Leaving Psychiatry. J. R. Ó’Braonáin. M.D.

Leaving Psychiatry - J. R. Ó’Braonáin. M.D.


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others in the machine includes terms like as “I”, “me”, “you”, “feeling” and so on. And that is what mind is, semantically emergent yet materially (and metaphysically) non-existent. Or so some might say.

      I have sometimes been tempted to walk some way down this line in an objection to Descarte. When Descarte thinks he can step outside of the perceptions given him that he doubts the authenticity of, and instead rationalizes his own existence as a mental actor, he is using language that is not his own, language he acquired from a source that he has already considered suspect and unknown. He remembers once having been a child and learning a language. But was he and did he? His is a conversation that he has been thrown into with a game which is not his own. It is impossible for him to extricate himself and start anew, even if he imagines himself as come into being a second ago with false memories given him by the demon. Every way he might know himself, in its language dependency, is suspect. And so he cannot say “cogito ergo sum” (I think therefore I am), yet rather “cogito ergo cogito” (there are thoughts, therefore there are thoughts), or “sum ergo sum” (or I am therefore I am), both statements empty of meaning. What is left of the person when void of language used to communicate self to self? There would be raw consciousness and qualia, with little else besides. In a primitive sense there would be mind without the one with the mind, this leading to contradiction.

      And yet here we are confronted with a reality of our own consciousness that is neither rationally a priori or axiomatically true, yet simply proven a phenomenological fact in our being. And thank heavens we have our own personal consciousness as it is our only strong proof we exist at all as mental beings. Clearly our mind is not a material thing. Contra hard materialism, to argue anything successfully is partly an analytical exercise and partly an identification with the argument. A mind/brain material monism with emergence as merely property or operation of a biological computer (to not, in a stronger sense, exist), demands an almost mystical nihilism to successfully argue, let alone identify with it as an idea that is comfortable like hand in glove. In its radical self-denial, it is more Zen than science and yet neither at the same time. I am not proposing that mind brain monism is not true. I am arguing simply that to my mind it has not been adequately argued and I doubt it ever can be. It denies the undeniable. It is a hypothesis with which I cannot (as opposed to choose not) to identify, where non-identification is not trivial.

      The brain won’t go away

      One might say that we can philosophize until the cows come home, yet the mind is undeniably dependent on the brain. In its rather severe dependency we might have the proof of emergence at of least a ghost contingent on the brain for its ethereal existence (a substance dualism contingent on the brain), or the proof that mind is the workings of the brain (in which we return to a property dualism). I’m so frequently encountering people who argue these positions to have been the recent findings of post enlightenment neuroscience, though we can be reminded that Hippocrates (or someone claiming to be Hippocrates) stated over two millennia ago

      “Men ought to know that from the brain, and from the brain only, arise our pleasures, joys, laughter and jests, as well as our sorrows, pains, griefs and tears. Through it, in particular, we think, see, hear, and distinguish the ugly from the beautiful, the bad from the good, the pleasant from the unpleasant, in some cases using custom as a test, in others perceiving them from their utility. It is the same thing which makes us mad or delirious, inspires us with dread or fear, whether by night or by day, brings sleeplessness, inopportune mistakes, aimless anxieties, absent-mindedness, and acts that are contrary to habit. These things that we suffer all come from the brain, when it is not healthy, but becomes abnormally hot, cold, moist, or dry, or suffers any other unnatural affection to which it was not accustomed. Madness comes from its moistness.”

      Now Hippocrates was perhaps, nay was, working on false premises. He would have seen the changes in perfusion and colour to the body and face in various states of disease and might have made inferences as to corresponding humoral imbalances in the brain. In all likelihood he never even witnessed a brain dissection, if for no other reason that the brain turns to mush unless pickled. Not until the age of Thomas Willis was this problem overcome. But what I think would have been driving the mind equals brain hypothesis in ancient Greece might have been a common knowledge of many in antiquity. When, for example, a Greek strikes a Persian with a weapon or a Persian strikes a Greek, there are different outcomes following a central chest injury vs a blow to the shoulder or the leg. And all these might result in different outcomes, very different outcomes, to that of an acquired brain injury from a blow to the head. Most preliterate persons might well have well known that a knock on the head can profoundly change a person, if not kill them. And so it is not only the premise of Hippocrates observation, yet his place in the intelligentsia also as the one with licence to discover, both as further questioning the scientific metanarrative we have made for ourselves. In any case, the Greeks did not deny the embodied lifeforce that is the psyche or soul.

      Now we can say that we have moved beyond Hippocrates and Neuroscience texts such a Kandel and Schwartz “Principles of Neural Science” include the above quote as a throwback to the time when natural philosophers (i.e. scientists) were interested and conversant in history and the liberal arts, a projecting of persona to being the gentleman scientist. It's quaint isn’t it. In any case we have moved beyond Hippocrates. We now know the parts of the brain correlating with vision, olfaction, muscle movement and so on. If a part of the brain dies, there can be a more or less predictable range of outcomes such as loss of speech, vision, smooth sequential movement and so on. With respect to vision for example, we can even locate the place in the brain correlating with the perception of objects with certain orientation and movement. The teasing out of these modular brain regions and also more distributed so called circuits are what Chalmers calls the easy problems. Nevertheless, like shining a light in a furnished room containing an infinitely deep well at its centre, all we have simultaneously done is to resolve the even greater darkness of the hard problem, consciousness itself. Its edges are illuminated, this leading the neuroscientist to think they are closer to the solution when they are further away than ever. And so what have we gained from saying, for example, that vision is dependent on the unexplored whole brain to now say it depends on this particular part of the brain into which we have journeyed? Neither tells us what seeing is, let alone what it is when “I see”. And have we answered the question if mind drives brain as a necessary instrument, or brain drives mind, the latter as its secretion?

      An answer in favour of materialism might be in the fact of just how profound the changes to mind can be in disease or in states of drug intoxication. A congenitally blind person is likely never to describe a visually vivid dream and never say “I see with my mind’s eye, yet lack the apparatus to see in the world”. Helen Keller "saw" and held memory in her fingers. A demure introvert might experiment with phencyclidine and become a raving homicidal lunatic. The older person with dementia might not simply lose their memory, but their memory of having lost memory, and indeed their whole connectedness with themselves and the world goes with it. These are prima facie devastating blows to a non-materialist account of mind or accounts which place mind on a pedestal as anything more than epi-phenomenon, though their claim to being fatal blow is more a neuro-scientistic mode de jure, than a fact beyond other interpretations.

      One such non materialistic objection, and one which has been played out in religion and popular culture (cross culturally) from antiquity, is the notion that the person is primarily a non-physical substance that becomes attached to a material structure into which it grows and comes to identify. To a behaviourist the phenomena is actually a supernatural Pavlovian experiment without extinction being easily achieved. Just imagine it to be possible that there is something which is better described as spirit that comes to be shackled to a brain and grows with it. With time it would forget what it is in the greater sense, and contra Plato might never have known to begin with what it was then to forget. It might only know itself in the phenomena of its conscious awareness and in its intentionality, particularly its intentionality of moral faculties and the like. But this is the bitter joke, for the mind never achieves an emancipation from the attachment to the material brain, and neither ignorance of neuroscience nor a knowledge of its limitations is to any avail. When the brain bleeds the mind reflexively bleeds in its own way, even unto the end of the person as they knew themselves and were known to others. I am not proposing this ontology to be true, much less expecting


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