ME/CFS sufferers have felt abandoned for years
There is surely no disease more cruelly misnamed than “chronic fatigue syndrome”. It is mysterious, apparently triggered by viral infection, and can last for months, decades, even a lifetime. Patients can be housebound or even bedbound for years. But the name makes it sound like they are just a little bit tired.
Apart from Covid, it is probably the most controversial disease in the world and, in fact, chronic fatigue, or ME/CFS to give it its proper name, does seem to share many features and symptoms with “long Covid”: fatigue, brain fog, pain on exertion, the assertion that the affliction is purely psychological. And for over three decades, patients have been told that the treatment for it is to get up and do some exercise, even though for many, exercise seemed to actively make their condition worse. They have been told, in near-explicit terms, that it’s their responsibility to get better.
Recently, it looked as though that was going to change. The NHS guidelines for treatment were going to be updated, and patient groups were happy. But then, at the last minute, that was delayed, and many patients are feeling betrayed and furious. One man I spoke to, John Peters, has been in its grip for 35 years.
For John, formerly “the fittest man in his rugby team”, the main symptoms were cognitive. He struggled to remember things, or recognise faces. He walked past his own sister in the street; he once enthusiastically shook the hand of a stranger, thinking he was his cousin. But there was also psychic pain: an “electric storm in my head”. He’d get up at 1pm and go to bed at 10pm but not sleep, just have hallucinatory fever-dream “white nights” and be in tears at 6am begging for sleep to come.
John’s case is typical of many. The disease onset is often linked to a viral infection: patients recover from that, but then something goes wrong. Some recover in a few months. Others never do. And no one knows what causes it.
Hence the excitement last week about the National Institute for Health and Care Excellence (NICE) new guidelines for treatment. And hence the rage when the publication was delayed.
All those many patients — between 130,000 and 260,000 at the last count — who have felt ignored and belittled, or that they were being blamed for their own failure to recover, thought that, at last, their concerns were being taken seriously. Now that it has been kicked into the long grass, they are furious.
To understand the rage, it’s useful to understand the trouble with the currently disputed NHS-approved method for treating ME/CFS: a combination of cognitive behavioural therapy, CBT, and “graded exercise therapy”, GET. The approach is based on a theoretical model of how the disease works called the “biopsychosocial model”.
The basic idea is, first: someone gets ill with some virus. A cold, the flu, whatever. While they have that virus, they become deconditioned. So when they next try to do their normal level of exercise, it hurts, and they feel exhausted. The patients attribute that to the disease, and stop doing exercise. So they become even more deconditioned, and so the next time they try exercise, it becomes even more painful and exhausting. It becomes a positive feedback loop – the pain prevents the exercise, and the lack of exercise increases the pain.
This model was first really applied to ME/CFS in a 1989 paper: it represents, according to the authors, “a transfer of responsibility from the doctor, in terms of his duty to diagnose, to the patient, confirming his or her duty to participate in the process of rehabilitation”. Understandably enough, patients took this to mean that getting better is their responsibility, and if they don’t it’s because they haven’t worked hard enough.
The associated treatment involves a steady (“graded”) increase in exercise, and “cognitive work to break the association between increase in symptoms and stopping or avoiding the activity”.
Again: to many patients, this very much sounded like being told that their condition was their own fault. Your beliefs that you are ill are in fact causing you to be ill. And it didn’t match with their experience of the disease, and specifically something called “post-exertional malaise” – that is, huge flare-ups of the condition caused by exercise.
But it doesn’t matter whether patients didn’t like this model. What matters is whether it is a useful one, and whether the CBT/GET treatment works.
When the 1989 paper was written, there was no evidence for the model; it was purely hypothetical. In 2011, though, that seemed to change. The PACE trial looked at CBT/GET treatment for ME/CFS. It gave about 600 patients either normal medical care, or normal medical care plus CBT/GET. Then it asked those patients to fill out forms reporting how fatigued they felt and how well they were able to function physically. People who had had CBT/GET reported greater improvement than the ones who had only had standard medical care.
But patients’ groups were unimpressed with the study, and so were some other researchers. Jonathan Edwards, a professor emeritus of connective tissue medicine at UCL who has been a critic of PACE since its publication, told me that the problem is that PACE is unblinded, and uses subjective outcomes.
In the best research, subjects are “blinded”: they don’t know whether they’re getting the real treatment or a placebo. It stops the trial being biased by patient expectations. But sometimes you can’t do that, so it’s important to use an objective outcome. For instance, if you’re measuring the impact of a drug on your blood potassium levels, then it might not matter if the trial isn’t blinded, because patients’ expectations probably won’t affect their blood potassium. But you need to do one or other, either blinding or objective measures (and ideally both).
The PACE trial, though, took a subjective outcome – patients’ self-reported physical activity and fatigue – and an unblinded population, and so was at risk of patients simply telling researchers what they obviously wanted to hear.
You absolutely can get quite large effects like this, says Edwards. He refers in his evidence to NICE to a study into a drug, rituximab, in treating ME/CFS. It found an apparently strong effect – but it, too, was unblinded and subjective. And a follow-up study, with rigorous blinding, found nothing. It didn’t work any better than placebo.
Over the last four years, NICE has been reassessing the evidence, partly as a result of patient pressure. They looked at the PACE trial and several other more recent ones into CBT/GET. For both elements – the CBT and the GET – the experts who looked at it concluded that the evidence “ranged from low to very low quality”, mainly for the reasons described above.
That assessment was made public as part of a set of draft guidelines published in December last year. The new guidelines said that clinicians should no longer offer ME/CFS patients “any programme based on fixed incremental increases in physical activity or exercise, for example graded exercise therapy” and to only offer CBT as support for managing their symptoms, not to offer it as a treatment for ME/CFS itself.
Then, the day before the final guidelines were to be published last week, came the announcement that they were to be delayed. Clinical bodies, including the Royal College of Paediatrics and Child Health (RCPCH) and the Royal College of Physicians (RCP), put out statements welcoming the pause.
But no one seems to want to say why. For instance, Trudie Chalder, one of the authors of the original 1989 paper, gave a quote welcoming the delay because the new guidelines were “confused”. But when I asked her about it, she said she couldn’t comment until the new guidelines were published, which was odd, since she already had. “I can’t be more specific at this time,” she said when I followed up. “I think it’s better to wait until we see the final guidelines.” NICE themselves wouldn’t talk to me except to point me to their statement.
The RCPCH didn’t want to say anything except that they hope “our evidence and other people’s will be made public in good time”.
The only hint of what has gone on seems to come from Dr Andrew Goddard of the RCP, who said “We were extremely concerned that the final guidelines proposed by NICE may not have taken into consideration the extensive comments we made to the draft version.” It seems likely that NICE has delayed its publication because, basically, clinicians’ groups were angry that their preferred method of treatment has been dropped.
This isn’t how NICE is supposed to operate. NICE is supposed to take into account the clinicians’ submissions, of course, but not to be beholden to them. Chris Ponting, a professor of human genetics at Edinburgh University, told me that “The NICE panel was put together from all walks of life; highly respected individuals esteemed in their individual areas. They thought that all of the evidence [for CBT/GET] was of low or very low quality.”
“I’ve seen on social media that this is a political process because there is a veto given to certain groups,” Ponting added. “I really hope that these claims are wrong, and that these guidelines are published without any further delay. If NICE are bending to some professional lobby now, would they also bend to pharma companies?”
I am genuinely confused by this: NICE has, since its founding, been one of the best things about the British healthcare system. It has been scrupulous at establishing which treatments are cost-effective and which are not, often in the face of severe public and media pressure. So it’s really important to find out what’s happened here: the full publication of the guidelines, and of all the submitted evidence, would be a good starting point.
Researchers have defended the PACE trial by saying that it is difficult to do good blinding and use objective measures in things like ME/CFS. And the infectious disease physician Andrew Miller, in defence of the treatment, says that “without CBT and GET, there is nothing. No new therapies or approaches have emerged since 2007 [when the current guidelines were established].”
But the fact that it’s hard to get good evidence doesn’t make the evidence you have better. And the fact that there aren’t well-evidenced therapies doesn’t make the therapy you have better-evidenced. Science isn’t graded on a curve: “If results are unreliable, they cannot be considered reliable just because it is difficult to get more reliable ones,” as Edwards put it in his evidence to NICE (his emphasis).
Meanwhile, a fraught area of medicine gets even more toxic. When I last wrote about ME/CFS, in 2017, one researcher told me that “The last time I said anything public about CFS, I got followed around by an angry mob for about a year, on Twitter and email. Some even turned up to talks I gave, and I’ve heard of them turning up to people’s houses or doxxing them.” The author of a study in that piece said she had received death threats. Another researcher, who I know personally to be pretty fearless, told me when I tried to speak to them for this piece: “I’m afraid I don’t go within a million miles of ME/CFS these days. Just too much grief.” ME/CFS patients have a reputation for being angry.
Partly I think that’s caused by the sheer number of patients – approaching a quarter of a million in the UK alone. With that number of people, it only takes a tiny percentage to contaminate the whole debate. But it’s also because those people have felt ignored for so long.
Often the argument between sufferers and observers descends into a poisonous row over whether ME/CFS is “psychological” or “physical”. But patients like John are keen to stress that that shouldn’t be the area of contention. What’s important is that the CBT/GET paradigm doesn’t seem to work, at least beyond a placebo effect in a subset of patients. The evidence has been assessed and found wanting and the delay in publishing the guidelines just means that more patients will be put through it, against what appears to be the best scientific evidence.
So NICE must swiftly publish their new guidelines along with all the evidence from the patients’ groups and professional bodies attached. They should explain this delay, beyond the boilerplate statement, because as it stands it looks awfully like its decision-making process has subverted. And, they should trigger some more real research into the causes and nature of the disease. Perhaps the rise of long Covid will help encourage that. Otherwise more lives will be lived in a cruel twilight, like John’s, 35 years after diagnosis: “I’m 60 now. I have nothing, I have no one. I have no memories; my life is unlived.”
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SubscribeThe only right, proper and great thinking for the mind, is to ask what is ‘thought’. Is it a ‘subject or is it an ‘object’. Can it be studied when itself is the subject studying itself as an object?
I’d still position Alain Badiou and Jordan Peterson as the key thinkers of the Left and Right over the past 20 years.
Some might rightly mention Sloterdijk, and I would say that Zizek has been invaluable in bringing Lacan’s thought back into the culture in lieu of the Anglo academy’s rather toxic obsession with Deleuze and Guattari since the 1990s (they being another prop for the Judith Butler post-structuralist complex).
Ultimately only a handful of people are able to be true philosophers, because it is a destabilizing and mind altering endeavor.
Many more would be much better suited to following ideas rather than leading, not entering in any such dangerous intellectual exercise at all… much better for them to conquer intuitively, if at all, than to enter the intellectual labyrinth and ruin themselves.
As Nietzsche said: “Beware that, when fighting monsters, you yourself do not become a monster. For when you gaze long into the abyss. The abyss gazes also into you.”
Immortal Souls – Ed Feser. The evidence
https://www.amazon.com/Immortal-Souls-Treatise-Human-Nature/dp/386838605X/ref=monarch_sidesheet_title
As philosopher Ed Feser has shown, we in the west have literally lost our minds since Ockham’s absurd nominalism, Hume’s self refuting “fork” ideology, Kant’s incoherent antirealism, Descartes’ forgetting about that of which he thought and the train crash of disconnected postmodernism. The answer, preposterous as it might seem to claim in this wasteland, is in Final Causality and the realistic metaphysical foundation of Thomism. Sanity. Final Cause is the ultimate shaper of all reality; God.. all is moved by love. We are definable by the ends we seek. https://www.amazon.com/Thomass-Aristotelian-Philosophy-Nature-Obsolete/dp/1587314320
Well… he hasn’t “shown” anything; rather, he’s put forward an argument that we can either agree or disagree with, in part or in whole.
Reading this article made me wish that, hope that, Agnes Callard would write a piece for UnHerd on Fernando Pessoa’s very interesting (philosophical, anti-philosophical?) work The Book of Disquiet. (A brother can dream.)
I read TMWQ 50 years ago and it had a similar effect on me as listening to Like a Rolling Stone by Bob Dylan around the same time –
Neither author tries to offer a solution, or even a signpost, but the effect was to inspire me on the path to “relentless” discovery, honesty, self-knowledge and the realisation that the answers to the questions Musil & Dylan pose lie not in more “thinking” but in the realm of the heart, where experience and observation go much deeper than words and concepts. Dylan’s challenge had me travelling through 30 countries over the following years, but it was only later that I was fortunate enough to learn that the journey / challenge is actually more about undoing and realising what a wonderful life we ‘simply’ have, than embracing some convoluted (or even ‘sublime’) philosophical “truth”. As Socrates has it, “Know thyself” .
Nicely put. Though Dylan might be allergic to the very idea an encapsulated Life’s Philosophy, I’d guess he does have a sense of mission and purpose, and with some kind of through-line, though changing shape over the decades. To communicate that sense of questing, maybe, and to call out beauty and bravery as well as injustice, suffering, and sorrow. And to make much of it sound good—though many have disputed that. In Dylan’s body work, the emphasis is toward the grim and sorrowful, but with many notes of mercy and gladness (more so during some decades than others). The fact that he remains quite silent about his own inner motivations and even seems pretty uninterested in exploring them is part of his mystique, and legacy. But he doesn’t seem like a mere leaf blowin’ in the wind.
It takes different breeds of seekers to help feed the hungry spirit of the world—or somethin’ fancy like that. If nothing else, Dylan is clearly a noteworthy original of lasting impact.
What about those philosophers who believe that have found the answer to how people should live? Here’s a few: Marx, Lenin, Mao, Stalin, Pol Pot etc.
Better hope that you never find the answer!
All the best books do teach you how to live. This is one to avoid it seems.
There’s philosophy and being philosophical. You can peer at a drop of water in a cloud but it has condensed from the gas of water vapour and is about to fall earthwards. To do this one needs to be close up. A medium sized cumulus weighs 200 tonnes, one needs to be miles back from it to appreciate its majesty, its weight is counter intuitive but a small aircraft can fly through it barely impeded. Best avoided, big brother cumulo nimbus has a fearsome engine raging inside it
A big cloud looks as if it is heading somewhere, has a purpose. It has, it’s heading to where conditions are suitable to redistribute the world’s water. No volition beyond the prevailing wind ‘seeking’ to balance air pressure. It’s part of an auto balancing system but what did the primitives think before science appeared?
A primitive, a child even, will know clouds rain but not that they are completely made up of water. With experience the child grows and expands its purview.
The point? Learn to fly something. You’ll have something new to consider beyond the skill and the machine itself. Look out of a passenger aircraft window and smile at people who say we’re overcrowded. Ponder the narrow minded. Become philosophical over their philosophy, or lack of.
One of your primitives who predates our science is Aristotle. He said the cloud has a purpose, to provide rain.
He wouldn’t have agreed with your idea that its purpose is to redistribute the world’s water. That is not a purpose for him, nor for me as far as I can understand it, and so is not true. It is, using Aristotle’s ‘primitive’ terminology, purely incidental, and to him, of no account.
Therein lies your philosophy. You live in the desert and dismiss, begrudge others’ clouds. You miss the point. I dare say you now know more about clouds than before. Look up today, a huge cloud over your head, all you see. There’s still a stratosphere and more above. Both you and Aristotle don’t see the wood for the trees. A shame with centuries between you.
I am making the point that Aristotle sees further than you, and had the terminology to criticise and correct what you said.
I have a family member who is like this character. He collects trivia about far distant stars and arcane mathematical equations, but never researches the dangers of Diabetes 2. I once casually quoted to him a stanza from Bob Dylan’s Tombstone Blues, which I think makes the same point as the essayist, and he was highly offended:
Now I wish I could write you a melody so plain
That could hold you dear lady from going insane
That could ease you and cool you and cease the pain
Of your useless and pointless knowledge
Living only in the mind breeds impotence. Your heart or gutfeel can give your life direction and then one should commit oneself to act on this. That gives experiential knowledge, the only true knowledge. The rest is mental masturbation.
Thank you for explaining to me why I find Robert Musil unreadable
That’s funny. I gave up halfway through the article. I had no idea who Musil was and now I’m not at all interested in finding out.
…..
It could be a variant of „the dependence effect” you mentioned another time: by giving information about Robert Musil’s book, you create the need to read it.
Don’t mean to be intentionally cruel but this is pretentious twaddle. “All that can be said can be said clearly.” Where’s Wittgenstein when you need him.
The Tractacus is unreadable.
Wittgenstein might reasonably ask: What do you mean by that?
A classic example of why I dislike philosophy – the idea that you will be able to understand everything if you just think hard enough. Reality is much more complex than that.
It is also self indulgent; you can’t think much about these things if you’re up at six to get to work
Golly. If only someone had thought to make a distinction between the active and contemplative lives, and to observe the value of leisure and contemplation for any human life that aspires to be anything but merely slavish.
Agreed.
Even the very concept of truth is a bit ridiculous. In many, if not most, areas of inquiry there simply is no possibility of landing on a singular, undeniable truth. The complexity is what makes our world so interesting.
For instance, what is the meaning behind the name “Boxing Day”? I’ve already seen three different explanations in my email today. So, this question, which first occurred to me fifty years ago, is still up for debate.
Note: It’s likely that the first uses were a) oral, not written and b) very local. The people involved are long gone. I think.
2+2=4 is pretty straightforward, I think.
Yes, I believe Aristotle tried to drill down to the basic, uncontroversial truths starting with “A=A”.
‘Identity,’ logic’s most fundamental axiom: whatever a thing is (A, B, P, X… whatever), it is whatever it is.
The clue is in most but not all
However, when there are multiple interpretations available for a set of evidence, not all interpretations are equal. It seems to be not that simple to assess which is the best interpretation, one useful tool being Occam’s razor.
Not in BLM land it doesn’t.
Being that I am currently at the Trona Pinacles in California which is on Bureau of Land Management land, your comment took me a second to realize that you’re not commenting on thar BLM land. Hahaha!
Not if you are off the Post Modernist persuasion or you subscribe to the white patriachal approach to maths-its whatever you want it to be-which is great unless you are doing a job that requires mathematical precision!!
That’s axiomatic, rather than the truth.
Are you saying that it’s not true that 2+2=4?
It can be true, assuming the digits are numbers.
If they are strings, ‘2’ + ‘2’ = ’22’
What is true, isn’t true, always. Someone will come up with the same question, but in a different context. But the original will likely still stand.
Anybody capable of reading this understands they are numbers and therefore the concept represented is always true. Only a deliberate misinterpretation would say it is not. If we didn’t all agree and assume such notation represented numbers mathematics would be nigh on impossible. If it was intended to represent a string that would need to be clarified in accordance with the conventions of our common language and one way of doing that is enclosing in quotation marks as demonstrated yourself. ‘2’+’2′ means something completely different than 2+2.
No one told Microsoft (if you’ve ever programmed in VB you have to be very careful )
There is a difference between a simple fact and a complex truth.
Straightforward, but like all analytical truths–things true by definition–not very interesting. According to the conventional meanings arbitrarily assigned to the symbols in the equation, as far as equivalence is concerned ‘2+2’ is just another way of saying ‘4’–or ‘3+1,’ ‘9-5,’ etc. This doesn’t tell us any more than what we already had to know in order to use the symbols correctly in the first place.
Beware of: ‘2’ + ‘2’ = ’22’
(?) It doesn’t follow from our frequent inability to ascertain what’s true that the concept of truth is itself ridiculous. As for ‘complexity,’ this is a comparative term: it would make no sense to situate things on a complexity continuum that didn’t offer both lesser and greater complexity alternatives. Plus if simple things aren’t themselves interesting, at what point in the complexity hierarchy does interest make its appearance, and if there, why not earlier or later?
Surely what your thus far unsuccessful quest for the meaning of ‘Boxing Day’ should turn your attention to isn’t any opacity in the concept of truth but the very nature of explanation itself, and its limitations. If you wonder how an animal knows how to do something despite no other animal having taught it, for example, and someone suggests, “That’s its instinct”–swell! That clears that up! Now you know how and when to use the word ‘instinct’ appropriately in an English sentence; but are you any wiser than before? In fact, you’ve been given a mysterious black box where an explanation should be; and yet, we accept such black boxes as ‘explanations’ all the time. As long as we can stick labels on things, enabling us to tidy them away into the right closet, our desire for order is appeased and we don’t inquire further. Poke around too closely in those closets, though, and the world can suddenly reveal itself to be much less satisfactorily explained than we thought.
Reality is complex because every individual lives his own reality, reality is a mix of family and societal background, genetics, experiences, what you read and learn, culture, interactions with others, religion or lack of, urban or rural ilfe, etc. There are many different realities, that’s why no one agrees on anything.
I respectfully disagree with the notion of many different realities. There are many different perceptions of reality.Yes, reality is complex, and ultimately unknowable, in total, in this incarnation. We perceive reality through the lens of the inputs you described. Consequently, we interpret reality with varying degrees of correctness and incorrectness simultaneously.
What you have described is not philosophy at all. Some sort of pastiche of someone thinking.
PPE (and History) graduates are why we have rampant NET Zero policies.
The art of thinking has withered on the vine in recent decades. Having been surprised at a request to teach critical thinking to PGs, a data search showed no mandatory twaching of this skill in the Russell group, with creative thinking consigned to schools of management entrepreneurship/ innovation modules. Doubtless a focus on certification over education has not helped, but senior academics are now discusslng whether AI jeopardises even this functional outcome and what can be done (central exam halls ar the obvious answer but resisted because of the cost relative to the Covid virtual option – univeersities being a profit maximising racket these days).
We need to start thinking again, to become excellent secondary data researchers, build inductive/deductive skills and enjoy the freedom of our own conclsions. And to do that we have to make the time for reflection. I saw a hopeful shift in last year’s UG cohort, and I hear this years are more Why (is that so) than How (do I get a first).
Your comment is very interesting. In the light of your words I wonder what you think of my (self serving) thoughts.
So, I teach mathematics and statistics at a pre/first year university level and believe that students should be able to do pen and paper calculations. For example, work out the variance by first principles for say five data points. Any big data set, shove it into a calculator.
Am I silly? Is there any value in this?
Not at your level but I’ve had occasion, with younger people, to revisit the lost mysteries of arithmetic. They complained it hurt their heads. I used to ask them what it was like to go to the gym after a long absence. That Maths is the mental gym? Train hard, fight easy stuff.
At school we used log tables, I used to write down the numbers as powers after taking the log, e.g. if the calculation involved taking the log10 of 5.2 I would write down 10^0.716 for that number. Helped me to remember what it meant. I don’t think anyone else did that. Even then most students were just going through the motions.
Not sure how useful this is at University level.
You must be as old as I am. You said:
Not sure how useful this is at University level.
It is of historical and theoretical value for young engineers to known their heritage.
Log tables were useful for engineers before they were elegantly encapsulated in the slide rule. What an absolutely brilliant and elegant mechanical device for advanced mathematical calculations. It took quite a long time for computers to surpass it.
You’re posing at least two questions here: will it have pragmatic value for young peoples careers – the mundane question; or more importantly for me, will it provide them with pleasure and satisfaction throughout their lives like some find in killer sudoku, the Times crossword, learning other languages, or playing with recursive structural equation models in the social sciences. There is incredible value for those who find it thrilling, or even just fun.
I’m long retired from teaching mathematics and statistics, but I still savour them – and intellectual play in general.
Perhaps a cycle is being broken? First requirement is an inspirational teacher, next the inspired who will grow to pass it on.
When I studied Philosophy over 59 years ago I concluded Western Philosophy’s search for truth was doomed to go round in circles and it should be focussed on choice. Since then the choices available to humans have multiplied and their capacity to make them has diminished. It will disappear completely with a reliance on AI in LLMs that mimic the lowest common denominator of the past thoughts of humans. At first aimlessly and then mindlessly.
I read TMWQ twice twenty or thirty years ago, and always understood Ulrich’s intellectual prostration as a metaphor for the teleological vacuum besetting the Austro-Hungarian empire on the eve of its eclipse. (For the record, I was also a decidedly second rate analytical philosopher, and quit academia the day I got my PhD.)
Bravo RC! Humblebrag of the year. Love it!
Hai thang yow!
“also a decidedly second rate analytical philosopher” – ouch!
I thought this was a fascinating piece. Exactly consistent with how the Old Testament describes human nature.
Upvoted, not least because I don’t understand why you received downvotes without a comment to explain what you got wrong.
So does Star Wars
Star Wars is more realistic though
The essay by Agnes Callard managed to explain the difference between a life guided by the pursuit of serious self reflection, a moral code by which one might try to live and a life that was “a machine for the relentless devaluation of life.” In that former mode, one might as Callard notes be frightened of what one might find in such a serious pursuit of meaning, or truth and perhaps simply see the whole activity as overwhelming us. But at far as I can tell, she nonetheless comes down on the side of those brave enough to inquire, to seriously question ourselves, even in the face of arriving at some revolting conclusions–a task for which philosophy is uniquely suited. Musil, for all his interest in different experiences really is aptly described “what happens when ideas are forced to do the work to which they would only be suited if you did not remove any possibility of ever wholly encompassing some subject matter”. All in all, her essay takes dead aim at Musil’s glibness and deeply cynical approach to living. Under the description she offers, Musil is unarmed without philosophy–something he considers uesless. Too bad for him.
The author uses a novel to try to explain something about the human mind, and i can see what she’s getting at.
She invokes two different approaches and tellingly, describes philosophy as “a safe space for the unfettered operation of mind” as opposed to an untethered approach as characterised by Musli. (I’m tempted to call him muesli, as a scattering of all kinds of ingredients.)
So what i find interesting is how the internet is changing the way our consciousness works; or rather, how we allow it to work. The scatter-gun approach with lack of lengthy concentration is an obvious parallel with browsing, allowing a huge number of ideas to flit through our heads.
To cut to the chase, the question is: what should we do with consciousness? It can be both a blessing and a curse, a tool to advance ourselves and our species whilst also creating a void to be filled with potential harm and falsehood. When young, many find themselves becoming captured by ideology as a means to fill that void (see yesterday’s essay by Mary Harrington) until the realities of life intrude. Some never escape that trap (see any essay by Terry Eagleton).
It just feels like something vital is changing. We’re becoming far more aware of these issues than hitherto, as both the intellectual space freed up by mechanisation and the pace of life expands, whilst our output into – and receptivity to – the internet creates an externalisation for us all, a kind of universal consciousness, along the lines envisaged by Teilhard de Chardin, or perhaps a less holistic way.
Perhaps philosophy provides “a safe space for the unfettered operation of mind” – but there are many philosophies, religions and political systems of thought competing for attention. Strangely none of them converge on a single truth, possibly because there will always be people motivated to break any emerging consensus for all sorts of ‘reasons’.
Thank you, but do not all things in fact converge on a single truth? Is it not love in its unlimited expressions, in its eternal and universal utility?
Doubling Down, continually, is a limited version of ‘unlimited expressions’, and even that ends in unintended consequences, which disrupts any Eternal, Universal Utility.