“He who has a why to live for can bear almost any how.” ― Friedrich Nietzsche
A poignant clinical interaction with an elderly gentleman demonstrated a common psychosocial crisis that impacts many people. After he recovered from his second ketamine session, I sat down to check in to see how he was doing.
As we spoke, he shared that he was retired for three years after a long successful professional career. He was battling depression that was mild to moderate for parts of his adult life, but it was only after retirement that his symptoms began to worsen, and now he found himself struggling to enjoy the fruits of his life’s hard work.
He was perplexed because he no longer needed to deal with the stress of his busy and demanding schedule. He listed all the good things he had in his life, citing his stable family support, financial stability, relatively good health, and the achievements he could look back on over his career.
Yet, he was unhappy and filled with depression and even to the point of having suicidal ideation. He could not understand why. There were no improvements when working with his psychologist, and various antidepressants. He went on numerous cruises to clear his mind, and while these vacations were fun, when he returned home, a state of depression would take hold again and again.
“I don’t understand. I should be enjoying my life of hard work and success.” He stated this as he described his identity as a form of resume.
It was clear to me that he was suffering from a classic case of “modal confusion.” Cognitive neuroscientist John Vervaeke, and professor of psychology at the University of Toronto who conducts research and writes on the topics of meaning, consciousness, and philosophy, uses this term to describe a common and often repeated source of dissatisfaction in life when individuals focus too heavily on having rather than being.
Having versus being as a concept was first introduced by psychologist Erich Fromm in his book “To Have or to Be?”.
The concept of having refers to the idea that people often define themselves by the possessions or external objects that they possess. In this view, people place a high value on material possessions, wealth, and status, and often measure their success and self-worth by these external factors.
The concept of being, on the other hand, emphasizes the idea that people can find meaning and value in their existence by focusing on their inner experience and relationships with others. This view emphasizes personal growth, authenticity, and meaningful experiences, rather than external possessions and achievements.
Fromm’s book and Vervaeke’s Podcast “The Meaning Crisis” assert the belief that modern society places a greater emphasis on having, and that this has led to a sense of alienation and emptiness in many people.
Modal confusion is a phenomenon when individuals seek more profound meaning and purpose in life through having. These misdirected efforts will leave a void that can only be filled through being. In the end, fulfillment is achieved by acting as a human being rather than a human doing.
To help distinguish a human being and a human doing, the two states can be contrasted:
|Seeks||Personal growth||Accumulation of wealth or things|
|Desires||Deep relationship||Sexual gratification|
|Desires||Peace and harmony||Escape from stress|
|Prefers||Balance of two viewpoints||Black and white|
|Focuses on the||Journey||Destination|
|Succeeds by||Depth of salience||Meeting measurable outcomes|
A human doing behaves in a programmed state that focuses attention on meeting economic and social status pressures. Human doings are designed for survival, operate to get things done, and accumulate wealth, power, and respect. Yet, these efforts do not promote the search for meaning, harmony, and connection in our self and environment. Deep fulfillment comes by cultivating the being part of human nature.
My patient conceived of himself as a human doing. He spent his entire life striving to demonstrate value, and through his professional efforts where he succeeded. The respect and money he earned provided a belief of purpose and meaning, but it was hollow. By going to work every day, he was distracted from the void he had in his life. Very little time was directed to tending to the awareness that he is a human being.
In retirement, he started undergoing a profound existential crisis, and on reflecting on his thought patterns, it is evident why he was stuck in this trap of focusing the value and direction of his life as depending on external outcomes and measures that can only come from doing or having rather than being.
Psychedelics allow one to connect deeply to the sense of being. Boundaries, categories, the artificial surfaces are dissolved away, and during the ketamine journey, one can experience raw awareness, which is the foundation of meaning.
I discussed the being vs. having crisis with my patient. This was a concept that he would struggle to understand prior to his treatment sessions, but through the power of psychedelics, it resonated with him. At the end of the treatment sessions, he was no longer suicidal. His depression scores were reduced by an astounding 70%. He still had work to do, but he had greater clarity on focusing his attention on becoming a better human being.