In Freudian psychoanalytic theory, ego defence mechanisms are unconscious processes that we use to diffuse the anxiety that arises when who we really are (our unconscious ‘id’) comes into conflict with who we think we are or who we think we should be (our conscious ‘superego’). For example, at an unconscious level a man may find himself attracted to another man, but at a conscious level he may find this attraction completely unacceptable. To diffuse the anxiety that arises from this conflict, he may use one or several of a number of defence mechanisms. For example, (1) he may refuse to admit to himself that he is attracted to this man. Or (2) he may superficially adopt ideas and behaviours that are diametrically opposed to the fact that he is attracted to this man, for example, go out for several pints with the lads, speak in a gruff voice, and bang his fists on the counter. Or (3) he may transfer or ‘project’ his attraction onto somebody else and then berate him for being ‘gay’ (young children can teach us much through utterances such as ‘mirror, mirror’ and ‘what you say is what you are’). In each case, he has used one of three common ego defence mechanisms which are, respectively, denial, reaction formation, and projection. A broad range of such ego defence mechanisms are recognised, and the combination in which we use them reflects our personality. Whilst we cannot escape using ego defence mechanisms, we can gain some insight into how they are used and of how we use them. This self-knowledge enables us to better understand what is happening to us and around us, and, quite simply, to make the best of it.
Epicurus of Samos, who flourished not long after Aristotle died, founded a school of philosophy that convened at his home and garden in Athens and that dedicated itself to attaining happiness through the exercise of reason and the application of rational principles. According to Epicurus, reason teaches that pleasure is good and that pain is bad, and that pleasure and pain are the ultimate measures of good and bad. This has often been misconstrued as a call for rampant hedonism, rather than the absence of pain and tranquillity of mind that Epicurus actually intended. Indeed, Epicurus explicitly warned against overindulgence, because overindulgence so often leads to pain.
Epicurus wrote prolifically, but the early Christians thought of him as especially ungodly among the ancient philosophers, and almost none of his works survived their disapprobation. Epicurus held that the gods exist, but that they have absolutely no concern for, or even awareness of, humankind. Indeed, for them to get involved in the menial matters of men would be to perturb the supreme happiness and tranquillity that characterises and even defines them. Human beings should seek to emulate the gods in their supreme happiness and tranquillity, but they need not to fear them.
Neither need they to fear death, this for two principal reasons. (1) The mind of a person is a part of his body, and, just like other parts of his body (and everything else in the universe), it consists of atoms. The death of the person entails the death of both his body and his mind and the dispersion of their atoms. As there is no longer any person to be troubled, death cannot trouble the person after he is dead. And if death cannot trouble the person after he is dead, then nor should it trouble him while he is alive (this is the famous ‘no subject of harm argument’). (2) The eternity that comes before a person’s birth is not regarded as an evil. Therefore, nor should the eternity that comes after his death (this is the famous ‘symmetry argument’).
Epicurus himself died at the age of 72 from renal colic (kidney stones), which is associated with one of the sharpest and most intense of all bodily pains. On the last day of his life, he penned this remarkable letter to his friend and follower Idomeneus, which is nothing if not a testament to the overriding powers of philosophy.
I have written this letter to you on a happy day to me, which is also the last day of my life. For I have been attacked by a painful inability to urinate, and also dysentery, so violent that nothing can be added to the violence of my sufferings. But the cheerfulness of my mind, which comes from the recollection of all my philosophical contemplation, counterbalances all these afflictions. And I beg you to take care of the children of Metrodorus, in a manner worthy of the devotion shown by the young man to me, and to philosophy.
Epicurus agrees with Aristotle that happiness is an end-in-itself and the highest good of human living. However, he identifies happiness with the pursuit of pleasure and the avoidance of pain rather than with the pure exercise of reason. Pleasure is the highest good, and anything else that is good is so only by virtue of the immediate or deferred pleasure that it can procure. The behaviour of infants confirms that human beings instinctively pursue pleasure and that all of their actions, including those that may be construed as being either virtuous or altruistic, are ultimately aimed at obtaining pleasure for themselves. Just as human beings can immediately feel that something is hot or cold, colourful or dull, so they can immediately feel that something is pleasurable or painful. However, not everything that is pleasurable should be pursued, and not everything that is painful should be avoided. Instead, a kind of hedonistic calculus should be applied to determine which things are most likely to result in the greatest pleasure over time, and it is above all this hedonistic calculus that people seem unable to handle.
To help them a bit, Epicurus proceeds to distinguish between two different types of pleasure, ‘moving pleasures’ and ‘static pleasures’. Moving pleasures involve the satisfying of a desire, for example, eating a meal when hungry. Static pleasures on the other hand involve the state of having had a desire satisfied, for example, feeling sated after eating a meal. Static pleasures, says Epicurus, are better than moving pleasures because they free us from the pain of need or want. Epicurus also distinguishes between physical and mental pleasures and pains, and argues that anxiety about the future, especially fear of the gods and fear of death, are the greatest obstructions to happiness. To attain a state of perfect mental tranquillity or ataraxia, a person needs to avoid anxiety, which he can do by learning to trust in the future.
Pleasure often arises from the satisfaction of desire and pain from its frustration. Thus, any desire should either be satisfied to yield pleasure or eliminated to avoid pain, and, overall, it is elimination that should be preferred. There are, Epicurus says, three types of desires, (1) natural and necessary desires such as those for food and shelter which are difficult to eliminate but naturally limited and both easy and highly pleasurable to satisfy, (2) natural but non-necessary desires such as those for luxury food and accommodation, and (3) vain desires such as those for fame, power, or wealth which are inculcated by society and which are not naturally limited and neither easy nor highly pleasurable to satisfy. Natural and necessary desires should be satisfied, natural but non-necessary desires can be satisfied but should not be depended upon, and vain desires should be entirely eliminated. By following this prescription for the selective elimination of desires, a person can minimise the pain and anxiety of harbouring unfulfilled desires, and thereby bring himself as close as possible to ataraxia. Given the prime importance that he attaches to the avoidance of pain, the elimination of desire, and peace of mind, Epicurus is far more of a ‘tranquillist’ than a hedonist. ‘If thou wilt make a man happy’, he says, ‘add not unto his riches but take away from his desires.’
If I take death into my life, acknowledge it, and face it squarely, I will free myself from the anxiety of death and the pettiness of life – and only then will I be free to become myself.
– Martin Heidegger
In his influential paper of 1970, tersely entitled Death, the philosopher Thomas Nagel asks the question: if death is the permanent end of our existence, is it an evil? Either it is an evil because it deprives us of life, or it is a mere blank because there is no subject left to experience the loss. Thus, if death is an evil, this is not in virtue of any positive attributes that it has, but in virtue of what it deprives us from, namely, life. For Nagel, the bare experience of life is intrinsically valuable, regardless of the balance of its good and bad elements.
The longer one is alive, the more one ‘accumulates’ life. In contrast, death cannot be accumulated – it is not, as Nagel puts it, ‘an evil of which Shakespeare has so far received a larger portion than Proust’. Most people would not consider the temporary suspension of life as an evil, nor would they regard the long period of time before they were born as an evil. Therefore, if death is an evil, this is not because it involves a period of non-existence, but because it deprives us of life.
Nagel raises three objections to this view, but only so as to counter them later on. First, it is doubtful whether anything can be an evil unless it actually causes displeasure. Second, in the case of death, there does not appear to be a subject to suffer an evil. As long as a person exists, he has not yet died, and once he has died, he no longer exists. Thus, there seems to be no time at which the evil of death might occur. Third, if most people would not regard the long period before they were born as an evil, then why should they regard the period after they are dead any differently?
Nagel counters these three objections by arguing that the good or evil that befalls a person depends on his history and possibilities rather than on his momentary state, and thus that he can suffer an evil even if he is not here to experience it. For example, if an intelligent person receives a head injury that reduces his mental state to that of a contented infant, this should be considered a serious ill even if the person himself (in his current state) is unable to comprehend it. In other words, if the three objections are invalid, it is essentially because they ignore the direction of time. Even though a person cannot survive his death, he can still suffer an evil; and even though he does not exist during the time before his birth or during the time after his death, the time after his death is time of which he has been deprived, time in which he could have continued to enjoy the good of living.
The question remains as to whether the non-realisation of further life is an absolute evil, or whether this depends on what can naturally be hoped for: the death of Keats at 24 is commonly regarded as tragic, but that of Tolstoy at 82 is not. ‘The trouble,’ says Nagel, ‘is that life familiarises us with the goods of which death deprives us … Death, no matter how inevitable, is an abrupt cancellation of indefinitely extensive goods.’
Given the sheer pain of this conclusion, it is hardly surprising that philosophers throughout the ages have sought, more or less unsuccessfully, to undermine it. Death not only deprives us of life, but also compels us to spend the life that it deprives us from in the mostly unconscious fear of this deprivation. And it is precisely this unconscious fear that holds us back from exercising choice and freedom. In short, death is an evil not only because it deprives us of life, but also because it mars whatever little life we do have. While we may be able to somewhat postpone our death, there is absolutely nothing that we can do to prevent it altogether. In the words of the ancient philosopher Epicurus, ‘It is possible to provide security against other ills, but as far as death is concerned, we men live in a city without walls.’ All that we can do is to come to terms with death in the hope of preventing it from preventing us from making the most of our life.
Doctors often tell people starting on an SSRI such as fluoxetine or paroxetine that they have a 55-70% chance of responding to their medication. However, a recent paper by Turner et al in the New England Journal of Medicine (358(3), 252-260) suggested that the effectiveness of SSRIs is greatly exaggerated as a result of a bias in the publication of research studies. Of 74 studies registered with the United States Food and Drug Administration (FDA), 37 of 38 studies with positive results were published in academic journals. In contrast, only 14 of 36 studies with negative results were published in academic journals, and 11 of these were published in such a way as to convey a positive outcome. Thus, whilst 94% of published studies conveyed a positive outcome, only 51% of all studies (published and unpublished) actually demonstrated one.
Another paper by Kirsch et al in Public Library of Science Medicine combined 35 studies submitted to the FDA before the licensing of four antidepressants, including the SSRIs fluoxetine and paroxetine. The authors of the study found that, whilst the antidepressants performed better than a placebo, the effect size was very small for all but very severe cases of depression. Furthermore, the authors attributed this increased effect size in very severe cases of depression not to an increase in the effect of the antidepressants, but to a decrease in their placebo effect.
If, as these studies suggest, the efficacy of SSRIs has been greatly exaggerated, their cost-benefit urgently needs to be re-evaluated. In any case, there can be little doubt that at least some of the benefit of an antidepressant is attributable to its placebo effect.
Some self-proclaimed authorities will tell you all there is to know about chicken soup for the soul, but I would rather tell you how to make it. It’s a great dish, and this for several reasons: healthy, comforting, and ever so delicious. Although the recipe could not be more simple, its execution does require a modicum of that proverbial je-ne-sais-quoi that so many souls could be doing with a little bit more of. I can only hope that yours is not one of them. A soup should not be a bunch of ingredients floating around in a dilute liquid, but a subtle, balanced, and concentrated infusion of those ingredients. To get there, you need to simmer over a small heat and a long time. You are aiming for nothing less than the holy trinity of chicken soup: a bright golden colour, a marbled patina, and – last but not least – for the steaming flesh to fall off the bone and melt in the mouth. You can wash it down with a glass of meursault or any other quality chardonnay that has been suffused in buttery French oak. Go to The Oxford Wine Blog for a close to perfect match which, at £9.50 ($14.80) a bottle, represents excellent value for money. Ingredients for 2 people – The best chicken thighs and/or drumsticks that you can find: organic, free-range, corn fed. Four pieces. – Two or three leeks, finely sliced. – A little bit of celery and carrot, finely diced (optional). – A home-made bouquet garni consisting of a small handful of parsley, a few sprigs of thyme, and four or five bay leaves, all tied together in a bundle. – Chicken stock, not the cubes. 1.5 litres. – A knob of butter. – A few pinches of sea salt and freshly ground black pepper. Instructions – Melt the butter in the pan and brown the chicken until the skin is a rich golden colour. – Add the leek and any other vegetables. – Add the stock and top up with some water if need be. – Add the bouquet garni. – Add some salt and pepper. Don’t overdo it. – Simmer under a lid for about one hour. – Discard the bouquet garni. – Adjust the salt and pepper. – Decorate with some parsley – or not. – Serve with bread and wine. You can improve the soup by letting it sit overnight or by letting it simmer for longer, but, just as with ‘the good enough mother’, there is such a thing as ‘the good enough chicken soup’. For more on the good enough mother, see my good enough friend’s blog article, Learning to be good enough. Bon appétit!
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