Experiential Psychopathology - Dr John Howells

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I - Experiential Psychopathology

Damage to the Organism

General

Like all elements in the cosmos, human organisms – individual, family and society – are controlled by the formulas governing the universe; they are part of the “cosmic design”.  One of these formulas is the need to function harmoniously.  The cosmos, the universe as an ordered whole, remains imperfect and therefore the possibility of dysfunction is still an essential ingredient in it.  Evolution strives to reduce dysfunction.  Our developing awareness of psychic matters and our striving for psychic self-improvement are parts of this movement onwards.  As the universe evolved, man developed the capacity to evaluate life experience and change it, to produce harmony.  Therefore, man is driven on by a need to be harmonious and this in action is creative.  This creative capacity is part of the cosmic endowment.  The origin of this process, its rules and its regulation is a mystery.

Evolution affects both physical and psychic matters.  Each has equal worth in the universe and, furthermore, the physical and psychic are linked.  For this last reason there is value in considering psychic matters in known physical terms, as long as it is appreciated that each has in addition qualities of its own – even if at opposite ends of an elemental spectrum.  Just as a caress can lead to a pleasurable physical sensation, so psychic communication can lead to a pleasurable feeling.  Psychic messages are needed to satisfy the intra-psychic processes of behaviour.  In the cerebrum there is a sensitive highest level functional area that can function harmoniously or unharmoniously.  It seeks pleasure and harmony.  It has a capacity to want this, i.e. given an equal choice of harmony or disharmony it will select the former.  Possibly there is a regulator or governor, imposed by the developing plan of the universe, that works towards harmony.

The organism moves through time directed by its place in the cosmic plan; the motivation of the organism is beyond its control, it dances to the tune set for it in the pattern of things.  The organism has a capacity to understand and react to situations but this capacity is the result of previous events and is thus, again, controlled by the cosmic plan.

Homeostasis, maintaining the constancy of the internal environment, is one factor in good functioning – as it is in its other sense, maintaining the balance between internal and external environments.  Homeostasis, in both its meanings, is not as fundamental as the need for harmonious functioning, but it is an indication of good functioning.

The organism has an endowment of a physical and psychical apparatus, e.g. an apparatus that allows it to think, an apparatus which has a number of properties that can be developed to an optimum capacity, i.e. a determined degree of intelligence for a particular thought apparatus.  The human fabric, somatic and psychic, is complex and composed of multiple, different, but linked elements.  Experience acts on this endowment.  Experience can be beneficial or harmful, good or adverse.  As the result of experience the organism accumulates added characteristics.  (“Properties” denotes the endowed entities, “characteristics” denotes the acquired entities.)  If the experience is beneficial, the organism manifests indications of good functioning; if adverse, it displays indications of malfunctioning.  Usually, in its imperfect state, it shows indications of both.

The fabric of the organism, be it individual, family or society, is the area on which the psychic noci-vectors operate, its most vulnerable part being its acquired characteristics.  Within the fabric is found the morbid process – either organic or psychic pathology.  In both the organic and psychic areas there are not only changes due to the noxious agent, but also changes due to attempts to cope with the agent, when coping devices come into play.  Thus what is seen in the fabric following damage is due both to the damage caused by the noxious agent itself and to the attempt to cope with the agent; there may be great elaboration of the coping devices.

The organism is always under day-to-day fluctuating trauma, which can be neutralised, or can leave behind small blemishes, e.g. cat phobia, like a bunion, is inconvenience, but not a threat to the basic integrity of the fabric.  Even so, the weakness can fare up, e.g. if a person makes a living by looking after cats, it would be a liability, or a bunion is a serious liability to a runner.  Again, if a person with cat phobia married a woman who is fond of cats the strain on the relationship might be severe.

There are degrees of disability; few people are completely well and unblemished, e.g. at any time a twinge of indigestion under psychic trauma may become a stomach ulcer, perforate, and so threaten life.

Discussion will now be centred on the damaged fabric, as it affects the simplest organism, the individual, then the special aspects of family and society will be discussed.

The Individual

The organism consists of a somato-psychic apparatus.  This is made up of its endowment and its acquired part.  The organism is subdivided into a number of systems, each of which is served by an apparatus with properties and capacities.  Here we are concerned with the psychic system, the organic substratum of the brain and the other systems that serve it.  The cerebrum has a number of sections with apparatus, properties and capacity; some are associated with feeling tones or moods.  The general aim of the organism is laid down by the “cosmic plan” of which it is a small part.

The organic brain makes psychic functioning possible.  Sensations become percepts in its reception areas by consulting previous experience held in its memory areas.  Percepts can pass to the thought areas and creative and original ideas can be formulated by manipulation of new material and old material stored in the memory.  Action is initiated through the motor areas.  This endowed machinery can be damaged.  Intoxicants can disorganise it.  (So, in the author’s belief can the agent responsible for encephaloataxia, where the agent strikes at the endowed machinery of thought.)  The “higher” properties of thought, imagination and creativity, transcend local areas and require the activity of a number of areas.  The ultimate awareness of activity in a feeling tone is termed a mood; some moods are direct and easy to interpret, but others are mixed, complex, and difficult to describe.

The endowment interacts with the environment and through experience develops a number of acquired characteristics, e.g. attitudes (including a central “idea of self”), character, temperament, knowledge, etc.  It is this acquired part of the organism which is predominantly damaged by adverse psychic experience.

Some attitudes are complex in that they are composites of a number of basic attitudes.  One blends with another to form a composite attitude and this then blends with another basic or composite attitude to form yet another.  The basic English vocabulary is of about 1,000 words, only some of which are verbs.  The number of basic attitudes that can be covered by these words are few, but they are still sufficient to describe adequately the fundamental attitudes.  Blending of attitudes leads to the use of more elaborate words.  Exact words must be distinguished from those used merely to hide attitudes; anxiety is a great coiner of abstruse words, as they make the best smokescreen.  Basic attitudes are the raw material of society and the produce of experience over time; these attitudes are available to families and individuals.  We must differentiate an attitude from mood, e.g. to be aggressive towards someone and the mood of feeling angry.  The damaged “idea of self” may set up wrong attitudes in an attempt to cope.  These may aggravate the situation by provoking the attacker to strike again.

The “idea of self” is acquired over time due to the interaction of the endowed psyche with the environment.  This interaction produces the acquired aspect of the psyche.  It is this “idea of self”, built up layer by layer in its many aspects through experience over time, which is attacked by opposing attitudes.  The “idea of self” is a summation of attitudes – ideas, beliefs, interests, values, conscience, character.  It is complex and has many elements, all of which can be damaged.  Some elements are fundamental and important, e.g. notion of self worth.  Some are less important, e.g. the notion that one has very good hearing.  Any aspect or the whole can be attacked and damaged.

People are hugely concerned to meet “nice” people.  A “nice” person is he or she who does not antagonise the “idea of self”, or, better still, actively supports it by praise, encouragement, appreciation, etc.  “To be liked” is very important to people.  A great deal of effort in social intercourse goes into establishing whether others are “nice’” or “nasty”, for or against one, a support or a threat.  A clash of attitudes leads to dislike and antagonism.  Appreciation comes from others and thus there is a need for companionship, “belonging” and acceptance.

In a damaging interaction, the sequence of events is as follows:

Psychic noci-vector → awareness of attack (sometimes) → insecurity → attempts at coping → if failure to cope → damage.  The chances produced by this total process – psychic noci-vector, damage, and coping – are what the subject notices in himself – symptoms, and what an observer can perceive – signs; these changes are termed indicators and include both signs and symptoms.

Why is there a need to attack?  Attack is dictated by a clash between the attitudes held by the protagonist and attitudes believed or known to be held by the antagonist.  Disagreement is often mutual.  The incompatibility may be very basic and hidden behind superimposed and secondary disagreements.  The basic clashing attitudes can be strongly held and have been created by lengthy exposure to experience in the past.  The more basic attitudes are created within the family – usually the preceding families.  The epitomes of the preceding families come into the present family with strongly held attitudes (sometimes amounting to strong needs – “I need to be loved”, “I need to be protected”).

Attitudes are expressed in the present family and may clash with those of the spouse, if he has equally strongly held but opposing attitudes.  Children too, in the present family, soon come to adopt strong attitudes, e.g. “I need mother to love me”.  But if father holds the view, “I need all my wife’s attention, as my mother gave me none”, then there is an inevitable clash between father and child.  Some of the attitudes are carried down the generations (we have yet to work out all the rules that govern this).

The attack may be aimed at one aspect or the whole of the “idea of self” of the antagonist.  The one aspect is selected because:

The attack arouses insecurity and attempts to cope.  The attempts to cope will meet with complete, varying, or no success, depending on circumstances.  If the attack is acute, the coping will be assisted by the automatic arousal of mood, e.g. anger or fear.  A more insidious attack is less likely to arouse mood.  The response may be automatic at the behest of mood.  The advantage of this primitive response is that it is automatic, quick, and massive.  It also has dangers in not being guided by forethought.  Sometimes to interpret the aroused mood may be difficult as a number of conflicting moods may be aroused or they may be mixed and complex.  A young woman finds herself unexpectedly pregnant and she may experience a number of moods:  “I have done wrong” – guilt; “He imposed this on me” – anger; “Can I manage?” – anxiety.  Thus, she may well say, “I don’t know what I feel”.  Due to previous experience, people differ in the capacity for arousal of mood, which may vary from excessive arousal to lack of it.  More often, thought takes over and directs the coping efforts, of which there are many.  If the possibility of further attack persists, then the psyche remains in a state of expectant fear – anxiety.

Damage may be completely repaired, partially repaired, or permanent – unless contrary experiences eradicate it (a sudden loss of confidence may be repaired almost at once by sustained praise and encouragement by an ally).

If there is a failure in coping, then there will be damage to an aspect or aspects or the whole “idea of self”, e.g. : (i) Depreciation of the value of self, “I am unworthy”,  leaves a mood of depression (which can be mixed with other moods, e.g. anger or anxiety at the same time).  (ii) The thought that the self is to blame arouses a mood of guilt.  (iii) That the “idea of self” is utterly worthless, “I cannot live with myself”, leads to the action of self-destruction, either by a negative act of not protecting the self, or by positive destruction of self (suicide can go hand in hand with other attitudes – to be a martyr, to arouse attention, to punish others).

The counterpart of damage to one aspect of the “idea of self” in the organic part of the person would be damage to one organ.  The counterpart of damage to the whole “idea of self” in the organic part of the person would be damage to the whole body.  Death of the body is the counterpart of complete loss of the “idea of self”; they coincide.  Damage to the “idea of self” is the essence of psychonosis, i.e. damage to the acquired part of the psyche primarily (in encephalonosis, including encephaloataxia, damage is to the cerebral apparatus of psyche – i.e. the endowed part).

Aspects of the “idea of self” may be vulnerable to special stimuli.  These vulnerable areas have been produced in the past.  There may be no awareness of them.  They may not be adversely stimulated for long periods of time.  Children are very susceptible to damage.  This may handicap them in basic functions for the rest of their lives, e.g. abilities to express love to another, to have intercourse with a spouse, to parent children, to relate to people, etc, i.e. from damage and from coping have arisen attitudes which hamper these basic functions.

Severe emotional trauma leads to damage which is at once manifest in a number of ways: (i) The damage may be severe enough to allow the use of the words “shock” or “stupor”.  (ii) The coping mechanism must come to the fore and this negatesmore constructive efforts in our activities.  (iii)There is the experience of an unpleasant mood, e.g. anguish, anxiety, depression, guilt.  (iv) Organic functions and apparatus may also dysfunction.  (v) The “idea of self” suffers damage.

Long-drawn-out engagements may produce an escalation of coping and damage.  The engagements may only cease after exhaustion on one or both sides.  The coping devices, physical and psychic, tire, thought tires of producing more countering arguments, the centres of mood are completely discharged, and the damage done demands a respite.

The physical response of the body is automatic, although it may be influenced by previous experience.  Some responses are coping devices – the action of brain centres, the autonomic nervous system and the hormonal pattern as a reaction to aggression and fear – to help fight or to aid flight.  Primitive mechanisms prepare the person for either.  With both there is an accompanying mood.  Secondary ill effects can develop from using this machinery excessively.  These ill effects may be local.  The local response may be determined by a weakness in a particular system, which has been produced by previous psychic experience involving it, or by organic weakness, e.g. an existing arthritis gets worse.  A local response may also carry the full weight of an idea, i.e. cerebral mechanisms may dictate a small lesion at a particular highly meaningful point, for example, blush associated with shame.  In addition to the acute reactions, chronic stimulation over a long time can also have its physical counterpart – no psychic condition is free from a reflection in the physical sphere.

So close is the tie between the acquired and the endowed physical apparatus of psyche, the cerebrum and the nervous system, that damage to the acquired part is reflected in bodily change also.  A depressed person shows physical changes – pale skin, lifeless facies, flaccid limbs, constipation and slow pulse (unless there is concomitant anxiety).  Acute fear may cause perforation of the stomach, or the hair to turn white or voiding of urine.  The physical change in a person may belie his insistence that he has no problems.  Again, we see the need to practise a medicine of the whole man and to assess the physical condition of a psychonotic sufferer.

Here is an example of a traumatic exchange.  The analysis of a brief statement by a daughter concerning a quarrel with her father a few minutes before displays how, on both sides, the attack is directed at the “idea of self” (both father and daughter are present in the interview):

Therapist: What happened in the last hour then?

Daughter: He was being 100% selfish.  Driving along, he wouldn’t let me   open the window.  He had the heating full on and I was suffocating and I was very tired.  He swore at me and called me a yob and God knows what, because I wanted the window open.

Father’s attack on daughter during quarrel:

He would not open window  — i.e. would not listen as she is unimportant  

He kept the heating one  — i.e. he is overbearing – he attacks her notion of adulthood within her “idea of self”.

He swore at her  — i.e. he debases her – attacks her notion of adequacy and self respect within her “idea of self”.

He calls her a yob  — i.e. he makes her feel inferior – attacks her notion of self respect within her “idea of self”.

Summary: He is aggressive, both verbally and non-verbally.  His mood is of anger.

Daughter’s attack on father during interview:

He was selfish  —  i.e. attack on the altruistic notions within his “idea of self”.

He would not let me open the window   —  i.e. he is unreasonable – attacks his notions of a responsible adult within his “idea of self”.  

He had the heating full on  — i.e. again unreasonable, as above

He swore at me  —  i.e. he uses bad language – attacks his notion of fairmindedness and rational notions within his “idea of self”.

He called me a yob  — i.e. he is unfatherly – attacks his notion of fair play towards adolescents within his “idea of self”.

Summary: She retaliates after the event, she is verbally aggressive and hostile.  Her mood is of anger.  She conveys attack in two ways: (i) directly, and (ii) in statements of fact which carry implications of criticism.

Conclusion: Father attacks her during quarrel.  She attacks him during interview.  Both are aggressive and hostile and hurl hurtful attitudes at the other aimed at damaging the acq2uired “idea of self” of the other.  The mood of both is anger.

The present exchange points also to the basic attitudes from which they spring.  He dislikes her as a rival for the mother’s affection.  She fears him because of his continual attacks on her.  At this moment she is stung into attack and hopes that in the presence of the therapist father is less likely to retaliate.

The Family

The fabric of the family must be briefly described before consideration is given to its damage, additional to that of the individual, by the psychic noci-vectors.

The family is a somato-psychic entity derived from somato-psychic fragments of preceding family entities.  The endowed organic part consists of its individual members together with its collective possessions.  Its endowed psychic part includes a cerebral apparatus in a number of individuals, which, collectively, allows of rapid communication amongst its members.  Meanings are conveyed, percepts are formed, memory is consulted, thoughts are conceived and fresh ideas flow out through the motor systems, both to other family members and to the external world.  The collective apparatus has a number of feeling tones – more complete and diverse than in the individual and more often an amalgam of feelings.

The family system continually changes due to interaction within itself and interaction with the environment outside.  Thus, it acquires general characteristics – knowledge, attitudes (beliefs, values, interests), character, conscience, temperament, aims, skills, role playing, control and decision-making machinery, arrangement and climate.

The psychic noci-vectors can be aimed at any aspect of the integrated structure of the family.  There is awareness of attack, insecurity is created, there is an attempt to cope and its failure leads to damage of some aspect of the family fabric.  The family differs from the individual in that the structure is looser and there can be conflict, giving rise to noci-vectors, between elements in the family.  Frequently, the noci-vectors arise from clashing attitudes brought by family members from preceding families.

The “idea of self” is built up by the family over time and is a complex summation of characteristics – ideas, beliefs, interests, values, conscience, character, temperament.  Any of these can be damaged.  Roles may change, the controlling and decision-making machinery may fail or weaken, integration is lost, conflict is increased and the climate becomes tense, traumatic or hostile.

The threat of attack causes insecurity – long-drawn-out insecurity produces continual anxiety and tension; the whole family, or fragments of it, await renewed attack.  Strong moods are generated – of guilt, anger, and fear.  Shock may be the initial reaction.  Efficiency, harmony, confidence and cohesion are lost.  Fragmentation may occur and finally the family may break up completely.

Not only does the psychic part of the family react, but so does the somatic.  Somatic illness springs up in various parts of the whole – in individuals or dyads or sub-groups.  Sometimes the whole family is affected.  The expression of the somatic illness may change its locus as the dynamics change – indeed therapeutic intervention on a locus often merely moves the somatic disorder to another part of the family.

Family members involved in a pathological family process become a part of it and, as epitomes of the family, move on to produce potentially pathological families in the future.

Social Pathology

Society, like the family and individual, is a somato-psychic organism.  The somatic aspect consists of all individuals, families and groups within it together with its material possessions.  The psychic endowment consists of the collective cerebral endowment of all its constituent parts together with the complex pattern of interaction between its multitudinous parts.  Over time, like the family group, it has acquired an immense superstructure of attitudes, etc.  It is this superstructure which is vulnerable to psychic trauma.

From the interaction of its parts – ethnic groups, political groups, families, individuals – can arise many areas of conflict producing potent psychic noci-vectors that threaten and harm it and its constituent parts.  Society has yet to achieve the harmony which would fulfil the master plan devised for it.  It has yet to find the correct pattern of functioning.  Its parts are disharmonious and thus conflict and noxious vectors are inevitable.  It has been especially unable to understand and control its psychic aspect.

Society is nearly always understood in economic, or material, or geographical terms.  But the underlying psychic implications go unevaluated.  Selfishness must lead to irresponsibility, “playing the market”, and economic crisis.  The crisis is studied, its toll in money is compounded, but its psychic origin remains overlooked.  Hurt pride leads to a desire for revenge and self-expression which in turn can lead to war.  As important as the statistics of wasted finance, the number of dead, and the economic consequences is the need to evaluate the psychic origin of war.

Society’s psychopathology is essentially similar to psychopathology in the family.  Any facet of society can be damaged.  The noxious vectors may or may not be perceived.  Insecurity is created.  Attempts at coping are made and if they fail there is damage to some facet of society or to the whole of it.  The controlling and decision-making machinery may fail, perverse roles are created, e.g. the Inquisition, McCarthyism, etc., integration is lost, conflict increases, and the climate becomes tense, hostile, and traumatic.  Continual threats provoke anxiety and tension.  Strong moods are generated.  Efficiency, confidence, harmony and cohesion are lost.  Fragmentation leading to warring factions may be a feature.  Finally, the whole society may disintegrate and perish.  On a small scale, the impact of so-called “modern” or “developed” society on a different society, e.g. the Australian Aborigines, is a violent illustration of multiple, noxious, clashing vectors on a hitherto fairly harmonious society.

As in families and individuals, the somatic and material aspects of society are involved in the pathological process. The level of physical ill-health is one index of social pathology.

Naturally, the state of society is transferred to its constituent parts – its groups, families and individuals.  To understand and improve social pathology is a fundamental way of improving the state of families and individuals.  Hence the importance of creating a salutiferous society.

Associated Matters

Conflict is not damage.  But it can lead to damage as trauma can arise from it.  Conflict is a clash or difference between two attitudes.  It can arise in a number of ways:

Guilt is especially likely to occur in people of strong moral convictions when their actions are in contradiction to those ideals.  Damage is done to the moral aspect of the “idea of self”.  There is an attitude of “I am blameworthy, I should be ashamed” and a mood of guilt.  The feeling of being wrong may be so great that it cannot be tolerated: “Such an offensive object should not live and should be destroyed”.  Those continually blamed in the past are very vulnerable to blame now.  In pure grieving there is a feeling of loss.  If there was antagonism to the dead person in the past, there may be not only grief, but also a feeling of being “to blame” and of guilt.

The description given earlier of the functioning of the psyche puts reproductive and sexual activities in perspective.  They are major activities of the person, but far from his total, or most important activity.  A mood of sexuality is a potent motivator of action, but so are thirst – and many other activities.  To explain psychic disorder in terms of sexual dysfunction alone is to limit grossly the knowledge of individual activity.  Furthermore, sexual malfunction often arises secondarily to other psychic damage, e.g. in a state of depression there is a loss of desire to eat and also loss of desire for sexual activity.  Again, frigidity may be secondary to an inability to express emotion for another person, or anxiety may make sexual performance impossible.  Difficulties in sexual activity can cause consequential reactions, e.g. wife loses her mother and is disinclined to have intercourse, husband becomes irritable at her refusal and develops a gastric ulcer.  To explain behaviour in terms of stereotyped sexual dogma is to grossly limit the range of human behaviour.  It is also a serious error to impose adult concepts of sexuality upon children.

Security, fear and anxiety must be differentiated.  In the absence of threat or stress to the self and in a state of optimum functioning and harmony, there is a complete security.  Fear is aroused by something which is harmful to the self.  The threat is seen and the mood of fear experienced.  Fear can sometimes be displaced to harmless objects.  It can be exaggerated by introspection when allowed to hold the field of attention and push out ideas that would put the fear in perspective.  It is a primitive response and has an attached physical apparatus.  Anxiety is a state of anticipation of threat to the self.  It is sustained.  People talk of being in a state of tension.  There is a continuous alerting of the associated physical apparatus.  Chronic body changes may occur – loss of weight, moist skin, furrowed face, etc.  Because of previous experience, some people expect stress – they are of an anxious disposition.  They may react to a minimal stimulus.  Such persons are at as great a disadvantage as those who are so non-sensitive to stimulation that their phlegmatic reaction puts them in danger.

Aggression is a primitive coping mechanism associated with a physical apparatus for its performance and a mood of anger in awareness.  It has increasingly come under the control of thought.  The physical apparatus can even be dictated to put on a sham demonstration of anger.  Anger in performance or in threat is one way of contending with attack.  Thus it is prevalent in those who are insecure.  It can be stimulated by childhood experiences; some families regard it as the first choice when attacked, threatened or anxious.  There is an attitude of hostility, an activity of aggression and a mood of anger.

Anomalous conditions of the person due to untraumatic experiences must not be confused with danger, e.g. lack or excess of emotional response (cold or volatile people).  A person may display such anomalies without being disharmonious or dysfunctioning, if in an environment where the anomaly is acceptable.  For example, a homosexual may be healthy, balanced and happy if in an environment that accepts his way of life; in a different hostile situation, he can become psychonotic, if he is the recipient of psychic stress.

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