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Medicine, Therapy or Relational Revolution?


As Ivan Illich wrote:  

“The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. ‘Iatrogenesis’, the name for this new epidemic, comes from iatros, the Greek word for ‘physician’, and genesis, meaning ‘origin’. A professional and physician-based health-care system that has grown beyond critical bounds is sickening for three reasons: it must produce clinical damage that outweighs its potential benefits; it cannot but enhance even as it obscures the political conditions that render society unhealthy; and it tends to expropriate the power of the individual to heal himself and shape his or her environment.”  

The real role of medicine in the capitalist economy is to: 

        maintain the healthy ‘functioning’ of the labour force.

        deny the relational dimensions of health and illness, physical and psychological.

        make up for the lack of deep relational health.

        compensate for the fundamental sickness of human relations in capitalist society.

        contain social symptoms of this sickness (drug abuse, family breakdown etc).

        ensure that these do not lead to total economic breakdown.

        provide a profitable market for the corporate health and ‘life’ industry.

        sanction and safeguard the dominant scientific and technological world view.

        promote the military paradigm of a techno-biological ‘war’ against illness.

 The professionalisation of psychotherapy, like that of somatic medicine, has already become a case of what Illich calls” institutionalized counter-productivity”.

         reinforcing the split between psychotherapy and somatic medicine.

        lending scientific authority to medical models of ‘mental illness’.

        Adopting  fashionable genetic and psycho-neuro-biological languages to legitimise psychotherapy in ‘scientific’ terms. 

The de-professionalisation of psychotherapy does not make it ‘unprofessional’ or mean giving up high-quality training and supervision for therapists. On the contrary, it means  deepening and broadening the relational and spiritual depth and socio-spiritual scope of that training and supervision. That in turn requires that we cease to see individual problems in the psychoanalytic manner - as the ‘private property’ of the individual or as symptoms of character deformations rooted only in early childhood relations – but recognise all symptoms as expressions of a general sickness of human relations in capitalist society. It also means that we cease to base ‘therapy’ on the ‘medical model’ of illness, but instead understand it as one means to improving the health of human relations. 

        as a subversive spiritual practice, based on the recognition that the human being is more than just a body or mind, a set of genetic structures or energetic processes.

        as an ethical and educational practice, challenging all forms of medicine which reduce the inner dis-ease of the individual human being to a mere ‘case’ of some generic ‘disease’ or ‘disorder’.

        as an essentially relational and re-ligious practice: helping each other to inwardly ‘re-link’ to the inner depths of our being and relate to other human beings from them.

The potential depth and richness of the therapeutic relationship is itself a challenge to the superficiality of human relations promoted and sustained by capitalist culture. All the more important then, that this depth and richness is not kept within the confines of the therapeutic relationship, But neither a satisfying personal relation nor a purely professional relation to a client constitutes an authentic human relation.

An authentic human relation is a relation in which every encounter with the other is taken as an end in itself and not a means to an end - even if this end be ‘healing’ or ‘therapy’. It is a relation in which we recognise that in every encounter with another human being, we encounter both a face of ourselves and a face of the other – and do so quite independently of any processes of ‘projection’ or ‘transference’. An authentic human relation is above all a relation in which we acknowledge the other as more than just the face or faces they present to us, more than just the role or roles they adopt in relation to us.

A revolution in human relations can only come about through a change in the way in which each of us, as human beings, relates to ourselves and others, to our inner being and to other beings. Its philosophical basis cannot be a scientific psychology, biology or anthropology of the human species. It must be grounded instead in a genuine human ‘ontology’ – a phenomenology of the human being ( from Greek ‘ontos’).

The New Science
provides a new phenomenological and ontological foundation for both the human and natural sciences. Its basis is fundamental distinction between the human body and mind on the one hand, and the inner human being on the other. The inner human being cannot be reduced to an “It” of any sort: to a set of cognitive behaviours or bodily characteristics, a set of unconscious drives or archetypes, a set of energetic processes or neural networks, environmental conditions or genetic blueprints. Biological and ‘energy’ medicine are based on the belief that it is bodies and brains that think and feel, genes or energies that miraculously ‘produce’ aware human beings. Human Ontology is revolutionary science – turning this assumption upside down. It is founded on the understanding that it is not bodies that see and hear, think and feel, breath and metabolise, but beings. The body’s organic functions are the embodiment of innate capacities of being. Our genes the expression of inner potentials and propensities of being.

‘Physical’ science is based on a belief in the miraculous emergence of awareness from an otherwise non-aware universe. The New Science is phenomenological rather than physical science: recognizing all physical events and processes as phenomena arising (Greek phuein) in fields of awareness. A phenomenological science of human nature begins with the recognition that the inner human being is not a ‘soul’ or ‘psyche’ externally bounded by the physical body but an inwardly unbounded field of awareness linking it with all other beings. The human organism is not the physical body through which we relate to other people’s bodies in space and time. It is the felt body with which we relate directly to others as beings – getting closer or more distant from them without physical movement, touching or being touched by them without physical contact, feeling their warmth or coolness, radiance or dullness in a way that bears no relation to the physical temperature of their skin or the physical light reflected by their eyes.

The New Science
is also the foundation for a new noetic and phenomenological understanding of human organism as a body of awareness, composed of qualitative states, flows and movements of awareness. These in turn express our movedness as beings – our ‘ontodynamics’.

Awareness as such is not consciousness of a pre-given world of light, matter and energy. It is the field condition for our very experience of the world – the light in which all physical phenomena – even light itself – first become visible.  Matter is not an expression of ‘quanta’ of electro-magnetic energy but of qualities of awareness or ‘qualia’.

‘Organisms’ are the embodiment of organized flows, forms and figurations of awareness. The cell, for example, is not essentially an ‘orgone’ envelope but an envelope of cellular awareness. Awareness as such however, is intrinsically relational –an awareness of ourselves in relation to something other-than- self.

Physical body ‘functions’ such as respiration, digestion and metabolism etc. embody the way in which, as pyschical organisms, we breathe, digest and metabolise our awareness of ourselves and the world.

If it is ‘energy’ that links or relates things externally – as bodies in space and time - then it is awareness that relates them inwardly, as beings. ‘Energy’ is not a ‘thing in itself’ independent of our own awareness of it. Instead awareness itself is the very inwardness of energy in all its forms and the medium of our own vital, inner relatedness to things and people.

Much somatic psychotherapy is still wedded to a quintessentially Western paradigm of organismic life as an outward movement of biological energy from self to world. This contrasts with the Eastern paradigm of life as an inward movement of awareness or from world to self. A ‘Third Paradigm’ is the understanding of organismic life as a rhythm or pulsation of outward and inward movements. The New Therapy is based on a Fourth Paradigm – the recognition that the inward movement of awareness from world to self is the condition for a genuine inner relation to the world and other people. Vital relatedness to ourselves and others is not, as Reich believed, the result of an outward movement from an energetic core to an organismic periphery. Instead it is only through the inward flow of awareness towards the core of being that we can learn to relate to others from that core.

The muscular ‘armouring’ that Reich saw as restricting the outward flow of energy is in reality a substitute for authentic strength and depth of character – the capacity to mentally restrain the outward flow of awareness and stay grounded in our innermost being. 

The old cultural taboo on sexuality and emotional expression which Freud challenged, has today been replaced by new, post-modern taboo – the taboo on healthy spiritual contact with our inner being and deep soul-spiritual intercourse with other human beings. For capitalist culture essentially reduces all deep human relations and values into mere means to an end - whether this be the satisfaction of personal needs, the pursuit of profit, or the application of professional skills. If psychotherapy is not to become a mere accessory to the culture of capitalism, then the training of therapists must be grounded in their innermost calling. This is the call for a characterological deepening of human relations in all spheres of life - not just the consulting room but the workplace and corporation.


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