Dementia and Living in the Moment
I just read an article on the controversial strategies for helping people live with dementia (The Memory House, by Larissa MacFarquhar, The New Yorker, October 8, 2018).
What is living well with dementia? The article asks if it is remaining true to the truth or if it is creating small—and then much bigger—lies to shore up the past someone is living in?
The question points to the meaning of living well for all of us: Is it better to live with hard truths or expedient ones? I have no answers, only more questions.
The philosopher Robert Nozick asks whether we'd want to be hooked up to an Experience Machine where we could have any experience we wanted for the rest of our lives with the caveat that we would know it wasn't real. A medical ethicist says no, because people want to do things, be a certain way, and, most of all, live in contact with reality. For her, a stream of pleasant experiences is not enough.
Another philosopher, Ronald Dworkin, takes the view that people don't live just for pleasure, they live to preserve dignity, feel whole, and experience a sense of integrity and coherence.
This sets off questions for me about whether living more in contact with reality is a path to well-being, whether one has dementia or not.
The challenge is that we already live with large gaps in our perceptions (see Leonard Mlodinow's Subliminal), which we fill in with what we think we know instead of looking more deeply into the nature of those perceptions.
If we do look more deeply, are we better off? Whether we are or not, I believe choosing to increase self-awareness is one of the gifts of our humanness, leading to more insights, connections, and awakening. That's why it's so distressing to hit the bump in the road called dementia when our loved ones no longer have that choice.
Even though we can increase self-awareness, we regularly filter our perceptions. We avoid certain feelings, certainly painful ones, or, if you're me, you pretend the laundry doesn't really need doing, rather like a baby who hasn't yet developed object permanence (the ability to know things exist even if they can't see them). In spite of filters and avoidance, it is possible to move toward greater self-awareness because, unlike a baby, I do know the laundry is there.
The gift of acknowledging the present
It's not easy to increase self-awareness. It's often a process of clarifying what we can't feel rather than what we can. Because the Feldenkrais Method® asks us to look profoundly and deeply at ourselves, what we find is not always ease and comfort, but the hard truth of our limitations. It's a challenge to practice finding our limitations over and over again, what my teacher called “ruthless self-inquiry.” Often it's a process of bumping up against the limitation and choosing to move easily in spite of it.
The limitation may or may not shift. What will shift is our movement, and then our lives. We can increase our scope, our vantage point, and the depth and breadth of our experience because we are able to acknowledge the present through our sense perceptions.
Dropping into the present moment of this leg moving, this hip rolling, this breath expanding has a sharp pang of illumination and recognition to it. If you're really in the present moment, it's not something you can escape like I am escaping the laundry.
When we access our present sensations and create more linkages, what Dworkin calls more integrity and coherence, we increase our choices for moving, for living. This is the absolute pivot point of our humanity. The loss of that access is the sadness of dementia.
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