The Map and the Territory

The other day, a colleague of mine called me to consult on a case.   The client was a young adult who had been diagnosed with autism.   At one point she said, “His black and white thinking is caused by his autism…” My heart rate instantly quickened and before the apoplexy could do too much brain damage I interrupted her and curtly said, “No. His black and white thinking isn’t caused by his autism, his black and white thinking causes his autism.” She seemed confused, so I did my best to explain the damage that can be done by reifying labels.   I probably did a lousy job, because her mystification lingered.   I don’t know if I can do it better now, but I have the advantage of being able to cut and paste, so here we go.

I told my colleague that the more you rely on a label (a diagnosis) the less you are likely to know your client. Although it’s helpful, indeed necessary, when starting out in any field to learn the jargon, and thus have a convenient shorthand for describing a phenomenon and reducing the morass of information into manageable wholes, it can also lead us down wrong paths.   It is no accident that the more experienced a clinician the less jargon you will hear.

Humans are simply far more different from each other than we are alike.   The self-proclaimed “autistic” psychology professor Stephen Shore is credited with the cute saying that “If you’ve met one person with autism, you’ve met one person with autism.”

Diagnostic labels obfuscate more than they clarify.   Reducing someone’s personality to a group of symptoms does serve to focus on what some have concluded are the most meaningful bits and pieces, but by doing so we too easily fail to see the richness and contradictions of those behaviors that lie outside what we expect to see, and that makes us prone to errors.   If the label we give to the jar with the white powder in it is “flour” then that is what we expect will be in the jar, not the sugar that you put in the wrong jar when you were preoccupied with getting the internet upgraded. It is not necessarily that it becomes a self-fulfilling prophecy (although it could, if a therapist subtly steers his or her client toward the expected set of symptoms through explanations or interpretations that elicit those symptoms), but rather that the therapist actually “misses” the deeper truths of who is sitting opposite.

Diagnoses are, essentially, metaphors, in the same way Susan Sontag brilliantly described cancer as a metaphor in her seminal essay “Illness as Metaphor.”   Metaphors can be compelling ways to describe things, but they are not the same as the things we are describing. You can’t meaningfully say that John is schizophrenic any more than you can put a blanket of air on your bed, shoot an idea, buy a moral compass from the nautical supply shop, or really give me a piece of your mind.   That is not to say that—like John the Baptist, I cannot be a good shepherd even though I have no sheep. What I do mean to say is that I may indeed be a good shepherd, but I am much more than that, and by the way, I have goats (well, I used to). As the semanticist Alfred Korzybski famously said, “The map is not the territory.”

Another Hungarian hero of mine– Thomas Szasz, made a career out of professing that psychiatric diagnoses were essentially a form of social manipulation.   A psychiatrist himself, Szasz insisted that he was not anti-psychiatry, but anti-coercive psychiatry.   He saw psychiatric diagnoses as socially constructed with little to no medical evidence to support them, to be used, perhaps, to remove someone’s freedom (as in the case of hospitalizing a schizophrenic), cast someone aside from society (such as calling homosexuality a disease, which although eventually abandoned was done for decades), or sell drugs that don’t work or cause more harm than good.

Too many wrong roads are driven when we begin to think that the metaphor is the real thing.   The depth of personhood, the miraculous complexity and uniqueness of each individual, is transmogrified into the label we put on the package.   Korsybski once dramatically demonstrated this when he took a break from a lecture to eat some biscuits that had been wrapped in white paper. After commenting how much he enjoyed them, he offered some to students in the front row, who enjoyed their taste until Korsybski removed the white paper to reveal that they were dog biscuits. The students became nauseated, and Korsybski said something to the effect that we not only eat food, but we also eat words.

The problem with my colleague stating that her client’s “black and white thinking was caused by his autism” is that “autism,” as are most psychiatric diagnoses, is merely the label on the dog biscuit package.   It may or may not have anything to do with what is inside the package, but instead may have everything to do with what we think is in the package.   The truth is that, to this day, as is so with many things, we scientists know a lot about what the collection of symptoms we call autism looks like, but we don’t know much at all about how it comes about, or what goes on physiologically to cause those symptoms.

When we reify something, we also give it a static quality. We take something that should be a verb and turn it into a noun that just sits around on a shelf waiting for someone to pull it off.   And in doing so, we begin to think that there is little we can do with it.   If we only referred to John as a noun, as proper as that would be, we would imagine him standing somewhere.   But if we said he was “Johnning,” we would imagine all that he does that makes him tick.   Saying someone has autism, or depression, or even a virus, leaves us little to do with it, freeze-drying it as it were, and even creates a bit more distance between us and them.   If autism, or any diagnosis, was a verb rather than a noun we would be more interested in what it does and how it works, thereby bringing it to life and moving us to engage with it.

Another problem with my well-intended colleague’s comment is the direction of causality.   We need to know the territory before we can draw a map, but drawing the map will not create the territory.   We could say with some certainty that the more it rains the more umbrellas will be sold, but no matter how many umbrellas we buy we can’t make it rain. Does giving someone the label of autism make that person lose the ability to perceive life’s grays, or does the inability to perceive gray cause us to give someone the label of autism?   And if, as I would insist, it is the latter, then what useful information does that give us?   And if we make the mistake of reversing causality, thinking that this thing we call autism causes black and white thinking, it could freeze us in our tracks. We would have succeeded only in thinking we know something that we don’t, becoming autistic-like in our thinking and missing the grays, the subtleties that might lead us down different and potentially fruitful paths.

My colleague fell into a dangerous trap, but although the landscape of our language and everyday thinking is littered with those traps, no experienced clinician or practitioner of life should fall into them.   Confusing the map with the territory is something that ultimately can hurt our clients when the label is a psychiatric diagnosis, and when the labels we serve up are liberals, conservatives, Palestinians, Moslems, Jews, Christians, or maybe even Hungarians, we may succeed only in creating obstacles to understanding each other.




lessonIf you become a pilot you will be greeted with poetic terms such as “unusual attitudes” and “going missed.”   “Holding patterns” is pleasingly romantic, while “death spiral” could easily be a feature film title.   One term of which I have always been particularly fond is “angle of attack,” perhaps because I used to fence in college and the term, which is a key concept in aviation, has both martial and mathematical bits, and it’s alliterative to boot!

The goal in landing an airplane is to fly a “stabilized approach.”   Failing to do so often results in a “missed approach,” which is redolent of my entire adolescence, although words such as “awkward,” “clumsy,” “incompetent,” and “hopeless” could apply equally to teenage and airplane approaches.   The best I could manage in those awkward, clumsy, incompetent years as an adolescent was an occasional “touch and go.”  How life does imitate art.

When pilots fly “deadstick,” they have lost their engine power.   It’s a bit of a misnomer, in that the actual stick is alive and well– it just has no power behind it, but you really can’t beat the word for its rather perfect sexual connotation.   Conscientious pilots practice “deadstick landings,” which sadly describes some of my own geriatric tribulations.

And, just to get past the suggestive bits, when learning to fly on instruments pilots are taught the proper procedure for “entering holds.” I imagine that is also something pilots have in common with wrestlers.

While it isn’t required, the best among us get “spin and stall training,” which would have helped me once years ago when I stalled in front of more than a hundred people while giving a presentation at a psychology conference. It was difficult to recall in which order I needed to reduce power, slam on the rudder and level my ailerons.

We learn not to “scud run” and aviation lore tells us about “barnstormers.” I’m not exactly sure what a “barnstorm” is, but it sure sounds awesome. Somehow I imagine a bunch of drunken, squaredancing cowboys in too-tight boots and cowgirls in fripperies frenetically whooping it up on a Saturday night.

Speaking of cowboys, pilots learn how to lasso, but we spell it LAHSO, which stands for “land and hold short operations.” This could be the title of a chapter in the Kama Sutra, or something you wished your father had told you about. Pilots land with a flare, not just because it’s pretty, but also because it increases drag.   Too much flare, I imagine, can turn you into a drag queen, potentially resulting in a tail strike.

Most pilots speak French, although they often don’t know it.   “Mayday” is merely the Anglicization of venez m’aider (come help me) or simply m’aidez (better get off your ass and help me now), and pan-pan (the urgency call) is simply the French word for bread.   No, wait, that’s Spanish. It’s actually the French word for “breakdown,” as in “you’re really a pannes in the neck.”

When you fly an airplane, you are controlling three things: pitch, roll, and yaw.   I can’t help wonder if Bill Haley or one of the other Comets took flying lessons thus inspiring the classic song “Shake, Rattle and Roll.”   The latter might, on second thought, be a better description of flying through turbulence.

“Dead Reckoning” is not what a jury does when considering the consequences of an accused’s misbehavior, but rather a shorthand derived from “deductive reckoning,” a form of navigation based on computing timing between visual cues.   Both, however, may have a similar result. (Full disclosure: some historians believe “dead reckoning” stems from following straight roads, as in “dead ahead.”)

I love practicing “accelerated stalls,” which, although it sounds like a contradiction, can happen if you rotate too much on takeoff.   I think it is also the process behind stuttering.

Enough already.  Before I get behind the airplane and lose control, I should quit today’s aerolinguistics lesson.   Don’t know about you, but I need to pitch, roll and yaw my way out of bed, take a shower and go to the scale and compute my load factor.   Hopefully, there won’t be too much turbulence ahead.





Play Missedy For Me

Returning home once from a flying lesson, my wife asked me what I had worked on that day.   I excitedly told her that I worked on “missed landings,” and that I “went missed” three times in one day!

She seemed puzzled, and said something to the effect that, yes, it was foggy that day, but her brow remained crinkled.   When I asked her what was wrong, she timidly said that it seemed dangerous to be landing an airplane in such misty conditions.   It took me a few seconds before I realized that she heard my saying “missed landings” as “mist landings,” and that I “went mist” three times!

I wished I had really meant to say that I “went mist,” because it was clearly more poetic, but while I often get overly poetic in my prose, I rarely speak that way intentionally.   It was, simply, another mist-understanding, and all I felt was amused and some shame at being done in by a homonym.   It wasn’t uncommon for my wife and I to be speaking different languages to each other, and this particular mist-communication (stop it already) was delightfully benign, but many, if not most, misunderstandings have toxic outcomes.

I suffer from an over-attachment to the literal.   I can’t honestly say that such a problem arises out of some scholarly or writerly perfectionism in which –as commandants of writing camps are wont to repeat—there is only one word that is ever precisely correct for each situation.   It is, rather, possibly a biologically driven manner of thinking (he said frustrated by his own lapse into dualism), a way of perceiving the world that many have attributed to gender differences.    While I have many feminine characteristics, when it comes to following a set of instructions, alphabetizing my record collections (I still have them), constructing a chair or deconstructing an argument, I am hopelessly male in my tendencies.

The chief problem (of many) in stereotypical maleness is that one about forests and trees.   I may be able to tell you all about the tree in front of me, but sometimes I am clueless about what forest I am in, or even realizing that I am in one.  This can turn mundane conversation into both silly and profound argument.   The silly end of the spectrum is exemplified by the misunderstanding that occurred some months back when I was scolded for (after all these years) mixing up the long forks and the short ones in the silverware drawer. How can I be wrong? I stood them on end, and put the longer ones in one bin and the shorter ones  in the other.   NO! “Longer,” as any civilized spouse will know, refers to the length of the tines, and not the entire body of the fork.

On the deeper end, accusations can go flying when one person insists he or she said one thing and the other insists it was another thing, or no such thing at all, and the consequences are severe.   When you asked me if I would like to pick up our child after soccer practice and I said I would and then you assumed that meant that I would actually pick up our child rather than that I simply would like to but instead had to be at the office for a meeting so the child was left abandoned and feeling entirely unloved—that sort of thing.   (This actually never happened, but that is generally how it goes.)

John Gray’s “Men are from Mars…”, according to Harper Collins, is the largest selling hardcover book of nonfiction in history, spending over 2 years on the best-seller list. It sells so well that Gray’s “Ph.D.” still adorns the cover of the book despite having been received from a non-accredited correspondence school (i.e., diploma mill).   His work was loosely based on the research of the very legitimate psycholinguist Deborah Tannen. I have never read “Men are from Mars…” although I started it but couldn’t get past the first few paragraphs.   (If there’s two things I can’t stand, it’s pop psychology books and seeing white men dance– even though I wrote one myself and on occasion have been seen dancing.)

But I have read two of Deborah Tannen’s books, which to some degree bridges the pop and “legit” genres. She asserts, among many other things, that men typically engage in conversation for different functions than do women.   Men engage primarily to discover their current status in the power hierarchy and/or to learn what activity they are being required to do at the moment.   Women, generally speaking of course, engage in conversation primarily to serve the function of a shared emotional experience.   These are certainly broad generalities, but I have found them helpful, nevertheless, in sorting through the mist.

I have learned, mostly through my work as a therapist and the much more difficult work of being a spouse, how to converse like a girl.  It’s still a bit like throwing a ball with my left hand, but it helps to remind myself before engaging in a conversation that the purpose of the conversation is not to learn what I have to do or where I stand but rather to have a shared emotional experience.   It can be rewarding, like reading a good book or going to the theater, but sometimes I become mystified (mistified?) and have to work my way out of the farrago by rewinding the words I heard and struggle to find their hidden meaning.

I suppose my testosterone rises and suddenly the forest transforms to a collection of disparate trees and I feel like a lost child wondering if his parents will ever pick him up from soccer practice.

In the end, there may be little difference between missed communications and mist communications.   In an airplane, pilots “go missed” when there’s just too much mist to see the runway, which may or may not be beneath them. It’s just safer to miss an approach than it is try one’s luck at a mist approach.   Did you get that, or did you go mist?