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Tallis in Wonderland

An Introduction To Incontinental Philosophy

Raymond Tallis extracts some principles.

Before I spring this brand new branch of philosophy on the astonished world, I must declare an interest. More precisely, three interests. Firstly, a personal interest. As a child I suffered from what was called by the impressive Latinate name of ‘Nocturnal Enuresis’ – a.k.a. ‘bedwetting’. Over half a century later, waking up dry still seems to me a miracle for which I am grateful. My second interest is professional. For many years I ran an Incontinence Clinic, for people whose problems not only made their nights amphibious but their days miserable. Thirdly, I have published a novel, styled a metaphysical comedy, Absence, (whose sales I would like to increase), which had a continence adviser as a heroine.

It may seem perverse to seek philosophical illumination in such unpromising material as urine that ends up in the wrong place. Some context-setting is in order. One of my longstanding preoccupations is the great gulf that separates us from the animal kingdom – a gulf that many writers would like to deny, or at least to minimise. That is why various species of biologism, such as ‘evolutionary psychology’, have attracted my baleful gaze. I am instead in agreement with V.S. Ramachandran, who, in The Tell-tale Brain: A Neuroscientist’s Quest for What Makes Us Human (2011), asserts that “on the great Darwinian stage we call Earth… there has not been an upheaval as big as us since the origin of life” and that “humans transcend apehood to the same degree by which life transcends mundane chemistry and physics.”

Our differences from beasts are not confined to those rather upper-crust activities such as composing symphonies, fretting over transfinite numbers, or arguing for changes in corporation law. The differences are present in everything we do; and this includes the humble business of striving to be and to remain continent. All animals have plug-holes, but our relationship to our plug-holes, as it is to our bodies in general and what comes into and goes out of them, is unique. Micturition and its control is as good a place as any to pause when we think of our transcendence of apehood.

The Basics of Control

Let’s begin with a bit of basic urology. The output from the kidneys is collected in the bladder, which has to be emptied at intervals. This can occur as a reflex: the bladder wall automatically contracts when it is stretched beyond a certain point; and at the same time, the sphincter at the bottom of the bladder relaxes, so that the urine goes southwards to the pan rather than back up towards the kidneys. This reflex is under the control of centres in the spinal cord and the lower part of the brain stem, so that, for example, an animal doesn’t pass urine while it’s fleeing from a predator. The brain stem reflexes are in turn influenced, at least in ‘higher’ animals such as ourselves, by neurons in the cerebral cortex. To pee or not to pee lies within our control.

The reflexes in the centres of the brain which control the automatic emptying of the full bladder are called ‘long-loop reflexes’, because they involve nerve pathways which link the spinal cord to the higher reaches of the nervous system. In us human beings, the loops get longer and longer, and less and less reflex, and more and more deliberate: the steps intervening between the ascending nerve impulses reporting that the bladder is full, and the descending impulses giving the bladder permission to let go, get progressively more numerous and elaborate as they reach outside of the pathways of spinal cord, brainstem and cerebral hemispheres.

Dogs of course can be taught to urinate in the right place at the right time by being shouted at – a process which involves canine neural control at many levels. But for us the biological mechanisms are not the end of the story. The trail goes cold (or dry) in the frontal cortex. We are the only living creatures who urinate after consulting the clock – whose patterns of micturition are determined by a sense of the appropriate time and place to urinate and an assessment of the likelihood of future needs for micturition. For example, I used to make sure I had had a pee before I gave my lectures on incontinence, because I knew that I would not have the opportunity to do so for some time.

Prudence of this kind is an interesting place to examine the intersection between involuntary biological mechanisms and voluntary activity. It illustrates one of the big stories of our life: that we subordinate bodily mechanisms to non-mechanical, indeed non-standard, ends; forge conscious deliberate actions out of biological events we do not enact, but which we rely on to happen of their own accord. ‘Nipping out for a slash just in case’, in response not to a stimulus but to an opportunity to bank some empty space in one’s bladder, is epistemologically very sophisticated, involving many layers of awareness of the infinitely folded field of possibility that is the world. It is worthy of a philosophical discipline in its own right: Pisstemology, perhaps.

Consider this commonplace example. You’re driving down the motorway and note that there are service stations with public conveniences one and twenty miles hence. You don’t want to stop at the first station because you’re listening to something interesting on the radio. You calculate that you can ‘hang on’, as the expression goes, until the second station. This belief presupposes a mode of bodily self-awareness which enables you to translate the sensations you are having now into an estimate of the time when you will be desperate, and to connect this with your guess as to how long it will take to drive twenty miles, itself based on previous experience, your reading of the road, and so on. This depends not only on a unique relationship to your own body as an object of knowledge, but also on a sense, unique to humans, of patterns of singular events set out in quantified time; on a sense of an explicitly formatted future populated by possibilities, of events and outcomes.

Public Inconvenience

So much for the private element of this archetypally private activity. But there is an intersection between this and the public realm, captured in the notion of ‘the public convenience’. Indeed, for the several million UK citizens who have bladder problems, the domain beyond their front door sometimes look like a map of havens of convenience in an overwhelmingly inconvenient world. This space is distinctly non-Euclidean. Ensuring that the contents of your bladder will be deposited in the correct spot a mere square foot out of the square miles you may have traversed, mobilises an impressive network of chains of practical reasoning incorporated into the loop connecting the ‘full’ signal from the bladder with the act of micturition. The physical trajectory alone – think of parking the car, of looking for the necessary coins in one’s wallet (or buying something to acquire the necessary change), of following the signs to the toilet, etc – is immensely wiggly, and no-one could follow it if its component movements were not illuminated from beginning to end with a deliberate intention that had a clearly envisaged goal. This illustrates the essential character of free actions.

The business of urination also touches directly on our notions of privacy, and of the layers that separate our first-person singular being from the first-person plural being of the crowds of which we are an involuntary part – the I-being from the we (or wee)-being. Even the best-kept public urinal is something of an assault on your self-esteem. I cannot comment on the life in the Ladies, but in the Gents the requirement to take your place among a row of urinators, like a battery hen (or a male of the same species), temporarily reduces your humanity to animality – to King Lear’s ‘poor, bare forked animal’. The million-stranded narrative of your life seems to part, like a dividing smoke-screen, and its biological underpinning is revealed.

But any inchoate feeling of metaphysical exposure is cancelled by relief at averting a more profound and personal exposure. As a urologist colleague of mine once said, “Urinary incontinence may not be fatal, but it can mean social death.” Being ‘taken short’ prompts a primordial sense of shame: the initial dampness and the subsequent pong become signals, shouted to the world at large, that one has failed to contain those bodily fluids that carry so much significance when they break out of the private realm to which they belong into public spaces and the awareness of that collective of strangers called ‘the public’. Even timely urination is somehow seen as an intrusion into the proper flow of events. It is not merely something for which we have to be excused; it is called ‘being excused’. (Of course, being humans, we can turn this to our advantage and utilise urination as an excuse to leave the room in order to check our messages or plot with a third party or escape paying the bill or standing our round.)

Incontinence humiliates because it reminds us of the helplessness of our beginning, and, indeed, of our end, when we look back in Kanga at the dry years between. Which is why, of course, urine in the wrong place is the theme of so much humour, gentle and far from gentle. We may boast of ‘getting pissed’ or ‘bladdered’ (ie, getting drunk) to show how wild, daring, off-the-scale we are – but we do not boast of having ‘an accident’. Laughter registers the difference between how things are and how they ought to be, and can be provoked by the kind of category error that wetting one’s pants as an adult seems to instantiate. Laughter itself is not without its hazards, and it serves them right who mock the incontinent if they piss themselves laughing.

Lavatorial Lacan

All animals excrete – it is necessary in order to maintain the constancy of the internal environment of the body – but only humans enclose excretion in so many layers of privacy. The lockable toilet door is as much a monument to the difference between human and non-human consciousness as Mozart’s symphonies. The strategies we may use to make our ‘gentle tinkle’ less gentle as a warning when we hear someone approaching the toilet, is a truly remarkable example of how we transform biological events into meant meanings. As that great philosopher C.S. Pierce said, anything can be a sign so long as someone uses or interprets it as a sign.

Those readers who were hoping for a connexion between Incontinental and Continental philosophy need look no further than the work of Jacques Lacan. This French structuralist (and the shrink from Hell) spoke much opaque nonsense; but he was on to something when he observed that “our public life is subject to the laws of urinary segregation” – he saw the existence of separate Ladies and Gents as symbolising how we create meanings, including identities, through opposition. At any rate, Incontinental philosophy suggests that willy- (and other) leaks, and the institutions we have constructed round them, may be even more revealing than Wiki-Leaks. Honestly. I’m not taking the piss.

Raymond Tallis is a physician, philosopher, poet and novelist. His latest book Aping Mankind: Neuromania, Darwinitis and the Misrepresentation of Mankind is just out.