if you or someone you know and care about has challenges with depression, read the Harvard article linked in the text at very least; and check out the other links as well. This is as close as I ever get to a public service announcement, but the urgency is explicit.

Science & philosophy

The small, religiously-affiliated university at which I work graduates, percentage-wise, a large number of baccalaureates in the sciences although it offers a liberal arts-based core curriculum. How does that affect what coursework students must do? For starters, two Theology courses and one Philosophy course are required for graduation.

Three critical-thinking method, scholarly courses ought not to be more than a student in the sciences–or any other discipline–can handle; but I hear a bit of resentment among the undergrads. They question the necessity of abstract ethics classwork, wondering how such material will be applicable to a fast-paced, technologically-advanced, science-oriented career or life. Philosophy doesn’t seem to be a skill set to them.

SocratesWhile I fundamentally disagree, I take their point. With so much new information coming at them, info-savvy young people might well feel skeptical about what they can gain from reading texts by Plato, Aristotle, Augustine, or Aquinas.

Philosophy has been around for millennia, though; empirical science as we know it–with electron microscopes, satellite-mounted telescopes, petri dishes and x-rays–is brand-spanking new by comparison. The techniques we use today seem concrete and tool-like rather than theoretical; yet as every real scientist knows, the only way developments occur is through hypothesis–theory–claim–assertion–question–pushing the envelope of the known.

Which is what philosophers have been doing for thousands of years.

The budding scientists and medical-studies researchers I encounter seldom realize that without philosophy, science would not exist. Philosophers asked the “why” questions, came up with theories and categories, tried to see into a future that might someday have the technology to confirm or refute the theories they came to solely through human observation and deduction. Problem-solving skills. They were the scientists of their day, and the methods of thinking they came up with are those that contemporary scientists in all disciplines continue to employ.

http://www.isys.ucl.ac.be/descartes/images/Descartes.gif Descartes

Descartes, 1640s

A wonderful book on the way philosophy developed into biology (to take just one of the scientific disciplines) is Marjorie Grene and David Depew’s The Philosophy of Biology: An Episodic History.

The authors–a philosophy professor and a rhetoric professor–provide a history lesson in science, taking us by steps and by leaps into the development of a scientific (empirical) skill set as derived from insightful cognitive understandings of those Dead White Guys on whose thinking Western philosophy is based.

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Darwin’s finches, 1840s

Now, I am not an advocate for a strict return to the Western Civ canon; I think university education should diversify into exploring (and questioning) other modes of cognition, culture, and philosophical approaches. Yet it seems to me imperative that students continue to study, and learn to value, the history of human thought. You can be a nurse without a thorough background in Aristotle’s categorical concepts; you can learn the drill about washing hands, donning gloves, and inserting catheters–all practical, concrete skills. You can understand the rationale for all of those skills; that’s true, and practical.

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Cajal’s drawing of a pyramidal neural cell, 1913

Nurses today, however, should have the thinking skills to solve unexpected problems rapidly and rationally, which is how things play out “in real life,” to deduce that something’s going wrong even when the readouts look stable, to recognize that the hurried intern added an extra zero to the number of milligrams of medicine prescribed. They need enough background in the history of medical care-giving to question a doctor or administrator when the ethics of a patient’s care seem to be at risk. These problem-solving skills are not only crucial, they are philosophically-based.

~

 

I will dismount from my high horse now. With all the disorienting information being bombarded at me these days, I need a poem to reorient myself. Here’s one by Mary Oliver.

Snowy Egret (by Mary Oliver)

A late summer night and the snowy egret
has come again to the shallows in front of my house

as he has for forty years.
Don’t think he is a casual part of my life,

that white stroke in the dark.

==

We shake with joy, we shake with grief.
What a time they have, these two
housed as they are in the same body.

 

Coincidence & synthesis

I adore random synthesis. I love how coincident information, ideas, and experiences connect to enrich my understanding or pique my interest.

Today, a friend sent me a link to a chapter from the Dalai Lama’s book and another friend sent me to New York Magazine‘s Science of Us blog to read Cody Delistraty’s piece on the neurology of poetry reading. Meanwhile, I have been cleaning my bookshelves and reading Jane Hirshfield’s Ten Windows.

books1Delistraty’s essay reports on a study (in Germany) conducted by Eugen Wassiliwizky, a researcher at the Max Planck Institute for Empirical Aesthetics, on what happens in the human brain when people read or hear poetry. The Institute has sponsored quite a few studies on the neurological responses to the arts, which offers researchers not just the findings from one area of aesthetics but the opportunity to compare responses across artistic disciplines.

For example:

…[Neurological] responses… seemed to be unique to poetry: Scans taken during the study showed that listening to the poems activated parts of participants’ brains that, as other studies have shown, are not activated when listening to music or watching films.

The authors also found evidence to support the idea of poetry’s pleasure as a slow-building experience, or what they called a “pre-chill”: While listening to poems they found particularly evocative, the listeners subconsciously anticipated the coming emotional arousal in a way that was neurologically similar to the reward anticipation one might get from, for instance, unwrapping a chocolate bar.

Delistraty notes that in this study, “the poetic lines that most emotionally stirred people were also most memorable for them later.”

Our brains ready themselves for surprise, delight, arousal, some emotional leap in the poem–even before the poem ends–anticipation. I know that feeling well. We are anticipating some kind of surprise or delight as the poem unfolds in our reading or listening real-time imaginations: a kind of freedom that we anticipate but cannot expect (the poem may surprise us in ways we had not anticipated; or it may disappoint our hopes).

Hirshfield writes:

On the one hand…poetic transformation occurs by what might be called the paradox of intimate distance. The freedom inherent in art to choose stance, attitude, approach, form, word, is in itself an act of emancipation. When distance increases…we often feel more, not less, because we are able to take in the whole.

What we “take in” as whole includes the phenomenon of reality, even though the poem operates in the imagination–another paradox. Reading a good poem, then, opens consciousness. bkmk-violet

I realize that in the years keeping this blog, I have never yet found a satisfactory understanding of what makes human beings conscious or from whence consciousness originates; but that’s one reason I keep reading and writing, Socratic gadfly that I am. And that brings me to the third random reading that, to my mind, synthesizes well with the essays I’ve mentioned. Here’s an excerpt from one of the Dalia Lama’s books that was posted on Lion’s Roar, a Buddhist-oriented website. In this chapter, His Holiness has been visiting with neurosurgeons and brain researchers at the cutting edge of medical science–people deeply, empirically engaged with the science of the human mind:

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The Buddhist understanding of mind is primarily derived from empirical observations grounded in the phenomenology of experience, which includes the contemplative techniques of meditation…

The view that all mental processes are necessarily physical processes is a metaphysical assumption, not a scientific fact. I feel that, in the spirit of scientific inquiry, it is critical that we allow the question to remain open, and not conflate our assumptions with empirical fact…A crucial point about the study of consciousness, as opposed to the study of the physical world, relates to the personal perspective. In examining the physical world, leaving aside the problematic issue of quantum mechanics, we are dealing with phenomena that lend themselves well to the dominant scientific method of the objective, third-person method of inquiry… In the realm of subjective experiences, however, the story is completely different. *

~

Part of what makes poetry, or any art form, “work” is that appeal to the subjective. Subjectivity excludes the empirical; there’s always, somehow, more to art than science can explain–wonderful as science is. Delistraty writes, “poetry transcends…methodical scrutiny. It valorizes the unconscious, opening us up to new perspectives; it implies the possibility of unlimited pleasure.”

Hirshfield names that pleasure, that surprise, that alteration within the reader “hope” –a wonderful synthesis.

snowdrops

~

* The Universe in a Single Atom by His Holiness The Dalai Lama; full discussion on https://www.lionsroar.com/studying-mind-from-the-inside/

Aesthetic values

Today, the weather was beautiful; the trees, early-greening, and the gold tassels of oaks shimmering in the sun, and the cherry and dogwood blossoms: beautiful.

I think about how we value beauty. And maybe do not know what it is–or recognize its many forms–as it is, by its nature, subjective.Liz MZ

A friend I knew was physically beautiful. Or was that mostly her generosity and cheerfulness, her sparkling eyes? She had specific aesthetic tastes she followed with delight; but she remained practical, full of humor. Today, there was a poetry reading in commemoration of her life.

A beautiful day, a beautiful event, a beautiful friend.

~

The aged best-beloved who recently departed was also a person who had particular ideas about beauty. She cultivated flowers, liked certain artists, wanted her rooms decorated just so. She had an expectation that she could control her death, too–she wanted it, also, to be beautiful.

She was, I fear, thwarted in that desire.

~

My brother the amateur science historian has taken it upon himself to defend the reputation of Johann Friedrich Blumenbach, a late-Enlightenment scientist best known in the 20th century for coining the term “Caucasian” (though there is some dispute about the neologism). An overview can be found here, but my brother’s argument hinges upon the way the word “beauty” was defined in 18th-century Germany and the ways Blumenbach employed it in Latin in his 1795 masterwork, De generis humani varietate nativa (3rd ed).

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What do we mean by beauty? Must the meaning hinge upon perspective and culture?

~

There are tumors in the body of the beloved. The surgeon, with his amazing equipment that can take photographs deep inside the tubes and organs of a human being and his unimaginably small and precise surgical tools, shows me “before and after” images.

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His enthusiasm enlivens his description of the surgery: Look at these tumors–unusual, hardly see these and I’ve been at this thirty years–but afterwards, very clean. Look here–no sign. Went very well. Beautiful!

Beautiful?

Does he mean the tumors, or his surgical work? In either case–would I define this as beautiful?

~

And a colleague who has had major surgery does a close reading of the (“rather horrifying”) fluoroscopes from the operation and in them finds something beautiful. Something she can create her own art from. Because what the surgeon accomplished was to her mind art; and art is beautiful, though often in a way that isn’t necessarily aesthetically pleasing as, say, a lilac in bloom is pleasing.

lilac

Does it matter–should it–that something is ‘beautiful’ ?

I am asking but I do not expect to find an answer, myself.