1 | It is tempting to suppose that no other species knows so much about the world as we do, but perhaps it is more accurate to say that no other species has worked out how to systematise its knowledge of the world, and that is why we rule it. But we know very little about how to be in the world, very little about what our motives are. We have very little self-knowledge. We know ourselves least of all. We are full of inconsistencies and incongruities, hardly able to control, understand or even acknowledge our needs and drives. It is possible that other animals – perhaps most other animals – are better at being in the world than we are.
Freud’s word for the instinct-driven unconscious part of his triunal self was the It, das Es, which became ‘id’ in English, a term he borrowed from Georg Groddeck, who wrote, ‘I hold the view that man is animated by the Unknown, that there is within him an “Es”, an “It”, some wondrous force, which directs both what he himself does and what happens to him. The affirmation, “I live” is only conditionally correct, it expresses only a small and superficial part of the fundamental principle, “Man is lived by It.”’
Siri Hustvedt, The Shaking Woman
When I look out on a night such as this I feel as if there could be neither wickedness nor sorrow in the world; and there would be less of both if the sublimity of Nature were more attended to, and people were more carried out of themselves by contemplating such a scene.
Fanny Price, in Jane Austen’s Mansfield Park
Scenery is fine – but human nature is finer.
John Keats, in a letter
Human life – that appeared to him the one thing worth investigating.
Oscar Wilde, The Picture of Dorian Gray
The great effort of construction that is living.
Clarice Lispector, The Passion According to G.H.
A vale of soul-making.
John Keats
Human relationships aren’t nearly as complicated as people make out: they’re often insoluble but only rarely complicated.
Michel Houellebecq, Platform
We are born mad, develop a conscience and become unhappy; then we die.
David Eder (1865–1936), psychologist
2 | Madness, or at least the possibility of it, creeps up on us when we are alone too long. It is as if other people contain us and keep us sane; and that without them we are liable to flow out of ourselves, messily.
If we were not all so interested in ourselves, life would be so uninteresting that none of us would be able to endure it.
Arthur Schopenhauer (1788–1860), philosopher
Being alive is like getting a gift you didn’t ask for. You can return it, but that’s in poor taste and hurtful.
Wendy Wasserstein (1950–2006), playwright
‘Anyway – doesn’t matter.’ One may hear this statement, which is analogous to a reflex, spoken by all who have a touch of self-esteem, in circumstances which can vary from the trivial to the tragic, and which reveals, as it did on the present occasion, how much the thing which is said not to matter does matter to the speaker; and in the tragic vein, the first thing to come to the lips of any man who takes a certain pride in himself, if his last hope has just been dashed by someone’s refusal to help him out, may well be the brave, forlorn words: ‘Oh well, it doesn’t matter, not to worry – I’ll think of something else,’ the something else which is the alternative to what ‘does not matter’ being sometimes the last resort of suicide.
Marcel Proust, Remembrance of Things Past
We are a race with conscience enough to feel that it is vile, and intelligent enough to know that it is insignificant. We survey the past, and see that its history is of blood and tears, of helpless blundering, of wild revolt, of stupid acquiescence, of empty aspirations. The energies of our system will decay, the glory of the sun will be dimmed, and the Earth, tideless and inert, will no longer tolerate the race which has for a moment disturbed its solitude. Man will go down into the pit, and all his thoughts will perish.
Arthur Balfour,1 The Foundations of Belief
At the Times Square subway station in New York is a seemingly endless tunnel that joins 7th and 8th Avenues. At intervals along the tunnel, in capital letters just above head height, you may read the Commuter’s Lament by Norman B. Colp:
Overslept,
So tired.
If late,
Get fired.
Why bother?
Why the pain?
Just go home
Do it again
We, like everything, are driven by purposeless decay.
Peter Atkins, chemist
The firm foundation of unyielding despair.
Bertrand Russell (1872–1970), philosopher
3 | Freud said of psychoanalysis that he hoped to transform hysterical misery into common-or-garden unhappiness.
Only unhappiness is elevating, and only the tedium that comes from unhappiness is heraldic like the descendants of ancient heroes.
Fernando Pessoa, The Book of Disquiet
That daily dose of poison, recently invented, that we call happiness.
Coco Chanel (1883–1971), fashion designer
4 | When we first meet Madame Merle2 she is seen from behind, sitting at a piano playing a piece that Isabel Archer cannot quite place. Isabel waits for the music to finish and for this unknown and unexpected guest to reveal herself. In just a few sentences, out of the blankness and possibility of a back, and a piano expertly played by an interloper, James somehow manages to establish Madame Merle’s mystery and her sinister controlling passivity. Madame Merle – even her name is disquieting – turns to Isabel, and her first words amount almost to a philosophy: ‘I’m afraid there are moments in life when even Schubert has nothing to say to us. We must admit, however, that they are our worst.’ It would be a refined existence indeed in which Schubert arbitrates our mood rather than, say, the need to earn money, or the zealot at the door with a machete. I had a friend who fainted in the face of too much beauty. He had been brought up by aunts, his sensibilities tuned to fever pitch from an early age. A world of Jamesian refinement may not be for everyone. But there are many worlds, and we might agree that too much refinement is better than none.
5 | On an idyllic summer’s day the then provost of King’s College, the philosopher Bernard Williams, invited a group of friends on a picnic. Kitty Godley (daughter of the sculptor Jacob Epstein), whose favourite painters were Crivelli and Fantin-Latour, excused herself in the middle of lunch, saying: ‘This is too beautiful. I just have to leave.’
She wanted to lie in a hammock beside a blue tideless sea and think about Tibullus.
Ford Madox Ford, Parade’s End
6 | There are days when the world is a veil and days when it is a rock. There are yawning days when yet again Rochester does not return, and there is nothing to do but stare out of the window at the rain. There are days when like N for Neville3 we might die of ennui.
I know no one but you who can be fully sensible of the turmoil and anxiety, the sacrifice of all what is called comfort the readiness to Measure time by what is done and to die in 6 hours could plans be brought to conclusions – the looking upon the Sun the Moon the Stars, the Earth and its contents as materials to form greater things – that is to say ethereal things – but here I am talking like a Madman greater things that our Creator himself made!!
John Keats, in a letter to Benjamin Robert Haydon, 10–11 May 1817
7 | Without scientific progress there would be no refined life indoors from which, should we care to, to disparage progress. Comfort grants us the luxury to suffer existentially, which is preferable to suffering physically. Only on our most pampered and pessimistic days would we claim that humans have not progressed. Life is better when we are protected from the weather and unwelcome parasites. We may not be free, nor know how to deal with our freedom, but we can hardly blame scientific progress for that.
It’s rather a strong check to one’s self-complacency to find that much of one’s right doing depends on not being in want of money.
George Eliot, Middlemarch
8 | From a Darwinian perspective, it is clear that it is harder to do good when the struggle for survival dominates life. Logically, it could be argued that to do good when living conditions are harsh (or to do nothing towards the general good when those conditions are fair) might constitute criteria for assessing moral worth. It was why Henry James chose to write about the rich. The poor might be excused bad behaviour, whereas observing the rich behaving well or ill was a way of scrupulously investigating scientifically purer specimens.
Intellectual freedom depends upon material things.
Virginia Woolf, A Room of One’s Own
9 | It is hard to believe in anything in our cynical age. I know that I live, as most of us do in the West, a privileged life. I know I am protected from the wildness of nature because of technological affirmations of the scientific method. I know I am also protected by relative wealth, by democratic liberalism and peace (or at least the illusion of them). I know that the main obstacles to freedom are material: the shortage of fresh water, of enough to eat, of proper housing. I know that in the world elsewhere poverty, disease, war and tyranny bring unremitting suffering to millions. I know that not to be grateful for the life I have is to dishonour the lives of the millions who died in wars where personal freedom found itself challenged by dictatorships. And if, for a new generation, the weight of that past begins to fade along with the collective memory of the world wars, a new oppressive atmosphere rushes in to fill the vacuum. The life we fear we do not sufficiently appreciate, but to which we are nevertheless addicted, has come at the cost of a fading future. We find ourselves in an apocalyptic age, in which we are in danger of denying the wonder and difficulty and uniqueness of being human beings. And yet is our age any different from ‘The dark dawning of our modern day,’ that Livy wrote of in his History of Rome, ‘when we can neither endure our vices, nor face the remedies needed to cure them’? Life as we find it, Freud once said, is too hard. And it always has been. The first noble truth, said the Buddha, is that life is suffering. These are not necessarily apophthegms of despair; they can be seen as declarations of hope. The Buddha contemplated the nature of suffering in order to understand how it might be transcended. Christ suffered so that we might not. Kindness is the highest human quality, says the Dalai Lama; charity, said Christ.
What is the meaning of life? That was all – a simple question; one that tended to close in on one with years. The great revelation had never come. The great revelation perhaps never did come. Instead there were little daily miracles, illuminations, matches struck unexpectedly in the dark …
Virginia Woolf, To the Lighthouse
A human self … has a strong tendency to maintain a constant form and it accepts only those new experiences that are appropriate to its form and rejects those that are not. Normal human behaviour ranges between the extremes of nervous breakdown, on the one hand, which occurs when incoming experiences disrupt the self due to their intensity or the fragility of the self, and catatonic states, at the other extreme, which occur when the self maintains its integrity by refusing to respond to new inputs. Most humans live between these two extremes, work hard to maintain the structural integrity of the self and modify it only under great pressure and with great reluctance … Such rare changes in selves are called ‘conversions’ or crises experiences.
Manuel Davenport, The Mystery of Morality
10 | The psychologist Dorothy Rowe (b.1930) wrote that anxiety and depression are what follow when our world view is challenged and we find that we no longer fit the universe as we find it to be.
I know of nothing more difficult than knowing who you are and having the courage to share the reasons for the catastrophe of your character with the world.
William Gass, novelist
And this, of course, was the simplest definition of depression that he knew of: strongly disliking yourself.
Jonathan Franzen, Freedom
The mere thought of having to enter into contact with someone else makes me nervous. A simple invitation to have dinner with a friend produces an anguish in me that’s hard to define.
Fernando Pessoa, The Book of Disquiet
I don’t know if I’m unhappy because I’m not free, or if I’m not free because I’m unhappy.
Patricia Franchini in Jean-Luc Godard’s film À bout de souffle
This melancholy of yours, this brooding … is really a sign of strength. Sometimes an active questioning mind tries to probe beyond normal limits and, of course, finds no answers, and that’s when the melancholy sets in … a temporary dissatisfaction with life … a deep-seated frustration with life for not yielding up its secrets.
Ivan Goncharov, Oblomov
What can the word ‘depressed’ mean to the depressed? It is no more than the echo of the patient’s voice.
John Berger, A Fortunate Man
11 | About a decade ago I began to suffer panic attacks. They were frequent but not regular. I could not predict when the next one would arrive nor what might precipitate it. At that time in my life I only admitted consciously as guides to decision-making whatever I could work out logically or rationally. Clearly my first concern was to have my condition diagnosed. The first doctor told me that I was depressed and put me on a combination of Xanax (an anti-anxiety drug) and Cipramil (a serotonin enhancer). The latter drug initially had the effect of making my panic attacks so acute that for a few days there was the possibility that I might have to check into a clinic in order to be eased onto the drug (unlike most of the patients at this somewhat famous establishment who were there to be weaned off the drugs to which they had become addicted).
There must have been curious firing patterns in my brain. I felt that whoever I used to be had fled. Someone was left behind, but not anyone I recognised. I began to understand what the horror of madness might be like. When there is nowhere to go to, when all the exit routes are blocked, life is a prison in which one has become not so much imprisoned as the prison itself. Whatever had precipitated what I had become, I was certain that chemical treatment for depression would not get to the heart of the matter.
The next doctor told me that I was pre-diabetic and that I would need to change my diet for the rest of my life. I had become highly sensitive to anything sugary or that soon changed to sugars. I could begin to predict that twenty minutes after eating pasta a panic attack was in the offing. But then other things also seemed to trigger an attack; not just food, thoughts too. I understood what I had not understood, that there is no boundary between mind and body, that a thought is as powerful a physical agency in the world as any material object. It was as if my body had been retuned, becoming now as reactive to a thought or the ingestion of a biscuit as it might once have been to a blow to the head.
When it is your own life or sanity that seems to be at stake, collectivism, I discovered, goes out of the window. Traditional medicine was not working, and I had to look elsewhere, the elsewheres being places I would have scorned from the smug heights of my well-being.
12 | As soon as I was returned to wellness, as soon as the self I thought had fled forever returned home, I began to justify my experiences in the old ways. There are no supernatural powers. In medicine, whatever happens supranaturally can be explained by the placebo effect.
‘The doctor will see you now’ was once a spell. To be looked at intently is rare and powerful. To be a good physician maybe requires some of the qualities required of a good magician, to notice tics and read signs. These days most doctors do not have the time even to look up from their computer screens. Perhaps what I was paying for when I looked for help outside the boundaries of orthodox medicine was the belief radiated from another human being that I would be well. Which is something.
As Nicholas Christakis, a medical sociologist, has pointed out, many commonly used remedies, such as Viagra, work less than half the time, and there are conditions, such as cardiovascular disease, that respond to placebos for which we would never contemplate not using medication, even though it proves only marginally more effective in trials. Some patients with Parkinson’s respond to sham surgery.
Louis Menand, New Yorker magazine
Many alternative practitioners develop an excellent relationship with their patients, and this helps to maximise the placebo effect of an otherwise useless treatment.
Edzard Ernst, professor of complementary medicine, in the New Scientist
13 | Some placebo studies appear to undermine the foundations of evidence-based medicine. One study showed that nearly 80 per cent of the effect of antidepressants derives from faith that they will work. The effect of belief may be even stronger in alternative medicine. Another study – conducted among patients with Parkinson’s disease – showed that a certain drug increased the secretion of the neurotransmitter that the disease depletes. This could be taken to be evidence in support of the efficacy of the drug, except that even those in the control group produced more of the same neurotransmitter, and at the same levels; presumably because they believed that they were not in the control group.
14 | It has been suggested that patients have now become so knowledgeable about the nature of control groups that they can tell if they are in a control group or not, simply by noting that if they do not experience any side effects they must be taking a placebo; knowledge which is enough to undermine the validity of the control. But the complications do not rest there: some studies have found that even knowing you are receiving a placebo doesn’t necessarily reduce its effectiveness.
It is in moments of illness that we are compelled to recognize that we live not alone but chained to a creature of a different kingdom, whole worlds apart, who has no knowledge of us and by whom it is impossible to make ourselves understood: our body.
Marcel Proust
15 | Descartes desired ‘the general well-being of men’ (a desire that came, unfortunately, at the expense of the well-being of all other animals). He believed that advances in medicine would have the greatest influence on human happiness, and make men ‘wiser and more dexterous’. He tried to turn medicine into a deductive science, but found it harder even than turning ethics into a deductive science.