Nothing that is Human is foreign.

This is an old therapist saying.

 Terence was on the money.

The therapeutic community is on the money for claiming it.

Now several years ago it came up in a discussion with a colleague and he pointed out how unfortunate it was that so many in the community only give it lip service.

I can certainly say that is so often true in my experience in medicine.

I often say that I am quite sure that I would not be alive today without the understanding of the material I came across 13 years ago which gives me a clear understanding of why even healers give only lip service to Terence's saying. To go to the extreme why one of Osama Bin Laden’s lieutenants can be a physician? Or why even a colleague of mine, that supposedly understands seemingly the same material, can refer to young girls that are caught humiliating a classmate on video as less than human? 

To be clear about what Terence is saying it is this, the therapist should not be surprised by any human act, and I take it to mean that we should treat all comers. Jeffery Dahmer was a human being, he is not, not human, no matter how greatly he “disgusts” us. He is not “foreign.” Of course, Terence knew nothing of “therapists” having lived c. 3 BC to 65 AD and it is therefore all the more remarkable the statement.

The answer as to why we give lip service to his statement is simple, human beings know squat about their emotions and thus often mostly miss the mark about what is causing behavior no matter how bizarre. 

We are humans living in what Western humans call the twentieth century at the end of only a few hundred years of using what we call a scientific method that has been looking at our species. Then add to that the man that saw us as we are only lived 150 years ago. That man was Charles Darwin. Darwin knew a lot and knew a lot about emotion but not many others did then or now.

We had to wait a while to advance. It was not until the 1950s and 1960s that Silvan Tomkins picked up where Darwin left off and started to tell us about ourselves. It was then people could start to understand why humans talked so clearly out of both sides of their mouths; could talk of accepting all comers but in practice always discriminate.

Tomkins taught us about how our emotions were seated in our bodies and biology. How we felt things. How we tingled with excitement, shuddered with shame, and were seized with fear. Stuff we all knew anyway but seemingly needed to be told.

But we did not know about shame being so ever-present in our lives and how it could be commingled with fear to terrorize us into being seized with guilt. Nor did we have, nor do we have, much understanding of how our sense of taste and smell can be bastardized as children, to again, enslave us socially and sexually so that we are forever handicapped to exclude people, places, or things from our lives for no articulate reason other than “I don’t like that?” “That disgusts me.” “That is contemptible.” “I never liked that.” “I feel uncomfortable around those types of people.” “I wouldn't see those people in my practice.” “I'm not one of your junkie patients.” 

Our emotions are not much talked about. We grow up knowing something about Joy(happiness), anger, fear (being scared and a sissy), being sad, and that is about it. Somewhere along the line, we learn to say oh that is “disgusting.”

We are just all ignorant of where it all starts. Where the cultural norms came from? Why do they eat dogs in the Orient and nowhere else? So it is with thousands of likes and dislikes and the basis for cultural norms and laws and canons all coming from the deep human recesses of stored memories linked with unpleasant feelings. If you will “affect”(the bodily potential to feel, just like we have the apparatus to have the potential to feel our heart race or have “goose bumps.”) We have never had the occasion of being introduced to recognizing precise emotions such as disgust, distress, and shame. 

We can chant Terence's wonderful ode to humanity until hell freezes over but unless we have had a pretty special and liberal childhood. An upbringing that has taught us to be open to the world and its people we are going to have a hard time making it through without developing strong dislikes, even hatreds of others through no fault of our own. 

This is going to cause much confusion in our lives especially as professionals as we are going to find ourselves rejecting people and feeling terrible about it, disavowing it, and “acting out” about it. This even despite strong liberalizing experiences in later years that might end in many torturing private moments that end reinforcing our ‘beliefs.” We may be tortured as we simply feel we are “all wrong” but as we still do not understand the confusion we feel we must persist as we always have. We may become even more salt-wort in our actions. 

The most persistent place I see this is in the treatment of the “drug” addict Across medical specialties where there persists great personal dissmell and disgust for the “drug addict.” Now despite emergency medicine being a “specialty” for more than twenty years, they are poorly trained to deal with the phenomena. Or let us say individual doctors are poorly trained and this is the point of the essay in part, individual emotion is brought to the table, is not brought to consciousness, and is carried through and into practice despite exposure to dramatic experience and training. They are our own dissmell and disgust and shame that sabotage our reason. It is as if an invisible hand is pushing against what our better angels know to do. It is still not uncommon to hear reported: “Get out of my fucking ER, you fucking drug addict.” Yes, that is a direct quote of course, by a physician. 

Of course, number one, addiction is a medical problem with treatment options and the patient has many reasons to be there. They are all legitimate despite their drug-seeking lying and manipulation. They are all legitimate as they are all part and parcel of being human and therefore are not foreign to the experience. Everyone that walks into the emergency room, pretty much short of firing a nine millimeter at you, which happens, is your patient. 

It is our job to develop the interest you can in them. It is the doctor's dissmell and disgust and shame that she or he does not know of. Nor do we, in our daily lives, when we reject another human out of hand. So if we are lucky we might stumble across some knowledge of what deeply motivates us. But we should go easy on ourselves, always, as we could not have known about these deep complex emotions and their intertwining until now.

And unfortunately learning about precise emotions and becoming aware does not suddenly make things easy. It seems not to be the whole picture or answer. It can, at times, take years of digging to unravel the tapestry life has woven. Many hours of thinking and practice to undo the program; is very much like rewriting the code to the software. “At the time ‘x’ conditions occur ‘y’ will take place and not ‘z.’” 

We have to truly “get ahead of the curve.” That means understanding that I Brian Lynch truly think and believe that it is worthwhile and beneficial for me to understand what I call my “disgust” in and my “hatred” of all members of the religion of Ordeu and what I find dissmelling in their practice of sucking each other's little fingers is precisely because I feel something based in unpleasant feelings that are based in my past that I am projecting forward on them and not in some “pure” preordained “logic.”

So, we begin to understand that, for the most part, there is a “logic”. A logic of deep seeded culture and individual and group likes and dislikes. 

Brian Lynch