Ultimacy and Triviality in Psychotherapy

By Ernest Keen | Go to book overview

CONCLUSIONS

Has our sampling of our knowledge about trauma treatment and psychopharmacology enabled us to see differently the format issue of our knowledge? Some behavior and experience is caused; some is chosen; some is physiological, or even mechanical; some is mental, considered, and voluntary. Some behavior and experience appreciates ultimacy; some conceals ultimacy with engaging trivialities. Drug therapy may reveal ultimacy, but the more common concern with chemicals, physiology, side effects, and so on tend to generate another layer of triviality.

The neuron and the narrative affect each other; each conditions the other, with such complexity that it seems that a third format for our knowledge is necessary. Perhaps probabilistic thinking, which simply tries to stay very close to the quantified data, solves our conceptual problem by eschewing both the experiential/voluntaristic format and the causal/mechanical format, and by speaking in the grammar of statistics.

The issue, however, is more than one of language. We have two languages, with two formats; they are each self-contained and incommensurable with one another. Intellectually, this duplicity is incoherent. Beyond that, existentially, this doubleness distracts our attention from more ultimate issues and creates a focus on another layer of triviality. The professional attitude of indifference toward all this incoherence and triviality seems to me a professional disgrace.


NOTES
1
Sacks ( 1970) puts the matter this way:

We have always two universes of discourse -- call them "physical" and "phenomenal," or what you will -- one dealing with questions of quantitative and formal structure, the other with those qualities that constitute a "world.". . . We can usually tell a man's story, relate passages and scenes from his life, without bringing in any physiological or neurological considerations: such considerations would seem at the least, supererogatory, if not frankly absurd or insulting. . . . Usually, but not always: for sometimes a man's life may be cut across, transformed, by an organic disorder; and if so his story does require a physiological or neurological correlate. (p.50)

Sacks argues, however, that even when there are such symptoms, this "does not detract in the least from their psychological or spiritual significance" (p.130). Indeed, the particular music heard during a seizure, as sometimes happens, is not random music; it is meaningful to the individual experiencing it. This sort of "personal epilepsy" is a contradiction in terms, for epilepsy is stereotyped and impersonal, while these symptoms

-28-

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Ultimacy and Triviality in Psychotherapy
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Preface ix
  • Introduction xi
  • PART I - Theoretical Incoherence 1
  • Chapter 1 - Critical Reflections on Psychopharmacology 3
  • Notes 14
  • Chapter 2 - Neurons and Narratives 19
  • Notes 28
  • Chapter 3 - Explorin Theoretical Incoherence 31
  • Notes 43
  • Chapter 4 - Wider Echoes of the Incoherence 45
  • Notes 58
  • PART II - Ultimacy and Trivialit 61
  • Preface to Part II 63
  • Chapter 5 - Narrative, Coherence, and Ultimacy 65
  • Notes 81
  • Chapter 6 - Discourse, Therapy, and Science 83
  • Notes 93
  • Chapter 7 - Trivialization, Ultimacy, and Discourse 95
  • Notes 107
  • Chapter 8 - Triviality and Ultimacy in Therapy 109
  • Notes 122
  • References 125
  • Name Index 131
  • Subject Index 133
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