Know Thyself: A Journey Inward

behind the facade

The Delphic maxim “know thyself” is inscribed in the forecourt of the Temple of Apollo at Delphi and has been used by a diverse array of thinkers Socrates, Plato and Aeschylus, among others, to prompt awareness of the self.

 In the Christian tradition the necessity of ‘knowing thyself’ has a strong pedigree.  Calvin, for example, argued in his ‘Institutes of the Christian Religion’ (particularly in 1.1.1) that one cannot truly know and understand God until one is sufficiently self-aware.  St. Augustine is famous for his autobiography ‘Confessions’, a powerful exposition of his spiritual and psychological struggles.

In the world of psychotherapy, it was Carl Jung who famously wrote: “Your visions will become clear only when you can look into your own heart. Who looks outside, dreams; who looks inside, awakes.” The father of psychoanalysis, Sigmund Freud drew an important distinction between self-analysis, which he promoted, and introspection, we he viewed as defective.

However we view ourselves and our place in the world, we can all agree that we are intrinsically complicated creatures.  Our inner worlds are often suppressed and hidden behind a facade; we project onto the world what we think the world wants us to see.  The great psychiatrists and psychologists – Freud, Jung, Adler, Frankl – all understood this and incorporated it into their work.

There is one book that I came across recently – ‘Behind the Facade: A Psychiatrist’s View’ – that highlighted the complexity of the human condition wonderfully.  Written by the late Dr. Dennis Friedman, who famously blamed the 2008 banking crisis on banker’s mothers, ‘Behind the Facade’ is a fascinating insight into the subconscious and the secrets it holds.  Friedman does this via a series of stories, or case-studies, based on the myriad patients he has helped throughout his long career.  He lays bare the dynamics and drivers that lead to relationship issues, sexual dysfunction and work problems, particularly stemming from parenting issues and childhood traumas.

Friedman tells each story masterfully, never telling the reader what to think, rather leaving him/her to make their own conclusion.  Some stories, at least in my case, needed to be read more than once to get the full import of the psychological nuances that were presented.

If you are fascinated by people in general and the psyche in particular, this book comes highly recommended.  Friedman’s psychoanalytic approach, presented in this way is illuminating, prompting self-analysis, an endeavour that can only be useful in understanding oneself better.  After all, many of us can surely identify with what Lewis Carroll wrote in ‘Alice in Wonderland’: “Who in the world am I? Ah, that’s the great puzzle.”

Understanding Altruism

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A multi-disciplinary research team from Washington DC and Washington State have published an important new study entitled ‘Neural and cognitive characteristics of extraordinary altruists.’

Altruism, and particularly costly altruism toward strangers, such as kidney donation, is poorly understood by science, particularly in the fields of evolutionary biology and psychology. The question has been posed time and time again: ‘How can such behaviour be rationalised and explained?

Although it is fair to say that the propensity to engage in costly altruism varies widely across and within populations,  Abigail A. Marsh and her research team argue that although it may be genetically mediated, very little is known about the neural mechanisms that drive it. In order to make more concrete conclusions, the Washington team used structural and functional brain imaging to compare extraordinary altruists, specifically altruistic kidney donors, and controls. What did they find?  Fascinatingly, it would appear that altruists exhibit variations in neural anatomy and functioning that are the mirror image of patterns previously documented in psychopaths, who by their very nature are callous and lacking in empathy.

Such findings are significant in that they suggest that there are neural correlates that underlie social and emotional behaviour and help us to understand the science of empathy.

The Washington researchers anticipate that their findings will provide the basis for an expanded scope of research on biological mechanisms that enhance altruistic behaviours.

 Empathy, and altruism, is the cornerstone of Christianity; the Sermon on the Mount says it all.  So it’s interesting to note that some of us may be hardwired for empathy and altruistic behaviour, whilst others find it more difficult.  This study raises the interesting question of whether neural mechanisms can be changed by behavioural input, that is, modulated by our own behaviour?  Can neuroplasticity facilitate a more altruistic outlook on life? Science may well provide that answer more quickly than we might think.

You can read the entire article here:

Book Review: In My Room – The Recovery Journey as Encountered by a Psychiatrist.

Prof. Jim Lucey, Medical Director at St. Patrick’s Mental Health Services and Clinical Professor of Psychiatry at Trinity College Dublin, has more than twenty five years’ experience in his field of specialisation.

Lucey has used this experience to pen a thoughtful and compassionate look at the varied experience of some of the patients he has encountered. Coalescing around the themes of experience, worth, freedom, memory, truth, balance, hope and possibilities, he explores individual stories, and pieces together complex narratives with a view to understanding and facilitating recovery.

In My Room

At the outset, Prof. Lucey sets out the conceptual framework around which he practices medicine.  He writes: ‘psychological medicine has no role in directing anyone along any specific philosophical route or towards any specific response to the personal challenge of existence’. Whilst I very much agree that it is never the place of the physician to dispense spiritual advice, it has to be acknowledged that each form of psychological intervention, from CBT to logotherapy, and from psychoanalytic psychotherapy to individual psychology, is underpinned by a specific psychological worldview.  Consider Viktor Frankl’s logotherapy where the ‘will to meaning’ is at the fore; contrast this with Freud’s psychoanalysis where the ‘will to pleasure’ underpins the therapeutic theory.

Notwithstanding minor differences in semantics, Prof. Lucey understands exactly what it means to be a patient.  He very perceptively writes: ‘to be a patient describes an experience that deserves respect.  We will all be patients at some stage and this is part of what it is to be alive’.

Depression, anxiety, self-harm, OCD, suicide and other issues are explored through the lens of his patients.  The pain is obvious in each individual, but crucially so too is the will to wellness and the capacity to recover. And if you’re not sure about some of the medical terms, the author has included an excellent jargon-free summary in the notes section at the end of the book.

Prof. Lucey does a superb job of dispelling the myths that all-too-frequently surround mental illness.  Shockingly, Lucey writes this of his own institution’s findings:

‘In 2013 St. Patrick’s Mental Health Services published some disturbing findings from its own nationwide survey of attitudes to mental health disorder in Ireland.  Over one-fifth of people surveyed believed that those suffering from mental health problems are below average intelligence and 31 per cent of respondents revealed that they would not accept someone with a mental health disorder as a close friend. It was discovered that 62 per cent would discriminate against hiring someone with a history of mental illness on the grounds that they would be unreliable, and 42 per cent believed that undergoing treatment for a mental health disorder is a sign of personal failure’.

That this degree of ignorance and prejudice still exists in a modern society is deeply worrying.  And that is why Prof. Lucey’s book makes such a valuable contribution; it is very well written and one senses that author’s deep concern and sensitivity for those in his care. In describing ‘ordinary’ people dealing with mental ill health, Prof. Lucey does an enormous amount to normalise our perception of mental illness and to see his patients just as they are – just like any other person, but with the added burden of living with a complicated condition.

Recovery is very much possible, as attested to by Prof. Lucey’s clinical experience.  With the right blend of medication, therapy and psycho-social intervention, recovery is achievable, although it does of course look different for each patient.  Lucey demonstrates that Psychiatry is very much an art as well as a science and understanding individuals, their circumstances, drivers and aspirations are as important as prescribing medication.

And before I forget, there is another aspect of the book that I really like – Prof. Lucey uses poetry at the end of the chapter.  By referring to Emily Dickinson, Robert Herrick, Philip Larkin, Seamus Heaney and other such literary luminaries, Lucey adds to the poignancy of his case studies and encourages reflection. It really does round off the book beautifully.

I thoroughly recommend this book to anyone who lives with mental illness, those who treat them and to the wider population looking to understand a phenomenon that is still shrouded in too much mystery, misunderstanding and prejudice.

Mystics, Mental Health & Lessons to Learn


Whilst watching a documentary on Schizophrenia the other day, the words of the psychiatrist, neurologist and founder of the third Viennese School of Psychotherapy, Viktor Frankl came to mind. Frankl once famously said of Joan of Arc in his book ‘Will to Meaning’:

“There is no doubt that from the psychiatric point of view, the saint would have had to be diagnosed as a case of schizophrenia; and as long as we confine ourselves to the psychiatric frame of reference, Joan of Arc is ‘nothing but’ a schizophrenic. What she is beyond a schizophrenic is not perceptible within the psychiatric dimension. As soon as we follow her into the noological (spiritual) dimension and observe her theological and historical importance, it turns out that Joan of Arc is more than a schizophrenic. The fact of her being a schizophrenic in the dimension of psychiatry does not in the least detract from her significance in other dimensions.”

Frankl’s observation is an important one.  In some circles, it is common to refer to mystics as suffering from a mental disorder thereby detracting from their worth as a pointer to the divine.  Moreover, such sweeping statements forget that although there is some overlap between mysticism and mental health, they function in different domains.

Frankl’s warning that it is a mistake to over-identify individuals with one aspect of ‘the self’ has implications not just for mystics, but for us all.  Writing off those who live with mental illness as being incapable of an authentic mystical experience, or negating any such experience as solely an expression of their illness, is a mistake.  Moreover, Drazenovich & Kourie1 make the point in their article ‘Mysticism and mental health: A critical dialogue’ that:

“Contemporary research in mysticism illustrates that mystical experience is an integral aspect of the human person and the recovery of the mystical tradition will fill a much-needed void in society. A society that denies the mystical, and lacks a prophetic religion that insists on the primary role of the mystical within the psyche, will fall into various forms of pathological pseudo-mysticism. Indeed, in our contemporary era, we have seen the ascendancy of various forms of pseudo-mysticism such as nationalism, militarism, fascism, technology, consumerism, fundamentalism, new ageism, asceticism, and psychologism.”

Thanks to Viktor Frankl’s prompting, there is much that we need to reflect upon when it comes to the mystical expression of our human self, and how this interacts with our mental health and wellbeing.  A world where people like Joan of Arc are relegated to being ‘nothing but’ a schizophrenic misses the totality of their contribution and how they have enriched our understanding of the mystical.

1Drazenovich, G. & Kourie, C., 2010, ‘Mysticism and mental health: A critical dialogue’, HTS Teologiese Studies/Theological Studies66(2), Art. #845, 8 pages. DOI: 10.4102/hts.v66i2.845

Dr. Michael Stone: The Psychopathology of ‘Evil’ Children

Dr. Michael Stone, a Forensic Psychiatrist from Columbia University, is perhaps best known in popular culture as the the host of the Discovery Channel show, ‘Most Evil’.  In ‘Most Evil’, Stone developed and employed a ‘scale of evil’ which took into account a number of factors with the aim of categorizing perpetrators of heinous crimes.

Exactly how one defines evil is hugely problematic and depends on your theological, philosophical and sociological stance, as well as your understanding of psychopathology.  We have increasingly become uncomfortable, and I would argue for very good reasons, in applying the term ‘evil’ to describe an individual as opposed to a set of behaviours and moral choices.

And this vexed issue becomes particularly relevant when it applies to children. In Dr. Stone’s ‘Big Think’ contribution entitled ‘The Psychopathology of Evil Children’, he explains that a very small percentage of children express callous and unemotional (CU) traits which consist of a persistent pattern of behavior characterised by a disregard for others and a lack of empathy.  Although these traits and associated behaviours cannot be ‘cured’, there are behavioural and pharmaceutical approaches that can, albeit to a very limited degree, ameliorate the negative effects explains Dr. Stone.  This raises the interesting question of whether we can identify a neurochemistry or genetics of  ‘evil’ as Dr. Stone seems to suggest; my own thoughts are that this reductionist approach is not likely to yield all the answers we need.  Moreover, the prospect, and indeed practice, of branding children as intrinsically ‘evil’ does not sit easily with me and may even be counterproductive.

 You can watch Dr. Stone’s ‘Big Think’ interview here:


Can Meditation Really Make You A More Compassionate Person?

Image courtesy of stockimages at
Image courtesy of stockimages at

A recent study by Northeastern University’s David DeSteno, published in Psychological Science, gives a fascinating insight into the impact of meditation on interpersonal harmony and compassion.

According to DeSteno, “The truly surprising aspect of this finding is that meditation made people willing to act virtuous – to help another who was suffering – even in the face of a norm not to do so,”  

Such empirical investigations add credence to what Buddhist practitioners have said all along, namely that meditation leads to greater feelings of compassion and ‘oneness’. And it’s not just Buddhists: Jews and Christians have long made the connection between compassion and contemplative prayer.

Often we over-analyze faith and how we live it when all we really need to do is to keep it simple….and nothing is more simple than meditation and contemplation….and nothing is as powerful than compassion.

You can read the press release from Northeastern University outlining the key points of DeSteno’s paper here:

Can Meditation Make You a More Compassionate Person?.

Religious Fundamentalism: A ‘Mental Illness’ To Be Cured?

Image courtesy of Ambro /
Image courtesy of Ambro /

According to, Oxford Neuroscientist Kathleen Taylor made a very thought-provoking comment recently during a talk at the Hay Literary Festival in Wales.  When asked what positive developments she anticipated in neuroscience in the next 60 years, rawstory states the following:

‘“One of the surprises may be to see people with certain beliefs as people who can be treated,” she explained, according to The Times of London. “Somebody who has for example become radicalised to a cult ideology – we might stop seeing that as a personal choice that they have chosen as a result of pure free will and may start treating it as some kind of mental disturbance.”’

Taylor’s statement raises many questions.  How is ‘fundamentalism’ to be defined? Is it right to medicalize belief systems that are held in the absence of other manifestations of mental illness/disturbance? How should the ‘disturbance’ be treated?

Personally, I find the Austrian Psychiatrist and founder of Logotherapy/Existential Analysis (or the Third School of Viennese Psychotherapy), Viktor Frankl, to have the most sensible approach to fundamentalist ideology.  Frankl would point out that when a person’s religious worldview becomes distorted, it ceases to fulfill its function and a spiritual malaise develops.  That malaise can only be rectified by re-discovering the core meaning at the heart of a religious experience.  Once the individual  recognises the freedom that  now exists to change his/her way of thinking, life has renewed meaning and the spiritual dimension is expressed in a more positive manner. Crucially, the spiritual dimension of the individual’s life is affirmed and developed, not denied.

You can read the rawstory article here and make up your own mind.


Mental Disorders: Confusing or Instructive?

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The mind fascinates me. It is dazzling in its complexity and can throw up some incredibly interesting questions.  Take the more outlandish mental disorders as an example.  The website rather helpfully has put together a list aptly entitled ‘10 little known mental disorders‘ that include details of the following and really make us think:

1) Cotard’s Syndrome – someone afflicted with this disorder believes that they are dead, non-existent or have had all their blood or organs removed.

2) Body Integrity Identity Disorder (BIID) – causes the sufferer to have an overwhelming desire that they want to be an amputee; the urge to amputate a healthy limb is very strong.

3) Synesthesia –  a disorder resulting in the sufferer experiencing an different sense as a result of the first sense.  For example, the person may experiencing the sense of sight as the sense of taste, or vice versa.

4) Windigo Psychosis – a disorder involving an insatiable craving for human flesh, coupled with the fear of becoming a cannibal.

5) Genital Retraction Syndrome (GRS) – people living with this disorder are overcome with the fear their genitals are either shrinking or retracting into the body and will eventually disappear.

6) Foreign Accent Syndrome (FAS) –  here the sufferer speaks with a new-found accent that bares no relation to their place of origin. For example a FAS sufferer may be British, but might speak with a strong New York accent.

7) Trichotillomania (TTM) – a disorder that results in a person feeling a strong urge to literally pull their hair out.

8) Mary Hart Syndrome –  a disorder characterised by “sound induced” epileptic fits.

9) Paris Syndrome – reserved solely for Japanese tourists traveling to Paris, those who exhibit this condition are essentially suffering from extreme culture shock.

10) The Jumping Frenchmen of Maine – a disorder that brings on an extreme response to a startling noise or sight.

Quite a list that extends from the outlandish to the downright strange! But at one level these conditions raise existential questions that encompass many interlocking fields including neurology, psychiatry and psychology.  How we perceive our external environment is crucial; when one or more element of that complex apparatus goes awry it can have profound implications. And these implications can even extend into the realms of faith or religious experience.  Although not a defined disorder, hyper-religious delusions are sometimes associated with particular clinical presentations of bipolar disorder or schizophrenia.  How we see the world is often not objective, a point we should remember as we reflect on the worldviews and ‘Godviews’ we’ve constructed to make sense of the environment we live in.

And as you ponder on that thought, you might want to read a bit more on the ’10 little known mental disorders’!  You can access the website here.

Spotting ‘Evil’ In The Brain

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The PsychCentral website has posted a fascinating article about a German neurologist who claims to have identified a very specific area of the brain “where evil lurks.”

As part of his government sponsored research, Dr. Gerhard Roth scans and analyzes the brains of violent criminals such as rapists and murderers. And he’s found that they all have something in common: a “dark patch” in their frontal brain. Interestingly, Roth says he can predict with 66% accuracy that an adolescent with anomalies in this area of the brain, is a “felon in the making.”

You can read the whole article here.