Positive Health Online

The phrase "I'm not myself nowadays" and its many variants are, paradox apart, often a central complaint. People arrive at a state in life such that their present self seems awry and is to be changed: therapy can only indirectly alter the surrounding world. Sometimes the treatment may disregard how this state has come about, but often its genesis matters, whether due to self, to others close by, to remote factors or to mere chance.

The central idea in this article is that it helps us attain a more positive view of our lives if we can understand our history – and future intention – in a way that makes some overall sense; that achieves a form. Design is a useful word here because of its double meaning as both pattern and order, intent and purpose. Needing to understand is a familiar aim, but applying the aesthetic notion of form may be more puzzling. Even with a painting it seems easier to talk about content rather than structure, about whatever is depicted rather than how it is organized into an expressive whole. Appreciating a life is, I think, a similar task.

Stories

Therapists often encourage taking control and responsibility. Yet much that occurs in life can either be largely predicted at birth from family circumstances or comes accidentally, more or less at random; for these neither blame nor admiration are appropriate. A friend recently told me how she had prayed for years for a child but had finally adopted a son and so made a loving family; and that it had all along been God's plan for her. Now I have no such religion, and to me the idea that there is a Lord of the Universe who had personally devised this curious drama for her is utterly unbelievable. But it certainly provided a story that she could live with, and divine intervention could cover any and every event.

We tell stories by hindsight. Our founding literature, the Greek tragedies, brilliantly espoused the idea of a crucial wrong act that would inevitably unfold to disaster. We have an instinct to assign responsibility to someone. 'He did it' somehow lets us move on, however doubtful the assertion may be if closely examined. A medal here, a hanging there, does the job. Such rough justice has consequences, and mistakenly applied to the events of our own life results in conceit or self-deprecation – or much worse. Psychosomatic disorder is another consequence of the mismatch between mental construction and experienced reality.

In truth, our personal stories are almost all modest, their form without huge climax. Unfortunately there is current a notion that fame is available to all and that we should seek celebrity (perhaps a reaction to an over-populated world which hardly recognizes us as individuals). To achieve outstanding good usually does require character to match, but the opportunity is also needed. Alas, the only reliable route is to the infamous by some appalling deed. If our lives are on a small scale it is no bar to satisfying form, and that is rather like Jane Austen writing, she said, as if engraving a small piece of ivory only.

It is worth noting how modern art works, dance for example, have been able to accept, even embrace and incorporate, elements of chance. So doing has illuminated the transition from the accidents of personal experience to aesthetic form in life.

Therapies

The urge to tidy up personal history is so common an inclination that it is to be suspected beneficial and, deliberate evasion excepted, it often is. One of my patients had an odd feeling of disloyalty to her younger self because she was now able to abandon the tentative and timid character of earlier life. "But do you think she would have been pleased to see the future?", I suggested, "And her sensitivity you have retained, don't you think?" I was then told how some years ago she had pondered her difficult youth (the family defended huge lies) in a kind of meditation based on a dream. A long corridor – at the end an armoured figure. Closed doors. These she opened in turn and found her younger selves, and was able to console and reassure them. The corridor no longer ended abruptly, but opened out somehow.

This was a triumph of the imagination. You may indeed recognize it as similar to certain therapeutic techniques of revisiting the past. Another patient, an older man, had many problems resulting from a vicious mother and tyrannical previous wife. He was a good visualizer and was able to hold a childhood image of his mother in fury as if on a large screen indicated by my arm. The image was processed to make it less fearsome, diminished and finally ridiculous, the screen being lowered as he grew adult in comparison. Gradually he became strong enough to reflect on his earlier life and to gain a confirmation of his present abilities as won in the school of hard knocks. Very much a self-educated man, it was a pleasure to share with him some basic philosophical tools. Action in the community became a well-fitting expression of his effort in life.

The eminent counsellor Carl Rogers remarked that acceptance enables change. The only caveat is perhaps that such acceptance has to be in a context that is both bearable and coherent. One of my recent cases seemed simple enough initially, but ended in our failure. An obese woman sought short term help to lose weight, but practical tactics met with disdain and a larger picture (such as the likely differences that would come along with slimming) defied focus. Above all, I think, the obstacle was that only others could be, in her words, fat and frumpy.

Another woman, age about thirty, had accepted without much resistance impolite labels for 'small, quiet, blushing' as wounding criticisms. It was essential to revalue these features and see the worth in them. After all, half the world is below average height, and half is introvert; and even blushing has its nice side. Various procedures helped, some with amusement. Inoculation comprised exchanging insults and responses. The most useful all purpose reply to a jeering "You're microscopic/ speechless/ beetroot" seemed to be "Well there's some truth in that. But let's talk about you (or whatever)". The content, the fact if you will, remains but is recast. Instead of a self-portrait that was a failure ("I'm not bubbly enough") as an extravert picture in bold colours, a gentler image made for her an integrated whole.

Representations

It is not necessary to produce in physical form some kind of representation of life, but it can be illuminating. A practitioner should of course begin with the self and build up some wider experience before trying it within therapy. But encouraging something to be made and simply listening with person-centred care to what is said about it can scarcely go astray. Such representations can be most transparent, and a splendid relief from the language games in which therapy can get stuck.

If you have practical skill in any art form, why not try to show yourself or moments from your life in that medium. Can you make an abstract picture of colours and shapes, a sort of unfolding ribbon or spiral? Can you visualize yourself as a time series of snapshot figures, in a setting or with others around, rather as a theatre may display stills from the performance? Perhaps present or past can be encapsulated musically in a rhythm or a few chords. Can you directly show how you are in a sculptural position or mime (do not think too much, just do without hesitating: try to identify the feeling, fix the image); and what adjusted position would suit better?

If you have clear tastes (and highbrow is not required) consider those. Perhaps at different ages you have had a favourite song or poem, or you have felt overwhelmed by a novel or play? What is it that really works for you in Baroque music or a stand-up comedian, Romantic ballet or minimalist decor? Might these values point a way forward for you? Look around your home, and if you are comfortable in the environment (if not, how about making changes), what does it say? If, by some analogy, you were a garden (or perhaps a vehicle or an animal), what sort and why?

A third approach is to begin with a short description of yourself which you write as if by a friend who knows you well: " (Own Name) is ... " Take from the text the key words and arrange them as a kind of spider diagram. Develop this into a graphic design, perhaps giving words different styles, colours and sizes. Some may connect, others seem isolated: some you might wish to enlarge, others to fade. Much the same can be done beginning with a list of occupations or roles in your life, and again some will seem fertile, others dead ends. How might the design proceed?

Further along this way come the formal arts therapies working with expression projected into particular media – drama, music, dance, art. These often have distinctive techniques and interpretations (the standard tray for sand play with its Jungian repertoire for example), but all should be open to a general aesthetic understanding. They also have certain common features of process, and all are doings (there is movement, consideration, performance): this itself may constitute the therapeutic focus.

Lifetimes

As we go through life, our abilities and possibilities change. The most important principle is that each age should yield its distinctive values while they are available. The slogan 'First experience, then understand, finally teach' sometimes applies. Physical capacity clearly declines (though not in all aspects at the same pace) and its diminution needs to be compensated – economy, neatness and elegance may help. Better still is to develop new values – social, mental and ethical perhaps – to characterize a new competence.

The most serious and global failure, affecting individual and society alike, may be in the upbringing of our children both at home and in a school curriculum, which largely ignores their rights to their age (oh for better parents and schools and fewer therapists!). Obviously damaging tactics which replace good parent-child relationships include ignoring (watch the screen), placating (junk food), and suppressing (shut up or else). But the more subtle damage of viewing of children simply as little-adults-in-the-making (so, for example, their learning should follow the pattern of adult thinking), is pervasive institutionally.

As adults, the difficulties of youth can remain unresolved, so that we continue to struggle in childish or adolescent ways (rather like a dramatist stuck with constantly reworking an unsatisfactory scene). Though some of us do seem old before our time, more commonly our society celebrates youth and resists ageing as if wholly negative. Yet much of our culture, of the arts and sciences, has been achieved by those past the age of eager sexuality and fertility – the only preoccupation of genetic inheritance attuned to short life spans.

Time and mortality present an existential crisis which is far from easy. At the simplest we can become old realizing what we have missed and with accumulated resources that are sadly irrelevant (the pursuit of money beyond need and good use is a mighty sickness in the world). Withdrawal from the reality of time in our design leads some to fade easily into dreary stereotypes. Others are cruelly doomed by scripts inflicted in childhood to a marginal life, or to claiming a diminishing label (luckless or loveless, put upon or put down) as a bitter defence.

Solutions

It is the privilege of the therapist, expert and apart however congruent or empathetic, to see the wider picture because unbuffeted by the immediate difficulty. The trap has a door, a maze its logic, oppression a release. The seemingly unique problem is (usually) soluble because its context enables interpretation.

Works of art too are individual but only make sense in a community of art. For an aesthetic therapy, Wilde's Life imitates Art far more than Art imitates Life gives one clue, the old Stoic adage 'There's nothing good or ill but thinking makes it so' another. Both as they stand seem too contrived to me because they do not capture fully the interaction of self-perception and brute fact, the processes of forming and catharsis.

There are a couple of practical consequences of the general perspective I have tried to sketch. First is that therapy, as a whole process and in each session, should have some dynamic shape. Not a flatness (which may seem perfunctory) of 'start – talk/ listen segments – stop' but an emergent form of sensings and seeings, calms and accelerations. In this way therapy itself has aesthetic criteria. Second, I often work directly with expressive behaviour therapy – particularly through speech and movement – to rebalance difficulties and bring good possibilities to life.

Immortality for the writer Gertrude Stein perhaps lies in her final questions "What is the answer?" and (following silence) "Then what is the question?" which Douglas Adams delightfully echoed beginning with the answer "42" (!) We cannot expect to complete our personal work of art so aptly, but it is striking how strongly we resent the possibility of an inappropriate, wretched dying. Hopefully a core of our essential selves will persist through our children or accomplishments, the myriad of small doings imparted to the world.

The concern for our children can sometimes be damaging when it is dominated by our own issues, aspirations and disappointments (and problems are often, of course, two way). But the sense of contributing to the future, and the desire to be indirectly represented in it, is entirely understandable in both psychology and biology. The very contemporary enthusiasm for family trees extends our search for personal meaning into the past. The therapist's geneogram has become generalized to a very common fascination with ancestral lives as perhaps (often in far-fetched ways) explaining our own personality and experiences. Though our desire for context, for being securely embedded in time and family, can indicate a lack of realistic commitment to living in the present, it may also be a dubious attempt at self-help in an age of extraordinary change, disenchantment with the leadership and structures of society, and with even the physical environment in great peril. The past, at least, may seem a fixed frame: but it is the developing design that most needs our effort.

For positive health we do need to act authentically in the present and in the real world. The blurring of what is actual with the spurious – whether that is media distortion, ideological absurdity or the fictions of electronic phantasy – undermines our ability to act in worthwhile ways for ourselves and others. The close connection of being oneself, having a good enough sense of fulfilment, with psychological and physical health needs no emphasis here.

So the suggestion made is essentially about personal awareness, that the pattern of our lives may be reviewed and reconsidered with an aesthetic appreciation. Not for deception, but the better to understand what persists and evolves in the individual design, what form of wholeness may be found. And is yet to be created.

Notes

1. For some readers the foregoing attempt at persuasiveness may be irritatingly atheoretical and anecdotal. The central idea emerged from a doctoral thesis in aesthetics (CNAA 1983); and 'therapy as art' was described in an MA dissertation (Suss. 1994).
2. Articles in Positive Health by this author that are relevant to Expressive Behaviour Therapy have been Moving Well (Issue 107. 2005) and Breath-Voice-Speech (Issue 135. 2007).
3. The phrase The Body Ideological was the title of my article in Movement and Dance 25.1 2006 (pub. Laban Guild), while extending the present ideas is an article due in The Hypnotherapy Journal, Spring 2010 (pub. National Council for Hypnotherapy) entitled Pasts and Futures: Regressions, Geneograms, Genetics
4. Any comments to  kl.humanfactors@virgin.net please.