RESISTANCE AND COMPLEXITY: SOLUTIONS TO URBAN CRISES OF HOMELESSNESS AND PSYCHOPATHOLOGY THROUGH PSYCHIATRY, ARCHITECTURE AND PHILOSOPHY by EDWARD LEE DURGAN M.A., Katholieke Universiteit Leuven, 2000 M.A., Seattle University, 1998 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Interdisciplinary Studies) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) September 2013 ? Edward Lee Durgan 2013 ii Abstract This is an interdisciplinary attempt to analyze the ongoing and progressive urban crises of homelessness and psychopathology. It intersects three disciplines: architecture, psychiatry, and existential-phenomenological philosophy. I have coined the phrase ?anarcha-existentialist? to describe a method of questioning political and epistemological authority. It extends work on schizophrenia conducted under the supervision of Roger Burggraeve. Primary philosophical sources include Emmanuel Levinas, Martin Heidegger, and Jacques Derrida. I used descriptive and interpretive phenomenology with thematic analysis in qualitative research on the subjective experience of severe mental illness across dwelling types on Vancouver?s downtown eastside. Emergent themes included a struggle for fundamental human rights, distressed personal time, and a relationships between homemaking and management of mental health. Histories of psychiatry and asylum architecture reveal their inseparability from the state. I carried out architectural case-studies of the Woodsquat, the Woodwards redevelopment project, and the Olympic Tent Village that took place during the 2010 Winter Olympics. The crises in question are intractable and existing interventions cannot succeed comprehensively. The disciplines in question appear as auxiliaries to a capitalist-state apparatus to which they are fettered. In architecture, dialectical narratives of modernity are perpetuated. Psychiatry acts to reify the American Psychiatric Association?s diagnostic and statistical manual (DSM5). Together they succeed in re-institutionalizing chronically mentally ill adults and youth while reducing social housing and low-income rental stock. Contemporary architecture theorists and architects have appropriated philosophical concepts to fabricate ethical narratives that justify the gentrification (or class iii transformation) of urban environments. Vancouverism is an example of the neoliberal economic collusion of civic government, the developer class, and clinical psychiatry. Criminalization of poverty in Vancouver is part of a North American trend. Behavioral genetics and genetic counseling are disciplines bearing direct methodological/ideological lineage to eugenics that inform public policy in Vancouver and elsewhere while aspersions are cast on them by a growing consnsensus of scientists. Complex theoretical models and non-pacifist modes of resistance are recommended to stem the crises. Revolutionary transcendence of nation-state models and establishment of worldwide socio-political relationships based on anarchism portend the diminishment of psychopathology in the world population while providing adequate homes for all. iv Preface Dr. Erin E. Michalak of the University of British Columbia Department of Psychiatry and the Collaborative Research Team on Bipolar Disorder initiated the grant application and acted as Principle Investigator on the study from which data has been drawn for this essay. Erin also advised on the research design, data collection and initial data analysis on that study. That study was titled: Subjective Experience of Quality of Life Amongst Chronically Mentally Ill Adults in Vancouver?s Downtown Eastside Across a Variety of Dwelling Situations. The study was approved by the University of British Columbia Behavioral Research Ethics Board and assigned the number: H08-00977. The sponsoring agency was Mathematics of Information Technology and Complex Systems (MITACS) ? Networks of Centres of Excellence. The study took place between June 12, 2008 ? June 12, 2009. The Downtown East Side Resident?s Association (DERA) and Vancouver Area Network of Drug Users (VANDU) facilitated the study by helping to recruit participants and provide space and further advising for the individual interviews. Kim Kerr, the executive director of DERA, as well as other staff members were helpful in the design of the questionnaire for the semi-structured interviews that appears in the appendices of this essay. Twelve residents of the downtown east side directly participated in the study and they will remain anonymous to protect their confidentiality. A preliminary analysis of the results from this study, which was done under Dr. Michalak?s supervision, was presented in poster format at conferences including UBC Psychiatry Research day, 2010 and the College for Interdisciplinary Studies/Interdisciplinary Studies Graduate Program poster competition in 2010. The v research poster won a silver award for excellence in research at the Canadian Student Health Research Forum in June, 2010 in Winnipeg, Manitoba. An abstract for that poster appears in the booklet that accompanied the conference: ?Infectious Disease and Global Health.? The poster was designed with the help of Matt Filipiak who also helped with data analysis. Some information that was included on the research poster was reproduced below. Appendix one contains a semi-structured interview composed of a series of questions co-authored by myself, Erin Michalak and Kim Kerr. Appendix two contains twelve word-for-word transcriptions of those semi-structured interviews that I conducted with each of the twelve pseudonymous volunteers also known as ?participants? in the study. Joe Guppy helped with editing and re-writing of some passages in the document in order to bring it into closer compliance with general rules of grammar. I am the sole author of all other writing, except where other authors and images are cited. vi Table of Contents Abstract..................................................................................................................................................................ii Preface...................................................................................................................................................................iv Table of Contents ................................................................................................................................................vi List of Tables.......................................................................................................................................................vii Acknowledgments ............................................................................................................................................ viii Dedication............................................................................................................................................................xv CHAPTER 1: Introduction ................................................................................................................................1 1.1 ANARCHA-EXISTENTIALISM .....................................................................................................................1 1.2 HOCKEYSTICK: AT HOME WITH HOMELESSNESS .................................................................................3 1.3 DWELLING AND HUMAN EXISTENCE .......................................................................................................9 1.3.1 Poetic Dwelling.................................................................................................................................14 1.3.2 Dwelling and Language ...................................................................................................................19 1.3.3 Dwelling and Ethics: Levinas and the Crisis Respite Program ....................................................22 1.3.4 Phenomenology of Dwelling ............................................................................................................34 1.3.5 Existential Analysis of Dwelling and Good Mental Health ...........................................................38 1.3.6 Architecture of Dwelling with Severe Mental Illness .....................................................................43 1.3.7 Psychiatry and Phenomenology.......................................................................................................55 CHAPTER 2: Urban Crises of Homelessness and Psychopathology.........................................................58 2.1 HISTORY VERSUS IMMEDIACY: METROPOLIS 2012.............................................................................58 2.2 THE MOLOCH WITH MANY MOUTHS ....................................................................................................63 2.3 POVERTY; INADEQUATE DWELLING AND HEALTH ON THE DTES ....................................................70 2.4 THE CLINICAL SENSE OF SEVERE MENTAL ILLNESS...........................................................................72 2.4.1 Genetic Psychiatry............................................................................................................................72 2.4.2 Polygenic Variation and Epigenetics ..............................................................................................90 2.4.3 Urbanicity as a Risk Factor .............................................................................................................94 2.4.4 Viral Infection and Urban Density ................................................................................................100 CHAPTER 3: The Personal Experience of Living with Severe Mental Illness on the DTES Across Dwelling Types..................................................................................................................................................102 3.1 RESEARCH APPROACH ..........................................................................................................................102 3.2 PARTICIPANTS ........................................................................................................................................104 3.2.1 Homeless ~ Conspiracy Theory: ...................................................................................................106 3.2.2 Shelter ~ Klondike: .........................................................................................................................108 3.2.3 Single Room Occupancy (SRO) ~ Belle: .......................................................................................111 3.2.4 Single Room Occupancy (SRO) ~ Backyard:................................................................................114 3.2.5 Single Room Occupancy (SRO) ~ Eagle: ......................................................................................116 3.2.6 Bachelor Apartment ~ Pinkwatch: ................................................................................................118 3.2.7 Bachelor Apartment ~ Phillip:.......................................................................................................120 3.2.8 One Bedroom Apartment ~ Collector: ..........................................................................................124 3.2.9 One Bedroom Apartment ~ Floppyhat: .........................................................................................126 3.2.10 One Bedroom Apartment ~ Nice Girl: ........................................................................................130 3.2.11 Multi-Room House ~ Glitter: .......................................................................................................133 3.3 DISCUSSION.............................................................................................................................................135 3.3.1 Emergent Themes............................................................................................................................137 3.3.2 Distressed Personal Time: .............................................................................................................139 3.3.3 Management of Mental Health ......................................................................................................144 3.3.4 Homemaking ...................................................................................................................................147 3.3.5 Contingencies of Being Poor in the DTES ....................................................................................150 vii 3.3.6 Fundamental Human Rights ..........................................................................................................152 CHAPTER 4: Case Studies in Architecture and Resistance on the DTES.............................................154 4.1 WOODSQUAT; WOODWARDS; OLYMPIC TENT VILLAGE AS CASES ................................................156 4.2 WOODSQUAT: PROTESTING THE CRISIS .............................................................................................158 4.3 THE WOODWARDS REDEVELOPMENT .................................................................................................167 4.3.1 Reifying Modernist Dialectic .........................................................................................................167 4.3.2 Reinstitutionalizing Severe Mental Illness ....................................................................................172 4.3.3 Gentrification ..................................................................................................................................176 4.3.4 Vancouverism..................................................................................................................................179 4.3.5 Anti-Ethics in Architecture and Social Policy ..............................................................................184 4.3.6 Interlude: The Elitist Borderlands of Urban Existence................................................................190 4.4 MODES OF RESISTANCE TO THE CRISIS...............................................................................................199 4.4.1 The 2010 Anti-Olympics Convergence ..........................................................................................200 4.4.2 Olympic Tent Village ......................................................................................................................214 CHAPTER 5: Conclusions..............................................................................................................................222 5.1 Integration of Disciplinary Results .........................................................................................................222 5.1.1 Modes of Resistance Radically Re-Frame Human Existence ......................................................228 5.1.2 Dwelling, Psychiatry, Drug Dependence......................................................................................233 5.2 Solution: The Transcendence of the State..............................................................................................236 5.2.1 Anarchism as The Humane Society ...............................................................................................242 5.2.2 Complexity.......................................................................................................................................245 5.2.3 Resistance........................................................................................................................................252 5.2.4 The Non-Pacifist Possibilities of the Humane Society .................................................................257 Works Cited ......................................................................................................................................................260 Appendices ........................................................................................................................................................284 APPENDIX 1 ...................................................................................................................................................284 APPENDIX 2 ...................................................................................................................................................288 vii List of Tables Figure 1 Affective continuum of severe mental illness based on Levinas' ontology. .......................................32 Figure 2 Priests attend as slaves ascend stairs to feed Fritz Lang's Moloch. Image courtesy of F. Mirnau Stiftung. .................................................................................................................................................................63 Figure 3 Possible continuum models for severe mental illness that are compatible with latest findings in genetic research. From Craddock et al. 2009....................................................................................................93 Figure 4 Table showing participant's gender and Dwelling Type..................................................................104 Figure 5 Organizer Ivan Drury of the Anti-Poverty Committee rallies support at Woodsquat. Photo -- Murray Bush ? Flux Photos. .............................................................................................................................160 Figure 6 Activist's camp inside the derelict Woodwards Building. Photo Murray Bush : Flux Photos. .....161 Figure 7 Woodsquat's tent-city phase. Photo--Murray Bush--Flux Photo. ...................................................162 Figure 8 Temporary Liberated Space on Woodwards roof. Photo--Murray Bush--Flux Photos.................163 Figure 9 Anti-Olympics banner drop from W Tower. Photo--Murray Bush--Flux Photos...........................165 Figure 10 PHS Woodwards is what I call Self-Contained-Permeable Stacked Corridor Asylum style architecture at the Woodwards Complex for social housing. Image credit Henriquez Partners Architects and Dallas Hong. ...............................................................................................................................................174 Figure 11 Ripple Effects on Low Income Communities: credit Carnegie Community Action Project ........178 Figure 12 Atop the new tower of Babel, Freder chases a the sex-workers while a fashionista looks on in the Garden of Earthly Delights in Fritz Lang's film Metropolis. Courtesy of F. Mirnau Stiftung. ...................194 Figure 13 Gentrification Ripple Effect on the DTES: with permission from Carnegie Community Action Project.................................................................................................................................................................198 Figure 14 Fritz Lang's 'club of sons' from Metropolis (1929). Lang foresees the essential role of elite sports events in future dystopian societies, presaging here Riefenstahl and Vancouver, 2010. Image courtesy of F. Mirnau Stiftung. .........................................................................................................................200 Figure 15 Callouts for the Anti-Olympic Convergence endorsed by the EZLN proliferated the streets, the internet and radical networks everywhere: Credit Olympics Resistance Network and Warrior Publications!.............................................................................................................................................................................202 Figure 19 The Complex Model of Mental Health and Severe Mental Illness. Image by Kris Emig Kuhn. .250 viii Acknowledgments Dr. John Beatty accepted my application for entry into, what was then known as, the Individual Interdisciplinary Studies Graduate Program. As chair of the IISGP they were a tireless advisor, administrator, and advocate in the bewildering forest of grad studies at UBC. Each time I met with Dr. Beatty to decide my continuing advancement I could see from the look in their eyes that I did not ?look good on paper.? In retrospect I know that Dr. Beatty?s strength was care and empathy. On every occasion they showed faith in this project and gave me the benefit of the doubt. Thanks to them I am on the threshold of completion. I must also acknowledge the unwavering patience and guidance of my supervisory committee. Dr. Tania Le Comte, at UBC psychiatry, was the first person to agree to support this project. They also hired me as research assistant in the Methamphetamine Psychosis Study (MAPS). That RA position was crucial for my success in two ways. First it allowed me to secure a modest, but substantial income that made it possible to survive in North America?s most expensive city for the first year after my move there from Seattle. Second, it helped me to gain a familiarity with all of the area hospitals, their emergency room staff and procedures, as well as some of the residents and housing programs in the downtown east side (DTES). The DTES would have otherwise remained more or less impenetrable for me as a solo researcher years later when I confidently approached those who would be my allies in the following research endeavors. Dr. Le Comte resigned as my supervisor after taking a position at another school. That may have signaled the end of this project if Dr. Alasdair Barr had not ix agreed to take their place. Thanks to them I was able to keep my place in the department of medicine through the schizophrenia research lab. Dr. Barr guided my work through comprehensive examinations as well as most of my scholarly research on Schizophrenia. Dr. Steven Taubeneck has been my primary advisor for the past six years. I count them among a few of the most influential mentors I have had in the Continental Tradition of philosophy, especially Existential-Phenomenology. Interdisciplinary scholarship produced many unforeseeable challenges and Dr. Taubeneck helped to overcome many of them. They also provided the employment opportunity that helped me gain a teacher?s assistantship after I left the yearlong MAPS RA position. Dr. Sherry McKay of UBC school of architecture (SOA) was the second of three faculty members from whom I gained crucial support. I had never studied architecture before coming to UBC and through two years of intensive coursework in the SOA, including Dr. McKay?s history of modern architecture course, I came to an understanding of architecture that is presented here. The depth of historical instruction at SOA set my mind to a deeper historical examination of psychiatry and philosophy. The sharp rise of modernity, unmistakable in urban architecture, sets up the problematic of this essay across disciplines. Dr. Erin Michalak holds position in UBC psychiatry that includes founder and coordinator of the Collaborative Research Team on Bi-Polar Disorder (CREST-BD). They appeared at ISGP with a grant proposal from Mathematics in Technology and Complex Systems program (MITACS). The grant called for a faculty level researcher to collaborate with a graduate student and a community-based program to conduct original research, which would advance of the graduate student?s work. Dr. Beatty alerted me to x the opportunity and made online introductions. I wrote the grant application together with Erin and sympathetic community based service providers. We were granted the funds and I was recruited to CREST-BD before I knew it. For the next year my study was facilitated from their offices in UBC?s Detweiller pavilion, the home of the psychiatry department and mood disorders clinic. The other locus of my research was a world away in Vancouver?s downtown east side. Kim Kerr was the executive director of the radical renter?s union known as Downtown East Side Residents Association (DERA) when I approached them with the idea for our study. Kim was enthusiastic from the beginning and saw the project as an opportunity to gain insight, and raise awareness of the ongoing and increasing crises of homelessness and mental illness. The eventual coordination with the Vancouver Network of Drug Users (VANDU) was initiated by staff at DERA. I was able to collect the data that is partially presented here over the course of a year, prior to the 2010 Olympics and midway through what I now view as my ?Vancouver period.? Additional inspiration and materials were generated and given to this project by grassroots organizers in the DTES including the indefatigable Wendy Pedersen and the vociferous genius Ivan Drury. I hope my efforts meet with their satisfaction. I am also indebted to the various individuals and organizations that have permitted me to use images including: Henriquez Partners Architects, the Carnegie Community Action Project, Murray Bush/Flux Photos, The Olympics Resistance Network, Warrior Publications, and the Friedrich Wilhelm Mirnau Stiftung. I acknowledge them with thanks. xi A lot of personal friends and family supported me over my six year stay in Canada. Hope, Crystal and Trevor Bath were my first housemates and they were like a second family at times. Lizabeth Morrow was my personal angel who?s kindness supported me at crucial points of my journey through this project. John and Pamela Grinter also sponsored my efforts at important moments when financial security disappeared. I was put to work on Mark Lennin?s Atlantean cleaning crew counted me amongst their laborers, like Sisyphus, for a summer. Mack Honey, the sous chef and rapper, also helped me to gain sustenance through work. Carlos Vinas was a kind sponsor and thoughtful interlocutor at various points from the beginning of these efforts who helped frame the problems in terms of phenomenological and revolutionary praxis. It was at UBC in 2007-2008 where I fell in with a group of militant feminist activists involved in organizing the UBC Students for a Democratic Society (SDS) to resist the rapid neoliberalization of the university. SDS successfully employed a diversity of tactics, including direct action, in efforts to save the UBC farm and last green student common area next to the student union building known as the Grassy Knoll. By the end of 2008 my scholarly research and radical activism led me to the conclusion that no systemic reform would ever protect the most vulnerable members of society; the crisis of mental illness and homelessness was accelerated by neoliberal capitalism and had no solution. The irrepressible spirit of dissent, embodied by the UBC SDS opened the perspective that another world is possible and my hypothetical solutions shifted from ?reformist? to ?revolutionary.? Many artists and musicians took the stage at the protest/concert Knoll Aid 1 and 2.0 as SDS exploded on our campus. At those events I learned that artists must make xii hard choices between endorsing and adding power to systems of oppression, or remaining independent. I remained aware of those tensions until my eventual departure from Vancouver. I am thankful for the lesson that democracy is only possible where artists can create and perform/share their work freely. Their ability to actually stand up and express profound and complex truths about the state of affairs in the world inspired the courage I needed to express the most original ideas presented here. So, many thanks go to the Fur Bearing Animals, Spring (formerly SSRIs), Trike, Robb Hill Band, Brujo, Jake Money and Chinois Blanc, Matt Filipiak, RinjustRin, Say LaVie, Carthage, Cry of Silence/Ed Lam, Alexico, Matt Filipiak, and the UBC Guitar Club. Through gains made by my predecessors in the Teacher?s Assistant union, Canadian Union of Public Employees local 2278, I secured three years of full time employment within UBC?s Philosophy department, a position usually reserved for philosophy graduate students. CUPE 2278 represents teaching assistants, language instructors, markers and tutors at UBC. Our members conducted a strike and savvy negotiations with UBC some time before I became a graduate student. Without that contract, I could not have made it through those very lean years in Vancouver. Finally, the PhD tuition waiver, also procured as part of the strike settlement, together with the international student tuition award were essential to my success. When I returned to Seattle in fall of 2011, I did so having depleted all of my financial resources. I was able to call on some relatives and old friends for help. My cousins Pat Kristovich and Jeannette Ocampo provided hospitality while I made the transition back to the U.S. They also counseled me and encouraged me in a way that only family can do. Pat and Jeanette had taught me how to grow up on the deck of a xiii purse-seine fishing boat off the coasts of Washington and Southeast Alaska long ago. Now they have taught me how to continue to grow in what has somehow become ?middle age.? Without their unconditional love I would have folded, like a pocket-knife, two years ago and these words would never have found the page. My dear friends Joe and Nancy Guppy also extended helpful hands. Eventually I wound up in residence with Pauline Guppy, Joe?s octogenarian mother, in her mansion house in the heart of Seattle. Pauline, who is a great matriarch and accomplished science fiction writer, has graciously allowed me to stay free of charge while I finished this project. They know how difficult it is to complete a doctorate and so has extended this sponsorship in the spirit of charity. The final draft of this essay has benefited immensely from feedback given by my examination panel. A lively discussion was had at the dissertation defense, facilitated by the patient staff of the Faculty of Graduate Studies in the Koerner house. My friend and colleague, Miguel DeGreiff, has read this manuscript and provided critique and encouragement on a few occasions that has been very helpful. I am indebted to the thoughtful feedback of my external examiner, Dr. David Seamon as well as my university examiners, Dr. Tom Kemple and Dr. Barbara Weber. I have attempted to respond to their suggestions as thoroughly as I could. Special thanks to my brothers, sisters, nieces and nephews who always had kind words of support and forgiveness for all the holidays and birthdays I missed while away at school over the years. Dedicating this essay to my mother, Marcia Ann Durgan would be redundant because I dedicated all my efforts in life to her memory when she passed away some two years ago; may she rest in peace. If the faith that carried my Mother xiv fearlessly from this world be true then I may yet see her again, some day, alongside my father Edward Leroy Durgan. xv Dedication To Mieke Schappe with Gratitude 1 CHAPTER 1: Introduction 1.1 Anarcha-Existentialism Our society bears a crisis of immense and growing magnitude; the crisis of homelessness and severe mental illness (SMI). Since the first time I visited a large city I wondered why this was and whether this crisis could ever be solved. How can housing be provided for all? When I came of age, I pursued related questions through training and research in psychology. Later I approached it through the philosophical tradition, eventually combining them in existential-phenomenological psychotherapy. SMI occurs at higher rates in cities and often accompanies homelessness, so psychiatry and architecture became the necessary interlocutors with philosophy. Like heralds, these three led me to many branching paths of thought and practice that converge here for the first time. Nearly every inch of the urban environment is built by human hands. Architecture (and related engineering and ?planning? practice) is the discipline through which human intentions take shape as dwelling places. Psychiatry is the medico-scientific discipline deployed in response to SMI in a given population; the state?s steward of scientific knowledge and medical efforts towards the cure for SMI. Despite the mastery of material and form, the ever-renewed modern metropolis is a terrain of uneven privilege. And despite the multi-billions of dollars profit of the pharmaceutical industries and technique sharpened to molecular accuracy, the modern mind eludes psychiatric healing. Given the scope of the crisis at hand, no disciplines have failed more spectacularly than these. Everyone will readily agree that it is of the utmost importance to know whether we have been duped by authority. 2 I started this project by doubting all accepted authority on the questions at hand. As a result, and by the words of one preliminary reader, the project itself is homeless. Maybe this is another way of understanding interdsciplinarity. It is obviously a critique of psychiatry and architecture, but also of the very concepts of the psyche, the self, the individual. Notions of health and mental illness fragment and fall apart very quickly without these frameworks. The concepts of the social systems known as the ?city,? and the ?state? follow into the space of radical doubt. If this anarchist impulse saves us from unconscious slavery, then face-to-face dialogue saves us from ultimate meaninglessness. Phenomenology achieves the doubt of all knowledge through a description of human existence founded on such a dialogue. Phenomenology, since Being and Time (Heidegger, 1927/1962) and as I will discuss below, is existential-phenomenology. Anarcha-existentialist best describes the method that I have contrived as an academic vagabond; like a gadfly buzzing about between academic departments, the stricken cities of the West, and the receding horizon of a dying empire. Dear reader; I invite you into this new terrain with these disclaimers: if you find yourself torn and confused, left alone and abandoned to find your own meaning and reasoning by the following content please remember this key phrase. And if at some point along the way your heart breaks as I hope it will, please do not turn back to the patriarchs that promise to protect you from the unknown. Go forward with me towards justice, like black-clad militants with rage in their hearts, and smash the beguiling fa?ade of the global city! 3 1.2 Hockeystick: At Home with Homelessness My speculations and those of other researchers must be constantly checked against the supreme experts on SMI and impoverished or homeless dwelling; those people themselves. Hockeystick1 was a male-bodied aboriginal, radically homeless person, 30 years old, who carried a hockey stick and a tennis ball when we met in a back room of the Downtown Eastside Residents? Association (DERA) administrative offices. He was the first participant to volunteer for the study presented here. By ?radical homelessness? I refer to people who have been called ?street homeless? or ?absolutely homeless? (Hales, p. 8). This includes people that have no place to call their own. They dwell and sleep in places that are not meant for human habitation such as garbage dumpsters, cardboard boxes, or doorways. They may also sometimes spend nights in emergency shelters, squats, tent-cities or hidden camps. Hockeystick slept most nights in the doorway of the building we were in, facing Hastings street ? the busiest thoroughfare of the neighborhood and one edge of ?the blade,? the area of the city of open drug and sex trade. Filthy, he was dressed in a pair of beige colored sweats and a white t-shirt that was also dirty and discolored. The room where we met doubled as DERA?s break-room and a soup kitchen pantry oft utilized by the anarchist street-feed collective Food-not-Bombs. I hoped we would be uninterrupted when I sat down at a table opposite him while he remained standing at first. While I prepared the study questionnaires, by laying them out on the table, he put the tennis ball down on the floor and took the stance of a hockey 1 I use pseudonyms for participants that somehow impressed upon me the unique character of the particular person in order to code them in my records. I came up with this mnemonic device during the year I assisted in the methamphetamine psychosis study on the DTES. It helps satisfy the ethical requirement of preserving the anonymity of participants, but also to recall more vividly the quality of our meetings. 4 player. Although he wobbled, he pushed the ball back and forth a few times, showing stick control, before he reached down and picked it back up. He pulled out his chair and sat down putting the tennis ball on the table and laid the stick down on the floor. He looked up at me briefly and made eye contact. I can still clearly picture that immeasurable moment when I like to think that we established a genuine rapport, he trusted me and I respected him. At the start of the interview he spoke in brief, almost startled, utterances. I could see that one side of his face hardly moved as he spoke. When he blinked, his eyelids were out of synch with each other. His face seemed to droop on his right side and his lips turned slightly downward while his mouth was slightly agape when he was silent. A trail of dried blood started inside his right ear and ran down his neck where it disappeared under a brown splotch on the dirt stained collar of his t-shirt. His right hand was swollen and seemed permanently cramped into a fist. He had grasped the hockey stick with his thumb on that hand, so it appeared he could not open it. He had difficulty grasping a pen as he scrawled his signature on the study?s consent form. The initial interview included the administration of a neuropsychiatric inventory (known as the ?MINI?) that was designed to specify any of the DSM IV?s axis one disorders. These disorders include the severe and chronic disorders that are among the main concerns of psychiatry. I was looking for signs of schizophrenia, bipolar disorder, major depression, and substance abuse or dependence among others. These diseases are mysterious and require a specialized branch of medicine to address them. Unlike other diseases they have no definite physical markers and cannot be detected with a blood test or x-ray. Diagnosis in these cases, the prerequisite for all medical treatment, requires 5 psycho-social assessment. As we made our way through the questions, Hockeystick began to pause at intervals, more and more frequently gazing into the corner of the room or looking up at me while repeating the questions. He validated my sense that he was honestly engaged in the interview by insisting, eye-to-eye, on clarifications. His physical gestures were often exaggerated, and he spoke in the deep-voiced accent of the Coast Salish. He had been the witness to, and victim of, violence many times over many years and had been homeless for more than four years. He used heroin almost daily, as well as cocaine and alcohol less often, but frequently. He reported alternating constantly between states of depression and anxiety. When probing for signs of psychosis I asked if he had had any extraordinary experiences, like receiving messages from the television or hearing voices that other people don?t hear. He said ?No,? but when I asked if he had ever felt that he had been possessed by a demon, his expression changed. I had struck a nerve. He said that he had at times been possessed by a demon. Through my experience in the field I knew that moments like this can be damaging to the client?s, or in this case the research participant?s, well being. I dutifully marked down his response and continued to the next questions, being careful not to validate or invalidate his experience of this. I wanted out of that situation before I opened a can of worms that neither I, nor the research design, was equipped to deal with. Once we scheduled the next interview he grabbed his stick and ball, and headed for the door. I asked him to wait a moment so I could pay him the twenty-dollar stipend and get his signature on the receipt. He was ambivalent about accepting the cash, 6 expressing that he appreciated the opportunity to contribute to this important study. I said that I was required to pay the stipend. Inculcated by UBC?s culture of research, I had assumed he was participating for the money. He finally took the money and signed the receipt, surrendering the dignity of voluntary participation, and giving me more insight into my own prejudice. The results of the interview showed that Hockeystick exceeded diagnostic criteria for Major Depression, Generalized Anxiety Disorder, Post Traumatic Stress Disorder, an unspecified Psychotic Disorder, and Substance Abuse/Dependence according to the MINI. We met the following week for the second, final interview. For well over an hour he spoke to me in low tones to an internal down-tempo metronome that seemed to keep perfect time. He stopped talking when he nodded out a few times, perhaps lulled to sleep by his own heartbeat. Slowly a description of life as a homeless hard-drug addict on Vancouver?s Downtown East Side (DTES) emerged. For over ten years he had lived in cardboard boxes and hustled money to score dope, managing to stay high most of the time. He had grown up on one of the many impoverished reserves in B.C., and had not paid rent in his own apartment since his late teens. He declined to discuss further his experience of demon possession, except to say that sometimes when he was using or seeking drugs ?a demon would take over.? Hockeystick displayed a keen awareness of his life and its contingencies. He made this, as well as his conviction that he had chosen this lifestyle, clear throughout: ?For the most part I spend a lot of time being on guard. There?s a lot of danger in this lifestyle that I?ve chosen to live? It is a life or death situation in a lot of ways. And a lot of fucking people that I choose to spend time with ? some people will get in a dispute 7 over a ten-dollar crack deal and somebody ends up dead.? He had a complex understanding of himself based on a multi-faceted anthropology: ?There?s the physical me, my mental state, my emotional state, and then there?s the spiritual that makes me who I am, and this is a physical disease that I have. It affects my physical, it affects my mental, and it affects my emotional. Obviously it turns me cold.? Very quickly, it occurred to me that I was learning some very special knowledge. This stuff is hard to get and even harder to know what to do with. Towards the end of our meeting I felt that I had witnessed a profound account of survival on the streets just outside the door. I was fascinated and began to sense the growing burden of responsibility; Hockeystick was entrusting me to witness, analyze and share his life experience. He included a description of a repeating cycle of behavior: ?I?m either in hot pursuit of my next fix, or else I?m stoned out of my mind after I get that fix. Or I?m sleeping and then I wake up and I?m sicker than a dog and I need to have that heroin or cocaine. So that?s basically the four states of my being: being stoned out of my mind; sleeping; looking for a fix; or sick.? Having established his dis-ease, I just had a couple more questions. ?So do you feel at home where you live?? I asked, expecting an answer in the negative. ?Yes? he replied. Incredulous, I slipped. ?You do?? I asked. I struggled to reset my brackets, check my prejudice and reaffirm an openness to outcome: ?What makes it feel like you are at home? What makes it a home to you?? ?Basically, like I said, I guess it?s the way I carry myself. I try to respect people 8 to the best of my ability,? he responded. ?So you are in a community where there is a familiarity with other people?? I said. ?Exactly,? he assured me and continued: ?Yeah, you know it has become a home by way of, yeah, people are used to seeing me in the doorway now.? ?So there is a social familiarity with the place and that makes it your home?? I asked. ?Yeah they even call it [Hockeystick?s] place sometimes,? he said in an ironic tone. I struggled with this point. My assumption, based on years of direct service positions and research was that sleeping in a doorway facing a busy downtown east side street would surely qualify as homeless, by any measure ? especially the subjective. However, according to Hockeystick?s own account, I was wrong. He felt at home-in-community. This was partially due to his own effort of carrying himself, and the community?s acknowledgment and acceptance of his own personal space. I see it now as a socio-linguistic network that affirmed personal dignity and was centered on the recognition of the individual?s personal place by his own name. This is precisely what the existential philosophers would predict, but the tradition had never been read into the special case of urban homelessness. We are not merely animals that depend on physical dwelling; we also dwell poetically, linguistically ? always navigating a co-constituted reality in a mutually caring community by way of personally meaningful decisions. 9 1.3 Dwelling and Human Existence Regression from the natural attitude to the lived world is the goal of phenomenological method. If I had not managed to finally bracket my assumptions about Hockeystick being homeless, I would not have reached the epoche? ? the way the at-homeness in his experience showed itself in my awareness. This epoche? of consciousness allows what is perceived to be known for what it is. A description of the fundamental existential conditions of dwelling is then possible. The natural attitude, a comportment of prejudiced interpretation, reigns in every day life; and it reigns in the scientific approach to gaining knowledge. The epoche? can be a suspension of biases in theories that frame scientific questioning. The natural science method begins questioning into homelessness and mental illness from a theory, or a set of theories. The phenomenological method begins this questioning from descriptions of homeless dwelling, and descriptions of mental illness, taking existence as a starting point. This method can be seen as an anti-method that allows special epistemological claims. It is worthwhile to highlight differences between this method, founded by Edmund Husserl (1859-1938), and certain other methods of inquiry such as psychoanalysis (Freud, S., 1913; Lacan, J., 1958); structuralism (Titchener, 1902; Levi-Strauss, C. 1955); and functionalism (James, W., 1890; Searle, J. 1980). Respectively these presume to reveal an ego hierarchy, a psyche, or effective causes in personal existence. Phenomenology does not reveal these, nor does is assume a transference of energy, collectivism, or will power in social existence as they do. Instead it reveals a concerned perspective and a nascent logos in flux with a body?s sentient, unmediated encounter with reality (Merleau-Ponty, M., 1964; Behnke, E., 2011). 10 The lack of rigorous descriptions of homeless existence is a blind-spot in psychiatry, psychology, and phenomenology. The position that ?? people are not viewed as just objects in nature. Rather, the existential-phenomenologist speaks of the total, indissoluble unity or interrelationship of the individual and his or her world? (Valle, King, and Halling, 1989, p. 7) stands in stark contrast to mainstream reductionist/materialist models. And yet, existential-phenomenological psychology has made some of the same mistakes. All of these positions accept the clinic as a neutral territory where psychopathologies, such as schizophrenia, will show in their pure form ? as if they existed in what philosophers of science refer to as ?natural kinds.? They also make the mistake of assuming that the homeless person is on equal ontological footing as the domiciled person. My rejection of these assumptions at the outset of this essay offers a novel phenomenology of dwelling and psychopathology. Being and Time (German Sein und Zeit 1927/1962 English translation) is the milestone essay by Martin Heidegger (1989-1976) that originally brought the methods of phenomenology to bear on the questions of existence. Phenomenology had already produced a new approach to epistemology (Husserl, E., 1931/1960), while existentialism had produced an altogether new morality and anthropology (Kierkegaard, S., 1843/1992; Nietzsche, F., 1882/1974; 1886/2003). This philosophical movement allowed a renewal of the questioning into ontology, or the emergence of subjective consciousness of ?being-in-the-world.? ?Homelessness,? or Unheimlichkeit, is an aspect of our basic mode of being and one of Heidegger?s most stunningly original concepts. It is often translated as uncanniness. Dwelling, or being at home, is seen here as a temporalizing event while homelessness always threatens to plunge the individual into the immediacy of perception. 11 It threatens all possibilities because it disrupts personal time. Thus it reminds us again and again of death! Dwelling then is seen, from the phenomenological perspective, as the ceaseless activity of creation of bulwarks and fortification against the dread that encroaches on subjectivity. In the home I find everything that I live for and live from. Even the things, people, and events of the world that lie beyond the threshold of my home are present. Objects are pregnant with meaning that echo a deeply embodied attunement with the personally historic world. The beloved Other is there as kin or partner, ever present in corporeal or phantom form and, sometimes, even relics. The spaces where I prepare and share food, and lie down for sleep are cultivated places. Here the tasks of existence are given over to the physical frame of the dwelling. This is especially true of the bed, or base, where I abdicate the vigilance of consciousness and give over my existence to place in sleep (Levinas, 1947/1978). Through these acts my subjective sense of time and self arises (Heidegger, 1927/1962). Freedom is the opportunity to go beyond the ego and its private solipsistic version of reality. Transcendence of the self is granted by the appearance of the face of the autonomous Other which gives me the opportunity to act for the sake of something other than myself. Ethical action in the form of altruism is synonymous with freedom (Levinas, 1961/1969). In the appellation ?Dasein,? Heidegger describes a human being that is radically temporal. I am thrown into my existence, inheriting certain inescapable facts that are not given by a mediating rationality or a metaphysical form, as in Kant or Plato, but by the things that I encounter themselves. Essences shine forth, self revealing, in a field of being. However, they take on significance as part of my always-already-active and 12 ongoing plans. My ability to respond to what the world gives to my perception, greatly depends on my comportment. While Heidegger describes a person as always with others and never alone, I am always concerned for my own-most projects. Existential anxiety is rooted in the fact that I always face the potential for the impossibility of all possibilities: death. Other writers in the tradition suggest that my efforts can best serve, not my ego, but the needs of other people. The greatest tensions generated within the existential-phenomenological tradition are between Heidegger?s ontologically-based morality, and Emmanuel Levinas? pre-ontological ethics. I am exploiting this tension to examine the special case of homelessness and SMI. Levinas suggests that my responsibility imposes itself as my most primal decision to respond to the given situation of the world for the sake of other people, and not just for my own sake or for my projects as in Heidegger?s account. The appearance of the face of the Other person is an epiphany that calls my actions into question. They are without edges, and unfathomable. While the rest of the world calls me to respond in whatever way I will, the Other calls me to respond to his or her needs. The kernel of the argument is that arbitrary decisions appear to be free, but are actually contingencies of a self-obsessed madness. The face sets me free from solipsism; free from my personalized desires and reflexive attempts to meet them. This essay is an attempt to respond to my research participants and those who share their plight ? people often labeled as sick, insane, junkies, whores, prostitutes, hobos, bums, schizophrenics, bi-polar, addicts/drug users, sex workers, transients, homeless, and criminals. These labels limit the person?s existence to categories that generalize them into a certain classes, stripping them of individuality and damning them 13 to generalizations. This is often referred to as ?stigma,? and whether it is culturally or technically imposed it is equally dehumanizing. Each of my participants suffered from severe emotional stress and lived in impoverished conditions and yet they participated in the study with the intent of helping other people. Their efforts offer novel access to the basic nature of psychopathology. For Levinas, the regression to the lived world follows a ?trans-ascendance? towards the face of the Other, always higher than my own. I approached the case-studies and semi-structured interviews presented later in the spirit of Levinas? ethics of the face of the Other. BT is a work aimed at the elucidation of a fundamental ontology, being-in-the-world, which characterizes our existence. This key phrase and concept for Heidegger maintains central significance in all of his later works. It has had an enduring resonance within holistically oriented social sciences and existential psychotherapies. It is an antidote to the dualist tradition that began with Descartes? supposed mind-body split, and lead to the current state of affairs in modern thought. Heidegger?s use of this phrase stems from an etymological analysis and he argues that dwelling is already embedded in any utterance of the word ?being.? "In" stems from innan, to live, habitare, to dwell... The expression "bin" is connected with "bei" "Ich bin" means I dwell, I stay near... the world as something familiar in such and such a way. Being as infinitive of "I am"; that is understood as an existential, means to dwell near... to be familiar with... Being-in is thus the formal existential expression of the being of Da-sein, which has the essential constitution of being-in-the-world (BT, p. 151). This shows that ?dwelling? has the highest importance in Heidegger?s philosophy. The emphasis is on the verb to dwell and its equivalence to the infinitive of ?being.? The mind-body split is overcome through this finding which shows that we are inseparable 14 from the world and from the other people we share it with. There is no mind, or thinking thing that is distinct from the body. I am a being immersed in a world that I cohabitate, or dwell together in with neighbors. The passage also alludes to the ontic/ontological distinction revealed by Heidegger?s existential analysis of being. The existential ?I am? is not extended into the world like a tree or rock, but stands out as distinctly temporalized from the immeasurable flux of time. It is the qualitative distinction between human beings and all other beings. Dwelling is an essential attribute of an ecstatic being and to dwell means to have time, as past, present and future as an attribute. It is ability to recognize the facts of reality: the past events that precede the present; and the potential consequences of my actions on the future state of affairs. The dwelling space is like an always-transforming sculpture. We learn how to clean, and how to order our environment as children. ?Clean your room/put your toys away? are common parental instructions in some homes, for example. I think of this essay as an introduction to metaphysics for psychiatrists, psychologists, therapists or anyone working with homeless and/or mentally ill people. Regardless of whether one presumes a psyche, mind, or merely behaving organism, the accomplishments of dwelling precedes all of these. What is accomplished in dwelling? 1.3.1 Poetic Dwelling In this section I present Heidegger?s account of poesis, or poetry, in dwelling. Dasein never leaves behind the multi-faceted angst that underlies all mood. We make decisions whose value diminishes with time, or that disappears entirely if we do not act upon them. In at least three essays Heidegger emphasizes how these existential facts unfold in and through dwelling: Being and Time (referred to below as BT), Poetically 15 Man Dwells (1951, referred to below as PMD), and Building, Dwelling, Thinking (1951, referred to below as BDT). It is important to understand Heidegger?s concept of poetry in order to apply it properly to later parts of this essay. ?Poesis? should be understood, not merely in reference to literary poetry, but also in the ancient Greek sense of the word which meant ?to make.? These last two of Heidegger?s essays are directly concerned with dwelling; they read as some of the clearest and broadest statements of his anthropology. He wrote BDT for the ?Symposium on Man and Space? held in Darmstadt, Germany in 1951 (BDT, p. 344). After recapitulating his position on dwelling he adds: "We do not dwell because we have built, but we build and have built because we dwell, that is, because we are dwellers? (p. 350). Architecture, i.e. that which is built, is an inevitable product of the being of humanity. PMD was written in the same time as Building, Dwelling, Thinking. It is a careful analysis of some lines from the poem ?In Lovely Blue? by the great German poet Friedrich H?lderlin (1770-1843). Heidegger seems to see him as a kindred spirit, and envy him for his eloquently written voice. I believe that Heidegger sees in H?lderlin?s work an earlier iteration of the main thesis delivered in Being and Time. His interpretation includes an account of the appeal to the divine; something greater than humanity. It is part of a fourfold of existence, which he articulates with the help of this poem. Here dwelling is never a mere set of behaviors. This fourfold is: being on the earth; being under the sky; being with other people; and measuring oneself against the divine (PMD, p. 352). While each fold is distinct, they each always imply the others. Furthermore, "To 16 dwell, to be set at peace within the free, the preserve, the free sphere that safeguards each thing in its essence. The fundamental character of dwelling is this sparing? (PMD, p. 351). This is accomplished at the moment of ontological becoming, which equals care: ?Mortals dwell in the way they safeguard the fourfold in its essential unfolding? (PMD, p. 352). The free preserve for my research participant Hockeystick is not merely the doorstep where he sleeps, but the community of people in the neighborhood. Those people preserve and safeguard him in the essential form that his existence is becoming. In turn he carries himself in such a way that preserves his space and preserves other people?s comfort and dignity. This mutual caring has the characteristic of setting free. "Mortals dwell in that they save the earth... to save properly means to set something free in its own essence.? This saving of the earth is not to exploit it. Safeguarding is our authentic relationship to earth (PMD, p. 352). To exploit other mortals, or use up the earth, is to hold back the revelatory unfolding of the fourfold of existence. This unpoetic dwelling style, in turn, forestalls the wait for divinities. In near poetic prose Heidegger stated, ?Mortals dwell in that they await the divinities as divinities? They wait for intimations of their coming and do not mistake the signs of their absence. They do not make their Gods for themselves and do not worship idols. In the very depth of misfortune they wait for the weal that has been withdrawn? (PMD, p. 352). He is describing a spirituality that is free of nihilism and humanism, grounded in the dwelling. This spirituality is given when the spirit is broken, and when I have used my last resource and my fortune still wanes and I face the ultimate humility of impotence ? I must wait. Weal is related to both whole and heal by its etymology. The divine arrives to heal and restore wholeness of the being at home within the essential 17 unfolding of existence. For Heidegger, our task is not to choose between theism or atheism, Christianity or Islam, etc., but to discern what is divine and give our life?s energy to it. If the idea was latent in his early work, he brings it to fruition in these later essays. True divinity is distinct from mythical idolatry. It beckons toward healing, fulfilled existence and beyond to the great mystery. Here he calls for us to give up the customary notion of dwelling as a set of behaviors that can be isolated for analysis. Most importantly, we attain to dwelling by a poetic creation, or building (PMD, p. 266). Full of merit, yet poetically, man dwells on this earth. This line further bears the essence of Heidegger?s concept of dwelling. It means that dwelling is merited a priori. It does not rely upon evidence other than its appearance, and no further evidence can refute it. The mere inhabitation of space, existence itself, merits dwelling2. Poetic dwelling also brings me to earth, beneath the sky. The expanse between earth and sky is "? measured out for the dwelling of man?poetry is a measuring... with which man measures out his dwelling, his stay on the earth beneath the sky? (PMD, p. 271). The accepted, western concept of place relies on a na?ve realism, or objectivism that posits an ?out there.? Things in the world are reached and utilized by a remote, rational and autonomous subject. Heidegger describes a radically different state of affairs. I am immersed in an irreducible and unfolding nexus of relationships. Space as devoid of meaning, or as an abstraction, is dismissed by phenomenology. There is no 2 Granting that mere existence merits dwelling and therefore a just society must provide homes for all becomes the basis of my ultimate conclusion in the essay. 18 ?empty space? or terra nullius. Phenomenology reveals instead, locales; places of free inhabitation. Following Heidegger further leads to suspension of the ?means to end? relationship between building and dwelling. He points out that ?? to build is already to dwell? (BDT, p. 348). Dwelling both precedes and constitutes building. This implies that dwelling is pre-reflective and pre-cognitive, and that building actually constitutes the mind or thought. As in the title of Heidegger?s essay, building, dwelling, and thinking are inseparable activities. Building does not cease after the ?construction? of a place is done; it is carried on by its inhabitants. This helps explain the reasoning of Freud?s arche-tectonic ego structure, Plato?s cave, and even Theresa of Avilla?s Interior Castle. Consciousness is congruent with the dwelling space and they are built simultaneously through poesis. Building, dwelling, and thinking are inseparable activities. To be is to build. Later in this essay I consider one architect, Gregory Henriquez, who?s stated intention is to make architecture into a poetic expression of social justice. His mixed-use attempt at ethical architecture in the DTES, the Woodwards redevelopment project, actually increased social injustices. If anything his dismal failure points out what Heidegger was already telling us in the essays on poetic dwelling: it will be impossible to dwell poetically, or build ethical architecture, as long as it is meant to serve an elite class that does not recognize the a priori merit of every person to dwell freely. In conclusion, Heidegger blames the decidedly unpoetic state of affairs in western civilization on a frantic excess of calculating. Only kindness will allow us to heed the fourfold. He said, ?As long as this arrival of kindness endures, so long does man succeed 19 in measuring himself not unhappily against the Godhead. When this measuring appropriately comes to light, man creates poetry from the very nature of the poetic. When the poetic appropriately comes to light, then man dwells humanely on this earth? (p. 227). The humane society is a concept that I return to in my final conclusion. 1.3.2 Dwelling and Language Heidegger repeats one point in both of the essays under consideration: "Man acts as though he were the shaper and master of language, while in fact language remains the master of man. Perhaps it is before all else man's subversion of this relation of dominance that drives his essential being into alienation? (BDT, p. 348; PMD, p. 213). Alienation, homelessness, ?unheimlichkeit,? is the result of a built-in error in cognition that assumes we are on top of language like a winning wrestler, when language is on top of us. Strange distortions appear in our existence as we are driven into alienation. When language becomes only expressive instead of poetic, it decays to the point of becoming a relic that does not speak. Authentic speaking happens when it responds to the appeal of language to be spoken (PMD, p. 213). In my reading, this provides one way to distinguish between the psychological and the existential modes of being. The difference between response and reaction is the difference between a free choice and a conditioned behavior, the difference between the human person and the human animal. The emphasis Heidegger places on this point is unmistakable when he adds: ?Among all the appeals that we human beings, on our part, can help to be voiced, language is the highest and everywhere the first? (PMD, p. 213). Jacques Derrida?s (1930-2004) autobiographical essay: Monolingualism of the Other; or, the Prosthesis of Origin (1998) further elucidates this problem. It is his 20 personal description of experiences of growing up under linguistically restricted conditions as a Franco-Maghrebian Jew in French-Colonial Algeria. His personal case throws into relief the ontological conditions of the person in general as a dweller in the linguistic. Language has us, we do not have it. Derrida takes this to be the supreme condition of our existence. These conditions include the paradoxical linguistic law: ?We only ever speak one language? (yes but) We never speak only one language? (p. 10). He is wary of the effect this paradox has on us. He suspects that it, as well as language itself, is mentally ill, and that it is ?? the unique place and first condition of madness? (p. 10). If language is the condition for mental illness, and language is a dwelling, we may already understand mental illness as a problem with language. This is most interesting in regards to those psychotic states during which such phenomena as ?word salad? and ?loosening of associations? manifest themselves. It also applies readily to cases of rigid personality, to obsessions and compulsions in speech, act and in dwelling. Derrida makes himself at home within the language of Levinas and Heidegger. He occupies a space in-between and overlapping the two philosopher?s work. Language leads the ego out of the ?boundless? of Levinas. I inhabit language similarly to how I inhabit my dwelling. Both forms of inhabitation provide conditions for the possibility of personhood. Language cannot be surpassed or avoided because I am always in language before I arrive anywhere. This is because of the inescapability of the Other. I am always already in transcendent interpersonal relationships that precede even my own subjective relation with myself. One finds oneself coming after language, having been thrown beyond its origins. It is constitutive of the ?I-ness of the I? or ipseity. ?My monolingualism dwells, and I call it my dwelling; it feels like one to me, and I remain in 21 it and inhabit it. It inhabits me? (p. 11). The primal ?I can? here is not the hypostatic self of Levinas, it is more a nascent sovereignty over hospes. This word has etymological branches linking it with both hospitality and hostility (p. 14). For Derrida this is the very ipseity of the ?I,? ambivalently hostile and hospitable. This is a hospes within language, not in a house etc. as it is normally understood. This ambivalence will almost inevitably give rise to ??disorder of identity? in all its seriousness, without excluding its psychopathological or sociopathological connotations? (p. 14). This understanding of ourselves in relation to spoken language should be extended to architectural language. My thinking occupies a position overlapping these three thinkers. The language of architecture, as I will show in inner-city projects like the Woodwards complex, is ambivalently hospitable and hostile. Architecture is built form with a syntax that we rely upon to interpret and express meaning (Alexander et. al, 1977). Heidegger emphasizes our inverted relationship to language in the context of dwelling and architecture. Except for the poets, like H?lderlin who know their place as a being subordinate to language, we have not yet learned to speak. He correctly concludes BDT by asserting that mankind has not yet learned to dwell. If taken in terms of the fourfold, humankind has not yet produced an architectural arrangement that allows the essential unfolding of the earth, the sky, the divinities, and the Other person. Just as our relationship to language is inverted, so is our relationship to architecture. We have not yet found a way to dwell together. The post-modern movement in architecture has offered some resistance to this ancient and ongoing failure. According to Otero-Pailos (2010) the inspiration of phenomenology helped bring post-modern architecture to fruition. However, 22 architectural phenomenology has carried on ambiguously and without a proper definition of itself. Heidegger, along with H?lderlin, suggested that we could heed the beckoning of language. ?The more poetic a poet is, the freer (that is, the more open and ready for the unforeseen) his saying?? (PMD, p. 214). The more engaged one is in the fourfold, the wider the horizon of possibilities and the more likely one will have the ability to respond. Instead we find ourselves dwelling ?altogether unpoetically? (PMD, p. 225). Dwelling can lead to building, but not through technical architecture, construction engineering, or some combination of the two (BDT, p. 361). Authentic building, the primal form of which is poetic, can occur as long as poets are at work in the architecture of dwelling structures (PMD, p. 225). They should respect the aspects of the fourfold that affect the site. 1.3.3 Dwelling and Ethics: Levinas and the Crisis Respite Program Although I was introduced to the work of Emmanuel Levinas (1906-1995) as an undergraduate in psychology around 1990, it really began to speak to me while I was a case manager in the crisis respite program (CRP) for homeless, mentally ill adults in downtown Seattle from 1997-1999. This was initiated through an extension of my Master?s level, clinical psychology training at Seattle University. The Embodiment of Emotion Through Dwelling was my speculative Master?s thesis, written at KU Leuven, on a number of hypotheses that might inform praxis in such an environment. It was my first attempt to explain the severe mental and emotional disturbances I observed among homeless people. Levinas describes the person as they emerge out of an undifferentiated 23 boundlessness3 of general being. The horror of anonymity precedes, and is far worse than, the anxiety of being as described by Heidegger. Horror portends something more threatening. Anxiety coincides with the ?possibility of impossibility? (i.e. the inevitability of death) and for Levinas, horror accompanies the more radical apprehension of the dissolution of a self that can die, or the ?impossibility of possibility.? Only an ?I,? or self with an identity can die. John Doe does not leave a will. This description appeared in Levinas? first major work Existence and Existents (1945, referred to below as EE) and it was advanced in Totality and Infinity (1978, referred to below as TI). Emergence from boundlessness remains without meaning until the face of the Other appears. The uniquely human epiphany of ethical service frees an existent by giving it options that lie outside its own ego?s motivation. Seattle?s Downtown Emergency Service Center (DESC), where I worked in the CRP, remains the largest shelter in the city, located at the base of hill renowned as the original ?skid row.? The main shelter space was a ballroom that had hosted gigantic parties of loggers, fishermen and longshoremen through the first half of the 20th century. While it retains its cavernous layout, the building is now one of the last refuges for Seattle?s most vulnerable, providing emergency meals, showers, toilets, and shelter 24/7. Large folding tables would cover half the old ballroom during breakfast and dinner. At night, the tables were stacked aside and specially-made sleeping pads, resistant to all 3 According to a personal conversation with a close prot?g? of Levinas, Roger Burggraeve, the thought of the Presocratic philosopher Anaximander of Miletus (Circa 570 BCE) was very helpful in the development of this concept. Anaximander said that the first element, from which all elements arise and to which they return, was the apeiron (Waterfield 2000). This is translated as ?boundless? and when Levinas refered to the ?element?, il y a, (?there is? in English), or ?being in general? he was modifying this ancient cosmological theory and applying it to the personal-ontological sphere. 24 kinds of contamination, lined the floor from wall to wall, evenly spaced out and equally open for the hundreds of people who would spend the night. I was part of a small staff of social workers piloting a new program, called the Crisis Respite Program, that was an augmented shelter within the DESC. We were set up following years of federal and state funded research by DESC staff in outreach and shelter assessment. Our primary purpose was to house homeless mentally ill people who had been discharged from the psychiatric emergency room at the King County hospital (also known as Harborview) with no place to go. With increasing shortages of clinical beds, these folks did not qualify for long-term commitment, although they all carried diagnoses of SMI including schizophrenia, bi-polar disorder, and substance abuse disorders. This, in addition to the fact that they were homeless, still did not qualify them for long-term treatment. I saw and assessed countless exhausted, drug addled, traumatized, psychotic, depressed and homeless people there. I had already spent the better part of an academic year training in outreach psychotherapy as it has been developed by Dr. Craig Rennebohm (2008). I hypothesized that it is the place and act of dwelling (noun and verb senses of the term together) that separates an individual from the elements and allows for a passive and reflective mode of being to occur. These people had to be able to sit back, relax, rest, reflect and finally sleep in order to go on. This physical-subjective quality, the inner relation one has with oneself, precedes the cognition or psychic processes that is normally taken for granted. For Levinas, to dwell was to accomplish the ontological adventure and a victory of consciousness over anonymity, a state of powerlessness over the dissembling forces of 25 being-in-general (EE). Furthermore, overcoming this horror, this vertigo at the edge of the abyss, leads to enjoyment of the world or element (TI). This position had support in existing Levinas scholarship with the notions of affective intentionality; a bodily felt sense of meaning (Tallon, 1995) and that of the inter-twining of the body and the places of inhabitation (Jager, 1985). Besides the primal event of the overcoming of ceaseless flux of time, inhabitation of the dwelling space allows the careful articulation of a personal life. It is the act in which experience becomes possessed through reflection, and especially the activities of homemaking. The world, and one?s existence within it, takes on meaningfulness special to the individual. It is also the place where the subjective aspects of experience that cannot be articulated outside of dwelling are cultivated. One comes to be, and to know oneself, simultaneously. Over time the personality, biography and hospitality of the person is developed and expressed in the dwelling. Guests are hosted, intimacy is enabled and indulged there. Peaceful solitude is had in this personal place. The most basic act being that of lying down on one?s own bed and giving over the fundamental tasks of existence, protection and support to the architectural situation of the dwelling. Sleeping is one of the basic events that characterizes dwelling. In sleep one?s being is suspended while physically resting (EE). I proposed that the result of this cycle of lying down in bed, sleeping, getting up and going out; then returning home at the end of the day is what establishes mood: the bringing of the psychic and the somatic forces into harmony. This mood, a general state of feelings (i.e. how one ?feels? or how one?s body feels), is the sentience that acts as a template for experience. Mood is the embodiment of emotion that sustains a person with 26 a distinct past, a secure present and a future, to which one may realistically tend. It follows that certain deficits in dwelling spaces or the activity of dwelling could lead to the fragmentation of mood by interrupting psychological and physical processes of homeostasis. This fragmentation does not correspond to the ?bad mood? which we are so often acquainted with, such as when our favorite sports team loses. This is the disappearance and absence of mood, stripping bear the existent person, which leads to anxiety at best, terror and horror at worst. I took the case of radical homelessness to be the most severe challenge to the embodiment of emotion. This disruption of dwelling leads to the breakdown of the temporal sense that arises from the enjoyment of the element and normal embodiment of mood. The loss of mind and the experience of horror follows when one can no longer distinguish the past, present and future. Memories from the past, what is currently impinging on the senses, and what one imagines may happen in the future, all flash before consciousness with equal validity. When psychiatrists and other clinicians witness ?word salad,? or ?loosening of associations,? they assume this is evidence of a thought disorder. I argue that it is more accurately understood as a mood disorder, as a breakdown of dwelling and the inhabitation of language. The self disintegrates, becomes disordered and resorts to mythical interpretive themes to maintain linguistic coherence. Levinas called this state of prolongation of being in the elemental the ?reign of mythical gods? (TI 142). From social perspectives, the person then appears to friends and family as mad, crazy, or insane. Through the clinical process they will be ?diagnosed? psychotic, delusional, or schizophrenic (American Psychiatric Association [APA], 1994). 27 My reasoning set me at odds with the APA and concomitant social-services system. I was doubtful of the effectiveness of diagnosis, but the system depended upon it. Our goals in the Crisis Respite Program included medication stabilization, connection to necessary services (especially medical, psychiatric, and drug and alcohol recovery programs), and a transfer into short term or long term housing ? none of which could be done without a diagnosis. Clients are faced with a complex array of services from welfare to criminal justice, medical and mental healthcare, and shelter or social housing (housing situations that are fully or partially paid for by some level of government and that provide services of various kinds) that they must navigate. In many cases we would receive large files for the client from other service providers in various institutional settings such as hospitals, half-way houses, and the foster-care system. Sometimes the files were three to six inches thick, dating back for several years. Other times we wouldn?t get anything more than a one-page fax from Harborview that included a psychiatric diagnosis and a prescribed medication regimen. We considered these materials in conjunction with the assessments that we performed, which included qualitative and quantitative measures. Over the course of about a year, our team completed nearly a hundred such assessments. I observed that some clients who had significant history in the system had been diagnosed with more than one major mental disease over the years. These included, but were not limited to, the severe ?Axis I? disorders such as bipolar disorder, schizophrenia, and major depression. Psychiatrists and other medical doctors, as well as front-line workers, generally assume that each mental disorder has biological origins distinct from each other disorder. Therefore multiple diagnoses of this kind for one individual could 28 not be correct. Experienced advisors I consulted in the field responded to this observation in two ways. Social workers blamed psychiatrists whom, they would say, see a client for 15 minutes once a month in order to write a prescription. They are prone to mistakes because they simply do not care enough, or take enough time to do a proper diagnosis. Furthermore, certain MDs prefer to prescribe certain medications. They may be acting on quotas from pharmaceutical distributors and, in some cases pursuing rewards or kickbacks (cash bonuses or special reward packages, including flights to exotic locations for informational seminars about the product, for instance). They may invert the order, making a diagnosis based on which meds would be indicated for treatment. In short the fluctuating histories of diagnosis may depend on indifference, etiological prejudices, or pharmaceutical trends. Psychiatrists, on the other hand, would blame social workers and cite a sort of slop in the system. Their understanding was that the system was overburdened and understaffed with poorly trained personnel. The prison industrial complex, psychiatric inpatient and community based programs, and homeless shelters, were connected by revolving doors. No one questioned the existence of the diseases, or the diagnostic system itself. Some assumed ineptitude on the part of under-qualified, or neurotic front-line staff who had risen from the ranks of the population under treatment. Others would cite inadequate funding and systemic mismanagement of programs by city, state and federal authorities; and they reasoned that if there was more money, then there would be adequate services. I was not satisfied with any of these explanations. I was hearing something like an echo of observations made in D.L. Rosenhan?s study: Being sane in insane places (1973). To carry out that famous study, 8 researchers 29 posed as mental patients and gained admission to psychiatric hospitals by falsely reporting experiences that assessors interpreted as signs of psychosis. After admission research participants proceeded to behave as normally as they could. Their length of stay ranged 7 to 52 days, and the average stay was 19 days. Although some of the real patients in the settings recognized and called out some of the researchers, none of the clinical staff ever detected the pseudo patients. The researchers found that once a mental health patient was admitted to a locked inpatient facility and given a diagnosis, clinicians interpreted all of the client?s behavior in terms of that diagnosis. Furthermore, when pseudo patients approached clinicians with normal questions such as: ?When am I likely to be discharged?? they were largely ignored; most nurses and psychiatrists would avoid eye contact and move on without responding. Rosenhan also found that psychiatrists in the study tended to presuppose patient?s biographical details to fit the accepted theories of schizophrenia. The findings of the study shook the status-quo of clinical practice and observers were left with the question, ?who is crazy here, anyway?? (Hock, p. 221). The combination of the prejudice of assessors, the diagnostic trends that are influenced by the pharmaceutical industry, and blind faith in the assessment instruments, gave rise to a dogmatic belief system. Behind the revolving doors, the multiple diagnoses, and the class-like antagonisms between social workers, nurses, and psychiatrist is a complex set of assumptions. The patriarchal power structure and monumental architecture begs comparison to religion, but I will not attempt that in this essay. Clinical methods of assessment, diagnosis, and treatment have now shifted to homeless and impoverished inner-city dwellers. Absent the rigid treatment schedules enforced by clinical staff, and the concrete architectural conditions of the hospital, we have a 30 completely different picture of the human face of madness. Out there, away form the clinic, in homeless shelters and on the streets, there is an ambiguous state of pathology that does not fit neatly into diagnostic categories. Since the histories that appeared in client files were clinical histories, everything recorded there had taken place in a specific architectural form. Some of our clients had even spent time in state mental hospitals that resembled the classical asylums in which the clinical psychiatric syndromes were first elaborated. Clinics are characterized by architectures of control, administered by medically trained personnel with authority over patients. In these places, staff regularly employ physical restraint and coercion when patients were difficult to control verbally. Existential-phenomenological psychology suggested a different, more satisfying explanation for these discrepancies. In the cases we saw in the crisis respite program there had been a history of dwelling types ranging from total regimentation, like prison or jail, to extreme impoverishment or homelessness. Once institutionalized, these people had very little privacy or control of their dwelling spaces. Whether it was a jail, a hospital, a psychiatric facility, or a homeless shelter, they were unable to cultivate their space with any expectation of permanence or duration. They did not even wear their own clothes in some cases, but homogenous uniforms instead. Furthermore, their activities and length of stay were unpredictable and sometimes arbitrary. In those settings, no one really knew when someone?s stay might end. Clients might be aged out, kicked out, get out on ?time served,? or get bumped out so more severe cases could be moved in. They could be deemed fit for discharge by a psychiatrist or other mental health professional. An entire program could get shut down, and everyone housed there would be turned out on to the 31 street. This experience of chaos could account for some of the variation across psychological assessments for a given individual. It occurred to me that the major psychiatric disorders might be iatrogenic, caused by the treatment itself. It followed that the manifestation of pathology, also known as the ?phenotype,? results from a combination of physiological predisposition, trauma (associated with becoming homeless or involuntarily institutionalized), and the physical and social conditions of the clinic itself. This is predicted by a phenomenology of the body, such as that provided by Levinas, in the case of failed ontology and an immersion in the boundless there is. Anyone setting foot into almost any urban core will see concrete examples of this type of severe mental illness for themselves. One need not be a clinician of any kind to witness this all-too-human suffering. This theory challenges the validity of ?schizophrenia,? the APA diagnostic model?s keystone disorder, because it questions its veracity as a distinct psychological disease. The notion that each case of schizophrenia has a common origin, course, and predictable outcome is based on assumptions stemming from a medical theory of the disease. However, if thought of as a problem in dwelling, different theories arise. From this perspective, I predict SMI to follow from homelessness or severely impoverished dwelling. Furthermore, I predict that constellations of symptoms, designated as diseases such as schizophrenia, depend largely on the architecture, interior design and the administrative structure of the facility in which the designation happens. This leads to the continuum model of mental diseases represented by Figure 1. 32 Figure 1 Affective continuum of severe mental illness based on Levinas' ontology. Levinas argues that enjoyment, not anxiety (Heidegger), is the most fundamental feeling that arises through dwelling. Applying this to my observations in homeless shelters resulted in a simple understanding of the relationship between dwelling and the manifestation of mental illness. Inadequacies or restrictions of dwelling hinder or condition psychic genesis (i.e. the ontological event), with homelessness posing major obstacles to its achievement. As dwelling becomes impoverished, dangerous, or lethal, enjoyment is interrupted and fragmented. It is displaced by horror, dread, rage, social alienation and paranoia, under the reign of mythical gods. The impoverished dweller is drowned and dispersed in the immediacy of space and time. Drugs, whether prescribed by an MD or a street-corner pusher, impinge on the body in such a way as to replace the absent comforts of home. Using hard drugs or alcohol becomes an effective coping 33 strategy to maintain coherence of the ego in the case of homelessness. What appears as psychopathology to the domiciled, is a survival mode for the radically homeless. My perspective sees patterns of mood and meaning in the lived experience of severely mentally ill homeless people as intentional directed toward existential fulfillment. When a person is clinically assessed, the architecture, whatever combination of drugs (illicit and prescribed) the person happens to be on, the administrative structure of the organization, the empathetic abilities and prejudices of the assessor all combine with the biography and dwelling contingencies of the person assessed. A given disorder is given such as ?bipolar.? When this complex of contingencies changes the person may be labeled ?schizophrenic.? Clients would often arrive at the CRP with a ?provisional diagnosis of psychosis; not otherwise specified? or ?schizoaffective disorder;? diagnoses vague enough that a shift one way or the other wouldn?t be surprising. The system maintains a progressively downward trajectory through elaborate checks and balances. Errors in diagnosis are nearly impossible with justifications that shift with the wind. Psychiatrists and MDs maintain the hierarchy of authority, making diagnoses and prescribing meds. In every city in North America there are a handful of psychiatrists with legal powers comparable to civic or supreme courts judges. They can order the involuntary incarceration of individuals into a variety of locked facilities, based on psychiatric assessment. Front line workers control everyday dwelling spaces, monitor medication consumption, and engage in behavior modification regimens with clients. Together, medical doctors, nurses, and social workers condition the lives of clients in these spaces. The treatment of clients depends on their conformity to the rules of the place, and expectations that follow from the diagnosis. 34 About a year into my tenure at the DESC CRP, we received news of the death of one of our earliest clients. It had been several months since we saw or heard from this person. They had been discharged from our program, after ninety days, into the general shelter and homeless population. Our efforts to place them into stable housing had failed. The news was devastating to everyone on our staff except for our supervisor. After more than 20 years of direct service experience, he was used to that result. Although our program was created to prevent those kinds of deaths, I was na?ve to think that every one of our clients would make it out. I was learning that there was a formidable mortality rate for the population we were serving. The primary question became one of life or death. Can reforms to the system improve life expectancy of the homeless up to the level of the domiciled? How would that be possible? The only possibility for that would be to house every homeless, mentally ill person. For the first time I was contemplating the possibility of total system change. I was also having thoughts that resonated with those of other phenomenologists since the beginning of the tradition. 1.3.4 Phenomenology of Dwelling In one of his clearest polemics, known as the Paris Lectures,4 Edmund Husserl stated: ?Philosophy is the supremely personal affair of the one who philosophizes? (p. 43). He proposed that any person professing philosophy as their life?s pursuit must, at some point, follow Descartes? example of systematic doubt. It is work done subjectively, on one?s own. It requires that one ?? withdraw into himself and then, from within attempt to destroy and rebuild all previous learning? (p. 44). All that is known, or sensed, should be cast into doubt and not taken for granted. This turn to radical doubt is a way to 4 The Paris Lectures were delivered at the Sorbonne in 1929. They would later be expanded by Husserl and published under the name: Cartesian Meditations (1931). 35 empiricism and can be understood as a first step of phenomenological method. What I present here should be seen as a partial account of my personal process of this. When I was introduced to phenomenology I was at the end of my baccalaureate studies in psychology at Western Washington University. I began to question whether the theories of psychology I had learned about by then had been built on mistaken and unexamined assumptions. The systematic bracketing of assumptions, judgments, constellations of knowledge, vocabularies etcetera demanded by phenomenology. This was a new and welcome idea. This was challenging on a personal level since I had built an identity that was wedded to academic psychology, and the accompanying power structures inside and outside the academy. I felt at once liberated and threatened by the thought of setting aside assumptions and models that referred to a ?psyche? or ?mind.? It means the suspension of all anthropological, metaphysical, epistemological, and ontological positions. Many guardians of the tradition balk at the prospect of a purposefully destructive endeavor. This ?? ubiquitous detachment from any point of view regarding the objective world we term the phenomenological epoche'? (Husserl, p. 48). At that time I merely saw it as part of the position that I and my colleagues in the existential psychology branch of the discipline adhered to in the paradigm wars. Instead of substituting one model for another, this principle for that principle, we were called to suspend them all indefinitely while phenomena presented themselves. It is the very extreme insistence of this unrelenting pursuit that ultimately separates Husserl from Rene? Descartes (1596-1650). Descartes? Discourse on Method (1637) and Meditations on First Philosophy (1647), both of which famously advocate radical doubt of everything, had no intention of abandoning the assumption that there was a grand 36 cosmic geometry, which was meant, by God, to be methodically measured out by man. Husserl argues that Descartes made a fundamental error: he did not follow systematic doubt to the point where the epoche' happens. Instead, Descartes posits the ego cogito and its transformation into an independent human animus, one that has only to infer the rest of the world through deductive powers innate to the ego (p. 49). Descartes? position can thus be understood as a transcendental realism, in which the ego is separate from reality and the mind separate from the body. The legacy of this branch of modern philosophy can be seen in the various scientific disciplines and in the dominant Western worldview. Proponents of the western narrative of manifest destiny and the ascendancy of civilization argue that in the so-called hard sciences there has been an undeniable and unceasing ?progress,? but the foundations of these disciplines have only become more and more obscure (p. 49). This is an observation of Husserl?s in the Paris Lectures as well as a major focus of his later works. But what if radical doubt is pursued to the point that even the psyche is not assumed to exist? The epoche' reveals no ?I?, no psyche; only pure capacities like the capacity to abstain from judgment. The ego of the ?human being? is reduced to the transcendental ego, through which ?? the being of the world, and for that matter, any being whatsoever, make sense to me?This is the meaning of the phenomenological reduction? (p. 51). Early in his scholarly career while studying in Vienna, Husserl was greatly influenced by his psychology professor, Franz Von Brentano (1838-1917). Teaching from the late 19th to early 20th century, Brentano would also count a young Sigmund Freud (1856-1939), the founder of modern psychoanalysis, among his students. Well-trained in the scholastic tradition, Brentano singled out the medieval philosophical 37 concept of the intentionality of consciousness. His was a descriptive psychology that began with the observation that human consciousness is always consciousness of something, never a consciousness in general, or without an object (Moran, 2002). Husserl accepted this proposition and his life?s work amounts to an exploration of the implications of it for the philosophical and scientific traditions. The epoche' reveals that consciousness always has an object, and it is phenomenology?s only endeavor to describe accurately these contents, these intentions. As Husserl stated then: ?The essence of consciousness, in which I live as my own self, is the so-called intentionality? (p. 53), and furthermore that ?The tremendous task placed on description is to expound the universal structure of transcendental consciousness in its preference to and creation of meanings?? (p. 55). This eruption of original thought reawakened questions of meaning, being, and ethics. The new phenomenology would challenge positivistic science?s dogmatic insistence on establishing causality, society?s unquestioned traditional views of ethics and morality, and philosophy?s splintered post-modern mission to find clear and distinct ideas. Husserl saw phenomenology as a method that could replace the scientific disciplines as we knew them. He rightfully saw them as ego-centered narratives, blind to personal prejudices, and deeply embedded in equally mistaken, biased socio-cultural traditions. Phenomenology has had broad, but attenuated application. Besides more or less dominating philosophical discourse in Europe in the twentieth century, phenomenology has also been applied to art, literature, architecture and the social sciences. To my dismay, in nearly every case, these applications are merely examples of appropriation of the discipline, not for the advancement of humanity in general, but for 38 the sake of select classes, races, and nations. The most egregious example of this is its application to psychotherapy. Instead of helping the most vulnerable, the most highly trained and skilled therapists use phenomenology for the benefit of their neurotic, upper class clientele. 1.3.5 Existential Analysis of Dwelling and Good Mental Health Existential Analysis (EA) is a form of therapy based on the work of Viktor Frankl (1905-1997), a follower of Heidegger. It has been subsequently advanced by my teacher on the subject, Alfried Laengle5 (b. 1951). This model provides a robust psychotherapy with wide ranging implicatio