Article
Belief
Care
Creed
4 min read

Understand what we thirst for

Whether for water or meaning, it’s a primal force.

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A child wearing a wool hat holds a glass and drink water from it.
Johnny McClung on Unsplash

Quenching thirst is a global problem. It can also be profoundly personal, impaired by illness. For nurses, it can be ethically and emotionally difficult, when treating dying patients. But is there ultimate relief? 

Thirst is the subjective sensation of a desire to drink something that cannot be ignored. The world is thirsty; globally, 703 million people lack access to clean water. That’s 1 in 10 people on the planet. 

Thirst is a life-saving warning system that tells your body to seek satisfaction through swallowing fluid. It works in partnership with other body processes - such as changes in blood pressure, heart rate and kidney function - to restore fluid, and salt, levels back to where they belong. Failure of any part of this beautifully balanced system leads to dehydration (or water intoxication), and perhaps to seizures, swelling of the brain, kidney failure, shock, coma and even death. 

Sometimes it’s difficult to quench thirst, because of problems with supply. According to the World Health Organization, at least 1.7 billion people used a drinking water source contaminated with faeces in 2022. Sometimes in war, water is weaponised, with systematic destruction of water sources and pipes. Water laced with rat fur, arsenic and copper has meanwhile been reported in prisons across the USA.  

At other times, there may be “water everywhere, but not a drop to drink” because of individual problems with swallowing. As a nurse, some of my most heartbreaking moments have been when I have been unable to fulfil a need as basic as a patient’s thirst; when even thickened fluids have led to intense coughing and distress, and a realisation that I can only moisten mouths and give so-called “taste for pleasure”: very small amounts of a favourite liquid or taste using a soft toothbrush, or a circular brush gently sweeping around the mouth and lips to release some of the liquid - even, and especially, at the end of life when the patient is unconscious. 

Difficulties in drinking are common in dementia when fluid can seem foreign and swallowing a surprise to the system. It’s thought that over 50 per cent of people in care homes have an impaired ability to eat or drink safely; 30 to 60 per cent  of people who have had a stroke and 50 per cent of those living with Parkinson’s may struggle to swallow. 

Other conditions that may affect swallowing include multiple sclerosis, cerebral palsy, and head and neck cancers. Diabetes is characterised by a raging thirst owing to problems with insulin (diabetes mellitus) or an imbalance in antidiuretic hormone levels (diabetes insipidus). In intensive care, patients are predisposed to thirst through mechanical ventilation, receiving nothing by mouth, and as a side effect of some medications. But thirst is a “neglected area” in healthcare, writes palliative care researcher Dr Maria Friedrichsen.  

“Knowledge of thirst and thirst relief are not expressed, seldom discussed, there are no policy documents nor is thirst documented in the patient’s record. There is a need for nurses to take the lead in changing nursing practice regarding thirst.” 

Is there another thirst that is also being missed in nursing, and in life in general – a spiritual thirst, beyond the physical desire to drink? In his book, Living in Wonder, writer Rod Dreher argues that humans are made to be spiritual, and that a critical sixth sense has been lost in a “society so hooked on science and reason”. We humans crave love in our deepest selves; we have an insatiable thirst for everything which lies within – and beyond – ourselves. Auschwitz survivor Viktor Frankl, who was later appointed professor of psychiatry at the University of Vienna, became convinced that human beings have a basic “will for meaning.” “The striving to find a meaning in one’s life,” he wrote, “is the primary motivational force in man.”  

In the harsh sun of a Middle East day, an ancient story of a man and a woman encountering each other at a water well illustrates this dual thirst for water and meaning. The man, Jesus, thankful for a drink of water given to him at the well by an outcast Samaritan woman, said that “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give them will never thirst. Indeed, the water I give them will become in them a spring of water welling up to eternal life.” In that midday sun, such imagery made a powerful statement.  

Being mindful of spiritual thirst when drinking water is something also captured in a Ghanaian proverb and pictured perfectly in the many birds that drink by gravity, so tipping their heads back when they swallow.  

“Even the chicken, when it drinks, 

Lifts its head to heaven to thank God for the water”. 

Unsatisfied thirst is part of the human condition, we long for something more; it’s living proof of our immortality, says French poet Charles Baudelaire. Despite his Olympic success, athlete Adam Peaty said that society didn’t have the answers he was seeking, and that a gold medal was the coldest thing to wear. He “discovered something that was missing” when attending church for the first time, and now has a cross with the words “Into the Light” tattooed across his abdomen, symbolizing his spiritual awakening. We are more than mechanical machines with physical needs. We are rather gardens to tend in a dry and thirsty land, with souls in need of intensive care.   

Explainer
Creed
Seven Deadly Sins
Sin
9 min read

Reverse psychology: understand goodness then sin

Psychologist Roger Bretherton concludes our series on the seven deadly sins with a subversive proposition: we don’t understand sin because we don’t understand goodness.
An abstract shadow of a human reaching an hand skyward is overlaid by a trace of orange line that becomes a circle
Jr Korpa on Unsplash.

Over the last month or so, here at Seen & Unseen, we have been writing together about the seven deadly sins: greed, lust, gluttony, pride, sloth, anger, envy. If you have seen the David Fincher film, you probably have the grisly murders that illustrate them etched on your retina. But if there is one theme that comes up in all our articles on the subject, it is the fact that sin as a concept no longer carries any weight in our culture. A word that once bore all the heft of heaven and hell, is now the branding for a mildly indulgent discount day at the local health spa.  

One way of responding to the downgrading of sin as a meaningful and useful term, is to argue that we need a return to sin. Sin needs a come-back tour, a conceptual rehabilitation. We need to re-populate the word with meaning to make it current and plausible again. Without a consistent shared language of moral failure, of falling short, of ethical deficiency, it is difficult to imagine how responsible human community can be viable. Alasdair MacIntyre, the virtue ethicist, suggested that the problem with our culture is that multiple ethical games are being played. We are not just disagreeing about what the rules should be, but moreover what game it is we are meant to be playing. Our culture is a babel of voices, proposing conflicting versions of what a good life looks like. Consequently, in moral dialogue, we often fail to understand one another. As MacIntyre puts it: ‘my move to queen-bishop-three, is countered by your lob over the net.’

The etymology of the word sin is that it is an old English word originally derived from archery, meaning to miss the mark.

I am no etymologist. Very occasionally I dabble in a bit of New Testament Greek. But to be honest, I don’t know what I’m doing, and whenever I pronounce Greek root words they sound like items from the IKEA stocklist. And, given my tendency to talk to myself when I write, it’s almost inevitable that sooner or later the ever-attentive Alexa will accidentally order me a bedside lamp in response to what I thought was the Greek for bowels. That said, my understanding of the etymology of the word sin is that it is an old English word originally derived from archery, meaning to miss the mark. Miss by an inch, a foot, a mile – it’s all called sin (assuming archers in Old England preferred imperial units of measurement). Shoot the entire quiver in the opposite direction – that’s sin too. Linguists may tell us that this is an apocryphal origin myth, but it doesn’t matter. Whether in archery or ethics, the point remains the same. Sin is a relative term. It is relative to whatever it is we wanted to do, or aspired to become, but missed. 

Could it be then, that the root of our current cultural anomie is not so much that sin as a concept has been emptied of meaning (though it has), but that we no longer have any consensual agreement on what a good person should look like? We have no shortage of imagination when it comes to inventing new contents for the empty container of sin, but our thinking about goodness is woefully uninspired. Without a target to aim at, sin becomes vacuous. To illustrate this point, I’d like to tell you about two of the most eminent psychologists of the last hundred years. 

Hobart Mowrer and the psychology of sin 

Let’s start with a history lesson. O. Hobart Mowrer (1907-1982) is perhaps one of the most eminent, innovative and bemusing contributors to the short history of academic psychology. At the pinnacle of his career in 1953, he was elected president of the American Psychological Association (APA), the largest and most esteemed society of psychologists in the world. But as a life-long sufferer of recurrent depression, the announcement sent him into a deep psychological crisis that left him incapacitated for nearly four months. In 1959, he addressed the APA convention in Cincinnati with one of the most unusual and controversial papers of the decade, Constructive Aspects of the Concept of Sin in Psychotherapy, in which he argued that the euphemisms for sin preferred by psychologists (wrongdoing, immorality, irresponsibility etc.) were not sufficiently powerful to convey the distress of a guilty conscience. He had an ambivalent off-again/on-again relationship with institutional religion, but he was nevertheless impressed with the words of Jesus in the Sermon on the Mount that we should do our good deeds in secret. This principle – you are your secrets – became central to his development of Integrity Therapy, a group approach to psychological distress through confession. In the 1970s, the tide of cultural opinion turned against Mowrer, his Integrity Groups were accused of brainwashing their participants, and their popularity waned. Some say he subsequently retracted his views on sin. His episodes of depression continued to dog him, and in 1982, at the age of 75, he died of suicide, having long advocated this as a reasonable course of action in certain circumstances.    

This thumbnail sketch hardly does justice to the sensitive suffering genius of O. Hobart Mowrer. There is no space to recount the academic innovations that make him still one of the most cited psychologists in history. He coined the term ‘pathogenic secret’, the idea that sin – by which he meant the things that secretly bother our consciences – makes us sick. I think he was probably right about that. Take for example a freely available open-access list of what might be considered sin. It includes sexual immorality, impurity, sensuality, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, envy, intoxication, orgies, and things like that. It is not a particularly systematic or comprehensive list. It just happens to be the list of examples that Paul the apostle came up with in a first-century letter to residents of what is now central Turkey. They hardly make pleasant reading, but they make a great episode of Succession. 

Paul called these ‘works of the flesh’. Works, because they are things we do, situations we manufacture.  Flesh, not in opposition to physical pleasure, but because these kinds of responses (strife, envy, rage etc.) seem to be patterned bodily reactions, part of our conditioning, written into our muscle. The fact that Paul refers to them in plural (works of the flesh) is more significant than it initially appears. For him the unethical life is an incoherent ragbag of reactions, a series of plays and tactics designed to gain immediate personal gratification. As long as we come out on top, or at least think we have, they have done their job. But if we live by them, if we hand ourselves over to the universe of their self-centred cynical logic, our identity fragments, our sense of coherence shatters. We can no longer imagine who we would be if our greed, pride, lust or whatever, was taken away from us. Our appetites become our identity.  

This is why I tend to think that the instincts that led Mowrer to develop a therapy emphasising integrity was right.  Provided of course, that we embrace the full definition of integrity, rather than simply taking it as a synonym for honesty. The integrity to which Mowrer’s groups aspired was not just the truthfulness that comes from the disclosure of secrets, but the inner harmony that comes from the restoration of wholeness. What looked superficially like an unhealthy preoccupation with sin, was in fact Mowrer’s pursuit of the unified state of self that accompanies goodness. A sentiment that leads us to psychologist number two.  

Martin Seligman and the psychology of goodness 

Fast forward four and half decades from Mowrer’s election as APA president. It is 1998 and another newly-minted APA president, Martin Seligman – arguably the most famous clinical psychologist in the world – is making his inaugural address. Seligman is unique among world-famous psychologists in many ways, not least of which being his claim that he was ‘called’ to be a clinical psychologist. He later told a conference at Lambeth Palace that as a young research scientist, during his deliberations on whether to follow the path into clinical practice, he woke one night from a dream of visiting the Guggenheim Museum in New York. As he admired the architecture of the iconic building, God himself – a giant bearded old man – lifted the roof and boomed: I want you to be a clinical psychologist. Of course, as a secular Jewish academic, Seligman doesn’t believe in God, but this doesn’t deter him from openly admitting that his vocation in clinical psychology was not wholly chosen but issued from the unspoken depths of his being. 

This deep-seated sense of vocation may go some way to explaining why his 1998 inaugural address has gone down as a turning point in the history of psychology. His central assertion was that up until then psychology had been obsessed with the negative (what’s wrong with us) and that it was time to rebalance the discipline with a refocus on human flourishing, which at the time he formulated as the pleasant life, the engaged life, and the meaningful life. This is viewed by some as the birth of Positive Psychology, which according to Seligman was a corrective to the ‘rotten to the core’ view of human beings that had dominated the discipline since Freud. It is difficult to imagine a proposal more diametrically opposed to that of Mowrer. While Mowrer argued for a renewed awareness of ‘sin’, Seligman asserted to the contrary that it was the vast ignorance of goodness that bedevilled contemporary psychology. We already had a rich, ever-expanding science of what was wrong with people, what we needed was an equally detailed, every bit as expansive science of what was right with us. The explosive growth of positive psychology over the last few decades has been a response to that call, to develop a full-blown science of goodness. 

In the years that followed, Seligman revised his idea of the good life multiple times, perhaps his most ambitious proposal being the concept of Prospective Psychology; the idea that we as a species are best defined not by our past but by our future. He held this future-orientation to be so characteristic of human nature that we could name the species after it- homo prospectus.  We are defined not by what we have been, but by what we are yet to be. It is an insight he shares with many of the thoughtful people who have pondered ethics over the years. Take for example a freely available open-access list of what might be considered virtue. It includes love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control. It is not a particularly systematic or comprehensive list. It just happens to be the list of examples that Paul the apostle came up with in a first-century letter to residents of what is now central Turkey. I often feel better about life, just reading it. 

Paul called these beautiful qualities, ‘fruit of the Spirit’. It is significant that in the original New Testament Greek, the word fruit is singular: καρπὸς (No! Alexa! I don’t need garden furniture!) He doesn’t write fruits, but fruit of the Spirit. He points toward some kind of unity, harmony, consistency in these qualities. Mowrer no doubt would have called it integrity. Goodness is much more than the avoidance of naughtiness; it is the restoration of wholeness to our shattered and divided selves. Sin is much more than the cheeky indulgences we succumb to at the end of a bruising day at work; it is the misdirection and derailment of all we could become. And this is where the tale of two psychologists terminates. Contrary to what the marketing executives may have conspired to tell you, sin is not your friend; it is the enemy of your genuine divine magnificence. That’s what makes deadly sin so deadly.