When the string on an instrument such as a guitar is struck down to the fretboard, sound is produced from two portions of the string – not just one. The portion of the string in front of the fretting finger (toward the sound hole) produces the sound we commonly hear. But the portion of the string behind the fretting finger (toward the headstock) does as well. The string voices from both sides. Both sides of the string have a voice.
But typically, only one side is captured (by a microphone, or a cable out to an amplifier, or to a sound system) when a guitar is plucked. The sound that is typically captured is the sound produced from the portion of the string that is in front of the fretting finger. And typically, that’s the only sound that is heard.
The fact that sound is produced by both sides of the string can give us a fresh look at our work. And a fresh look at our work is especially possible when it’s held in mind that sound from behind the fretting location is commonly omitted in routine amplification and recording techniques.
Background
I was recently listening to an interview of a very accomplished electric bass player. The interview was conducted by a career-length and similarly accomplished musician/recording engineer/producer.
At one point the discussion turned to what the bassist’s solid-body instrument sounds like when it’s played unplugged and not being amplified.
During that part of the discussion the interviewee then did some playing unplugged, and said “You can hear…” and at that point the two said together, almost in unison, “…both sides of the string.”
I’ve played bass for 44 years, and worked in addiction treatment over 36 years. When I heard the phrase, “both sides of the string” a simple and profound notion struck me very clearly. And the notion that struck me could serve as an access point for improving our data collection, case formulations, clinical models, and research efforts.
What was the notion that struck me? And how can that notion possibly be useful?
As you read on, keep in mind that the string is a single entity that voices from both sides.
“…both sides of the string…”
I’ll start with an example from an acoustic guitar, then provide two examples from personality theory, one from primary health, and finish with some direct parallels and applications to our field’s clinical work.
Acoustic guitar
When a guitar player plays an acoustic guitar for an audience, the music in the mind of the guitarist is not what the audience hears. And the music emanating from the large body of the acoustic guitar is not what the audience hears.
What does the audience hear?
First of all, they do not hear both sides of the string.
The audience only hears the sounds the string makes from the location at which the string is being fretted, toward the sound hole and the bridge.
By contrast, if you stand next to an acoustic guitar while the guitar is being played, the instrument renders all of the information to the listener. And this is the case even if you don’t realize it. Even if you don’t realize what you’re hearing.
But in hearing the playback sourced from the instrument cable out of the acoustic guitar and to the recording console, one hears less information than the totality of sound that the whole instrument produces. On such a recording, one only hears the tones produced from the vibrations coming from the area of the leading edge of the fretted strings toward the bridge. And the recorded sound thus lacks the information from the entirety of the instrument that can be heard on stage when standing close to the guitar.
Next, let’s view some areas of our work through this lens. As you read, keep two things in mind: (1) the whole string as a single entity, and (2) hearing what comes from both sides.
Personality
Example 1:
The loner who essentially lacks desire for relationships and is naturally isolated can be viewed and understood as avoiding.
But beyond the outwardly facing set of facts there is other information. And it’s inward. Inwardly there is also active caution and active environmental scanning.
Thus, the schizoid character can be described as both outwardly avoidant and inwardly paranoid. And yet the personality structure can be understood as one entire whole comprised of all of these features and functions.
Example 2:
The person presenting outwardly with an inflated sense of self-importance can be seen as grandiose.
But there is additional information behind those outwardly facing set of facts. Inwardly there is also a sense of personal inadequacy.
The narcissistic character can thus be described as both grandiose outwardly and brittle/deflated inwardly. And the personality structure can be understood as one entire whole.
Do we look for, access, collect, record and incorporate the information from “both sides of the string”, or are we satisfied to do our work based only on what we hear as a so-called member of the “audience”?
Primary Health
I’ve previously written this true story related to Parkinson’s Disease on Recovery Review.
Here’s a short version.
“Someone I know was present when a neurological bench scientist working in Parkinson’s research met a person with Parkinson’s for the first time. They were delighted to meet each other. But when the scientist explained what they were working on (movement problems, naturally) the person with Parkinson’s asked if they ever worked on gut motility. The person with Parkinson’s had to explain to the researcher that there are whole sets of problems not visible to others. The bench scientist was very grateful to hear of a whole new array of research targets – from a person who knew in a whole different way.”
In the case of Parkinson’s Disease, the patient’s support people, clinical caregivers, and researchers easily observe the disordered motion the patient demonstrates. And the brief story above illuminates the existence of inwardly facing difficulties the audience of research scientists, family members, or clinicians might not see, hear, consider, or understand.
Applications to our work
By now the reader might have supposed my main point was the topic of internalizing vs externalizing symptoms.
But that’s not my main point.
What’s my main point?
My main point is that the string is a single entity. And that the so-called sides are from an artificially and secondarily imposed location – a point, or singularity – that itself also goes un-recognized. And that one might wonder what is located at that nexus of the two impulses, or sounds. And if the patient is consciously aware of all of these structures and functions.
Would such clinical awareness be helpful in some instances?
When we look at the patient, or hear the patient, or read the chart, or read previous medical records…
Are we mindful that:
- we might be only receiving what is outwardly expressed?
- inward-facing information exists that the patient alone may apprehend very easily, while they might wrongly assume everyone else easily does too?
- singularities may exist deeper in the patient’s phenomenological essence or developmental layers – from which information proceeds backward and forward in their etiological trajectory?
In our clinical work with addictions can we begin by understanding:
- addiction illness as one whole illness (rather than multiple co-occurring SUDs)?
- both resistance and compliance as forms of self-care emanating from the same single system (rather than putting them in tension and as reflecting two opposing systems)?
- the problems of Post-Acute Withdrawal Syndrome (PAWS) such as difficulties with memory, irritability, and sleep dysregulation might match perfectly well with craving, sensation seeking, and defensiveness – around the central feature of pro-active self-soothing, or its lack?
- addiction is seated behaviorally, cognitively, and emotionally in the web of a few critical social relationships (rather than merely being inside the brain of the user)?
- the value of the members of the family system as sources of information (that the audience of clinicians never hears)?
- the family system as a total entity (the sound of the whole instrument only those on the bandstand ever hear, and the clinicians never hear)?
- fear, shame, and avoidance might mask a vulnerability that a recovery fellowship can help care for and yet mitigate, with vibrancy from others like them – who are living out their spirituality in the context of their imperfection*?
Afterward
Some readers might enjoy the chance to explore other lessons from outside the field, including some practical examples that can serve as metaphors we can probe anew.
Planes, car repair shops, and dentists
Study betel nut before you finalize your public health or harm reduction policy
Our unconscious relationship with tobacco
Epilogue
(Paraphrase from wiki): A studio album by John Coltrane was recorded in 1963 during his Classic Quartet period. The album was lost for decades after the master tape was destroyed by the record label to cut down on storage space. The seven tracks survived as a copy Coltrane gave to his wife, and the recording engineer had made a copy for Coltrane to listen to at home.
The tapes resurfaced and the album was released in 2018. The name the record was given was “Both Directions at Once: The Lost Album”.
The title for the record came from Wayne Shorter recalling Coltrane stated that at one point what he was attempting to achieve musically was “starting a sentence in the middle, and then going to the beginning and the end of it at the same time…both directions at once.”
*Suggested Reading
Kurtz, E. & Ketcham, K. (1993). The Spirituality of Imperfection: Storytelling and the Search for Meaning. Bantam, Revised Edition.
Acknowledgement
I would like to thank Kelsey Crowe, Don Mrdjenovic, and Joe Najdzion for their comments on an earlier version of this work.
Recovery Review 