Altered perspectives

One of the arguments Arthur W. Frank makes in his book The Wounded Storyteller–and in his subsequent books about “illness narrative”–is that there’s a compelling ethics for medical diagnosticians and caregivers involved in just listening to the other person’s story. The difficulty emerges when the storyteller cannot put his or her story into words or lacks enough objective distance from the illness to narrate the kind of story that others are expecting.

When people’s circumstances push into the chaos realm, they’re in the midst, overwhelmed; few of them can construct a cogent and concise narrative. In their pain, in their grief, everything seems equal–no beginning, no end, all middle.

The listener expects: a beginning. a middle. an end.

The listener expects: chronology. a goal. a desired outcome.

If the listener’s job means determining a course of healing, the listener requires history, onset, comparisons. Truly good diagnosticians therefore need more than sleuthing skills, experience, and education. They need to listen well in the midst of the storyteller’s chaos; Frank calls this listening with.

That often means taking a deep breath and endeavoring to change perspective.

~

[Which, by the way, is excellent practice for poets.]

Tibet-Mountains-Everest-Kailas-Tibet-tours-Tibet-travel-Tibet-trekking-Tibet-hiking-3-of-8-1024x676

Himalayas: view from a high lake plateau (Snow Lion tours)

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Himalayas from satellite: a fractal view

~
We cannot climb into an airplane and get an overview of a human being’s situation. Nor can we get into another person’s thought processes to determine what’s going on. Listening without rushing the person, without offering advice, without finishing the sentences with what we expect to hear–that’s a hard task.

In a previous post, I tried to replicate what it was I could hear when someone I cared for experienced cognitive damage.

It was very, very difficult to listen. For me, heart-breaking because of my previous understanding of who the person was. It was only in her final days that I started to realize I’d needed to change in my relationship with her in order to get some idea of what she wanted to say. And it was too late, really.

~

As another Best Beloved is now experiencing significant cognitive changes, I want to do better. I need to acknowledge the chaos narrative, the interruptions, the lacunae in the person’s story. It’s important that I develop a new perspective on what a conversation entails, too; my expectations surrounding a conversation no longer hold, and both of us will get frustrated if we stick to former habits.

If sometimes a visit feels a bit like the Mad Hatter’s tea party, so be it. There’s a story in that, after all, thanks to Charles Lutwidge Dodgson.

mad hatter tea party tenniel

Tenniel’s sketch for Alice’s Adventures in Wonderland

And, just as an aerial view of the Himalayas alters the perspective of what the mountains are and how they appear, an altered perspective of a loved one keeps the person, as a human being still in the world (no matter how changed), in view. True, perhaps with changed patterns and unexpected gaps that we who love them may grieve the loss of. The conversations may be interrupted and chaotic, or full of long pauses and grasping for words and concepts. It is just a different kind of human communication.

Not what I expect, but what I am given. I’m trying to listen with, before it is too late.

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Listen better

Arthur W. Frank’s The Wounded Storyteller, which I’m currently reading, deals with medical ethics, personal narrative, illness, and the community (all of us, really) who may need care, give care, and/or who realize there is a socio-emotional impact when friends, coworkers, and family members become ill and thus require care. A sociologist by training, Frank examines illness stories as testimonies that point to a social ethic and asks all of us both to tell more when we experience pain and to listen better when others are telling us about their experiences of illness.

“Tell me about your despair, yours, and I will tell you mine.”

Mary Oliver, from “Wild Geese

At first this idea sounds unpleasant–one thinks of the stereotype of tedious conversations among the elderly about various surgeries and too-intimate revelations about prostates, livers, stomachs, and bowels (my dad calls these monologues “organ recitals”). That response–evasion, withdrawal, revulsion–is exactly what Frank seeks to change.

But then I consider the way I have heard stories of illness experience from hospice patients. How varied they can be. Some fragmented, some specific, some pious, some stoic, some anxious. And some that are beautiful. These stories aren’t just for (about) the person who has undergone the suffering. They are also for me, the listener. “When any person recovers his voice,” says Frank, “many people begin to speak through that story.”

He later writes:

One of our most difficult duties as human beings is to listen to the voices of those who suffer. The voices of the ill are easy to ignore, because these voices are often faltering in tone and mixed in message, particularly in their spoken form before some editor has rendered them fit for reading by the healthy. These voices bespeak conditions of embodiment that most of us would rather forget our own vulnerability to. Listening is hard, but it is a fundamental moral act…in listening for the other, we listen for ourselves. The moment of witness in the story crystallizes a mutuality of need, when each is for the other.

He would like to see an ethics among medical people and caregivers that dictates not just a compassion for the lot of the ill person but a perspective that the person, as a person, is not diminished by the fact of illness–not made into data, case study, or even into patient or client, any of which reduces the person to a body containing disease or disability. He argues for a full embodiment of pain in narrative as well as in physiology, for only with and through storytelling can we begin to experience the perspective of the other.

I am not very far into the book yet, but I’m finding the concepts relevant to my current life circumstances. I know how deeply I treasure a good listener. So working on listening better, myself, offers more people the chance to recover their voices, to speak through story.

Biodiversity & storytelling

As I have mentioned before in many previous posts, telling stories matters to humans. It’s the best way to get a person’s attention: if a writer wants to bring a fact, claim, event, person, or history to light, the best way to reach a wide audience requires spinning a good story about it. I recently finished reading a book about so-called living fossils, including bacteria and worms (not my favorite subjects), because the author’s enthusiasm for his subject was scaffolded onto a story of world-travel and time-travel. In the process of learning about coelacanths, horseshoe crabs, and echidnas, Richard Fortey also makes an impassioned plea for biodiversity–and storytelling.

“…I am not in sympathy with the idea that what matters about a species is how we humans react to it, which seems allied to a view that nature is only validated by observation from this particular hominid…We don’t reckon the worth of a species by the “damage” its extinction would do to other ecosystems. We cannot rank the products of more than 3 billion years of evolution in utilitarian lists. The richness of the biological world is the most wonderful feature of the biosphere, and every story is worth telling no matter how humble, or indeed insular, is the the organism concerned.” [my italics]

–Richard Fortey, paleontologist and expert on trilobites, in his book Horseshoe Crabs and Velvet Worms: The Story of the Animals and Plants that Time Has Left Behind. https://www.penguinrandomhouse.com/books/54786/horseshoe-crabs-and-velvet-worms-by-richard-fortey/9780307275530/

The lyric, the epic, the myth, the story written in the genome or the geology or the great vast cosmos–all of the things we know contain mysteries–intrigue us when we hear a narrative. Who knew that microbes and bacteria and alga have stories? They cannot tell their own unless “the storytelling animal” interprets them, raising their stature and importance in the eyes of “particular hominids.” In 1971, Dr. Seuss invented The Lorax for such a purpose.

It takes all kinds of people to tell good stories. Keep reading!

In defense of “is”

Contemporary poetry favors compression–perhaps all poetry employs that approach, condensing out of prose whatever has most vitality in terms of imagery, metaphor, emotion. Symbols, metaphors, actions, neologisms, wordplay, rhythm, whatever gets us to the kernel of the poem. My cultural inspiration began among biblical and metaphysical poems, however, and popular song lyrics (the lyrical narrative). Only later did I stumble upon the influences of Eastern poetic strategies, haiku and tanka, the Imagists, and the vividly imposing demand that writers of all kind, but especially poets, should avoid the “to be” verbs.

How would philosophy–or Hamlet–manage without to be? How shall a writer whose work often deals with the quandaries and paradoxes of being (namely: life, death) compose avoiding those verbs, verbs of existence? Existence has active components to it, to my way of thinking; and some of us need the to-be verbs, with all their various conjugations, to express the more inexpressible activity of being-ness.

During my long years of writing and of having my writing critiqued, I’ve been advised more than once to watch my verbs. I recognize the stylistic impulse and agree that too much to be, too much is, was, or has been, can slow or decompress a poem.

Sometimes, exactly what the poet intends to do.

Other times, exactly what the colloquially convincing narrator or character would say.

A time and a place for every verb.

~

Zhuangzi:zhuangzi

“There is a beginning. There is a not yet beginning to be a beginning. There is a not yet beginning to be a not yet beginning to be a beginning. There is being. There is nonbeing. There is a not yet beginning to be nonbeing. Suddenly there is being and nonbeing. But between this being and nonbeing, I don’t really know which is being and which is nonbeing. Now I have just said something. But I don’t know whether what I have said has really said something or whether it hasn’t said something.” (Watson, trans.)

~

I wrote this post not as an encomium for the to-be verbs but as a suggestion that they exist for good reason and possess action in their compressed sayability, that to be does not sidestep to mean. I defend “is” and its siblings. The important thing? Use them well.

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First person, continued…

When a poem employs first or, in some cases, second person, readers generally assume the stance is the writer’s. (For more on this, see previous post.) I won’t deny that that is sometimes the case, a situation which has led to the contemporary idea that a poem is always a form of self expression–yet another assumption that is only true in part.

My Best Beloveds have been known to accuse me of writing a lyrical narrative incorrectly. “That isn’t how it happened,” they say–and they are right. But poets are not journalists, nor even memoirists. A poet chooses the event, image, or story that will make the poem do its best work which, dear readers, is not necessarily factual.

Even relationships may be imagined, or imagined from a different-than-expected point of view. The poem may have emerged from a prompt having nothing to do at all with the poet’s own relationships or experiences, and yet seem true.

Here is an example of how the first person (lyrical narrative) point of view may or may not reflect the writer’s actual experience. In the example below, revision, change of stance, and allusion make this “father poem” not about my father, exactly. (For a poem that is about my father, as I imagined his experience, see this post.)

I began this poem when I came across the Chuang Tzu quote. Call that my “writing prompt.” As my father had been dangerously ill at the time, the aphorism resonated. Yet the poem did not seem to head where I thought I wanted it to go…to be specifically “about” my own father. The allusion to the Chinese sage does not feel much like my own family–the image did not jive with my parents’ backgrounds. I tried the poem without the aphorism, and it became totally boring. I returned the quote as an epigraph and tried couplet stanzas then, developing the image of old slide projector screenings (pardon the pun), something I recall vividly from my childhood.

Then, my dad’s condition improved. He recovered. I put the poem away for awhile, and when I went back to consider it, I realized the poem did not need to be about him. Or about me, for that matter. It’s still a poem in progress but works better now.

Who is the “I” in this poem? Shall I let the reader decide?

~~

莊子

Familiarity

The sage Chuang Tzu says, when you step
on your parent’s foot you know
you are already forgiven.

My father’s no sage,
just an old man beginning to die.
Unable to smile at his pain

he smiles at us
at my mother holding his hand
at my sister holding her anxious thoughts;

he smiles at her fears and they seem
translucent, like slides projected
on the wall, pictures of our childhoods

hovering near, colorful but not crisp—
and instead of our rounder faces
and smaller forms fading

he is fading, sallow among the sheets, white screen,
blank wall, and he’s forgiven me in advance
for all the injuries I may do

treating me with gentleness
though I’ve trod upon his foot
again, and again, and again.

 

~

continuum

The poet’s “I”

So often, when reading a poem written using the first-person perspective, my initial reaction is to consider the poet as the narrator–even though I ought to know better!

When I revisit the poem, when I analyze or interpret it on a more abstract or intellectual level, my view may alter. Interpretation sometimes leads me to decide that the “I” in a first-person poem may be a persona, a stand-in for the poet, or a perspective not of the poet’s personal experience but imagined or constructed. The foregoing are reasons to read and interpret poems with care and not to conclude, automatically, that the poet is writing from or of her own experience.

This makes poets sound like rather slippery or manipulative characters, employing use of the personal pronoun to mislead readers into believing something that isn’t “strictly true” (whatever that means). If I am telling a story, surely it must be my story; and if it isn’t my story—shouldn’t I confess that to my open-minded, engaged, possibly gullible reader? If a poem falls into the category of lyrical, readers tend to believe that the writer and narrator are one and the same, despite a reminder in the glossary of terms that the narrator who “expresses personal feelings” may be “the poet, the poet’s persona, or another speaker.” In other words—not the poet’s own feelings, despite the apparent authenticity implied in the use of the first-person pronoun.

Readers may feel betrayed by the writer. Yes, that happens. It also happens that rather awful human beings have penned soaring, beautiful, compassionate poems, because people are complicated and flawed and society often harms us.

And perhaps writing, in some complicated way, can redeem us. I’m not entirely convinced of that; but I do know that I have written poems that basically construct an experience or type of feeling I can imagine but do not authentically know, and that the work of having written such poems has felt like an enrichment of my own experience.

I have been asking myself why and how it happens that poets sometimes—often, perhaps—end up composing texts from other points of view, masquerading as their own. There seem to be a couple of reasons, one of which is simply that we practice writing by using our own much-loved poems as models. The lyric poem has a long history, and even autodidactic students of poetry eventually find that the biographies of some of their favorite writers do not correlate perfectly with the works themselves.

The lyric narrative has been around for less time, gradually supplanting the epic by drawing upon the ballad. And it’s here that readers often get confused about who is the “I” that tells the story, especially when emotional expressions of one kind or another enter the narrative.

I have more to say about this aspect of the poetic stance, the poet’s voice, and the lyrical narrative as lived or imagined experience. And about how that sort of thing evolves during the writing and revision process—with an example or two. But that is for another post. Meanwhile, I am mulling.

Image: Monterey Bay Spice Company

Mulling Spices

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?”]

~

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.