John Cage and Hypnosis

Through the course I am taking at the University of Maine on the History and Theory of Intermedia, I have encountered the ideas of John Cage.  I had always known that John Cage was an experimental musician and who has not heard of his performance in which the pianist walks on stage and sits quietly in front of the piano for 4 minutes and 23 seconds.  I had seen a performance by Merce Cunningham’s dance group for which Cage had provided the music, but as an audience member, I had had no idea that neither the dancers nor Cage had any clue what the other was going to do until the performance started.  It seemed flawlessly rehearsed to me, a member of the audience.  Having now encountered Cage, I assembled a group of friends for a discussion about his ideas in relation to medicine, psychotherapy, and hypnosis this past Saturday in New York City.  These were friends who had known John Cage in a variety of contexts.  All agreed that he was a pleasant unassuming man, unlike Dick Higgins, whom we have also studied and whom they also knew, but thought he was enigmatic.  I had just read Kostelanetz’s composite interview of John Cage from the Kenyon Review (Volume 9, Number 4, pp. 102-130, Autumn, 1987, at which time Cage was 75 years old). We also proceeded to by a MoMa tote bag on Sunday on which Cage is quoted as saying that he couldn’t understand people who were afraid of new ideas.  He was afraid of old ideas.  This was a nice entre to Cage and hypnosis for it is the old ideas that we hold sacred that get us into trouble.  Similar to Cage, Milton Erickson is credited for saying, “hypnosis is not getting someone into a trance.  It’s getting them out of the trance they’re already in.”  I think Cage and Erickson would have appreciated each other’s perspectives. 

For my creative response to this piece, I collected colleagues who had known John Cage in a room in Manhattan and advertised to everyone on my mailing list to come to a discussion of how John Cage related to hypnosis.  Additionally, we placed a sign at the entrance to the building inviting people to come upstairs for hypnosis or bacon, wondering if anyone would come and who they would be. This was also in the spirit, however weak, of the happenings of Fluxus, in which one cannot predict what will happen.

Here’s what I learned from our discussions and also from interviews I read with Cage:

Cage was more interested in a mediocre thing being made now, which is avant-garde, than in the performance of a great masterpiece from the past, which he said was a question of preservation.  Hypnosis is also about the present moment and not the past. Cage wanted to new things into being, which is the work of the hypnotherapist/psychotherapist.  Cage was devoted to being original saying that the more one knows, the harder it is to encounter the novel.  As an example, he cited cases in which the playing of new music by trained musicians required 75 rehearsals while young students coming from cornfields (I suppose he means anywhere that’s not a big city or perhaps Iowa specifically) who had listened to the music on the radio were able to play it with just two rehearsals.  This would be an example of a “beginner’s mind,” which works also in hypnosis. 

Cage believed that the music world had changed dramatically over the course of his life.  When he began to study composition, there were two possibilities – Schoenberg and Stravinsky.  Over time, everything became possible. Hypnosis is similar; more possibilities exist than can be described. Cage disagreed that music had lagged behind the other arts and acknowledged that he tried to make music which he didn’t understand, and which would be difficult for others to understand as well.  In the room, we agreed that some of our most effective hypnosis sessions were those that we couldn’t begin to understand. Cage likened art to the mysterious as is also true for hypnosis.  He wanted to use art to increase awareness because everyday life is more interesting when we become more aware of it.  Hypnosis has a similar motive. Cage’s goal was to become non-intentional, for then, everything is permitted.  He didn’t enjoy music that pushed him, and, famously, the Hallelujah Chorus was one example he cited of such music.  He spoke of the paradox of becoming free of memory at the same time that we take advantage of it, describing a dream he had once of composing a piece of music, all the notes of which were to be cooked and eaten. 

Cage considered the question of what is modern and decided that modern meant “not interrupted by the effects of the environment.”  For example, if shadows or spots fell on a painting and spoilt it, then it was not a modern painting.  If they were fluent with the painting, then it was.  He thought the way of deciding whether something is useful as art is to ask whether it is interrupted by the actions of others or whether it is fluent with the actions of others.  He spent his life denying the importance of relationships and introducing situations in which he could not have foreseen a relationship.  He gives as an example the Happening at Black Mountain at which many people were given the possibility of performing within compartments that he determined by chance operations.  If patterns did occur, they were patterns that had not been measured and weren’t emphasized.

Here is where we disagreed with Cage.  My friend, Peter, had been involved with Cage in his mycology hobby.  Cage was incredibly serious about mushrooms and bought books on these subjects. Perhaps mycology is a better metaphor than music; they are indifferent to human beings.  They go their own ways, cultivating their own survival.

Cage believed that this century saw an increasing gap between life and art.  He said that he was aiming toward a state of mind in which we don’t see things as ugly or beautiful but simply as they are – sans judgment. He said that the changes that have taken place in this century are such that art is not an escape from life but an introduction to it. He described eating lunch with de Kooning once who said a frame around the breadcrumbs on the table does not make it art, but Cage said it would.  When art is useful, it spills out of being beautiful and moves over into other aspects of art to influence our actions or our responses to the environment. We need help with the environment because it’s so crowded. We agreed that hypnosis is the kind of practical art in which we play with metaphors and images that are as evanescent as sand paintings disappearing after being used.  This attitude of not judging, eliminating the value judgments is also crucial to hypnosis, to accepting things as they are and not as we want them to be, and working from there toward where the client wants them to go.

Cage said that a mind that is interested in changing is interested in extremes.  The extremes give us a perspective from which to visualize the center. The logical mind is offended when it is confronted with things outside the range of its imagination whereas the accepting mind is delighted. In hypnosis, we strive to be delighted by whatever happens. Cage responded Zen answers the question of why compose by saying why bathe, why do anything.  Maybe because we enjoy doing it. I suspect we do hypnosis because we enjoy making word poem performances that may or not move the other person and that sometimes we are actually surprised when they work. Cage believed his feelings belonged to him and should stay out of his music.  We decided our emotions should always enter into our work for thoughts that cannot exist without emotion.  This perspective is perhaps different from the Zen Buddhist ideas embraced by Cage. He said that emotion didn’t fit into his work regardless of how many he had. We thought emotions were signals that were crucial to our artistic work in performing hypnosis. Cage said we must free ourselves of our likes and dislikes.  We concluded that we must become aware of our likes and dislikes and use them artistically which is the same as using them therapeutically. Cage said, if one gives up on the pleasures of one’s likes, then one’s pleasure will be more universal – more constant and more spacious. We thought the goal was to have pleasure without attachment.

In discussing abstract expressionism, Cage says that these painters wanted to put across their own images (identities), which he found disgusting.  We disagreed.  We found people’s identities fascinating and worthy of study and exploration. Cage believed that our ego and our likes and dislikes need to be removed from our compositions.  We believed that these were important aspects of the hypnotic, artistic performance. Cage said he’d changed his sense of responsibility from making choices to asking questions.  We agreed with that. By continually asking better and better questions, we elucidate the world of the client and learn how to function within that world instead of trying to make choices for people or even for how we should proceed.  Let the dialogue determine where the questions will go. Cage said that experimental music was experimental on his part, not someone else’s.  We thought that experimental hypnosis was an interactive dialogue of all involved.

Cage told how he stopped writing music until he found a better reason than “self-expression” for doing it.  The purpose of music, he said, was to sober and quiet the mind, thus making us accessible to divine influences.  He wanted to abandon the conventional idea that art is a means of self-alteration and say that what it alters is mind, and that mind is in the world and is a social fact.  This resonated also with our conception of hypnosis.

Cage described speaking in 1949 at the Artists School about sand painting.  He was promoting the idea of impermanence in art.  He denied that this related to Jackson Pollock whose work had permanence and who was concerned with the fact of gesture and painting on a surface which was on the floor.  His discussion of sand paintings related to their being discarded as quickly as they were finished.  The performances that we call hypnosis sessions are like this. Rarely are they recorded; rarely are they preserved.  Each one is constructed just for that moment, for that client, for that situation under consideration, and then it is gone – forever.

Cage used the word experimental to refer to actions for which the outcome is not known.  His goal in writing music was to make sounds that were free of his intentions.  By eliminating purpose, awareness increases.  Therefore, his purpose is to remove purpose. For us, hypnosis is different even though we now see it as art. Our purpose is to accomplish the purpose of the client added by sometimes our own perceptions of what would constitute greater health. Whatever we do with the client, the outcome is completely unknown.  Therefore, our work is experimental.

Cage distinguished three ways of composing music for these times: (1) writing music as he did; (2) performing music electronically rather than writing it; and (3) building the music layer by layer on recording devices in studios. He remarked that the directions in which we go are actually the ones to which we’re prepared to go, whether in music or any other aspect of life. Silence, his first book, contains an essay that he wrote when he was 12 years old called “Other People Think.” He proposed that we, in the United States, stop and listen in silence to what people in other countries think and to realize that they don’t think about us in the ways that we think about us. This is part of a more global goal of keeping his curiosity and his awareness open and trying to arrange his composing so as to have no knowledge of what might happen. This offered powerful parallels to doing hypnosis in which we must listen closely to the “other” so as to use his or her metaphors to accomplish the goal that he or she establishes. We must step aside from our own beliefs, interpretations, and judgments so that we can enter into the world of the client more effectively.

Cage said that the highest discipline was that of chance operations since they have no relationship to one’s likes and dislikes (I would disagree with him, having been using random number generators to pick what I eat in restaurants and what machine I use at the gym for many years, and having discovered that they are not random.  They do respond to what I like and don’t like.). We agreed that we use chance in our practice of hypnosis. We randomly select poems and stories that we might use before even meeting a person, and, more often than not, they are effective.  Is this chance or serendipity?

Cage talked about beginning his explorations of chance with the musical values of the twentieth century. He began using the I Ching as a kind of random number generator to select a sound or a note at random. Only those who are superstitious, he said, would consider this use of the book improper. Then he remarked that he had realized that Marcel Duchamp was working with chance 50 years before him. He said that Duchamp carefully chose the simplest method for his work. Cage said he enjoyed details and preferred to be more complicated. Cage further remarked that doing “just anything” in an unstructured way leads us to do what we remember or what we like which is quite different from what we would do as a result of chance. The audience can immediately tell when someone is doing something in a disciplined way or in an improvised way.  Cage criticized composers who combined mostly conventional methods of composition with a modicum of chance, saying that they were merely being careless about what they were doing.  He discussed having certain aspects of the composition controlled and others, uncontrolled. He believed we are in an urgent situation in which it is imperative to change our minds fundamentally. Hypnosis aims to help people change their minds fundamentally in the directions that lead them to less suffering and more happiness, for suffering is largely in our minds as Cage noted.

Art and Medicine

Art and Medicine 2020

At our Family Medicine Residency Program, we are starting a Medical Arts and Humanities Fellowship in collaboration with the Intermedia Program at the University of Maine.  In order to fully participate as a faculty in this program, I felt I needed to participate in some of the courses our fellows would be taking; hence, I find myself this semester in Intermedia 501 – the History and Theory of Intermedia.  Our first subject is Dick Higgins, the person who coined the term intermedia, and a person whom our professor, Owen Smith, knew well.  Owen delivered a lecture of Higgins at his memorial celebration.

Higgins wrote a book entitled Horizons, which was published originally by Roof Press in 1998, and republished by /ubu editions in 2007.  He opens with an interesting quote by art critic, Rosalind Kraus, spoken at the University of Iowa in April 1981.  She said, “I am devoted to the idea of burying the avant-garde.”  Later Higgins wrote about the important role of the avant-garde in exploring the fringes of what may become, so I found it curious that he would open with a critic who wants to destroy them.  We have the avant-garde in medicine, too – those who imagine a different future than the status quo and try to make it so. I have been in that fringe – those who imagine moving what was fabulous about indigenous medicine into our future.  We also talked about implementing a psychobiosocial model or a holistic model or an integrative model, but we were all careening and ricocheting in an obscure future in which we cannot imagine what will ever become.  Higgins talks about this for art – the role of the avant-garde in exploring what might become.  Comets are worlds that didn’t quite form.  They have their own beauty as they rush around the universe, but they are not planets. Some of the avant-gardes are destined to be comets.  Some will become planets. Only the future will know. It is the same in medicine, though its avant-gardes have fared less well than those of art.

Higgins said that avant-garde thought minimizes conventional forms and thereby tends to be an active, dialogical interrelationship between the form which a work assumes and the material of which it consists. He says that the avant-garde focuses upon the “up-to-now-this-wouldn’t-have-been possible.”  I see this as well in medicine and psychology, though each of these movements stand in direct risk of annihilation.  The mainstream, like Star War’s Empire, is strong.  It is all too easy to destroy a few rogue rebels.  So, we toil quietly in the shadows of the mainstream, slipping beneath the gaze of Big Pharma, hoping to acknowledge what is good about conventional medicine and to discard that which is solely commercial or anti-human. 

Higgins contrasts the avant-garde with the pop-garde, which is the follow-the-leader world of charm, including fashionable but safe dissent and high style.  Within medicine, yoga has entered the arena of pop-garde.  Yoga, itself, of course, is fabulous, and anyone can and should do it, but pop-garde yoga is chic and expensive and full of beautiful, rich people.  It’s not the yoga for the people, for example, that is advocated by Diamond Dave Phelps (DDP-Yoga) who worked with decrepit wrestlers (Jake the Snake, for example) and crippled former paratroopers, to bring them back to function.  It is the yoga taught in the fancy studios of New York and Los Angeles and Kripalu.  The pop-garde co-opts the discoveries of the avant-garde for profit.

Next, Higgins discusses conservative artists, who stick to the tried and true.  These constitute the bulk of the art world as they do the world of medicine.  They do what they’re told.  They follow the algorithms without question.  They faithfully implement the guidelines, whatever they are, without questioning the origin of these guidelines.  These are conservative doctors, similar in attitude to conservative artists. Higgins distinguishes between conservative artists who use materials in prescribed ways with avant-garde artists who allow the unique characteristics of the material to speak to them. The parallel for this in medicine is the application of the same algorithm to all patients while avant-garde physicians allow the being of the patient to guide and shape the treatment.

Higgins continues to define a good critic.  He says that a good critic points out the implications of the material and the work, forming a relationship with the material and the work in which any theory developed arises from the ensuing dialogue.  In medicine, we have no good critiques.  We are expected to mindlessly follow the dictates of the various professional organizations who rule the roost.

Higgins creates a term, “exemplative art,” in which the work is not a definitive realization of something, but one example of a sample of possibilities.  His term “allusive referential” refers to a displacement between what one expects to see or what one would logically regard as normative and what one does, in actuality, see or hear or read.  This displacement factor can trigger all the emotional responses associated with art independent of the artist. We have that in medicine. I am reminded of a 96-year-old man who was snow-blowing his driveway and got exhausted and bent over and passed out.  That would seem ordinary to me, but in our algorithmically driven Emergency Department, it triggered a $30,000 stroke work-up. The man was already on anticoagulants for his atrial fibrillation, so our work-up would not have changed anything in his treatment, but it is required by a protocol which we must blindly follow.

Instead of the modern/postmodern division (which Higgins places in the mid-1950s), Higgins prefers to make a cognitive/post cognitive distinction with the term “cognitive” referring to the sense of self or personal identity of the artist or the viewer of the art. I take this to mean that around the mid-1950s, the opportunities for creating identity dramatically multiplied. Before the mid-1950s, people’s identities were largely constructed by their context and rarely did people leave that context (family, community, church/temple).  Around the mid-1950s, people began to be more mobile.  In North America, we witnessed the birth of the car culture in which most people had one or access to one.  People became able to leave the context in which they had grown for a context of their own choosing. The rise of technology created jobs that had never existed previously.  The manufacturing and mining/farming industries began to decline in relation to the service/technology industries.  This has only continued until the present time.  If identity is more fluid and we can have agency in constructing and even changing our identity or holding several identities for the multiply different contexts in which we find ourselves, one could say we are post-cognitive, because our identity is no longer fixed and immutable. Higgins says that a post-cognitive perspective allows us to journey backward into works from the past without having to make elaborate justifications for doing so.  As someone outside the art world, I would not have known that such justifications were required in a modernist or cognitivist perspective.  Higgins says a post-cognitive perspective allows us to put the artists into a neater lineage as to how they feed into contemporary avant-garde practices. In medicine, a post-cognitivist perspective allows us to see the folly behind many of our algorithms, but that perspective is not rewarded.

Higgins uses the cognitive/post-cognitive distinction regarding the material of an artwork.  The cognitive artist uses expression to reveal his or her subjective persona.  The post-cognitive artists allow the material of the artwork to express itself. The parallel in medicine is that the cognitive physician imposes him or herself on the patient.  The post-cognitive physician is patient-centered and listens to the patient to collaboratively create a point of view.

Higgins says that the desire to fuse seems to be a part of our biological nature as living beings.  Certainly, we are all seeking that sense of belongingness and opiates work most powerfully on the neural circuitry of social relations and belongingness along with oxytocin (the social relations hormone). A number of religions seek a transcendental fusion with divinity or a spiritual realm.  We all need to belong and in an intensely connected way.  People fuse, he says, not just when they have sexual intercourse, but merely by being in love, and certainly a clinical literature exists on the dangers of fusing while in love and losing one’s own personal boundaries.  Historically, this tended to be more common for women than men due to differences in socialization to the roles we play in love relationships, and this is also currently in flux.  Higgins says that people even fuse in friendship to some extent, with the give and take of relationships and the deep involvement people have over the course of a lifetime. Higgins says that this desire for fusion is a basic hunger within us, which reflects how important belonging is for survival.  Humans survived by banding together in groups.  Without groups, we are vulnerable and easily defeated. We are incomplete without belonging. This need for fusion exists everywhere, and medicine can either contribute to it or detract from it. Conventional biomedical medicine detracts; patient-centered medicine contributes.

Higgins next criticizes structuralist and post-structuralist theory and cultural criticism.  He believes they lack any scientific validity and calls them science-as-metaphor rather than science-qua-science. I think Higgins lacks an understanding of what happens behind the scenes in science; that so many of the elaborate explanations are simply metaphor disguised as truth.  He elevates science-qua-science perhaps inappropriately. We are all trying to invent a story to explain “what is,” and science provides just one more story as does Levi-Strauss, Jacques Lacan, and Roland Barthes.  Higgins criticizes Barthes for writing about one work, a short story by Balzac, but Higgins also talks about exemplifying work, which provides an example of a type of work, which is just what Barthes is doing. I read Higgins as emphasizing keeping theory grounded in “the thing itself.”  When it becomes too abstract, theory suffers.  He criticizes the pretentions and limitations of academic thought and art criticism. He opines that the critic can contribute by identifying works that are unique and characteristic of our current era, because the only art we will ever know firsthand is the art of our current era, with avant-garde art containing the art of the future, albeit indeterministic of what it shall be.  This brings us to what he is calling intermedia, art that falls between established and conventional media.  He mentions concrete and visual poetry as an example.  He turns to painting, which was the elevated art of the past, which has migrated off the canvas in the world of visual arts, entering the world outside of itself, interacting and fusing with other media to form visual poetry, visual music, and more.  Higgins calls for a pluralistic approach, recognizing that a horizon has many points along with it, perhaps even an infinite number of points. 

Next Higgins returns to history, writing that the concept of the separation among media arose in the Renaissance. He says that the social problems that characterize our time, as opposed to the political ones, no longer allow a compartmentalized approach.  He thinks we are approaching the dawn of a classless society, which I reject.  Class seems stronger in America today, than during Higgins's time.  Pop art for Higgins is dead, bland and pure, but impotent.  The notion of a pure medium is depasse.  He invokes Duchamp’s pieces as being truly between media, between sculpture and something else, while a Picasso is readily classified as a painted ornament. The ready-made or found object is intermedium because it was not intended to conform to the pure medium, and therefore suggests a location in the field between the general area of art media and those of life media.

Higgins talks about how painters of the 1950s began to make work that adds or removes, replaces or substitutes or alters the components of a visual work but placing increasing incongruous objects in the work.  For example, Rauschenberg called his constructions “combines,” and went so far as to place a stuffed goat-spattered with paint and with a rubber tire around its neck onto one.

Higgins then turns his attention to the theatre.  He wants a theatre in which time and sequence can be utterly suspended, not by ignoring them, but by systematically replacing them as structural elements with change. Lack of change, he says, would cause his pieces to stop. He mentions his 1958 work, Stacked Deck, in which any event could take place at any time, as long as its cue appeared, provided by colored lights. This led to a happening, in which external events controlled the cues. The happening was an uncharted land that lay between collage, music, and the theatre, not governed by rules, each work determined by its own medium and form according to its needs.  In intermedia, the visual element (painting) is fused conceptually with the words. 

Higgins says there is always avant-garde in the sense that someone, somewhere is always trying to do something unique which adds to the possibilities for everyone else. These artists question established forms and media.  But if avant-garde is successful, it will become the new medium for its great significance, becoming truly important to large numbers of people. He says that one regrets the adherence of an artist to a set of dogma. 

Higgins's explorations of art can help us explore medicine.  Many of the same forces are at play.  The dialogue between the powerful and the powerless remains. The forces of the establishment and the radical extremes remain. The avant-garde exists in every field, trying to determine what will come next, though the orthodoxy usually prevails. Ultimately, the stakes are lower in art.  No one dies. Art, therefore, is allowed more possibilities which is why we in medicine should study it.