The man with no name (updated 2014)

(This piece first appeared in a local newsletter in 2008. At that time I slightly censored my original text but restored the cuts and updated the content when it was first posted here in January 2010. Now I’ve briefly added more text in italics at the end which brings it up to date again! When it first appeared some readers wondered if the other person referred to was real, I can assure you he is).

I first met him on a psychiatric ward, I knew his name then but have forgotten it since. We lived in almost the same street for many years but rarely spoke, though we saw each other all the time. The last time I saw him, a few weeks ago, he passed briefly through the café before jumping the train. We have known each other now for nearly sixteen years, and it seems that there is a bond of shared experience that will never go away. Let me try to explain.

At times he seems like my mirror image. He’s certainly a benchmark by which to measure myself. On one occasion when we met (passed on the street) I was in a neighbouring town, and waiting for the bus home. I was sitting on the wall, staring in the direction the bus would come, looking south-west; the setting sun illuminating me, my body relaxed and my eyes rested naturally on the horizon. I saw him coming from the same direction, the perfect opportunity to ‘read’ him and therefore myself - the simplest of encounters with the minimum of ‘noise’. I knew his gaze had to past across the uprights of the bus shelter and that would clean his memory at the right moment. I remained motionless and allowed the gaze of my eyes to remain fixed. At the right moment I glanced away for a split second in recognition, then back to look directly and uncompromisingly into his eyes - demanding a response. It was then that something remarkable happened. For the first time in all those years he looked undeniably normal, and his expression, in response to mine, was one of sorrow and sympathy. With my seemingly fixed stare I looked distressed to him - he had misread me, in a way only an ordinary person, who cares but doesn’t understand, can do. He had lost, for a while, his capacity to be mad.

He’s a walker, night and day, and so am I. But he needs to be outside more often - he covers more miles. Those who are disturbed don’t wander, they walk with purpose, rhythm and speed. To the onlooker they may appear to be staring blankly ahead whilst taking an erratic course - they look crazy. But this is only because urban landscapes are artificially regular and regimented. The real walker, who moves swiftly but smoothly, is actually following the most efficient path through the real contoured landscape beneath his feet. The path of least effort up a slope is always curved. The apparently fixed staring eyes have in fact come to rest naturally on the horizon - seeing through the fixed artificial urban skyline. But they do blink from time to time, like a camera shutter recording fixed points for navigation. The so called ‘psychotic’ hopes to achieve a kind of walking meditation; whereby the hallucinations, which may be of sound, smell, taste, touch or vision, and the unwanted delusional thoughts that emerge to explain them, may be relieved. If he can stay ‘in the moment’, in the here and now, create nothing but constant change around him, know that all thoughts and feelings can only be about the past or future and let them go - then survival is possible. Finally he may be able to allow his unconscious mind to make all the decisions and find a few hours of peace whilst in constant movement.

By the time he comes to rest, his ‘balance’ (physical coordination) and ability to ‘navigate’ (be orientated in three dimensions of space and one of time) will be restored and his mental awareness as acute as his hunter-gatherer ancestors. Alas, opportunities to be alone and abroad at night are ever more restricted by modern society. When forced into the crowd then disaster may strike unless you are particularly confident and relaxed. You may even be able to ‘part the waves’ by walking briskly in a dead straight line through a crowded pedestrian precinct staring relentlessly ahead, not deviating nor giving way even for a moment. The first time, I did it by accident; I was pre-occupied with my own thoughts and didn’t realise until I was in it and saw its effect. It’s both frightening and amazing if you have the confidence to keep going. The crowd parts in front of you, you are like an arrow travelling through air, it gives a wonderful sensation of power. But you mustn’t take your eyes of the real horizon and make eye contact otherwise you will become rapidly disorientated and liable to fall. I must have gone a hundred yards without touching anyone. Afterwards you need to be able to switch realities; and must make eye contact to be balanced, and able to navigate in the landscape of others!

When we met on the hospital ward it was a crazy place, the staff occupied one mental universe, whilst we the patients had our own individual realities - well almost! There is a realm where two, at most three, psychotics can understand each other and therefore act together. We each define a situation differently and ascribe different meanings to it, reflected in the mutually incomprehensible content of our words - but how much real communication depends on language? He’s a bit of an artist and one day I helped him cover the walls of the music room with graffiti. The unit was attached to a general hospital, any part of which could be explored - if you had the confidence to act as though you had a right to be there. At night the grounds could be a playground too.

The fastest way out of a prison is usually the reverse of the way you came in - through the front door! You are never more than three keys away from freedom in the psychiatric system; one out of seclusion, another out of a secure ward on to an acute ward which is open at some point in the day, and the third which unlocks the transport taking you to and from units or the outside world. Physical methods are extremely slow, the psychological much faster - you have to get those who want you in, to want you out. Using what have become the 'black arts' of psychiatry and psychology, against those from whom you learnt them, can be fun; non-verbal behaviour, hypnotherapy and NLP - plus a little old-fashioned distraction and sleight of hand. Two of you can cause chaos, three of you can get one of you - out of anywhere. And it is a game. If you can understand the source of your distress in the system of care; see its rules, routines and the habits of the workers who reproduce it - then there is much to amuse. But it is addictive and I still can’t walk away from it all.

(Oops! I may have just self-diagnosed myself with an ‘anti-social personality disorder’).

(Now it is 20 years since we first met, and I haven’t seen him for a couple of years – which doesn’t necessarily mean he is not around, just that our awareness’s have changed. I know mine have and I suspect his have too. First there was the time I saw him working in an out-patient art therapy room, absorbed in a very elaborate large drawing. Then months later he had a dog in tow, he was still walking but obviously the pace and priority had changed. Then came the van, the woman and the child. One day the van was parked outside the café – the first time we had been stationary in the same space for more than fifteen minutes, ever! Finally the last time, all three were dressed as if part of a wedding party, on their way to a local music festival.)

Bus shelters are often effective barriers for forcing a 'pattern break' from one kind of a 'trance' like state to another involving more 'reality testing'.

Eye movements and mental distress

Don’t you just love it when someone’s eye movements tell you what’s going on in the rest of the room and what they feel and think about it?

An outrageous claim? Yes, but only if you claim too much.

We take cues from everywhere, so quickly and usually unconsciously that the world around us seems seamless and our thoughts and feelings seem to come from within ourselves. But of course our mental map is not the territory itself, and whilst we can consciously cope with 40 pieces of information per second, our unconscious can handle 11 million. Our motivation to act and most of our learning comes from others. Facial expressions and tone of voice give us the vast majority of our information about others emotions. Language, spoken and accompanied by hand and other gestures, or written down, gives us all the cognitive stuff. Posture, our distance from others, and the degree of touch - tell us our relationship to another in any one moment. But all this information has to be structured in some way in order for us to navigate in the world, and there the eyes have it.

The eyes constantly make small scanning movements, the brain seamlessly puts the composite picture together so we have the complete illusion rather than the more prosaic view seen down a pair of binoculars. But those kind of eye movements can for most practical purposes be ignored, what concerns us here are two types of eye movements which we make in response to the actions of others - both involuntary and initially unconscious but which we habitually tell ourselves, after the fact, were a deliberate choice that ‘I’ made.

Trust your unconscious, it knows more and better than ‘you’ do. Whatever you are thinking and feeling in any given moment is being cued by something in the environment around you. (Remember, sensory deprivation is the fastest way to create madness!)

So, first your eyes will notice (recognise) something in the environment of others and track it before you are conscious of it. You feel a sudden emotion and may even have time to wonder why, before realising who has walked into the room ‘unnoticed’ by you a few seconds earlier. You may think about something from the past, little realising you are watching it happening to others in the present moment. (Afterwards many people will consciously attribute magical or other-worldly explanations to these real, commonplace, and mundane activities of the unconscious parts of the brain).

When observing others eye movements we can see what they notice, consciously and unconsciously, but those movements are overlaid with a second set which indicate their response to what they have noticed.

And it’s at this point that I must be especially careful about what I write, since people have got into all sorts of trouble by overstating the meaning of such phenomena which have been observed over many thousands of years. The problem is that many have wanted to explain the ‘what’ and ‘why’, rather than stick to questions of ‘how’. For the meaning of these second kind of eye movements, often called ‘eye accessing cues’ are almost entirely context specific, dependant on the how well you actually know the person you’re looking at, and of course how well you know yourself - since you are, by virtue of your very presence, cueing them!

The claim is that once you’ve controlled for eye movements in response to activity in the environment, then other movements will indicate how an individual is responding cognitively and emotional to the action around them - how they are thinking and feeling about you!

Now, what follows is my version, and compared with many others, a mild and tentative version, but it’s what my experience tells me is reasonable to claim. First is the observation that there is a marked tendency for people’s eyes to move in one direction (left or right) when trying to access memories, and in the opposite when constructing a thought - imagining some future action. The second observation has been that eye movements tend to stay either level or rise in an upward direction when thinking (particularly visualising), whilst tending to drop below the horizontal when feeling emotions (as bodily sensations, but also as felt in the sounds of the human voice).

When you combine the two elements you get a tendency to visualise thoughts about the future looking up in one direction and about the past in the other. A tendency to imagine future feelings through constructed internal dialogue when looking down in one direction, and remember emotions through the sounds of others speech when looking down in the opposite direction - both with, or without bodily sensations.

If you are in a normal state, that is not mentally distressed, these processes may be so seamless, unconscious, complete and taken-for-granted that you would wish to question their existence. But then you probably exist very efficiently in the world and are genuinely bewildered by the apparent psychological troubles of others. However if you have experienced periods of intense stress and consequent distress, or been witness to them over an extended period of time, and perhaps empathised with those around you a little too much, then you may have noticed the gap, or window that can open-up. Brief moments in which the very construction of social interaction can be seen and felt. The ‘digitised’ bites of which they are made up. A bit like those classic illusions used when being taught about visual perception, or when tiredness late at night causes you to loose the ability to synchronise the pictures and sounds coming from your TV.

But that’s as far as I go, others have and do claim a lot more - as a simple search of the web will reveal. Needless to say that with a lot of testing and matching with both the content of speech and the universal emotions all sorts of possibilities open-up.

Oh! I almost forget - if you are genuinely left-handed (one of the 10 to 13%) then all the above may be reversed, and happen in the opposite direction to the majority! Incidentally, did you know that it you have a diagnosis of Bipolar you are 3 times more likely to be left-handed than the general population…

A Desired Outcome

What will you feel, see, hear, smell and taste when you have achieved it?

You can bet your life a mental health worker won’t frame the question in such a way, although an NLP practitioner might - that is, what would be the sensory or experiential evidence? Rather your average worker would want some rational, cognitive (rather than emotional), probably written, description of a desired outcome to a well defined problem, which can then be made a measurable target - whether it be on a care plan, a WRAP or as a homework assignment for CBT.

But the real issue however, when trying to help someone in mental distress by asking them to set goals, aims or outcomes, is what I call the ‘future orientation’ problem. The worker is desperate to give hope (the promise of better times to come) and is often relentlessly positive. They ‘see’ the client’s negativity and respond by setting expectations which are too high for the client - today. The client then thinks I cannot possibly achieve that, I could barely get through the door to the appointment. Expectations or future tasks, like the skills and demands of any job, have to be set at just above the person’s current level of functioning. Something that is doable tomorrow!

At 17 (in 1976) I saw the world like Reggie Perrin. In his great speech to the British Fruit Association at Bilberry Hall, Reggie declares:

‘I know that I don’t know and believe in not believing. …Would the sun shine less brightly if there was no purpose in life? Would the nightingale sing less sweetly? Would we love each other less deeply? Man’s the only species neurotic enough to need a purpose in life.’ (David Nobbs 1975 The Fall and Rise of Reginald Perrin)

The problem is that if a mental health worker asks a client outright about their aims and goals they are likely to receive the reply; ‘I don’t have any’, or ‘I don’t know’. For every client I’ve ever met has been preoccupied with the near future - they don’t believe they have a long-term future - and equally have never been able to live ‘in the moment’. It is the potential disasters of the next week and their inability to get out of bed tomorrow which concern them. And with good reason. Mental health has been slow to understand the underlying rationale of positive psychologies. The point being that a normal person sees life a little too positively, with a level of optimism high enough to ride the waves of unpredictable events, but always believing in a brighter future and their ability to influence the outcome. The depressed person (all clients are a little depressed, whatever their diagnosis, due to their isolated situation) is actually more realistic, stares life in the face - is distressed because they see only too clearly. A situation in which the client may see their objective circumstances and limited opportunities more readily than the worker. It is with such basic insights that some experimental psychologists have embarked on ‘happiness’ research - and been blithely ignored by mental health services.

However, a virtue of the ‘define your desired outcome’ approach is that it may allow the brain to better identify anything which might bring you closer to it - opportunities only exist after they’ve first been recognised as opportunities!

Also if you know the who, what, when, how and why - then you can start to rehearse for it. Equally you should be able to identify someone who already has what you want and begin to imitate them. It is certainly easier to move towards something you want, than away from what you don't want (where your attention will inevitably stay on the undesired).

So how does one get around the paralysing belief of not knowing what you want? Easy. Outcomes are invented and if you don’t already have one, you make one up. (The real objective after all is the pay-off that comes from purposeful activity itself). Desired outcomes are just plans and fantasies about the future - conceits, albeit occasionally useful ones. They become useful (potentially real) if you can already see a series of actions you would need to take to bring them closer, rather than needing others to act for you. Is there something you can do tomorrow which will bring the desired outcome closer?

But it all starts to unpack when you consider achievability - or indeed ask yourself, how would I know when I had achieved my outcome? (Hence the question at the beginning of this post). The future is unknowable, you are not in control of the environment of others - now is actually all there is. The effective helper is one who acts today to make it easier for the client to get up tomorrow. The idea of ‘outcomes’ is only useful beyond today if it is flexible enough for a particular outcome to be changed in the light of unpredictable events (which occur often) but in the face of which other people’s response will, from habit, be to try to reproduce today, the world as it was yesterday.

Much better to follow an evolutionary social model of human behaviour as argued for elsewhere on this blog and understand that as social animals our motivation can only come from others. Seek movement and change, be always in the moment, let go of both the past and the future. Travel in the hope of never arriving, allow the brain and body to take you where it pleases. And never for a moment believe that the ‘I’ or ‘me’ of the so-called ‘self ’ is fixed forever. Outcomes? Like the past, the future is just an evolving story we tell yourselves about a person on a journey.

Psychological Skill

Psychology is best understood as a set of physical skills. Now I suspect that sentence will seem odd to most readers, but a small minority will be thinking, ‘tell me something I don’t know!’

Unfortunately as my writing gets better, along with my confidence in understanding our social world, there seems to be an ever greater risk of losing what modest readership I already have. Perhaps one should just practice psychological skills, rather than try to write about them.

You see the problem is, there is this strange phenomenon of people liking mysteries and not wanting them explained. A lot of modern magicians have experimented with building explanation into their acts, but have sooner or later hit a wall - and it‘s not just a need to maintain trade secrets in order to earn a living. People want to be amazed, in awe of, and frightened (up to a point). In the world of mental health it often appears that someone in distress, does not want, nor responds to, either explicit explanation of their difficulties, or to training in techniques to relieve them. It’s even got to the point in our individualistic society where many will argue that there are no universal ways of understanding or helping - apart from the mysterious ‘love conquers all’! And the more knowledgeable person certainly doesn’t want to end up suffering the emotional isolation of what I call Sherlock Holmes Syndrome - of going to the trouble to explain (about inductive and deductive reasoning, how he built-up his library, apprenticed himself to learn about such things as horses and dogs, the logic of railway operations and timetabling, etc, etc) only for Watson to call it all inborn ‘talent’ and ‘genius‘, the police to call it ‘luck‘, and the public ‘…well when you put it like Mr Holmes, I can see it really is so simple anyone could…’ It was others who set him apart. People fear something is lost in explanation when in fact the reverse is true - it only adds to the wonder of the world.

But there is a more fundamental problem about explanation, learning and skill. For those of us who did not learn our social skills unconsciously and naturally in early childhood, it is a cause of fascination to watch the socially skilled finding themselves quite incapable of describing what they do so self-evidently well! Conversely it is alarming to watch one’s own continuing incompetence at the same time as knowing exactly what one is doing wrong. The old truism that those who find a subject or skill difficult to learn make the best teachers, often holds-up. Now we are into the domain of tacit knowledge, the knowledge and skills we know others have, know to be vital to much social interaction, whether work or leisure, which have proved impossible to write about or codify in other ways?

There is a huge body of knowledge (useful or otherwise, effective or harmful) that one knows is learnt, over long periods of time, possibly quite unconsciously, when alongside the most experienced of practitioners. You know they have ‘it’, that’s why you place yourself alongside them; they know they have ‘it’ but can’t articulate it to you.

Consider the following. The range of human emotions are universal and so is the way they are expressed. Human emotion is communicated through facial expression and tone of voice. (Whilst thoughts are communicated through the content of speech and hand gestures). There is relatively little individual variation. Emotion is felt as your facial muscles react to what you see or hear in the other person. Emotion comes first, thoughts follow.

Some of you will be thinking ‘well that’s bleedin’ obvious’, for others it may be a ‘bolt from the blue’.

I don’t do empathy (the ability to feel what others feel). At least not very well, and not most of the time. I didn’t learn that basic human skill in early life, which most people acquire so un-self-consciously that they don’t even name it. It’s not a ‘learning disability’ - I have the capacity, it simply became blocked. Hence my adult life has been one long painful process of mechanically acquiring the skill. And I’m not fluent in it - others can see the joins, often become fearful of me, and turn away. (Doing one of Paul Ekman’s tests I correctly guessed only 3 out of the 8 universal emotional expressions - and that was with 30 seconds to think about it!)

As for a ‘theory of mind’ (knowing how others think) well, a long time ago when I was a patient on a ward a student nurse demonstrated a few NLP basics, such as the reasoning behind ‘eye accessing cues’ - you see I’m profoundly left-handed, I’ll move anti-clockwise when 90% of the population are moving clockwise.

Twenty wasted years in the psychiatric system. Being diagnosed with depression, schizoid affective disorder and manic depression - actual taught me nothing. They only described, rather inaccurately, how my limbic system reacted to such dodgy data!

Psychiatry, clinical psychology and mental health nursing don’t know they are stuck at the end of a cul de sac - ramming each other out of road rage, whilst the rest of the world passes on the main road. Paul Ekman’s Facial Action Coding System has been available since 1978 but I know of no mental health worker who has ever learnt it. And of course any part of NLP has been thought ‘beyond the pale’ for the last twenty years.

There is much that is not mysterious. Simple laws can lead to massive complexity. Complexity does not mean something is necessarily complicated to understand. Darwin taught us that 150 years ago - he also guessed right about facial expressions!