Having put the word epistemology on the table, I’d like to expand on what it means for us clinically. My understanding is that we are epistemologically driven creatures. What that means is that we humans, immersed as we are in an ocean of sensory triggers, are driven to assemble the incoming tsunami of data into coherent story. (Now’s not the place to get into what gets taken in, what get’s filtered out, and many other important questions.) From our earliest moments ex-utero to the final moment of consciousness (as far as I know) we’re busy weaving discrete data points into orderly stories. That’s epistemology in action; and all of us do it.

If we consider depression for instance, we can see this process in action. Let’s say John (just a name), is in what I call ‘check-mate’ despair. By check mate I mean that there is no ‘legal’ move that he can conceive of to better his situation. By despair I mean that he believes and feels that this state of check mate will never end. What that means is that our epistemologist has connected the dots into an ordered story which he is compelled to obey. He is not merely attached to that story; he is defined (and confined) by it. All because of his epistemological drive.

And who knew?

More on this tomorrow!