Saturday, June 21, 2008

Idling With Ivor 11

This will be my last post on Music and Madness, Professor Ivor Browne's memoir. 

Self-Reliance and Independent Thinking

This heading is a summary according to Ivor of what his book is all about.  I feel that both these aims are not alone the aims of all personal development, but also they should be educational ones also.  From reading this Memoir, Ivor has convinced this reader at least that he is a very self-reliant and strong individual who indeed has learned to think for himself - he certainly has achieved his aim in this book.

On Dependence and Independence:

Ivor records his thanks to Canon Herrick, C. of E. priest and member of the Tavistock Clinic for giving him a wonderful piece of advice on the dilemma of dependence either in families or on the psychotherapist: "You know, you've got it all wrong.  In your profession and mine we work continually in a context of dependency.  If someone were not feeling in some way dependent and thus unable to manage, they would not come to seek our help in the first place.  What is important is not that the person who comes to us is in a dependent state, but whether we use this dependency for growth towards independence, or whether we foster further dependence." (Op. cit., 197-198)

Co-operation Versus Competition:

Ivor states that what he learned from his years with The Irish Foundation and his work in Derry was "the gradual realisation that ultimately co-operation is more effective than competition."  (ibid., 225)

Final Chapters:

While the final several chapters that compose the last section of the book, grouped under the heading Spirituality and the Growth of Love are enriching personally and spiritually, I feel that there is nothing new there that the reader will not find treated equally as well or better even in standard spiritual classics.  Ivor does report some interesting recent scientific studies on the role of the organ of the heart in our emotions, viz., that the Atrium of the Heart produces a hormone called ANF which has control over the whole cardiovascular system (see ibid., 335-336) and studies which show that there are networks of neurones in the heart showing evidence of "mind" and "that the heart is the real centre of emotions, reflecting back on the brain." (ibid., 336) 

However, none of these chapters is as interesting as Chapter 33 on "Rebels and Reappraisals."  I will briefly highlight some points from this chapter and attempt to omit any that Ivor has mentioned before:

1. Freud was brilliant in the sense that he managed to create rebels and rival movements.  Whatever one may feel about the founder of psychoanalysis, he certainly provoked people's interests and enthusiasms.  Alfred Adler, Carl Jung and Otto Rank were original disciples of  Freud and they set up their own movements within the broader category of psychotherapy.   Without the master these schools would never have been set up. (see ibid., 310-311)

2. Once again Ivor takes the Royal College of Psychiatrists to task for the narrowness of their approach to psychiatry insofar as they practically rule out a lot of psychotherapeutic practices. (see ibid., 311)

3.  Personally I find his views on patients experiencing an episode from a former life somewhat unbelievable.  However, the good psychotherapist lists several cases and explains these experiences and how reliving their memory led to the lifting of some trauma or negative experience or block. (see ibid., 313-314)

4. He also avers that consciousness or the mind cannot be located solely in the brain.  In fact for Ivor, as for many other scholars, the brain is a sort of transmitter of the signals of consciousness as well.  What these signals are is anyone's guess.  I'm at a loss to describe them anyway.  I just find his image interesting anyway, and his take on consciousness intriguing too.  On page 315 he states simply: "The brain itself is an antenna receiver."

5.  Dissociation:  I liked this term and Ivor uses it with respect to cases who presented with trauma due to physical or sexual abuse.

Persons who have been traumatised or abused over many years will typically, for most of their lives, have a strongly negative self-image.  They think they are only fir to be treated badly, because they are bad.  They may have self-destructive tendencies, either to mutilate themselves or attempt suicide.  When they first present for therapy they are usually unaware of much of their traumatic history and major areas of their personality may be dissociated, so they do not know why they have all those negative feelings about themselves. It is only when they work through the painful experiences that these dissociated areas become accessible and they can begin to take responsibility for all that they are.  (Ibid., 316-7)

Needless to say the highlighted text is my doing!  Through therapy they can begin to integrate these dissociated areas.  This links in well with Dr Anthony Storr's (on whom I have written much in these posts see this link: AS and scroll to post "Personality 1") contentions in his wonderful little book The Integrity of the Personality.

6.  To finish with I found what Ivor has to say on family and psychiatric illness very instructive.  All families, of course, are to one extent or another dysfunctional, but unfortunately some are more dysfunctional than others. (my thoughts and my words). This has been my own experience from meeting parents over some 30 years of teaching experience. Here is Ivor on this subject, and his insights are so worthwhile in my opinion that I will finish by quoting the section in full:

If we take the view that not only in the person a living system but that this applies to the family also, the family can be seen as a living system in its own right, which it sown separate life and existence.  Where there is a block in a person's family of origin, what we typically find ids that there is not only a secret which cannot be allowed to see the light of day, but also a myth.  The myth is that if these things were ever to be spoken of, somebody would breakdown or be destroyed.  This is unlikely to have any basis in reality now, whatever may have been the situation in the past...In any of these circumstances, where the event is denied by the parents and hence by the family as a whole, the patient may unwittingly take on the role of scapegoat and guardian of the secret. (Ibid., 317-318).

There ends my treatment of what has been for me a brilliant read.  It has given me much insight into psychiatry, psychology and psychoanalysis, the latter which I intend studying from September next in the hopes of becoming a qualified counsellor.

Above I have uploaded a picture of the evening sky as I left the nursing home where my mother is a patient. This was taken on Chesterfield Avenue, Phoenix Park, facing west to the Castleknock Gate.

Friday, June 20, 2008

Idling With Ivor 10

I continue here with the random points of insight that I gained from reading chapter 32, "The Frozen Present" of Ivor Browne's memoir Music and Madness published earlier this year.  These following points are in no particular order:

1.  I was quite taken with Ivor's insights into Freud's early neurological work with Charcot (on whom I have written an entry previously. See Charcot) I learned interesting facts about studies on sexual abuse around this time in the capital of France and the probable influence of these on Freud's theories.  I was especially caught by this quote from Freud which Ivor uses:

"Influenced by Charcot's use of the traumatic origin of hysteria, one was readily inclined to accept as true and etiologically significant  the statements made by patients in which they ascribe their symptoms to passive sexual experience in the first years of childhood - to put it bluntly, to seduction." (Quoted op.cit., 293)

In other words we have here an explicit statement of Freud's early contention that a lot, indeed all hysteria is caused by the sexual seduction of children by adults (male).  Another elucidating fact for me is that hysteria today would be called PTSD (post-traumatic stress-disorder). Ivor mentions a study of which I had never heard, namely the Etude Medico Legale made by a professor of legal medicine at the University of Paris in 1857 - a report written by Ambroise Auguste  Tardieu.  This study reported that between 1858 and 1869 that there were some 9, 125 persons accused of rape or attempted rape of children.  The vast majority of the victims were between the ages of 4 and 12, and the vast majority of them were young girls.  In all probability Freud would have been aware of this from his studies in Paris and from the fact that he used often go down to the morgue there. However, there were contemporary Parisian experts like Drs Alfred Fournier and P.C. Brouardel who cast serious doubts on the reliability of reports of the sexual abuse of children.

2.  During the time Freud was in Paris (October 1885 - February 1886) these contentious and opposing views were live issues.  When he returned to Vienna he did some very important work in collaboration with Dr. Josef  Breuer whom I have written a post - see this link  Josef Breuer  They published an important book as a result of their joint studies which highlighted the following facts: i) hysteria is the result of traumatic experiences, ii) memories had a remarkable sensory force similar to a new experience and iii) the hysterical symptoms disappeared when the memory of the initial experience was called to light.  (These are my words and my assimilation of the facts; see op.cit., 294 for original account.)

3.  However, Breuer and Freud parted company on one important disputatious point.  Freud highlighted the importance of of sexual abuse and incest in the early years in the genesis of hysteria.  As Ivor points out Freud took his contention too far and no doubt undermined whatever validity it might have had by writing:

"Whatever case and whatever symptom we take as our point of departure, in the end we will infallibly come to the field of sexual experience." (quoted, ibid., 295)

This has been called within psychoanalytical circles Freud's "seduction theory."

As I have pointed out in my posts on Freud, while being extremely erudite and very well read, he had a habit of making very sweeping generalisations.  Just take a look at his language in the above quotation:  "whatever case" and "infallibly." Freud ruled his movement like and autocrat and brooked absolutely no opposition within it.  As Ivor wittily and correctly points out, with the above diktat Freud "was hoist (sic) by his own petard, and he prepared the way for the difficulties in which he soon found himself." (ibid., 295)

4.  However, I agree, with Ivor and with a host of other commentators, that it not at all too clear as to why Freud changed his mind suddenly on the etiology of trauma which he had stated categorically was located in the experience of child sexual abuse.  Ivor then refers to Jeffrey Masson's wonderful book, which I also have on my shelves and which I have only browsed through to date, namely The Assault on Truth.  Therein, Ivor learned the reason for Freud's about-turn in the matter.  His theory was so outlandish and indeed alarming - after all it was Victorian times - that Freud alienated himself almost completely from professional colleagues, one of whom accused him of promoting "a scientific fairytale."  Indeed, I'm sure that a lot of unconscious defences rushed to the surface to protect the male of the species!  In 1896, Freud wrote to his friend and confidant Dr Fliess  (See Fliess) in the following words: "I am as isolated as you could wish me to be, and a void is forming around me." (Quoted ibid., 297)  Coupled with this feeling of isolation and professional rejection, the operation on Emma Echstein's (Eckstein) nose went so alarmingly wrong.  This operation had been done by Fliess at the instigation of Freud.  He managed somehow to get another Doctor to undo as far as possible the botched job done by Fliess.  Therefore, to get himself out of a double bind as it were he abandoned his contentious "seduction theory."  This way, according to Masson and Ivor, he took the heat off himself.  Whether this was consciously or unconsciously done is a matter for further investigation.

5.  "When one combines the contributions of Pierre Janet (who, although originally a philosopher, studied medicine and went to work in Charcot's department in the Salpetriere Hospital in Paris - my note TQ)  and the early work of Freud, it is extraordinary how close they were to the view of the "frozen present" presented here."  (Ibid., 298)

6.  Some interesting statistics from Ivor's Unit in St Brendan's: Having carried out a review of 180 cases, as regards the etiology of the trauma in child sexual and/or physical abuse or loss of significant others during childhood.

True:                                                110

False Memory Syndrome                      6

Unclear                                              53

Dropped Out                                     11

Total                                                180

The above seems to give some indication of the probably truth of Freud's "seduction theory" though of course it is not obvious from the 110 figure whether the true report of trauma refers to physical or sexual abuse or loss.

7.  Ivor gives some interesting cases of Post Traumatic Stress Disorder on pages 302 to 303 where i) marital difficulties could be traced back to a forgotten and repressed childhood trauma and ii) a young man in his early thirties presented with paralysis of the arm following the death of his father.  In both cases there was a freezing of experience.

8.  I loved all Ivor's vivid accounts of his meetings with Dr R.D. Laing who also impressed  me greatly and on whom I have written several blog entries.  See this link RDL . As regards repression Laing said that not alone is the initial experience "cut off" and not available to consciousness, but the fact that it is cut off is itself "cut off," so that the individual now has no awareness that the traumatic event ever took place.  (Ibid., 304)


There is much else I could say, but I have now virtually exhausted my wells of inspiration and my assimilation of Ivor's wonderful insights.

Above a picture I took in the Burren some two weeks ago where many wild and beautiful flowers grow through the cracks.

Idling With Ivor 9

I continue here with thoughts that literally assail me from reading Ivor's marvellous memoir Music and Madness. With the possible exception of entries on Freud, I cannot think of anyone's book which has caused me to write as many entries as this wonderful work. I would highly recommend this memoir to anyone with an interest in mental health from the multiplicity of caring professions involved in that sector to anyone with an interest in helping people be they social workers, youth workers or politicians.

I have just read chapter 32, called The Frozen Present, which I can say in extremely insightful for any psychotherapist or counsellor or helper to read.  This chapter impressed me with its solid scientific base, its practical approach with some good clinical examples, with its considered assessment of Freud and the more recent history of treating Post Traumatic Stress Disorder.

Once again I was impressed, not alone with the erudition of the writer and his clearly extensive clinical experience - in short, he knows what he's writing about, and his exceptional courage and honesty.  In this regard I want to quote in full the final paragraph of this chapter.  As I have noted before Ivor is usual for a psychiatrist in Ireland as he is also a psychotherapist, whereas practical all, if not all, psychiatrists in Ireland today work from a medical/biological/pharmacological model of psychiatry.  With this in mind he was anxious as his retirement approached that his psychotherapeutic unit in St Brendan's would be continued and not allowed to fall into neglect and fade away completely:

The date of my retirement duly arrived in March 1994 but, but as nothing had been done to implement this recommendation, I decided to hang on, on a sessional basis, for a further year in the hope that there would be some positive development.  By the end of that year it was clear that the programme manager had no intention of seeing this work continue.  The simple fact that a unit of this kind causes a lot of disturbance and disruption in the smooth running of a hospital such as St Brendan's.  In my experience the administrators of a health board are not primarily interested in the therapeutic outcome and welfare of the patients.  Rather, they are concerned with running a service that is financially economical and causes them as little trouble and disruption as possible.  I apologise if this sounds somewhat cynical but it has been my experience over the years of the way such bureaucratic organisations function. (Op.cit., 309)

Let all those involved in helping people take note.  I have also noticed something similar in the educational field.  Bureaucratic organisations are often soul crushing and soul destroying. As this chapter was so interesting and also so deep and the arguments so broad scientifically that I would just like to list in no significant order some interesting insights therein:

1. I loved the title of the chapter, viz., "The Frozen Present" as it describes precisely how a person who is traumatised may freeze at the particular moment of trauma.  However, what really came home to me that while I might have previously put the emphasis on the adjectival part of this phrase, namely "frozen," Ivor insists that the emphasis be placed on the noun itself, viz., "present."  I found this really interesting and new for me.  Ivor points out that we all frequently fall into the error that we are dealing with the past.  "Actually, we are always involved in the 'now': the 'frozen present,' what is stored in our memories, in our bodies, our attitudes and behaviour." (Ibid., 284)  As he states a little later: "Whatever we are attempting to change, it is what is there now that we have to work with." (Ibid., 285)

2.  The person/client/patient/analysand is the only one who can change himself or herself; "...any change and new learning involves some pain, but if what we are attempting to change is ourselves, our deepest personality, this can involve a lot of suffering.  If the person you are dealing with is not prepared to suffer then, to put it will be absolutely helpless to do anything to help him." (Ibid., 285)

3. Traumas that have happened to us years ago are cut off into a "frozen present" and are stored somewhere in our body and mind or body-mind.  The latter part of this sentence is mine and not Ivor's - I am interpreting what Ivor is saying and drawing my own conclusions here, but I feel they are what he is on about in this chapter.

4. Ivor worked with a lot of patients who suffered from unresolved traumatic experiences in the old Protestant church in St Brendan's.  The idea behind his therapeutic sessions every two weeks with these patients was the integration of this traumatic experience.  Ivor used a modified version of Grof's holotropic method.  "For patients who were unable to get into the traumatic experience in this way, we could inject Ketamine, which, apart from being a legitimate anaesthetic, is also a powerful hallucinogenic agent." (Ibid., 286)

5.  As well as the "fight or flight" response documented by Walter Canon in 1929, Ivor refers to another ancient response to danger namely that of "playing dead" or also "freezing" which "involves the operation of a primitive, biological, adaptive response which acts at the level of the primitive brain (outside conscious awareness or control)." (Ibid., 287)  The author then goes into the physiology of the brain, locating the areas of these primitive responses.  See pages 288-291 for some very clear diagrams and a comprehensive explanation.

To be continued.

Above, a picture of a walker I took on Donabate Beach last Sunday

Thursday, June 19, 2008

Idling With Ivor 8

The Essence of Psychotherapy

Carl Rogers, a pioneer in counselling and psychotherapy maintained that therapists, counsellors or helpers need to communicate to the client/patient  three basic qualities, viz., Empathy, Warmth and Genuineness. The first quality is hard to define, but the person being helped will pick up very quickly whether the therapist is able to show real empathy - the ability to place oneself as near as possible "into the shoes" of the client as it were. Empathy, says Rogers, is the ability to enter the world of another person "as if" it were your own so that you can better understand what it is like to be that person in need of your help.  The second quality warmth is a little easier to explain. Rogers also called this quality "unconditional positive regard," and by this he meant that he wished that all counsellors and helpers to "prize the person" seated before them - to respect people for who and what they are, for their uniqueness and for their individuality.  In short the counsellor or therapist shows a warmth that indicates an acceptance of them.  Lastly he stressed the quality of genuineness.  Some writers refer to this quality by two other terms called "authenticity" or "congruence."  The best way to describe this last quality is  to regard it as open communication.  The posture and body language of the therapist or counsellor reflects what he is saying or communicating.  The counsellor is truly himself or herself - "what you see is what you get" or "it does as it says on the tin" would be appropriate metaphors for this quality.

Returning to Ivor Browne's wonderful memoir the first three chapters of Part 6 are three scientific or intellectually phrased and argued chapters - more like chapters from a university extended essay than from a memoir.  Nevertheless, they are significant and important as they explain the intellectual base for his growing understanding of a new living system's approach.  This meant a holistic approach to everything and everybody as we are all part of a nexus of interrelated beings: "...we are formed out of the matrix of relationships and environmental influences that we absorb from the moment of conception onwards." (Op. cit., 254)  In these three chapters Ivor rails against the pure impersonal thrust of all modern sciences, namely that of reductionism. (Ibid., 228-254 passim).  Chapters 30 and 31 are wonderful as they deal with (i) his considered thoughts on therapeutic practice and (ii) the Phyllis Hamilton and Father Cleary debacle respectively.

Once again at the beginning of his chapter on his therapeutic practice Ivor nails his colours to the mast.  One can only respect his enthusiasm and commitment to improving the lot of everybody whom it was his privilege to serve:

Back in 1962 when I returned from the States and started the psychiatric clinic in Ballyfermot, I had reached an existential point.  Either I would have to put my head down and just dish out tranquillisers to all and sundry, or else I would have to address the manifold social problems that were having a devastating effect on people's lives.  I became convinced that, behind the presenting symptoms of anxiety, depression and so on, lay the tortured traumatic life histories of the persons concerned and the environmental problems generated by poverty and social disorganisation.  (Op. cit., 255)

I find Ivor brilliant on the "therapeutic relationship" between psychotherapist and the patient:

...this is a real relationship, like any other, between two human beings.  But it is not simply that; it is a relationship established with a purpose, which is to help a client with their problems.  Therefore, there also has to be objectivity and the relationship has to be managed.  I feel there is considerable confusion about this amongst psychotherapists.  When it is said that therapy should be non-directive, this is essentially correct.  It is generally useless to tell a person what to do, or to do it for them.

Nevertheless, the therapy has to be managed.  If the client is left to feel and behave as they have always done, they will control the therapy and there will be no change.  There is an apparent paradox here.  What is often misunderstood is that it is the task of the therapist to manage the context of the therapy; that is to manage the boundary of the relationship...  (Ibid., 272)

This quotation merely gives a flavour of Ivor's insights into the psychotherapeutic relationship and I must direct you to read in full  Chapter 30 to understand what he means by "managing the boundary of the relationship."

Another scene from Donabate Beach - this time a rather ominous cloud!

Wednesday, June 18, 2008

Idling With Ivor 7

Group Work

I have always been fascinated with group work.  I was introduced to group work in adult education by Rev.Tom Hamill, B.A., S.T.L., L.S.S., scholar, genius and leader.  Tom is a prophet in his own right like Professor Ivor Browne.  The maverick priest and the maverick psychiatrist have a lot in common, and I doubt very much whether one has met the other.  They are both people whose goal it is to empower people so that they will be able to grow to their fullest potential.   They are essentially marvellous enablers and empowerers.  Tom has long been a believer in the power of group work in adult education.  It is hard to know what happens in group work because a lot of issues come up and it is fascinating to see the role of different individuals in a group:- one person (or more indeed) can struggle to dominate the group and become the leader, another can be the scapegoat of the group, another its emotional channel or weeper or crier, another its channel for anger, and still another can play the roll of jester or joker.  Then another interesting role is that of the mad hatter or the person who becomes the psychotic or mad one for the group.  I think I have observed most of these roles save possibly the last one of which Ivor gives a marvellously vivid account in his reminiscences on the Tavistock conferences in TCD and other venues in the 1970s.

Whatever the dynamics at work in such groups I have found through my experience of them that certain "powers" are experienced welling up in one as the work progresses.  I remember vividly Tom Hamill, the leader of the group, noticing that I had something to say.  As he invited me to speak he prefaced his invitation with the comments that I was like a volcano ready to explode or a crater reader to break open, mentioning that the original word in Greek was "krater" which meant an ancient vessel used to mix wine and water in.  I will never forget the welling up within me before literally the lava of my thoughts boiled forth.  Again, it is a marvellous experience to be in such groups as the "powers" or "dynamics" vary about the group.  Unlike Tavistock type work, our groups were deliberately and kindly and gently conducted by our spiritual guide or leader, namely Tom.  Tom was and is an exceptionally insightful group co-ordinator, facilitator and guide.  Anyone who has never experienced group work will not understand anything Ivor writes about his Tavistock conferences.  Again, I also have some understanding also of group therapy as I did a course for two years in counselling skills and we learned hands on what counselling is through such group work as it were.  While these were not called "group therapy" they operated very much on the same principles and were in fact very therapeutic.  Our trained counsellor and teacher guided the group.  Tavistock conferences have far less control - practically none from what I can gather from reading Ivor's account.  All I know is that I'd love to do such a conference for the deep learning experience it must be.

Now back to Ivor's book and his account of these conferences:

One of the most significant activities of the Irish Foundation for Human development was the group conferences we organised based on the method developed by the Human Relations Division of the Tavistock Institute in London. (Op. cit., 179)

Ivor refers to the fact that all his life he had great difficulty in spontaneously expressing anger, and was amazed that "in this small group, to find myself expressing rage quite freely." (ibid., 180)  This has also been my experience in groups and I have witnessed many explosions of anger from individual over the years.  I have also witnessed much weeping also.  On his rage in a particular group Ivor has this insight to share with us:

My rage was directed towards the consultants and I remember saying to myself, "I am going to hit one of those fuckers as they leave the room," but as they passed close by something prevented me from doing anything.  What really surprised me was that, ten minutes later, out in the bar having a drink, I felt perfectly relaxed as I chatted to other members.  I can see no possible explanation for this experience other than that I was flooded with the energy and rage of the whole group for a few moments before the event ended. (Ibid., 181)

The last sentence above is very important as each person becomes a channel for the energies or dynamics at work in the group.  I have experienced this happening myself.  It is an extraordinary experience to be part of and to reflect upon in hindsight.  Again Ivor offers us another insight:

...what happens in these conferences is not something artificial and separate from real life, which is a complaint many participants voice when they first attend a conference.  On the contrary the design of the working conference is such that it acts like a pressure cooker, bringing very intense emotions and primitive behaviours to the surface.  But everything that happens there can be found in ordinary life, albeit in a less intense and less intense form.  (Ibid., 184)

...The conference is designed to force out these primitive behaviours and to promote the use of defence mechanisms in order to reduce anxiety, escape ambivalence and preserve sanity.  But these behaviours are also present below the surface in our interactions in ordinary society. (Ibid., 186)

The four sequential chapters on The Tavistock Conferences and the following one on Derry, also the chapters entitled The Irish Conferences and the one entitled The Derry Youth and Community Workshop are especially insightful and profoundly moving for anyone interested in the power and potency of group work or group therapy to the human learning and healing processes.  Read with openness and be impressed.  Also, for anyone interested into community work, in helping the marginalised of any sort the insights of these four chapters are most helpful.  Reading both chapters on Derry, one will also be astounded at the insights of Ivor into what makes a terrorist because all of what goes to make one surfaced in the powerful group conferences of the local youths, mostly young men. 

Another thing I learned about intensive group work is that it can and does dissolve our personal boundaries for a certain period of time.  I found this fascinating. (cf op.cit., 202-205)

Minding the Members at a Conference:

Leaders or mentors or facilitators of groups have to be mindful of what is happening, especially if someone takes on a role, say the role of a psychotic for the group, that the group owns this and takes this psychosis back into itself and the poor person who has become the vehicle of the group's psychosis is not expelled from the group and left carrying it.  Here again, I will return to Ivor's words:

When someone becomes disturbed in this way in a working conference, it is vitally important that they are not exported out of the conference.  It is the task of the hold them in the conference and to get the members to take responsibility for what they are doing.  It is vital for them to take back the energy that they have projected into that unfortunate person before the conference is terminated. (Ibid., 200)

Anger and Union Reps:

People with aggressive temperaments almost always get sucked in to systems as shop stewards or trade union reps.

The Role of the leader:

I found what Ivor had to say here very illuminating indeed:

the essential function of leader then is to ensure that the members of society of which he is in charge take responsibility for all the positive and negative forces that exist within that group.  The task is to continually resolve conflicts and contradictions among them, and to manage these within the boundary of the group.  There is a paradox here, however, for looking at it in this way would suggest that the job of the leader is essentially to manage something other than him/herself.  In actual fact once the leader has emerged, s/he tends to become the stage on which the conflicting forces and contradictions of then group are acted out.  (ibid., 205)

Creativity and Control:

As a person with a considerable interest in creativity I find all of what Ivor has written in his wonderful book insightful.  Where people struggle for power or where there are power brokers or "control freaks" creativity will find it hard to put down any roots at all.  Once various vested interests seek to control anything it would appear to be a fact that creativity withers like an unwatered plant.


To be continued.

Another view of my favourite beach - Donabate Strand, June 2008.

Idling With Ivor 6

Frozen Grief

Ivor narrates a story of a woman who went berserk at the funeral of a local nun who had been very popular because she had nursed the poor of the area.  This woman had been a thorn in the side of the hospital (St Loman's) for years.  Periodically this woman would go into angry outbursts and into a psychotic state.  This time she overdid it and ended up overturning the coffin and kicking the Reverend Mother in the shins.  Anyway to cut to the chase, what Ivor found when this woman eventually succumbed to treatment:

She cried and wept for hours after that, and it was clear that all the anger was only a defence against the grief which she had frozen at the time of his [her husband's] death and never been able to release until that moment...she remained well and never again had a psychotic reaction. (Op. cit., 114)

The Patient's Freedom

I feel that the following lines Ivor wrote about Phyllis Hamilton and Fr Michael Cleary are insightful as regards human freedom and healing:

I have often wondered if, in the beginning, I could have done anything to avoid the years of suffering for Phyllis.  It was a mess that I felt would end in tears but I could see no solution to the problem other than getting her away from Father Cleary, or getting him away from the Church, but one thing that psychiatry has taught me early in my career is that you cannot tell people how to live their lives.  They make choices.  If they want to get better, they probably will and, if they want to create more problems for themselves, they will.  (Ibid., 117)

Dean Swift's Epitaph 

I loved Ivor's quotation from Swift - in fact Jonathan's Swift's epitaph.  St Patrick's is the oldest mental hospital in Ireland and is nationally and internationally renowned for its care and study of psychiatric illness.  Anyway here is Dean Swift's - who was dean of St Patrick's Cathedral - epitaph:

He gave the little wealth he had

to found a home for fools and mad

and showed with one satiric touch

no nation needed it so much.  (Ibid., 136)

Psychotherapy Versus Neurophysiology and Psychopharmacology

Ivor sees both these approaches as being polarised as regards the history of psychiatry in Ireland. (Probably it is such in Western Medicine also)  Psychotherapy has never been a main focus in the training of psychiatrists in Ireland, and as far as I know it is declining radically in international training also.  Ivor maintains that this psychopharmacological approach "essentially treats the human being as a machine to be tinkered with, and the relationship to the person tends to get lost." (ibid., 142)

Community Psychiatry:

Ivor argues throughout his memoir that successive governments failed to provide the infrastructure and the financial resources to make community psychiatry work.  He mentions the exceptional success of Dr Franco Basaglia's community psychiatric Revolution in Trieste, but laments the fact that it was not replicated with such success throughout Italy. (Ibid., 147-8)  With his background in community medicine from the States and such notable successes like Basaglia's Ivor spearheaded The Brendan Project:

Instead of a closed system like the old mental hospital, this would be an open system where as many as a thousand people could come each day to enrich their lives and engage in enterprising and productive activity.  (Ibid., 152)

It is interesting and alarming to note that at the time in 1980 when Ivor appeared on the Late Late Show with another psychiatrist Dr. Jim Behan and the then Minister for Health Dr Michael Woods mental health expenditure counted for roughly 10% of the entire health budget.  It has recently dropped to 6%.  This is alarming to say the least, and it does show society's priorities.

Community Health Activities and Power

No matter where human beings congregate the reality of power always rears its ugly head.  People are essentially power brokers and when put into groups members will always struggle for leadership.  This is a truism.  Just look at our places of work.  Anyway in the 70s and 80s starting any community activity that might empower people got vested interests worried and scurrying to their defensive parapets.  As Ivor points out, the Church had serious reservations about community activity as it had "always controlled the old people's activities and it strongly resented this being taken over." (Ibid., 171)  In one single week he had calls for his resignation from four vested interests:- The Church, Dublin Corporation, some local politicians and the Department of Education.  Again, this was a power game.  I find as I grow older I love watching to see how power games play out.  Under these last two headings I refer to two of Ivor's community projects namely The Brendan Project and The Irish Foundation for Human Development (1968-1979).

The healing power of walking on the beach. Above a picture of an area of sand and shells on Donabate Beach, June 2008

Tuesday, June 17, 2008

Idling With Ivor 5

Ivor on Schizophrenia:

Knowing quite a few people with this dreadfully disabling mental disease, I find Ivor's insights illuminating and helpful.  In post three of this sequence I have already mentioned his insight into why schizophrenics shut out others because "they are unable to maintain the normal boundedness between themselves and others, as they are far too open and vulnerable to being invaded by others in their vicinity" (Op. cit.,  59).  I have also learned the interesting insight that they are less well able to separate from the family of origin than we are and also that any psychiatric illness is rooted in the family as well as in the person who may be a channel for the illness.  While in the US studying he had the luck also to go for some time on a further fellowship to visit Gregory Bateson's Schizophrenia Research Unit in Palo Alto. 

The experience of hearing their views on schizophrenia was a further step for me in realising that the orthodox view of it as a largely genetic, biochemical disorder simply didn't add up. (Ibid., 96)

I hasten to add, here, for the sake of balance that Ivor Browne, along with the likes of the wonderful R.D. Laing fit into what in common parlance is called The Anti-Psychiatric Movement which would question the over-reliance on drugs or pharmacology.  I have no partisan views myself, but occupy a middle ground position of "both and" rather than "either or."  For me, as a sufferer from endogenous depression of the unipolar type who has to take medication, I deeply appreciate the relevance and importance of all psychotherapeutic methods.   Both approaches are needed in my opinion.

Anyway, back to what Ivor learned from Gregory Bateson's studies and those of Jay Haley.  He feels that these two scholars offered a valuable insight into disturbed family relationships generally.  Such disturbance in internal family relationships "can be found in virtually any form of psychiatric disorder where the family is 'enmeshed' and has failed to free the offspring to leave and lead a separate life." (Ibid., 96)

Ivor repeats yet again his insight into the schizophrenic's lack of boundedness further into his book with a certain impatience and exasperation:

One of the greatest pieces of nonsense in psychiatric literature, which is repeated ad nauseam in textbooks over the years, is the notion that schizophrenics are emotionally blunted and have lost the capacity to feel...schizophrenics have no recourse but to retreat into themselves, erecting a rigid wall around themselves for their own protection. (Ibid., 203)

Then later again in the book, when discussing therapeutic practice and personality types as a function of defence and coping skills, the latter which is mapped out diagrammatically as a  graph with four quadrants like a Cartesian Plane diagram, the four quadrants of which are named by the letters A,B,C and D, Ivor tells us insightfully:

In this final quadrant are to be found those who not only have weak coping skills but also have poorly organised defences.  this is because during the course of development they have failed to reach maturity, or to form an adult personality.  At the deepest level they have failed to create a personal identity; nor are they able to manage their personal boundary.  Within this segment will be those who fit the schizophrenic spectrum, and the more recently identified Asperger's Syndrome.  There will also be found some of those with eating disorders and those suffering with chronic social phobia, panic disorder and chronic anxiety. (Ibid., 265)

The Inadequacy of Drug Treatment

Ivor questions strongly the biological or genetic origin of schizophrenia.  He talks in general about all those patients who have failed to separate from their family of origin and who, although biologically adult, "are still functioning like children in the family setting and are incapable of managing their own lives.  These are the people who, when they break down, are said by psychiatrists to be suffering from a 'biological' mental illness and hence are not amenable to psychotherapy." (Ibid., 320).  Ivor has huge reservations with this orthodox contention.  In fact he sees it as downright erroneous:

If we ask what is the causal relationship of genetics to schizophrenia, we are already biasing the results of our research.  the genetic influence may merely relate to the personality type, for example, a more sensitive or introverted type of person.  There may be no direct relationship to schizophrenia as such.  (ibid., 320-321)

Needless to say, in such a context, drug treatment will be wholly inadequate.

All in the Psychiatrist's Mind

This heading may be a little biased admittedly, but I feel it is a fair criticism of Ivor's anti-pharmacological views of both psychiatry and the treatment of schizophrenia.  Towards the end of this fine, interesting and deeply humane memoir, which it is my privilege to have read, our man contends that schizophrenia is an invention of psychiatry.  I suppose every science and every technology and every branch of knowledge invents its own terms for the way they look at the problems or issues before them.  I'm sure there are many ways of seeing things rather than a specific way outlined and made almost axiomatic by a particular branch of knowledge, so this is no wonderful insight indeed.  I suppose it becomes problematic when we actually begin to believe that everything exists metaphysically as each particular science imagines.  In fact, it is my belief that most human organisations and societies begin to believe their own propaganda.  Anyway, be that as it may, Ivor claims that:

...the full picture of schizophrenia is, to a considerable degree, iatrogenic, that is, partially created by the psychiatric intervention itself, establishing a pathway of illness behaviour extending over weeks and months, with heavy medication and institutionalisation.  Thus the young person loses connection with ordinary living at a critical time and finds it difficult to reintegrate back into society.  It is only then that the full picture of the illness we call schizophrenia supervenes.  (Ibid., 327)

Walking the horses on Donabate Beach, June 2008

Idling With Ivor 4

The Patient Always Comes First

One of the greatest lessons in vulnerability and dependence anyone of us can get is that of being a patient.  Hence Doctors who have been patients at sometime themselves can really empathise with their charges.  Because of his suffering from TB and having been hospitalised for a considerable time Ivor tells us:

It was experiences like this (seeing a slowly deteriorating patient being passed over unconsciously by the attendant Doctor), as a patient, that made me careful of the feelings of patients and aware of the need to take the time to communicate as clearly as possible, so that the person has a full understanding of his illness and a clear picture of where he stands.  (Op. cit., 65)

One is left in no doubt as to the then state of mental hospitals or mental institutions in the late 1950s (and one might argue thus even today with respect to mental health treatment for the poor):

At the time I visited Grangegorman, the whole north-west of the city was neglected and run down, and there were only about 20,000 people living there.  Since all those neglected by society - the human refuse of Dublin society - were located in this area, it was as if the existence of this part of the city had to be denied.  (Ibid., 68)

 Psychiatric Illness is a Family Illness:

This insight I find interesting and quite logical after reading Ivor's account of the chronic agoraphobia suffered by a patient called Jane, the mother of three small children.  The grandmother looked after both her daughter, who was constantly confined to bed, and her grandchildren.  Ivor describes how he worked on getting to the source of Jane's illness, and he was so successful that this woman was able to come to the hospital alone for out-patient treatment.  No sooner had this woman improved considerably than the grandmother became very sick indeed.  Here is Ivor's account of why this happened:

I explained to him (the family's GP) that this was an extreme stress response due to the mother losing control over her daughter, who was now becoming independent and no longer needed her.  What had seemed like selfless care for her daughter was actually a desperate need to keep her daughter dependent and under control. (Ibid., 72)

The Importance of Separating from the Family of origin:

This heading reminds me of a book I once read by Dr Tony Humphreys called The Family, Leave it and Love it which is based on the same principle discussed by Ivor in his book.  Due to his early experience of working with the families of mentally ill people our unorthodox, sandal-wearing professor  has this to say:

From these and similar cases I realised the extent of the struggle which is involved for all of us in separating from our parental family and developing independence.  I knew this struggle already, of course, from my own experience of growing up in a family that was loving and caring but which saw itself as continuing indefinitely.  With the best will in the world, my parents did not intend to foster in their children the necessary separation and growth towards independence.  (Ibid., 73)

Beginning of Social Psychiatry:

In February 1960, having won a one-year fellowship to the US sponsored by the Eli Lilly pharmaceutical company, Ivor took up a post in the Massachusetts General and did an MS degree at The Harvard School of Public Health.  There, he was to learn the sound principles of social psychiatry and the principles of crisis theory from the likes of Professor Eric Lindemann and Dr Gerald Caplan.  I am delighted with the wonderful definition of crisis which Ivor quotes from the mouth of Gerald Caplan: "A crisis is an upset in the steady state, provoked when an individual , faced with an obstacle to important life goals, finds that it is, for the time being, insurmountable through the utilisation of customary methods of problem solving." (Ibid., quoted 88).  I was also interested in Ivor's contention that trauma and crisis counsellors are not needed in the immediate aftermath of a particular crisis.  This, to my mind, is a wonderful insight:

Droves of crisis counsellors descend on the scene at the very time when most people are in the state of shock or psychic numbness, needing rest and support and not in any sense ready to deal with the emotional effects of the traumatic experience... Much later I realised that, when the time was right and people feel safe enough to be able to react emotionally, crisis intervention can begin and people can be helped to integrate the pain and anguish surrounding what happened.  (Ibid., 89-90)

Bear in mind that Ivor was studying crisis management way back in 1960 while it is now only accepted here in Ireland as a normal response when crises occur some forty years later.  Once again, we see here that our man was a unique, prophetic and probably eccentric voice crying in the wilderness of the late 20th century Ireland.


To be continued.

Walking the dogs, Donabate Beach, February, 2008

Monday, June 16, 2008

Idling With Ivor 3

There's nothing you can do when you're on a roll except to keep right on going.  Hence, another entry in quick succession.

Illnesses have a way of working out for our good in oftentimes strange and unexpected ways.  I remember years ago when reading the Romantic English poets - Wordsworth, Coleridge, Keats and Shelley that I came across a wonderful insight in this regard.  Indeed, one scholar suggested that I read a book or article entitled something like "The Creative illnesses of the Romantic Poets."  This title is not accurate as I write this totally from memory, but I'm sure the reader gets my point.  I have recalled many times in these posts that I suffered a nervous breakdown and had to spend some seven weeks in a psychiatric hospital when I was forty.  In a strange and unexpected way, this experience has been life-shaping for me.  It allowed my creative wells to become full and teaming with watery life.  I wrote two books within a year or two of this major "set back", one of which I managed to get published.  Indeed, since forty I have been writing with greater and greater intensity.  Whether these writings ever get published or not is immaterial.  Most artists and painters follow their craft for the love of it and if they manage to publish or sell their work all the better.

Now back to Music and Madness and Ivor Browne.  Likewise for this marvellous man and brilliantly unique psychiatrist he, too, had a creative illness which kept him from college for two years.  The illness in question is TB.  I'll let Ivor speak for himself here:

It was during the two years I was sick, with plenty of time to think, that it came to me that fear of failure was worse than failure itself.  So, when the time came to face the world again, I said to myself, "From now on I will try things, and expose myself to not getting them right the first time."  It was a very painful but important learning experience, for, although I did have many failures and often made a fool of myself. from then on I tried new things and stuck at them.  To my surprise I gradually started to succeed, where before there was only avoidance and a feeling of failure.  (Op. cit., 36)

Ivor did his first six months as intern after qualifying  in the neurosurgical unit in the old Richmond Hospital.  As a young intern he often had to sit with dying patients as they passed away.  Another thing he had to do was assist with the now long-abandoned practice of lobotomies:

the most serious recollection I have of that time was of having to assist one of the surgeons on Saturday mornings in the operating theatre.  Nearly every Saturday morning one or two patients would be sent down from Grangegorman  to have their brains "chopped."  this was a major lobotomy procedure developed by Freeman and Watts, where burr holes were drilled on each side of the temples and a blunt instrument inserted to sever the frontal lobes almost completely from the rest of the brain.  At that time, in 1955, there were literally hundreds of very disturbed patients, both women and men, in St Brendan's Hospital...and this operation was seen as an almost miraculous method of calming their disturbance.  Indeed, it did succeed in doing this, but in the process many patients were turned into vegetables.  (Ibid., 50-51)

One can also marvel at Ivor's perseverance in study and his refusal to give in, to the point of being able to get honours in his Master's in Community Medicine at Harvard and even to being asked to stay on as a fellow of Harvard Medical School.  One begins to question how good any education system is if students who fail at secondary level can blossom at third level.

I loved Ivor's take on working at Warnesford Hospital in Oxford where practically all the mentally ill staff and students of the university were hospitalised.   There he was quick to see that both staff and patients could think for themselves.  Oxford has always been the home of independent thinking and research.  A consultant psychiatrist at Warnesford, Dr Richard Thompson gave Ivor a piece of advice which he was never to forget, and which obviously he put into practice throughout his long career in psychiatry:  "Don't accept any of the current theories or belief systems in psychiatry.  keep and open mind and listen to the patients themselves.  Eventually, you will form your own opinion about these questions." (Ibid., 55)

I loved Ivor's take on psychosis and schizophrenia because I know several people with the latter.  he informs us that the textbooks describe schizophrenics as being emotionally blunted (Ivor's term) and as having very flat indifferent personalities, almost expressionless. (My words and my own observations, not Ivor's):

Since then, , I have had a number of similar experiences with people who were apparently emotionally blunted and I have come to realise that it is not that schizophrenics are incapable of feeling but rather that they are unable to maintain the normal boundedness between themselves and others, as they are far too open and vulnerable to being invaded by others in their vicinity.  The are unable to control the influences in their environment and their way of dealing with this is to take the drastic step of cutting off all relations with other persons.  My understanding of this inner world of the psychotic only developed gradually over the years. (Ibid., 59)

And, then, we have this marvellously astute observation after some years of practice:

It was the first real lesson I had in family psychiatry, for the truth is that, as a rule, the whole family is involved in psychiatric illness, although the main pathology may be channelled into one member.  Not only is the patient as a rule not able to stand up for himself, but also the families are not competent either.  (Ibid., 63)

To be continued

View in Parc Montsouris, Paris, August, 2007.

Idling With Ivor 2

Every system needs its leaders, those who lead the onward progress of the institution.  However, every system also needs its prophetic and critical voices, too.  These prophetic and critical voices are, in truth, the conscience of the system, a conscience which can and often does prevent the institution from recklessly forgetting the individuals or clients or users of that very system.  Professor Browne has been truly one of those prophetic and critical voices within Irish psychiatry.  In this post I wish to continue my personal review of his wonderful memoir Music and Madness.

The Field:

I was fascinated with the fact that Ivor's father had leased or rented a field for his children and their friends to play in; wherein he would plant his own vegetables.  I was also fascinated by the fact this man managed to bring the seaweed (used as fertiliser - a traditional Irish practice) up from the shore to his "field" by rigging up a funicular system with pulleys and hooks and buckets.  The children learned good lessons in co-operation through this practice.  One can easily picture how this field became a veritable paradise for young children and their friends.  Being from a country background myself I have always loved the freedom of fields - the mystery, the magic and the wonder of it all - the very home of one's childlike imagination.  And then this insight into his father's treating his children to pints of Guinness Plain porter:  "We'd have a couple of pints and then go home for tea.  In this way I started drinking at the age of ten.  I suppose than nowadays my father would be in trouble for encouraging children to drink." (Op. cit., 21)  I can only marvel at the naturalness of this - Guinness as a refreshing drink after work rather like the way wine is drunk on the continent.  No hint of abuse of drink there!!

Obsession with Music:

Ivor's father was an accomplished musician who played the mandolin and guitar.  It is no wonder  than he became obsessed with music.  Throughout his memoir we have intriguing accounts of Ivor's addiction primarily to the trumpet (which, unfortunately he had to abandon because of that old Irish curse, TB) and also to the uileann pipes with which he used drive his colleagues to distraction through his practice.  Our man loves Jazz, Irish Traditional Music and Classical as well - altogether an very catholic taste in music.  We should expect no less from such an open-minded person.  My own uncles and aunts on my mother's side were all traditional musicians and some of them were dyed-in-the-wool traditional musicians with no time for other types of music.  This is an altogether too narrow an approach for me.  Throughout this memoir Ivor names his favourite jazz musicians, the first records he bought (78s), the Irish musicians in Comhaltas Ceoltóirí with whom he played and whom he befriended and the marvellous classical music concerts he attended when he was a Doctor and student at Harvard University.

I will return briefly here to another favourite psychiatrist and author namely the late Anthony Storr who wrote a wonderfully edifying book called Music and the Mind, (Collins, 1992) which attempted to pinpoint what exactly music is and what its role in human life and culture is.  It is a gem of a book with profound insights into the importance of music to our mental health:

In spite of its widespread diffusion, music remains an enigma.  Music for those who love it is so important that to be deprived of it would constitute a cruel and unusual punishment.  Moreover, the perception of music as a central part of life is not confined to professionals or even gifted amateurs... (op. cit. xii)

It will never be possible to establish the origins of human music with any certainty; however, it seems probable that music developed from the prosodic exchanges between mother and infant which foster and bond between them...Today we are accustomed to considering the response of the individual to music that we are liable to forget that, for most of its history, music has been predominantly a group activity. (Ibid., 23)

Languages are ways of ordering words; political systems are ways of ordering society; musical systems are ways of ordering sounds.  What is universal is the human propensity to create order out of chaos. (ibid., 64)

Music can enable brain-damaged people to accomplish tasks which they could not master without its aid.  It can also make life livable for people who are emotionally disturbed or mentally ill.  (Ibid., 107)

I had better bring to an end my quotations from Storr to whose wonderful writings I have been addicted for years and return to Ivor Browne.  I'm sure Ivor, as an addict of music will forgive this personal foible.   I'm sure also from my reading of Music and Madness that music was and is the unifying mystery that linked the whole enterprise of life together in some strange and wonderful harmony.  Music is of the soul and is and can be when used properly essentially therapeutic and healing of the wounds of the soul.  Hence it is no wonder that a therapist should choose such a wonderfully appropriate title for his memoir. 

Some wild flowers in my front garden, Jily 2007.

Idling With Ivor 1

Eventually I went out and bought Professor Ivor Browne's fascinating memoir called Music and Madness (Atrium, 2008).  At this juncture I have read all of Parts 1 and 2 of this memoir in seven parts.  Part 1 he calls by the wonderful title "Shapings 1929-1949." and Part 2 "Music and Medicine 1949-1962."  While each section follows the chronology of his life, this book is rightly called a memoir as it could in no sense be called an autobiography.  It is indeed filled with interesting things, both trivial and character forming, about his personal life but all the while we are very much in the presence of a wise old man ruminating on his professional and personal interest both in his own mental health and that of all others whom he has met up till now in the course of his long life.  There is also much wisdom in these pages and an honesty, integrity and congruence that would put any of his readers to shame.  One would expect no less from an exceptional human being and a talented professor of psychiatry who is also a psychotherapist.  This is a book we read for insights into the human condition and any purchaser would be disappointed were they not there aplenty.

I brought this book with me in the car today as a sort of "vade mecum" or spiritual resource for the day.  Having walked Donabate beach and taken some pictures I repaired to my car where I sat and read for almost two hours. I was conscious, too, ironically of my proximity to that famous or infamous mental hospital only a couple of miles from where I sat - namely St Ita's Hospital, Portran.

The Patient is what it's all about

This underlined title is my own, but for me cuts to the heart of what is important for Browne.  It is not very surprising, then, to find that his opening words under the heading "acknowledgements" read as follows: "My deep appreciation goes to my patients who, through the years, taught me so much about life and the nature of suffering towards growth...I so often think about their courage and affection.  Sure, where would I have been without them?" (Op. cit., viii).  All the way through this memoir we are introduced to patients anonymously or under pseudonym and Ivor's deep respect and concern are always to the forefront.

Deep Dissatisfaction with the Direction of Psychiatry

We are left in no doubt as to where Ivor Browne stands.  [I find myself using the Christian and surname more readily than any academic appellation because this book so personally addresses itself to the reader.]  In the first few lines  of the preface he pins his colours to the mast:  "I set about writing this book because of my deep dissatisfaction with the direction which psychiatry and the treatment of mental illness has [sic] taken.  There is also the wider question of the drift of western society into materialism, the mechanistic philosophy underlying this, and the growth of the free market." (Ibid., ix)  Throughout the book he elucidates on this early stated dissatisfaction.

Honesty, Humility, Congruence and Balance 

From the word go we know that this author is totally at ease with himself.  He has nothing to cover up.  Ivor points out that it was never his intention to write autobiography because firstly he readily admits that he is no writer or stylist and that much of his personal struggles and failings are of little interest to anyone except himself and also that his former wife and children as well as his current wife are entitled to their privacy.  However, because of his sheer honesty, humility and congruence we get to know what makes Ivor tick really well. He begins by being critical in an honest but balanced way about his father.  Like Johnny Cash's famous song "The Boy Named Sue", we find that he resented his father for christening him William Ivory after a Cromwellian soldier who had been given the lands that traditionally belonged to the Browne family in Wexford.  Also his father, somewhat rebelliously, joined the British Navy and married a Protestant girl.  We also find that his father resented his nationalist family because they had failed to afford him the opportunity to go on to third level education.  Because of this, unconsciously, Browne senior became very much a West Brit. In fact Ivor recounts his father's saying that "I'm afraid Ivor was a mistake.  I don't know if I'll ever be able to educate him."  Then he tells us that he spent a great part of his life trying to disprove this dreadful contention.  However, after his psychiatric training, he realised that his father had all the time been propping up his shaky self-esteem by these unconscious behaviours and even his remark about his son being ineffectual was part of this unconscious drive. However, he sees the positives in his father's character, too:  "...I feel a deep sense of gratitude...It was my father who gave me my appreciation of music, of literature, history and philosophy.  The environment that my father created around "the field", a field he rented, was not only a physical space but also a total way of life for me and the friends who lived in the area - a safe, alternative world." (Ibid., ix)  Without a doubt, his father appears to have been an unhappy man.  But, then again, so was my father for a rather long section of his life.

Fear of School and Shyness

Again I readily admit that I, like so many others, Ivor included, feared school.  I was also intolerably shy, also, at school.  While Ivor was uncommonly lanky and tall - eventually six foot four inches, I was just of average height - five feet ten and a half inches when fully grown.  Ivor recalls his fear of the huge matronly headmistress of his first school Miss Manley who was frighteningly huge and dressed in black. 

Fear of Failure 

Ivor is very good on this area of fear.  For Ivor this was essentially academic fear of academic failure, while for me I remember the dreadful fears I had as a child and adolescent of making a fool of myself on the sport's field.  I was fairly good academically and mostly got good grades all the way through school and college.  However, fear of failure at a more human level whether in games or friendships always dogged me.  I will finish this post with a quotation from his memoir on the fear of failure in general:

At last in 1951 (at 22), after two years, I was ready to re-enter medical school.  The two years of illness [TB] gave me another important piece of understanding.  Having always considered myself a mistake and a potential failure, my attitude, when presented with something new, whether it was swimming, playing tennis or whatever, was: "Oh, I wouldn't like to try that unless I was good at it."  What I failed to realise, of course, was that nobody is initially good at anything.  We have to learn to fail and try again.  The simple truth is that if we love what we do and keep trying then eventually we will succeed and can become good at virtually anything.  Human beings have an enormous potential, most of which is seldom realised. (Ibid., 35)

As a teacher, who is involved in attempting to build up the self-esteem and confidence of young adolescent pupils the above is worth contemplating for some time.


To be continued.

Psychotherapy helps us both recognise and integrate our shadow. Above a picture of my shadow, Rome May 2008