Thursday 19 September 2019

A trip to the psychiatrist's chair in search of happiness

In a revealing interview at the turn of the millennium, psychiatrist Dr Anthony Clare, who died last week, talked to Gyles Brandreth about what it is that makes us feel good, and bad, and detailed his seven steps towards achieving a positive state of mind

I WANT to be happy. How about you? People who know me probably think I am happy, almost irritatingly so. Well, I'm not. At least, not all the time. I should be, of course. I count my blessings: I have a good job, a fair income, a perfect wife (truly), three children with whom I'm still on speaking terms (that's the joy of money: it keeps you in touch with your offspring). I've got it all, and yet . . . Something's missing, something's wrong.

So I have been to see a psychiatrist. Indeed, I have been to see The Psychiatrist, the famous one on the radio, the one with the charming, disarming, penetrating way with him. Dr Anthony Clare is married with seven children and as delightful in person as he seems on the wireless. He is slight, twinkly, amused, amusing, attractive, wiry, beady-eyed, engaging: Gabriel Byrne meets Kermit the Frog.

He is medical director of St Patrick's Hospital in Dublin (the country's first mental hospital, founded by Jonathan Swift in 1745). To reach his office, I travel through a labyrinth of corridors and stairwells, past young women with eating disorders, past alcoholics and depressives, past rows of old people sitting sadly, gazing vacantly into the middle distance. By the time I arrive at the great man's room, I am feeling suitably shamefaced.

His welcome is wonderfully warm. "And what are you after?"

"I am looking for the elixir of happiness.

He laughs., but the professor of clinical psychiatry at Trinity College, a research scientist and a scholar, pours coffee, invites me to take my place in the psychiatrist's chair, and suggests we might begin with a definition: "What is happiness?" There is a long pause. He closes his eyes and screws up his face.

"The essence of happiness is a conscious appreciation of the rightness of being."

He looks me in the eye, to make sure I'm following.

"And it's a state. It's not a permanent trait. People aren't 'happy' -- they have experiences of happiness. Most people's customary state is one of balance between conflicting needs and desires and emotions, and happiness comes into play as one of those experiences which people from time to time describe and clearly aim for.

"For example, one of my happy situations would be sitting in the Italian sunshine, mid-morning in Umbria, and laid out on the table there's wine and cheese and tomatoes with oil dribbled over them, and with a few friends, I'm sitting there talking about something like this -- happiness -- and, so long as the wine's drinkable and the cheese smells like cheese, frankly I don't care, I'm happy. The people are key. Having people around you who make you feel good and think you're good is important."

"Can it be measured?"

"There's amazing stuff going on now with imaging scanners, looking at centres of the brain that light up when people are feeling good, when they're listening to Mahler or Mozart or they're watching a favourite movie. A number of biological systems are bound up with our feelings. Take the role of the endogenous opioids. These are opiate-like substances that we produce inside us, and sometimes activities that we engage in can stimulate them -- jogging, for example, or some of these arousal jags that people put themselves into: climbing mountains, putting themselves in danger. You do something that prompts a natural high. It's almost as if you have access to your own fix. And that has led to a lot of interest in the possibility that people who are prone to taking external substances -- opiates, hallucinogens, amphetamines -- are people who, for one reason or another, have an internal opioid system that doesn't work very well, so they need external stimulation.

"To test happiness, I look at the areas of life that people over the centuries have identified as the mainsprings of human happiness.

"Jung pulled them together in a listing. He identified things like having a philosophy of life, having reasonable physical and mental health. He thought an education mattered, but he didn't mean a narrow scholastic education. He meant an openness to the world, an openness to the arts, the sciences, human knowledge, an outward-looking approach. For inward-looking people, it isn't easy. It's not impossible, but introspective people have problems being happy.

"If I was testing you, I'd look at your philosophy of life -- is it positive or negative? It doesn't mean you can't be happy if you think life is an absolutely pointless exercise, but it's starting to tilt the balance a bit. What are you doing with your life? Freud thought 'to love and to work' were the two elements of happiness. Well, there's some truth in that. So, what's your work? How do you feel about it? Is it satisfying? Do you feel you are making a contribution and that it's valued? What about love? Do you love and are you loved?"

I change tack. "Do we have a right to be happy?"

"According to the American Constitution 'the pursuit of happiness' is an inalienable right. The Americans, of course, have changed the way we think about the whole subject. . .They took Freud and adapted him to their own purpose. Freud, of course, was a European pessimist. But the Americans, with their passion for self-perfection and their notion of perfection being achievable on earth, took Freud's theory and turned it into a therapy to make you happy. And the result is that now, along with our air-conditioned four-door car and our house and our couple of holidays a year and a reasonable standard of health, we all expect happiness, too.

"I remember in one of the prayers we used to say when I was a child there was a reference to life as 'a vale of tears'. Happiness was not for this world. IHeaven was happiness. You might get a glimpse of heaven on earth, but no more. When, in Irish Catholicism in the Fifties and Sixties, they were trying to come to terms with sexuality, some priests or nuns, who were supposed to know nothing about it, would assume that sexual ecstasy was a glimpse of heavenly happiness," he says.

"Bless them." We both laugh.

"Now we demand heaven on earth. All the psychological theories today assume some kind of maturing balance between emotion and perception and cognition and will and impulse control. To what end? Perfection. A mental state of perfection is happiness. And the psychoanalyst has become the secular priest who will take you to happiness.

"While people want to be happy, admitting you are happy is a different matter. People are wary of saying they're happy. Why? Perhaps because it sounds like an invitation to fate. Or it sounds smug. Or it sounds insensitive. Aldous Huxley in Crome Yellow has a character sound off about 'happy people' being 'stupid people', completely insensitive. There's the noise and the screams and the roars of life out there, and the happy people just don't hear them."

"How can you be happy when you see what's happening in the world?"

"It's difficult. I remember discussing this with RD Laing, who recognised that if you allow suffering to overwhelm you, you're not going to be of any use to anybody. So perhaps this process of being happy has an evolutionary purpose. It allows you to do things, move forward. If you were too ready to become, understandably, unhappy, you'd be paralysed."

"Why do some people talk of the Second World War as the happiest time of their life?"

"Among those who fought in the war there was a comradeship. People who might otherwise have found it difficult to socialise were thrown together. And there was a common purpose. The basic fighting man felt he was doing something worthwhile. That was why the 1939-45 war was so different from Vietnam, or even the Gulf."

"Is health important?"

"It can be an important component, but not necessarily. You will find disabled people who describe themselves as happy, and people who have led terrible lives who, because of a philosophical view of life and of suffering, describe themselves as happy, too."

"Does appearance matter?"

"Being reasonably attractive is a help. People come towards you, warm to you. But you can be too beautiful. Extremes are difficult for human beings to cope with. Marilyn Monroe wasn't very happy."

"What about family circumstances?"

"It may be relevant where you come in a family. There's some evidence that first-borns, who get all the initial attention and love, are more contented, more confident. They may also be more conservative, less radical because they like the world as they see it. A second or third child is immediately in a more competitive and challenging situation, so there may be a tendency for first-borns to be happier." He shifts a little uneasily and lowers his voice: "This is a terribly politically incorrect thing to say, but, on the whole, it's better to have two parents than one. This is not meant as an attack on single parents and, of course, we all know plenty of one-parent families that are successful and two-parent families that are a disaster, but as a general rule, two-parent families are more conclusive to happiness."

"What about marriage?"

"In essence, marriage is good for men; and can be, but is not necessarily, good for women. If you take the four categories -- married men, single men, married women, single women -- it does appear that married men are the happiest and single men are the unhappiest. With women it gets more complicated. For instance, married women with a poor level of education are unhappier than single women, but educated married women are relatively happy.

"Married men do badly when they're bereaved, very badly. They either quickly remarry or they die. You'll often hear men say they can see their wives surviving without them, whereas all women think their husbands will marry again. Women just don't believe their men can function without the kinds of support that marriage can give them, and it seems they're right. Women cope with bereavement far better. There's no evidence, as I understand it, of a higher mortality rate among women in the two or three years after bereavement, but there is with men."

"What about money?"

"It has suited all sorts of people to equate material possessions with a state of happiness, because that keeps you pursuing them. But money and material things are a means to an end. I do not knock them. Often they free people. It is difficult in situations of struggle to be happy, but it doesn't follow that in situations of plenty you will be happy."

"So winning the lottery won't make me happy?"

"Not of itself. Money is an enabler, but our society has got it horribly wrong and confuses the enabler with the end."

I have been with the psychiatrist for nearly two hours, but I tell him I can't leave yet. "In fact," I say, "unless I get what I came for, I can't leave at all. I have come to see the wise man and I can't leave empty-handed. I want the secret recipe: Anthony Clare's Seven Steps to Happiness. This is the bit I am going to stick on the fridge door."

The professor laughs. He is going to oblige. But first, the caveats: "Remember, psychiatrists are very much better at exploring the pathological and the diseased and the malfunctioning, so you've got to be wary of those who come to the issue of health from disease or come to the issue of happiness from mental illness. Remember, too, that the things I'm going to recommend are not all easy to do. If they were, people would have no problem being happy."

HE closes his eyes once more. He rubs his thumb against his forefinger until he's ready.

"Okay. Here goes. Number one: cultivate a passion. It is important in my model of happiness to have something that you enjoy doing. The challenge for a school is to find every child some kind of passion -- something that will see them through the troughs. That's why I'm in favour of the broadest curriculum you can get.

"Number two, be a leaf on a tree. You have to be both an individual -- to have a sense that you are unique and you matter -- and you need to be connected to a bigger organism -- a family, a community, a hospital, a company. You need to be part of something bigger than yourself. A leaf off a tree has the advantage that it floats about a bit, but it's disconnected and it dies.

"The people who are best protected against certain physical diseases -- cancer, heart disease, for example -- in addition to doing all the other things they should do, seem to be much more likely to be part of a community, socially involved. If you ask them to enumerate the people that they feel close to and would connect and communicate with, those with the most seem the happiest and those with least, the unhappiest.

"Of course, there may be a circular argument here. If you are a rather complicated person, people may avoid you. If, on the other hand, you are a centre of good feeling, people will come to you. I see the tragedy here in this room where some people sit in that chair and say they don't have many friends and they're quite isolated and unhappy, and the truth is they are so introspective they've become difficult to make friends with. Put them in a social group and they tend to talk about themselves. It puts other people off.

"So that's my third rule: avoid introspection.

"Number four, don't resist change. Change is important. People who are fearful of change are rarely happy. I don't mean catastrophic change, but enough to keep your life stimulated. People are wary of change, particularly when things are going reasonably well, because they don't want to rock the boat, but a little rocking can be good for you. It's the salt in the soup. Uniformity is a tremendous threat to happiness, as are too much predictability, control and order. You need variety, flexibility, the unexpected, because they'll challenge you.

"Five, live for the moment. Look at the things that you want to do and you keep postponing. Postpone less of what you want to do, or what you think is worthwhile. Don't be hide-bound by the day-to-day demands. Spend less time working on the family finances and more time working out what makes you happy. If going to the cinema is a pleasure, then do it. If going to the opera is a pain, then don't do it.

"Six, audit your happiness. How much of each day are you spending doing something that doesn't make you happy? Check it out and if more than half of what you're doing makes you unhappy, then change it. Go on. Don't come in here and complain. People do, you know. They come and sit in that chair and tell me nothing is right. They say they don't like their family, they don't like their work, they don't like anything. I say, 'Well, what are you going to do about it?'

"And, finally, Gyles, if you want to be happy, Be Happy. Act it, play the part, put on a happy face. Start thinking differently. If you are feeling negative, say, 'I am going to be positive,' and that, in itself, can trigger a change in how you feel."

The professor slaps his hands on his desk and laughs. "That's it."

"And it works?"

"Well, it's something for the fridge door. Try it and see."

© Telegraph

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