It is Wednesday and I am writing from my cottage in Derbyshire. All seems safe outside, a soft rain is falling and a thrush is singing from the gable end, but in the wider world that impinges on my consciousness through my radio and the Internet, the British government is in chaos, America has elected an unpredictable leader, there are terrorist attacks in London and Manchester, a recent massive cyber attack has seriously disrupted the NHS, there is a threat of nuclear conflict in Korea, a risk of economic meltdown, and all the while the planet continues to get warmer and the weather, along with our emotions, is becoming more volatile. No wonder so many of us feel unwell.
Perhaps this all too Orwellian, but if you are like me, you will perceive the same low level anxiety that the world as we know will soon spin out of control. We might derive some hope from the people who would lead us, we may achieve a sense of control by organising our domestic environment, we could obtain some comfort from our relationships, but to what extent are those delusions that shield us from harsh realities. As King Christian X of Denmark said during the Nazi occupation of his country, ‘ we comfort ourselves with our imaginings and our delusions’. So is the ‘connected’ world so threatening that we all have to take refuge in some kind of collective psychosis? Have we have so lost sight of intolerable reality that only fashionable ideas and fake news can keep us well.
Cultural delusions, fashionable ideas and fake news protect us from the intolerable reality that we are fundamentally alone, clinging onto a flimsy raft of assumptions that could disintegrate tomorrow; the only certainty is that we are going to die. We can only tolerate that dreadful knowledge by escaping into make believe. Life can feel more secure and less lonely if we can evoke God or Science or Freud to protect us, or better still, fall in love, but such expedients may leave us disconnected from reality and incapable with dealing with the vicissitudes of fortune.
When I was a professor back in the middle ages, I used to tell my graduate students and post-doctoral fellows that the most important quality in research is ‘imagination’, but it has to be tempered with reality. ‘Dream with your head in the clouds but keep your feet firmly on the ground,’ I would say, ignoring their unfocused stares. ‘Be inspired by what you observe or read, take in the cultural beliefs that fit, but use your creative and interconnected minds to create a synthesis that is your own, rejecting convenient dogma and false generalisations.’ That’s what provides the authenticity to deal with adversity, negotiate with others and remain confident and productive.’
Freud viewed personality as an amalgam of drives and instincts, but it is probably more a coherent combination of delusions, brought together by a meaningful mind. This works fine if the influences on our lives have been positive and supportive, but if our development has been less secure and our existence challenging, we can find ourselves clinging to our delusions like life rafts in a stormy sea, lacking the buoyancy to prevent illness.
Is it just my apocalyptic imagination or is it true that more and more people are ill these days. When people were asked if they suffer from a long term illness in the General Household Survey, about 40% respond in the affirmative. This is not just the effect of an ageing population; most of the respondents were young. In the UK, as many as 1 in 3 GP appointments are for illnesses that have no clear pathological basis and 1 in 2 referrals to hospital out-patients, while health care costs for medically unexplained illnesses are now about 3.5 billion pounds. Illness is a major issue that exercises the public and their representatives at every general election.
The majority of illness could be seen as a social phenomenon, induced by ‘connectivity’. Infectious diseases were spread when human beings developed a stable agriculture and began living in communities together with their livestock. Similarly, the apparent rise in mental illness and unexplained physical illness throughout the developed world, might be a consequence of the enormous increase in connectivity facilitated by electronic media. The more connected we are, the more aware we are of risk, creating a chronic background level of anxiety; the white noise of fear that continually excites our alarm system and makes us feel unwell. So have we all become passive recipients of cultural anxiety, our physiological systems regulated by factors outside our control?
The understanding of the way culture impinges on the inner life of humans, which might well include the unexplained illnesses we all suffer from, is the province of art rather than science. Science turns our existence into something collective, inanimate and measurable, generalisations requiring the dubious proofs of statistics. It is art and the humanities that describe the experience of individuals and their relationships with others. Diseases ‘validated’ by scientific methods demand proven treatments. Illness requires the quiet arts of healing, implicit in therapies. Both could be said to be delusions.
We are meaningful creatures, guided by imagination and belief. The thing that matters is not whether one treatment is true or not, but more whether we trust the treatment and the person who is advising us. Some people demand the evidence for a culturally approved belief. Others rely more on their personal intuition of what seems right.