How do Words Heal?

How is “healing” different than “curing?” I like the definition of noted cancer care specialist Michael Lerner: “Curing means to take a disease of a problem away completely. Healing, by contrast, is a movement toward wholeness. Healing can take place physically, mentally, emotionally, and spiritually. Healing can happen both in living and dying.”

What this definition nicely introduces is the distinction between the physiological aspects of illness and health, and their experiential, meaningful aspects. The biomedical model of health tends to deal exclusively with the former, while Western psychological traditions, especially “depth psychology” (psychoanalysis, analytic psychology, and their progeny) focus on the latter. Though there is a long history of medical professionals who work with both aspects, in practice the bifurcation of the field makes for different and often siloed approaches. Yet there are deep connections between the physiological and the meaningful, and it is that connection I want to explore a bit here. What I am specifically interested in is how and why meaning, especially linguistic meaning, plays any role in healing and transformation at all.

In the interest of looking for “full stack” answers to this question, I’m going to move rapidly through a bunch of ideas without giving them full substantiation. Consider this just a sketch of an argument.

Some connections between meaning and physiology in both suffering and healing

It is common knowledge among meditators that attuning to the quality of pain changes its experience. If you pay attention during a long meditation session to the pain slowly developing in your legs, you notice that the feeling comes and goes, turning here into a soft ache and there into more of a warm tingling, at times dissolving entirely. On the other hand, if you try to ignore it, or allow the thought “I am in pain” to dominate your mental state, your experience of pain will be completely different. The knowledge and thought of your own suffering constitutes a type of suffering in and of itself. American meditation teacher Shinzen Young puts the formula this way: “suffering equals pain multiplied by resistance.”

In the same way, suffering is a function of two variables: pain, and the degree to which the pain is being resisted. What do I mean by resistance? Resistance occurs in both the body and the mind, and may be either conscious or unconscious. Conscious resistance in the mind takes the form of judgment, wishes, fearful projections, and so on: "I hate the pain. I can't stand this pain. When is it going to stop?"

As Shinzen makes clear, it’s very hard to experience pain, whether physical or emotional, without making some meaning out of it. Many thinkers and physicians have recognized relationships between these two aspects of suffering, such as physical pain caused by emotional resistance. Freud introduced the concept of “conversion hysteria” to discuss how emotional distress is “converted” into physical symptoms; he treated patients with paralysis, spasms, and tremors through his freeform talk therapy method. A more contemporary example, the physician John Sarno became famous for treating chronic back and tendon pain by bringing patients’ attention to their repressed emotions. Freud and Sarno have slightly different ideas about what repression is, but that's for another day. For now I just want to point out this link between linguistic meaning-making and physiological suffering, the way that they are intertwined in experience.

These intertwined features are made to look apparently disconnected by the gaps between medical, psychiatric, and psychotherapeutic professional cultures in our time. It is easy to forget that Freud dealt largely with symptoms with a physical expression. His patients exhibited fainting spells, paralysis of entire limbs, and seizures. The distress behaviors of hysteria largely seem to have disappeared today. Instead we have panic attacks, depression and anxiety, and obsessive-compulsive disorders. These conditions are thought of as either “mental” and therefore related to meaningful content, or brain-based and therefore chemical. The perennial debate between psychological and psychiatric culture is on this point. Among psychotherapists, disorders are always framed as meaningful in nature: either as expressions of repressed emotions (psychodynamic), or of incorrect thought (cognitive), or as inflexible behavior patterns (behavioral), but always “mental” or semantic in origin. For psychiatrists, disorders are chemical, but both agree on the mind/brain as the origin point of disorders and the target point for intervention.

So to overgeneralize, within the mainstream of health professionals, when we leave physical pain and start talking about the semantic or meaningful aspects of suffering, there is a tendency to ignore the physiological dimension of “mental” disorders.

Outside the mainstream, however, some methodologies do try to address physiological dimensions of meaningful distress.

One such method is Focusing, an approach to psychotherapy developed by the philosopher and psychologist Eugene Gendlin in the 50s and 60s. Gendlin and his colleagues reportedly studied thousands of recorded psychotherapy sessions in an attempt to learn what variables determine successful outcomes. What leads to what psychotherapists recognize as an “opening?” This is a moment when a client comes into close touch with their feelings, or suddenly opens to a deeper understanding, in a way that leads to change in themselves. Such openings, or movements toward change, could be considered the success criterion of talk therapy.

From his analysis of these recordings, Gendlin arrived at the conclusion that statements, interpretations, and expressions must bring about a change in how the client’s problem is somatically experienced. His Focusing method therefore tries to address to the client’s physiological experience of their troubles.

To briefly describe the method, Focusing involves directing the client’s attention to their in-the-moment physiological experience as they discuss their challenges. After bringing up an issue, the client is encouraged to sit quietly with their felt physiological sense of the issue, to try to feel into it. Once they get a grasp of its bodily feeling, whether that is a where, perhaps a sense of tension in my hunched shoulders, or a how, perhaps a burning sensation in my stomach, this sense is then vocalized. It’s given a verbal expression, like “it feels tight” or “there is a hot churning.” Subsequently, the client goes back and forth between further focusing and verbal expression, trying to get a better and better sense of their feeling. Eventually, in a successful case, some particular expression is found that suddenly resonates: the words fit the experience.

Gendlin emphasizes, and as an experienced psychotherapy client I can confirm, that when one finds words that fit, a subtle shift occurs. There is a special rightness to the description or phrasing. One is somehow made more whole by having this description. (There is that word again, “wholeness.” We’ll have to wait for another day for a discussion of what it means.) The problem has not disappeared, but there is a new understanding of it, and perhaps a subtly different experience of it. This burning and churning in my stomach, I recognize, is a kind of jealous yearning. One can return to the problem, or to focusing, with new understanding: what is it about this situation that gives rise to this smoldering jealousy? And so on.

I wager that many of my readers have experienced something like this, even if it wasn’t in a psychotherapy setting. If you haven’t, then perhaps you can give it a try. If you’ve done even a little bit of meditation and know how to concentrate, it’s easy to do on your own. But let’s get back to the issue at hand. What is interesting to me about this is why certain words fit. Why is it that when you suddenly find an expression that matches the physiological feeling, a whole change occurs? What is that feeling of “special rightness?” Why does it matter that expression must be given to the feeling for change to occur?

What is self-interpretation?

Many readers will know I’ve been influenced by moral philosopher Charles Taylor. Few know that he published two volumes of papers on psychology and the sciences. I’ll list a few of my favorite chapters from Volume 1, Human Agency and Language, and their core arguments, in case you wish to reference them yourself.

• Chapter 1: Humans are moral evaluators, and such evaluation is constitutive of our own experience and agency.
• Chapter 2: Humans are self-interpreting animals. We intuitively grasp what is important in situations through our emotions. Emotions require linguistic interpretation to be understood.
• Chapter 3. Action and purpose are ontologically identical. Action involves working out a reflexive understanding of what the action is about.
• Chapter 8: The essential feature of an agent is that things matter to it. Without this, it is a mere machine.
• Chapter 9: Language does not designate meanings. Conversely it is expressive and invocative. Man completes himself in expression.
• Chapter 10: Language has 3 functions: a) it articulates things, bringing them to explicit awareness; b) it makes things public and thus creates public space; c) it provides the medium to discriminate human concerns

I’ve left out a lot here, but there are obvious connections to what I’m referring to when I talk about the experiential or meaningful aspect of suffering and healing.

For starters, it’s obvious that self-interpretation is critical to how we feel about ourselves, our self-evaluations. Sometimes just talking to others, having our belief changed, can transform a dour mood to a better one. Imagine a conversation with a colleague that ends with the following realization: “it’s not so bad that I had a disagreement with my boss, now that you reminded me that it means she trusts me enough that we can confront one another directly within our professional relationship.” Such a conversation could change my own self-interpretation from “I’ve been bad” to “I’m okay.” This is a kind of small change in self-interpretation that could happen any day.

But long-term psychotherapy also involves changing more deep-seated self-interpretations or beliefs about ourselves. And we can’t use a restricted sense of the term “belief” here. A thought, a long-held suspicion, an emotional resistance, or even a value we hold might be part of the same way of being. We could call that a “belief” or a “way of relating;” I want to call it a stance, because these interpretations involve our stances on things, including our own evaluative, existential stance on ourselves.

Now the feeling of the stance and the articulation of it, however vague or formalized it may be, are together in a person. But they can also be out of joint, as when my stated values and intentions of being thrifty are frequently betrayed by in-the-moment compulsions to buy this or that item. I’m not whole (!) or together with myself here. I’m confused and at odds with myself, perhaps deceiving myself, etcetera. It’s clearly possible to be wrong. I particularly like what Taylor has to say about this in chapter 3:

we have to see self-perception as something we do, something we can bring off, or fail to bring off, rather than a feature of our basic predicament. . . it requires that we conceive self-understanding as something that is brought off in a medium, through symbols or concepts, and fomulating things in this medium as one of our fundamental activities.

Obviously psychotherapy’s efficacy is based on this possibility of pulling off a correct self-perception. But how can you correctly perceive your stance on something? Well, let’s unpack “stance” a little more.

According to Gendlin, psychotherapy is most effective when it directs patients attention to their physiological feeling of the problem first and foremost. His Focusing method is basically trying to provoke a sense of their implicit stance on the situation. One reason I like the term “stance” is that it evokes a sense of physical posture. The body is the foundational medium, the basis of how we relate to the world, so it makes sense to me that Gendlin’s process is oriented toward generating postural language. On this point, Taylor agrees: “our direct, intuitive experience of [a thing’s importance] is through feeling. . . The chain of explanations must be anchored in our intuitive grasp of what is at stake.”

To clarify this by means of the previous example, let’s say I start thinking about my spending problem. Through Focusing I get an inchoate sense of “pulling” that I want to “shake off”. These are postural words that characterize my stance on the whole issue. Suddenly more words come to mind: I have been telling myself I shouldn’t spend so much money, but resisting it feels like “holding myself back.” This is the clue I needed. This holding myself back is a kind of self-denial!

What is happening here is the development of a lexicon that fits the phenomenological core. I have come to a new self-understanding or self-interpretation. In developing this interpretation, experience seems to change, even down to changing our posture, our literal physiological response to situatiations. We’ve brought off a self-perception, and it seems to make a difference.

Hermeneutics all the way down?

Now to understand what is going on with these self-interpretations we have to go deeper into the theory of language and meaning. Because on the one hand, the account above and the efficacy of focusing suggests that physiological feelings are in some way prior, and that language merely creates a symbolic map of this so-called “posture.” But on the other hand seems to matter a whole lot. Changing it around, rearranging the symbolic map, has the ability to redefine our entire constitution, our whole “posture” or physiological orientation toward the world. When we get it right, that is to say, when our interpretation fits our felt experience, we can say we understand ourselves. We feel more “whole.” How on earth can language do that? We’re not going to solve the mind-body connection today, but let’s give it a shot.

Taylor would say that language is an irreducible part of our whole being and that it’s hermeneutics all the way down. Although he might agree with what I said earlier about the body being the foundational medium of relating to the world, he attributes an equally important role to language. We are self-interpreting beings, and that language is the very medium of this self-interpretation—”it is the vehicle of this kind of reflective awareness.”

This comes through first in chapter 3, where Taylor dismisses Cartesian theories of action where our intentions cause our actions, in favor of a better view. The better view is that actions can be totally unreflective, and through the action we become aware of what we’re doing and start to formulate our purposes. On this view intention and action are not separable. This is a view compatible with “depth” psychology of all kinds, because it allows for an unconscious but embodied life process, failed self-understanding of that process, and for “the achievement of more and more adequate understandings” through our efforts to grasp ourselves.

I like Taylor’s account. It explains why expression must be given for change in ourselves to occur. This is explained even better in chapters 9 and 10, which explore how formulating things in words delimit the boundaries of our felt sense of an issue; and how language gives the basic terms we use to evaluate and descriminate among moral standards of behavior or issues which are characteristically human in importance.

But because for Taylor language is an irreducible, constitutive feature of human existence, this account doesn’t really explain what’s going on physiologically when these expressions are made. Can we get closer? I’ll give a second view, inspired more by Gendlin. He is a much weaker philosopher, but his views are compatible with Taylor, and he tries to give a much more phenomenological close read of the issue.

For Gendlin, words and sentences are are not entirely separate from physiological states. You can prove this to yourself by thinking about the meaning of “white wine.” You’ll notice that the intuitive meaning of this is some sort of felt sensation: you might have a sense of how it tastes, even how a particular wine tastes if you are knowledgable about wine. You might have a sense what it’s like to hold the glass of wine. If you’re a winemaker you might actually remember the heat on your back in the vineyard. This feature of language is related to what Taylor calls “invocation” and Gendlin calls “calling forth:” its calls something up or brings it about. What the term “white wine” or “democracy” evokes is its felt sense for you: an emotional, postural, intuitive sense. You’re not always attuned to these felt meanings, but they are always there, and you can sense them by focusing on them.

When we are sitting on the therapist’s couch and blabbering away, we often find ourselves talking around an issue. I suspect the resistance derives because the felt sense of the issue is painful in some way, and phrasing it directly, in the way that matters, invokes that pain. Like Taylor says, it brings the issue to awareness. But additionally it makes the pain of the situation, the tension, the hurt or anger in the situation come physiologically alive. And not just emotional pain; here we can come back to chronic pain, or a cancer diagnosis, and think about how language arouses all of the emotional meanings that has for us. Specific combinations of words will light up the whole physiological network of associations, and physical and emotional pain may arise. The arbiter of accuracy for any verbal expression is your feeling about it: did it hit or not? That’s the same as asking: did the felt meaning of these words match the more vague, physiological and emotional sense of the situation?

Gendlin accounts for change in feelings by noting the creative nature of verbalization. Each new verbalization invokes a different felt sense. But that sense will be like the prior sense. If our stance on an issue is a posture, a shape language, then new verbalizations will preserve the formal properties, while also invoking slightly new feelings. The posture changes. It’s a structure-preserving transformation.

The state of the problem

The schema that I’ve articulated here leaves some mysteries unsolved.

I’ve said that language is related to physiology through the “postural” quality of its felt meaning. On the other hand, language sometimes seems to function as a wholly abstract and disembodied set of symbols.

If language invokes posture, how could it be possible to speak from a place that is “posturally” incorrect? Yet we do so all the time, and psychotherapy demonstrates how vigorously we attempt to deceive ourselves.

On the other hand, there is an immanent success criterion for any string of language we utter. When it’s right, it just hits different. There is a physiological feeling of fitness.

Theory of mind, as well as classical metaphysical debates on the question of substances (mind and matter, experience and being), take up this problem.

Taylor’s provocative chapter 5, “Peaceful Coexistence in Psychology,” is concerned with the compatibility of biomechanical and hermeneutical sciences. He identifies three domains of psychology: the psycho-physical domain, the domain of motivated behavior, in-between domain. Taylor says that psychoanalysis and similar hermeneutic theories are suited best to the domain of motivated behavior, where we have to take interpretation as a fundamental constituent. The psycho-physical domain is where biomechanical or chemical models work best, and studies aim to show correlations between physically defined deimensions and psychic states, like body chemistry and being hungry or alert. He cites developmental theories of Piaget and Chomsky’s grammar theories as examples of the in-between category, where we need sorts of structuralist theory that can be empirically tested but may not be reducible to brute data.

In my opinion, the discoveries of psychoanalysis and the “talking cure” do make an important contribution to these issues, but not if restricted to the psychoanalytic method. Talk therapy considered at large is an enormous array of secular experiments in the connection between the substances. Gendlin’s theories are obtuse but are closer to the phenomenological metal; they’re closer to the in-between category. But we need more rigorous experimentation along these lines. Earlier on I talked about physical pain as conditioned by meaning-making or verbally constructed experience; I think that would be a good place for new experimentation along the line of Gendlin’s methods.

Thanks to Jake for conversations informing this post.

Further reading:

Focusing-Oriented Psychotherapy, Eugene Gendlin

Experience and the Creation of Meaning, Eugene Gendlin

Philosophical Papers Volume 1: Human Agency and Language, Charles Taylor

Break Through Pain, Shinzen Young

Healing Back Pain, John Sarno