[L. 33 | 40] 13 February 1964

Many thanks for sending me The Medical Mirror.[1] I don't know how it is in England—philistinism is the usual order of the day—, but it seems that the German doctors are not insensitive to current trends of philosophical thought.

I was struck by the remarks of one doctor whose task it is to look after patients suffering from anxiety. Formerly, no doubt, anxiety in patients would have been attributed to nervous (and therefore physiological) disorders, and the remedy would have been treatment by drugs or perhaps surgery. (Even now in America, I believe, the opinion is that all mental disorder will eventually be amenable to treatment by new psychotropic drugs and neurosurgical techniques—but then the Americans are the least philosophical of mortals. One of Sartre's characters remarks somewhere that 'For an American, to think about something that worries him, that consists in doing all he can not to think about it'.[2]) In other words, the whole matter of mental sickness would have been regarded as intelligible—in theory at least—in purely deterministic terms. But now this German doctor says

As some people commit suicide in order to escape fear, the knowledge of death also cannot be the ultimate reason of fear. Fear rather seems to be directly related to freedom, to man, whose task as an intellectual being it is to fashion his life in freedom. His personality is the authority which permits this freedom. But his freedom, on the other hand, allows man to become aware of himself. This encounter with himself makes him fearful.
With this, compare the following summary of Heidegger's philosophical views.
The only reality is 'care' at every level of existence. For the man who is lost in the world and its distractions this care is a fear that is short and fleeting. But let this fear once take cognizance of itself and it becomes anxiety, the perpetual climate of the lucid man 'in whom existence comes into its own'. (Myth, p. 18)
Man, in short, becomes anxious when he learns the nature of his existence; he becomes afraid when he finds he is free.

But if this is true, it is true always. Why, then, is anxiety so much more prevalent today, apparently, than it was formerly? The world is more comfortable than it was (and nobody has invented more unpleasant forms of death than have always existed), and yet mental homes are multiplying and full to overflowing. Why should it be so? This is where Nietzsche comes in—he is the diagnostician of our times. Nietzsche declared that 'God is dead', and called himself the first accomplished nihilist of Europe. Not, indeed, that Nietzsche himself assassinated God; he found him already dead in the hearts of his contemporaries; and it was by fate, not choice, that he was a nihilist. He diagnosed in himself and in others the inability to believe and the disappearance of the primitive foundation of all faith, that is, belief in life. (I am quoting Camus.[3])

Here, in a Buddhist tradition, it is not always realized how much in Europe the survival of death, and therefore of valid ethical values, is bound up with the idea of God. Once God is 'dead' (and he started dying, convulsively, with the French Revolution), life for the European loses its sense. 'Has existence then a significance at all?—the question' (says Nietzsche) 'that will require a couple of centuries even to be completely heard in all its profundity.'[4] And so the task that Nietzsche set himself was to find out if it was possible to live without believing in anything at all: to be absolutely free, in other words.

Being a man of integrity (there are not so many after all) he used himself as a guinea-pig—and paid the price with madness. But he discovered in the process that complete liberty is an intolerable burden, and that it is only possible to live if one accepts duties of one sort or another. But what duties? The question, for the European, is still unanswered. ('No one would start to play a game without knowing the rules. Yet most of us play the interminable game of life without them, because we are unable to find out what they are.'—Cyril Connolly in 1944.[5]) In the old days, when God was still alive—when Christianity was still a living force in Europe—, people were faced, just as they are now, with the anxious question 'What should I do?';[6] but the answer then was ready to hand—'Obey God's commandments—and the burden of anxiety was lifted from their shoulders. They feared God, no doubt, but they did not fear themselves. But now that God is dead, each man has to carry the burden for himself, and the burden—for those who do not shirk the issue and bury their ostrich heads in the sands of worldly distractions—is impossibly heavy. No, it is not death that these anxiety-ridden inmates of our asylums fear—it is life.

'And what is the answer?' perhaps you will ask. As I have tried to indicate (in KAMMA), the answer, for the ordinary person, is not self-evident. On the other hand, he may well feel that there ought to be some answer—as indeed Nietzsche himself did when he wrote

It is easy to talk about all sorts of immoral acts; but would one have the strength to carry them through? For example, I could not bear to break my word or to kill; I should languish, and eventually I should die as a result—that would be my fate.[7]
And this feeling is not mistaken—except that one can never have certainty about it until one has actually seen the Buddha's Teaching for oneself. In the meantime, all one can do is take it on trust—even if for no other reason than to keep out of the mental home. But these days are so arsyvarsy that anyone who does succeed in seeing the Buddha's Teaching may well find himself lodged, willy-nilly, in an asylum.

I was fascinated by the account of 'a surgical super-operation reported recently from abroad [America?], where in nine hours of hard work a patient was operated for a malign tumour, an intervention which removed the entire pelvis including the legs and re-established new openings for urinary and intestinal tract'. Just imagine—no more itching piles, no more ingrowing toenails. But surely they could have removed a lot more? After all, one can still live without such useless impedimenta as arms, eyes, teeth, and tongue, and with only one lung and one kidney, and perhaps no more than half a liver. No wonder the writer comments that the surgeon should make inquiries about the patient's reserves of asceticism—just the right word!—before he starts on his labour of love!


Editorial notes:

[33.1] Medical Mirror: The quotation is found in issue 6 of 1963, as part of a translated extract from a talk (in German) by Prof. Dr. Thure von Uexküll given at a symposium on 'Fear and Hope in Our Times'. [Back to text]

[33.2] Sartre: 'Americans do not enjoy the process of thinking. When they do concentrate, it is in order to escape all thought.' Troubled Sleep, p. 29. [Back to text]

[33.3] quoting Camus: This passage paraphrases sections of The Rebel, pp. 57-67. [Back to text]

[33.4] Nietzsche: From 6ET, p. 30. [Back to text]

[33.5] Connolly: The Unquiet Grave, p. 79. [Back to text]

[33.6] What should I do?: Check also the draft of an article The Foundation of Ethics found among the Ven. Ñānavīra's effects. [Back to text]

[33.7] Nietzsche: The quote is found at The Rebel, pp. 68-9. [Back to text]