Leaving Psychiatry. J. R. Ó’Braonáin. M.D.
opening gambit to an ontology that could be developed and indeed has been developed by better minds than mine. In its accommodation of both the facts of neuroscience and the miracle of consciousness as per outlined above, it is far from being the least parsimonious formulation either. The fact that it lay partly outside the bounds of what is ordinarily considered science provides no a priori’s to abandon it as a possible (nay plausible) way to see self in world.
The glimpses we have into this supra-material self may be within aesthetics, morality, peak experiences and the givenness of consciousness, along with certain aspects thereof. One of many places to which I was taken to marvel when I was younger was the spatial location and extension of consciousness. And this was a sense of marvel only to be amplified by a knowledge of neuroscience, as its answer to the mystery was as unfulfilling as an answer could possibly be. Take something sharp and jab it into your finger tip. The pain you feel is of course in your finger, not somewhere behind the eyes. Now I could tell you that there is a sensory representation of that same finger in the brain, this homunculus having been resolved with clarity by Wilder Penfield and others nigh on a century ago. Stimulate that finger part of the brain and you may have the very same sensation in your finger as if you dug into the fingertip itself. Ablate that same area in the brain and you might prick your finger a thousand times and feel nothing. We could also do, as nature sometimes does, cross wiring experiments where one physical stimulus leads to a different physical sensation, or where removing a limb results in the sensation that your limb still exists out there where it was and yet now only empty air has come to fill the space (see in the use of the word “wiring” the ease with which the technological metaphor creeps in). Now I, as well as anyone else cognizant of neuroscience, can dismiss the mystery here. I can say that the feeling of the finger as being spatially outside the brain and in the finger is simply the brain performing some strange ventriloquy, like the performer who projects the voice as if coming from the doll in their lap. But this neuro-ventriloquy, if true, is much more profound and cannot be simply believed without pause. For neuroscience would say, and say rightly, that the only the brain itself has the requisite complexity to effect the emergence of the finger consciousness. Certainly the “wiring” in the finger is just the ramifications of a simple nerve. There is no little brain in one’s fingertip sufficient for the complexity argument to hold, and so I am not in my finger they will say. And yet I do not experience things within the head as if to say “I the one behind the eyes feel a pain and know that it is associated with a noxious stimulus to the finger”. If I take upon myself the cap of the materialist neuroscientist I cannot liberate myself from the experience as being in a place (and time) which, so says the dogma, lacks the neurological complexity to be experienced. That is to say I cannot convert the beingness of the finger from spatially within the finger to within the head and somewhere behind the eyes simply in virtue of knowing about the sensory homunculus. Even an assiduous change in language to prohibit “in finger” consciousness cannot alter the basic fact of being out there. And so back we are to dismissing things as a trick of our ventriloquist brain, and the case is closed. The mystery does not go away however, nor does an evolutionary explanation which might pretend to answer the “why” or “how”. How am I, qua nothing but an emergent product of the brains complexity, consciously existing res extensa in the finger, a place of neurological austerity? I would suggest to the materialist that if they admit to the possibility of any ventriloquist act as they apparently must, then why not countenance one of a different kind, i.e. not one where matter automatically in the act of emergence thinks that it is mind (for lack of a better turn of phrase), and not one where the brain qua mind thinks it is spatially located “out there”. If the concept of ventriloquism exists in the world at all and it admitted into argument, then why not allow for the hypothesis that an immaterial mind confuses itself with the walls of its jail and automatically thinks that it is matter?
Another possibility, terribly unpopular nowadays more for falling out of fashion than plausibility and more a result of the sycophantic want for philosophers to cling on as scientistic appendages as opposed to the philosopher telling the neuroscientist how to think and where they have failed to think, is another kind of mind brain monism. Only in this case the monism is not material but mental and usually, though not necessarily, religiously informed. In such a world view what we think of as brains and rocks and the orbits of planets are thoughts within a greater mind. In their regularity and radical separation from our own little minds, certain of these thoughts are experienced as something solid, separate and “objective”. Our perceptions of this solid world out there are internally valid of course. Yet the solidity of the external world is a category error. For in the greater mind all in creation is weakly consubstantial, with thoughts merely crystalized in various forms in time and over time. Our own mind is a thought made free from the greater mind, with some limited agency to change itself and effect change. And what we cannot easily change is the brute facts of the material world. To disavow the existence of this greater mind is a projection of our own narcissism in defending the limits of what our own can know and do. We might think that if we cannot be more of ourselves, then this greater mind cannot be at all.
As Ronald Knox wrote, when thinking of the immaterial monist Berkley
There was a young man who said "God
Must find it exceedingly odd
To think that the tree
Should continue to be
When there's no one about in the quad."
Reply:
"Dear Sir: Your astonishment's odd;
I am always about in the quad.
And that's why the tree
Will continue to be
Since observed by, Yours faithfully, God."
All of the above is not offered as proof of what is, this being impossible. Rather it is a briefly reasoned defence of what might be. When multiple hypotheses explain the phenomena, we must in dint of reason be agnostic and know what we believe as an article of faith.
My own inclination is that things are of one of three possibilities. The first would be a mind brain material monism which denies the givenness of personal consciousness. This is so profoundly nihilistic as to require something of a paradoxical transcendent or mystical turn to explain mind away. And so for this and other incoherence in the argument besides, it lacks appeal both logically and intuitively. Then there is the (substance dualistic) notion that God has a sense of humour, making mind emergent each moment as a miracle of upmost immanence to us, with the brain being both the tool upon which mind works and the manifold upon which it stands to know itself. And yet in us being half mind and half matter we are not fully anything of either except a reminding of our own mortality, perhaps the one miracle which really can die and stay dead when its time is up. The final possibility is something akin to Berkley, where there is certainly only a monism, but it isn’t matter and any transcendence can only be found in placing a faith in a mind greater than our own to either not forget us or remember us in some hyper-time.
Now what has all this to do with psychiatry? Well we are back to where we started. There is nothing lost to the renal physician thinking the kidney is a glorified filter or the heart a glorified pump (yes they are both endocrine organs too of course). Both subspecies of physician may play about happily in metaphysically smaller ponds. But psychiatry has thrown itself into something deeper without being able to swim, and the village has invested it with the power to be our lifeguard.
Relativity. The Truth Makers.
Alice laughed. “There’s no use trying,” she said: “one can’t believe impossible things.”“I daresay you haven’t had much practice,” said the Queen. “When I was your age, I always did it for half-an-hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”
Alice and the White Queen (Lewis Carroll)
"Only in psychiatry is the existence of physical disease determined by APA presidential proclamations, by committee decisions, and even, by a vote of the members of APA, not to mention the courts"
Peter Breggin (maverick psychiatrist)
As