Jan

10

If you have ever been around an Alzheimer patient, one of the most troubling aspects of the diseases is the patient's inability to make sense of the present. You would think that this frustrating incompetence would be the victim's main concern. You would think that this confusion would make them submissive and accept the care of others.

I believe much of the confusing, frustrating, even belligerent behavior of the Alzheimer patient can be better understood as a desperate, intense search for self. Memory is closely linked to our personal identity. Their geographic roots, family (especially intimate partners), culture and religion become intensely important to them in this search.

It seems that much of their behavior is declaring their unique perspective as an individual since they are overwhelmed by their sense of confusion. While acknowledging it, often through fear, they don't know what is happening. They relish the ability to interpret events and personalize them, which is foundational in our perception of our selves as individuals. Therefore, while they are completely confused, and are trying to assert themselves as individuals, they often becoming belligerent, defiant or they make decisions in spite of their fears. While acknowledging they are completely confused, they still refuse to give up the right to make choices and to interpret the events themselves. The ability to make decisions is fundamental to our identity of self. They would rather make a terribly wrong decision than give up that right.

It would seem that many of their decisions are made through their intuition rather than through their understanding of the facts. "Fight or Flight" instills intuition within us as the primitive response to fear. Furthermore, Alzheimer patients often exhibit a child-like urge to engage in art and creative endeavors. If you, like me, believe that intuition is a subset of inspiration, then you will agree that they exhibit a need to sharpen their intuition.

As is clearly exhibited by the Alzheimer patient, I suggest that there is an intense battle of the legitimacy of our concept of self within each of us. Much of this focus is placed on our personal ideas and perspective. Often we use our intuition, in spite of the common sense dangers in doing so in many situations, to validate our identity or self.

Perhaps one of the most dangerous aspects of pseudo events is not just the staging of the event, but the staging of the audience. Often, the audience is staged to control his intuition, and then these pseudo events make it easy for him to rely on his intuition and the internalization of the event.

Consider porn, clearly the event and target audience is staged. But the personal internalization of the event leads to the wrong conclusion: the exhibitionist relates to our personal perspective. Magazines, web sites and other pseudo event outlets will gladly take your money to help you validate your personal perception with the glaring evidence to the contrary that there is nothing personal about the event.

And many millionaires have poured countless dollars in pursuit of the porn star trophy wife.

Acting on intuition derived from pseudo events is often like the Alzheimer patient. It's an action based on validating your personal perspective, rather than making money. Pseudo events for investors stage your intuition by staging a "Fight or Flight" event, and like the porn events, this reaction is irresistibly natural.

Here are some suggestions on how to prevent this.

1. Always be aware of whom the target audience is and the path the event is leading you down or painting, to make it look like your own intuition. Ignore your gut response if you are the target audience.

2. Try getting facts from outlets in which you are not the target audience. Vic and The Enquirers come to mind.

3. Get your information from the enemy.

4. Fear mongers. They will try to relate to you personally. Politics is a favorite. This causes you to trust them, and this also isolates you from the herd. Then they puff up the problem, and finally whisper, "run … run far, far away." They hate it when you turn and fight. But I've had some of my best ideas fighting fear mongers.

5. Seek out, do your own investigation, especially when you have personal expertise or attachment, such as regional companies. Don't rely on other like minded individuals.

6. Be well aware of the new ease to specifically target you. Niche marketing pseudo events are especially effective due to our personalization, and therefore implied uniqueness, of these mass marketers' message.

7. Recognize your vulnerability to pseudo events in times of personal trouble.

8. Seek sources of intuition from the distant past. There are pseudo events that have stood the test of time. Form your own interpretation of these views from the original source.

Janice Dorn comments:

I would refer anyone who is interested in understanding what might be occurring in an Alzheimer patient to the concept of Lifeworld. This has been articulated well in a paper entitled: The Lifeworld as a Phenomenon and as a Research Heuristic Exemplified by the Study of the Lifeworld of a Person Suffering Alzheimer's Disease by Ann Ashworth and Peter Ashworth. I do not have a link for the full article, but I do have the original article published in The Journal of Phenomenological Psychology, Sept. 22, 2003.

This work describes, among other things, the essential features of a Lifeworld:

Self
Sociality
Embodiment
Temporality (and its events)
Spatiality (and its objects)
Project
Discourse

As regards the person suffering from Alzheimer's disease and the caregiver, re: Self, the following are concluded, in part:

Self includes the attributions of identity as well as the person's experience of his or her presence, agency and voice within a situation. Perhaps, most fundamentally, it is plain that a person with dementia is a self in the sense of being the center-the point of view-of his or her psychological world. In the phraseology of Sabat (The Experience of Alzheimer's Disease-Life through a Tangled Veil, 2001 and Surviving Manifestations of Selfhood in Alzheimer's Disease: A Case Study, 2002), the person can say "I." However, the world of spatiality and temporality is not segmented in the conventional way (for example, with thresholds and boundaries) so the limits of self are not self-evident. Certainly, distinctions of ownership may be lacking, so that the self is associated with some objects (my robe, my slippers) and disassociated from other objects.

Putting aside the fact that the concept of "self" is a highly debated subject (ala. Satre, Hesserl, etc.), one may find quite useful, per the work of Sabat, to distinguish between three notions of self: Self One who is capable of saying "I." Self Two which claims, as it were, self-attributions, and Self Three, which is enacted in day to day relationships. If caregivers and others focus on deficiencies due to Alzheimer's such that they constitute much of a Second Self, then ongoing relationships are subverted. The Third Self is thus particularly vulnerable to deleterious and unnecessary social effects, specifically excess disability (prejudiced attitudes and behavior).

For example, a person suffering with dementia may find that a main way in which agency can be exercised is indirectly through requests for others to act. A time delay in response by the caregiver when asked to ask on behalf of the person with dementia can be enormously frustrating in the following way: the caregiver is seen as part of the sense of agency of the patient. Thus, it is as if the person with dementia had set off to walk, and found that her legs would not respond in the instantaneous way that their membership of her bodily self required them to act.

Additionally, there is a great need for presence and voice.

The concept of compassionate or right speech is one which cannot be overemphasized here. In fact, a study and adoption of compassionate listening is, in my opinion, critical reading for anyone who is dealing with persons with dementia. The best overall paper on this is by Gisela Webb and entitled: Imitations of the Great Unlearning: Inter-religious Spirituality and the Demise of Consciousness which is Alzheimer's.

What remains after the unraveling of mind, body, language and knowledge in Alzheimer patients, is what was there in the beginning.

If I had to read one paper on how to conceptualize and actualize interaction with a person suffering from dementia, it would be the work of Webb, as it is a wellspring of wisdom, enlightenment and acceptance that what we are, at the deepest level, dealing with in those suffering from dementia is a progression toward death, both for the patient and for the caregiver.


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