Anthony Storr - Solitude

Many Greek villagers subscribe to what can be called an indigenous theory of catharsis. They recognize that in spite of the desirability of immersing oneself fully in the emotions of pain, grief, and sorrow, the ultimate goal of a woman in mourning is to rid herself of these emotions through their repeated expression. 2

The end of mourning, the final acceptance of death, takes place after the body is exhumed. The bones of the dead person are then collected, placed in a metal box, and join the bones of other villagers in the local ossuary.

A new social reality is constructed which enables the bereaved to inhabit more fully a world in which the deceased plays no part … This process is brought about through a gradual reduction in the intensity of the emotions associated with death, through the formation of new social relationships with new significant others, and through the constant confrontation with the objective facts of death, climaxing in the exhumation of the bones of the deceased. The result of this process is as complete an acceptance of the final and irreversible nature of death as is possible. 3

Following bereavement, orthodox Jews are expected to stay at home, apart from a daily visit to the synagogue, whilst others feed and care for them. Although Murray Parkes casts some doubt upon how effective Jewish customs may be in some families, my own limited experience suggests that partial segregation of the mourner and the prohibition of normal working activities is beneficial. Coming to terms with loss is a difficult, painful, and largely solitary process which may be delayed rather than aided by distractions. Any rituals which underline the fact that bereavement is a profoundly traumatic event are helpful. In Great Britain today, religion is in decline, and there are few guidelines to indicate what is expected of mourners. When conventional periods of mourning were decreed, and the state of the mourner proclaimed by the adoption of black clothes, it was probably easier for the bereaved person to make the adjustment needed.

Although the support and sympathy of relatives and friends is helpful to bereaved persons, coming to terms with the loss of a loved person who was very close to one can only partially be shared. The process is essentially private, because it is so much concerned with intimacies which were not, and could not be, shared with others when the deceased partner was alive. The work of mourning is, by its very nature, something which takes place in the watches of the night and in the solitary recesses of the individual mind.

Mourning is one example of a long drawn out mental process leading to an eventual change of attitude. Instead of regarding life as necessarily bound up with, or even constituted by, the existence of an intimate relationship with the deceased person, the mourner comes to see matters differently. The mourner may or may not form new, intimate ties; but whether he or she does so or not, the mourner usually comes to realize that the significance of life is not entirely constituted by personal relationships; that the life of a person without intimate relationships also has meaning.

Changes of attitude take time because our ways of thinking about life and ourselves so easily become habitual. In the early days of psycho-analysis, analysts were reluctant to take on patients who were in their fifties or older, because it was thought that the possibility of bringing about changes in attitude were slender. In subsequent years, it has been realized that even elderly people are capable of change and innovation. Some people find it hard to adapt to any kind of change in circumstances; but this rigidity is more a characteristic of the obsessional personality than it is of being old.

Whether in young or old, changes of attitude are facilitated by solitude and often by change of environment as well. This is because habitual attitudes and behaviour often receive reinforcement from external circumstances. To take a trivial example, anyone who has attempted to give up smoking comes to realize that the wish for a cigarette often depends upon cues from the environment which recur at intervals. Finishing a meal; sitting down to work at a familiar desk; reaching for a drink after work is over – such trivial reinforcing stimuli are well known to everyone who has struggled with the habit. This is why many people find it easier to give up smoking when they go on holiday. In an unfamiliar place, where one no longer does the same thing at the same time each day, cues from the environment either disappear or lose some of their significance.

Holidays arc escapes from the routine of ordinary day-to-day existence. When we feel in need of a holiday, we often refer to needing ‘a change’. Holidays and the capacity to change march hand in hand. The word ‘retreat’ carries similar overtones of meaning. Although retreat in the face of the enemy may precede defeat, it does not necessarily do so: reculer pour mieux sauter applies to a variety of mental and physical manoeuvres including sleep, rest, and recreation. The word ‘retreat’ itself may be used to indicate a period of time, and by extension a place, which is especially designed for religious meditation and quiet worship. The Retreat was the name given to one of the most famous British mental hospitals, founded in 1792 and still flourishing, in which the pioneer Samuel Tuke instituted a regime of tolerance, kindness, and minimum restraint By providing a safe ‘asylum’ from the harassments of the world, it was hoped that salutary change in the disturbed minds of the mentally ill would come about.

This, too, was the concept underlying the ‘rest cure’ for mental disturbances promoted by Silas Weir Mitchell, an American neurologist who practised during the latter part of the nineteenth century. Its twentieth-century successor was ‘continuous narcosis’, a technique of keeping patients asleep by means of drugs for twenty or more hours out of the twenty-four. As we have seen, drugs, by inhibiting REM sleep, tend to prevent sleep from knitting up ‘the ravell’d sleave of care’ as effectively as it does unaided, which may be one reason why this treatment is no longer in use.

Both the ‘rest cure’ and continuous narcosis involved removal from relatives and partial isolation. Today, the fact that isolation can be therapeutic is seldom mentioned in textbooks of psychiatry. The emphasis is upon group participation, ‘milieu therapy’, ward meetings, staff-patient interaction, occupational therapy, art therapy, and every other means which can be devised of keeping the mentally ill constantly occupied and in contact with one another as well as with doctors and nurses. In the case of schizophrenic patients, who are too easily inclined to lose contact with the external world altogether, this ceaseless activity is probably beneficial. I am less persuaded of its value in depressed patients; and regret that the average mental hospital can make little provision for those patients who want to be alone and who would benefit from being so.

That solitude promotes insight as well as change has been recognized by great religious leaders, who have usually retreated from the world before returning to it to share what has been revealed to them. Although accounts vary, the enlightenment which finally came to the Buddha whilst he was meditating beneath a tree on the banks of the Nairanjana river is said to have been the culmination of long reflection upon the human condition. Jesus, according to both St Matthew and St Luke, spent forty days in the wilderness undergoing temptation by the devil before returning to proclaim his message of repentance and salvation. Mahomet, during the month of Ramadan, each year withdrew himself from the world to the cave of Hera. St Catherine of Siena spent three years in seclusion in her little room in the Via Benincasa during which she underwent a series of mystical experiences before entering upon an active life of teaching and preaching.