(Published December 1990; Journal of Optometric Vision Development, Vol. 21, #4)
This paper was written while I was an optometry student and published the year after I graduated. It attempts to explain to optometrists some ideas that occurred to me based on my earlier studies in philosophy and the connections I experienced during my time as a vision therapy patient. I found useful connections between ancient philosophy and the way doctors and patients could interact.
The Tao of Vision Training
Steve Gallop, OD (Published December 1990; Journal of Optometric Vision Development, Vol. 21, #4)
The ancient Chinese philosophy of Taoism speaks to concepts such as the patterns of flow in nature and how to make one’s life (and others’) minimally stressful and maximally useful, by tuning in to these natural forces. This desire to truly perceive and blend in with the world around us, in distinct contrast to the western approach where the ego-based search for control attempts to make nature useful on our terms. The Tao tells us that it is better, for all concerned, if humans would learn to make themselves useful on nature’s terms. Some examples of Taoist thought are:
The softest of all things can overcome the hardest of all things. Only that without substance can enter where there is no room. Thus, we know the benefit of non-interference. Teaching without words and the benefit of resorting to non-action. These are beyond the understanding of all but a very few in the world
Do that which is not done by doing.
Make that which is not made by making.
Thirty spokes share the wheel’s hub;
It is the center hole that makes it useful.
Shape clay into a vessel;
It is the space within that makes it useful.
Cut doors and windows for a room;
It is the empty space that makes it useful.
Therefore profit comes from what is there.
Usefulness from what is not there.
While I was in vision training (VT), I noticed a pattern that seemed to underlie the multitude of techniques I was asked to perform. This pattern, though not purposely implemented by my therapist (nor, to my knowledge, by many therapists), impressed me as being part of the deeper meanings/implications of vision training. This underlying pattern initially impressed me as having characteristics along the lines of Zen, which has its early roots in Taoism. Although my understanding of both vision training and Tao is in its early stages, I’d like to share my thoughts regarding their interconnectedness. But, as Lao Tzu reminds us in the opening statement of one of the major Taoist works, the Tao Te Ching, “The Tao as described is not the real Tao”
In Taoism, as well as in Zen and Native American cultures, it is felt that one does not reach desired goals by supreme effort, but by entering into the natural flow where form and process (human constructs) coalesce. One merely proceeds with life, living in a good way, in harmony with the environment, and one is already on the way to one’s goal. This does not preclude one’s conscious desire to choose a direction; it merely speaks to the mode of travel. Taoism also speaks of the interconnectedness of the “10,000 things” – the myriad creatures, concepts, and forms with whom we share this great life – these all having arisen from a common source. This may appear simplistic; however, the masters explain that the simplicity of these concepts is precisely the reason one may continue to react to situations without utilizing these ideas.
There is a fine line between the concepts of 1) conscious pursuit of a goal and 2) that of allowing the flow of the universe to guide one’s actions. Virtually unknown in today’s dominant (western) culture is this second concept. The two are not mutually exclusive but interact with each other constantly, often hidden from conscious reality. It is the strong belief in the west that humans, as the ultimate goal of creation/evolution, alone have the power to create their own destinies. This belief also serves to prove our superiority over the rest of creation. While we may in some ways be superior, the dominating force of the ego in our culture tends to obscure important evidence to the contrary. This evidence, which gives humans a more equal status, then becomes impossible to acknowledge without stepping outside of our strict world-view. That is no easy task. In his book, Chinese Medicine, Manfred Porkert, M.D. writes “We should learn a totally unfamiliar language as a way of ridding ourselves of the prejudice and the preconceptions that have become attached to our usual ways of thinking and speaking. And when we not only acquire a new language but also proceed to discover a new way of observing the world, then the spectrum of possibilities is extended and we can suddenly see things that were just not there before. At the same time, new pathways of actions will be opening up to us as well that will forever remain closed as long as we persist in our old, accustomed style of thinking.”2 This idea does not negate the value of, or benefits gained by, the western approach. Throughout history, Taoist (or Taoist-like) cultures have taken useful concepts from western culture, though this has not been reciprocated to any great degree until very recently.
Taoism does not acknowledge the west’s hierarchical perception of life. Not only are we completely dependent on so-called lower forms of life for our most basic survival, but the embryonic synthesis between physics, psychology, and philosophy is beginning to uncover connections between all aspects of our universe previously unknown to many. Foremost among these connections is the relationship of consciousness to the corporeal world, the recently fashionable concept of the mind’s ability to effect the body. This link was widely acknowledged by many ancient cultures.
It is now well accepted in the field of quantum physics that the concept of observer is no longer acceptable in scientific experimentation. It must be replaced by the concept of participator as any interaction with a system influences that system. Even so-called passive observation has this effect if only by the mere fact of the experimenter’s expectations for an outcome. A prime example of this is the now well known dualistic nature of light. Depending on the type of experiment, light acts as either particles or as waves. Again, consciousness intercedes where it is supposed not to tread. Often a skeptic will claim, “I’ll believe it when I see it,” when he really means, “I’ll see it when I believe it.” Science has consistently shown, with few exceptions, that the latter statement is the one truly reflective of prevailing attitudes.
VT, of course, cannot be grasped physically, nor drawn on a two-dimensional surface. It is an abstract process that works in, pardon the expression, mysterious ways. This causes the uninitiated to respond with the most convenient tool humans know in such situations: the fight or flight response. We have evolved very little in some aspects; if we don’t know what it is, run away or get it before it gets us. Fortunately, the fight/flight mentality can be augmented with driving curiosity, which can allow for growth.
Most of science remains trapped in the analytical approach to understanding. That is, by breaking things down into manageable bits, and by seemingly understanding these bits, it is then just a simple matter of extrapolation back to the object in question, which now can be fully explained. The first flaw that I find in this approach, the very basis of what is called scientific method, is the initial action of separating something from its actual whole, its normal environment. This maneuver immediately destroys the integrity of the subject. Next, this bit is taken into the laboratory, the natural environment of almost nothing. It is then investigated as if its behavior under these conditions equals its normal behavior. This cannot be. An entity does not exist without its environment; a membrane does not so much separate a cell from its surroundings as it does act as the interface between inside and outside. Science tends to view a membrane as a thing, though, when viewed in its entirety, it is more an event. This is why VT, especially in the behavioral model, lends itself so poorly to scientific scrutiny. Not only are the changes brought about by therapy often subjectively realized, but the specific mode of modification remains somewhat elusive. Therefore a major obstacle stands in the way of satisfying scientific demands: we aren’t even sure exactly what questions need to be answered. But as Albert Einstein said, “Imagination is more important than knowledge” which can be rephrased, the right questions are more important than answers.
The strictly analytical approach to knowledge is slowly but surely losing its stranglehold as the only view necessary or possible. Some of the most respected physicists of this century, including Wolfgang Pauli and David Bohm, have begun to realize the interconnectedness of the latest findings in quantum physics and appreciate many fundamental concepts held for millennia by ancient philosophies like Taoism, Buddhism, and Zen. As we dig deeper and deeper into the subatomic world, most of our safe, tidy conceptions of reality break down. Solid matter becomes mostly empty space; the atom, long held to be the indivisible building-block of everything, has been shown to be quite divisible. We finally found atoms to be composed of a nucleus with electrons orbiting around it, only to find that not only do electrons orbits not exist, but neither do the electrons, at least not for very long. It all appears to be energy that is more or less concentrated at any given point in space or time (which also seems to lose its usual meaning/concreteness at this level).
Our tendency to break down the universe into little pieces which are more easily understood is dangerous. All these little pieces do not even exist unto themselves and all the information we obtain by observing in this fashion is of limited value, unless it is synthesized into its whole before, during, and after the analytical process begins. Again, one is not able to be a separate observer, only a part of the system that is supposedly being observed. It seems to me that through science we have been able to learn much and have amassed quite a bit of knowledge in our search, but very little understanding has emerged.
Apparently, many of our ancient cultures understood existence on a more holistic level, in a deep and meaningful way, and employed this understanding in their daily existence without having to dissect things to derive meaning. Instead, we spend all our time scrutinizing minute details and rarely achieving any real understanding outside of our limited views. As we tear things apart in a mass myopic movement, we diminish our peripheral awareness/understanding, leading to not only social/cultural myopia but also to individual myopia of epidemic proportions.
Alan Watts, one of my favorite thinkers, stated that certain philosophies teach us “…that human life, and all life, does not work harmoniously when we try to force it to be other than what it is, for the very simple reason that this is based on the assumption that I, who would control things, am something apart from what I would control. This assumption is a hallucination supported by the force of almost universal social consensus.” 3 So far in the history of science this “social consensus” has caused great ideas of many creative thinkers to remain hidden from social acceptance for long periods of time, often until their originators have passed on. Fortunately for us, although VT holds a similar place, at least in some circles, we do not have to wait until we are dead to avail our patients of its benefits. Although some individuals and organizations claim a limit of hard scientific evidence to prove the efficacy of the VT approach to vision care, history will afford the interested observer decades of research; successful practitioners, and more importantly, satisfied patients.
Difficulties such as headaches, inability to sustain near activities, and poor reading comprehension (as well as accommodative problems, strabismus, and amblyopia) have shown marked improvement, if not elimination, through proper visual guidance. Again, it must be emphasized that these improvements are mainly realized subjectively by the patient. As previously stated, this is a major problem for the scientific community which insists on objective findings which are repeatable. While VT may not lend itself well to objective scrutiny, it is undoubtedly repeatable. After all, we are not treating laboratory specimens, but human beings who, when attempting to alleviate non-pathological conditions, are the only ones who can ultimately decide whether the feel (perceive) a successful service has been rendered. On a case-by-case basis, it is apparent that when properly evaluated, diagnosed, and treated, many patients have been satisfactorily relieved of the myriad complaints resulting from a poorly operating visual system. The evaluation, diagnosis, and treatment, to be successful, must account for the entire person/environment complex. This is why the Optometric Extension Program analytical is such a strong approach to optometric examinations. While it may be true that each of the 21 probes briefly analyzes a specific component of visual function, the main thrust of the process is the synthesis of these findings (as well as certain auxiliary probes). This serves to paint an overall picture of a person’s visual/perceptual behavior at a given point in time; therefore, it is much more of a synthetic approach than most analytical maneuvers currently in vogue.
The present scientific paradigm is due for a major overhaul. This overhaul is actually well under way, but it has yet to be acknowledged by many of those involved in the process. This can perhaps be explained by cultural anthropologist Jamake Highwater: “Another irony, of course, is that the most linear and material minds are not aware that history has relentlessly moved passed them, putting their values in a new perspective which they cannot yet see.”4 As one who understands the future, Highwater goes on to say “…this new, emerging mentality is strikingly similar to the sensibility of those who see the world through primal minds. And this progress has ironically verified the validity of peoples the west has been persistently trying to eradicate as obsolete, primitive, and useless.”4 A clear example comes to us from Cherokee culture which, in fact, predates and has persevered despite the overwhelming intrusion of western culture. The Cherokee word for doctor or healer translates as provoker, one who catalyzes an individual’s ability to bring about change in his or her own psycho-physical state5. The emphasis is on the individual’s innate mechanisms and the provoker’s only role is as facilitator. This definition of health care professionals is re-emerging as a valid approach to healing.
The role of consciousness in the physical world is now discussed, even in such organizations as the American Association for the Advancement of Science. Some members propose that “the new view of consciousness asserts unabashedly that conscious mental activity asserts measurable effects on the physical world – a world which includes human bodies, organs, tissues, and cells. Mind becomes a legitimate factor in the unfolding of health and disease.”6 This is not to suggest that the mind should or may force healing on the body, but that the person with physical problems should allow the mind to accept the fact that there is a healing force within which could then be utilized to act on the situation. This mind/body connection has also been shown to function on an interpersonal level; that is, the mind-set of a caregiver has an effect on the receiver.
This mind/body connection should be analyzed less and utilized more since its presence can hardly be ignored any longer. This is why practitioner attitude and patient motivation are so vital to the success of VT. First, the fact that one practices in a behavioral or functional mode presupposes an attitude that tells patients there are ways to enhance their condition. Patients are not merely victims of uncontrollable outside forces. It also states that the patient will not be a victim of the unintelligible outside force of being treated by someone, while they contribute little more to this treatment than paying the bill.
Patient motivation in VT is important not because the patient is actually able to change the alignment of the eyes but because he will immerse himself in the flow of the training program. This can only be possible when the patient is given a positive outlook on the condition which standard practice does not provide in its oh-well-your-eyes-have-gotten-a little-worse-so-you’ll-need-some-stronger-glasses approach to vision care. When you assume nothing can be done, nothing can be done. Einstein helps to explain again that we live in a participatory universe in which observation creates reality. What an individual brings to a situation influences, in no small way, the ultimate reality of the situation.
What we do in VT is to change our patients’ conditions of observation, which has the effect of modifying the reality observed. So, the patient is asked to participate in the relatively enjoyable procedures of training in order to entice the visual system into heightened awareness and performance. While the site of action of these techniques is not completely understood, results show that they are able to influence the rewiring of neural channels or subconscious behavior patterns in the visual system. I think it is because of this unknown quantity/quality that VT works so well. It is relatively easy to study the light/eye/cortex aspects of vision, but much more perplexing and enigmatic to investigate the subtle and profound aspects of vision throughout the body/mind. We tend to shy away from concepts which are difficult to name, draw, and quantify; but these are precisely the most important and fundamental aspects of our universe. We are distressed when things are beyond our control or comprehension. Then we insist that things are just as we see them until, as almost always happens, it becomes obvious that they are not. The whys and wherefores of VT remain somewhat elusive, beautifully flexible, and extremely successful.
It seemed to me, during therapy, that the underlying purpose of VT appeared similar to the Zen concept of koan in which the student seeking wisdom and enlightenment, was given a seemingly absurd, unanswerable puzzle/question to which the proper response would seem equally absurd, , to the outside observer. The solution to the problem was not the true issue. The important thing was the process through which the problem was approached. The harder one tries to definitively answer the question (especially on any kind of intellectual level), the further one gets from the essence of the situation. The koan serves as a vehicle, a meditation leading to deep-seated understanding, not of the specific question, but of the big picture of existence. Similarly, VT is not about the tasks one performs, but it is about involving one in the world of visual perception on deeper levels. One of my first impressions of VT during my training process was its tendency to confound one’s traps and preconceived notions of perceptions. This permits one the freedom to subconsciously allow the use of different perceptual patterns previously unknown to the system but certainly present and available. The language of perception, as the language of existence, is difficult to formulate and is, at best, a meager representation of that which it proposes to explain. Perhaps some day we will find the words, though I think and truly hope not. I hope not because of our persistent habit of confusing the name for the thing named. For now, we must realize that nothing can replace actual experience of such phenomena. Visual perception, like existence itself, cannot be taught by teaching in the usual manner.
Certainly there is reason and order to a program of VT. We have done well with the portions of the complex of vision that we understand. Fortunately, we have also done well with those parts we have yet to grasp, the parts that many of us have yet to even recognize. These are the more subtle, subconscious levels of vision/perception/personality. Of course, even in the process of not doing, a difficult blend of pursuit sans effort which is part of the essence of Tao, there is a need for inner discipline, both on the part of the patient and the provider. As Louis Pasteur stated, “Chance favors the prepared mind.” So the best one can hope for is to be, or to have a capable guide, one who understands the way to create the proper conditions for some insight to sneak through the various barriers we have constructed.
1. Feng, GF. English J. Tao Te Ching, A New Translation. New York: Vintage Books. 1972.
2. Porkert M. The Theoretical Foundations of Chinese Medicine: systems of correspondence. New York: Morrow and Co. 1982.
3. Watts A. Cloud Hidden, Whereabouts Unknown: A mountain journal. New York: Vintage Books. 1968.
4. Highwater J. ed. The Primal Mind: Vision and reality in Indian America. New York: New American Library. 1982.
5. LittleJohn, H. unpublished manuscript.
5. Dossey L. Space, Time, and Medicine. Boulder: Shambhala. 1982.