My Opinion:
The express purpose of this opinion piece is to question the
current widely held belief that biology, in the form of the brain, provides the
best explanation of, and holds all the answers to, “Mental Illness”. Firstly the Mind/Brain is examined
from an objective, reductionist point of view to try and establish from biological
criteria, just what it is that is being discussed. Secondly a subjective, even
philosophical approach is taken which adopts a more general, holistic view of
life experiences and the mind and how this alternative may hold the key. The
difficulties in reconciling these differing views are considered.
This approach may be deemed appropriate in light of recent
revelations that a significant percentage
of published psychological/psychiatric clinical research fails the replication
test, together with the related problems of publication bias.
It is worth remembering that the words Psychology and
Psychiatry derive from the Greek ‘Psyche’ (pertaining to the Mind or Soul). It
would be to the advantage of all not to lose sight of this primary meaning because
it should guide our thoughts on these matters. In this regard, personal life
experiences, a psychology degree, the examination of published papers and
extensive reading, have led to the rather uncomfortable conclusion that
research into mental health is trying to reconcile the irreconcilable. There is
an attempt to reconcile the objective, quantitative, scientifically measurable
aspects of the biological brain with the subjective, qualitative and
immeasurable aspects of the mind with the intention of arriving at some
meaningful answer.
Any answers arrived at, however, will
be dependent on the deep consideration of some difficult concepts which in
themselves give rise to many questions. For instance, what is Intelligence? Is
there a difference between brain and mind? What is “Life”? Is Life the same as Consciousness?
What is it that is absent when something that was “alive” is now “dead”? What
is a thought or an emotion and how are thoughts or emotions generated? These
terms (intelligence, alive, dead, consciousness, mind, thought and emotion) are
in the common lexicon, yet there is no agreed definition or consensus as to
what they are. The brain is considered to “contain” the mind and yet the mind may
not be confined to the brain – even though they appear to be related in some
manner as one affects the other.
Regarding the brain, while
imaging techniques, for instance, have shown that certain areas of the brain are
activated when thinking, it has yet to be determined whether thoughts, by some
means, activate the neurons or whether the activated neurons, somehow, create
the thoughts.
It is unfortunate that reason,
when considering the issues of mental disorders and aberrant behaviour, is often
sidestepped with the statement that such issues are “genetic” in origin. Yet
genes are not self-emergent. Genes are “switches”, activated - turned on or off
- by environmental “triggers”, something not generated within the body, triggers
introduced from external sources or via the senses. Over reliance on genetics,
however, is personally disempowering (“Doc – it’s in my genes – I can’t do
anything about it”) and fraught, particularly as it is now known that we humans
share half our genes with the banana.
It
will be recalled that all living things are formed from cells and all life forms
live and operate, in their disparate ways, by the functioning of these cells. This
is a biological function, but we seldom consider the cells – estimated at some
100 billion – which comprise our individual body forms (excluding the many
billions of bacteria that inhabit our bodies and which are so necessary for our
well-being). Yet these billions of cells – which are individual entities in
their own right – somehow co-operate to create the human form. This, by any
standard, is an astonishing achievement. Likewise these cells, which have a
limited lifespan, replicate themselves many times over, more or less exactly, to maintain what was there before. Furthermore
these cells, when replicating, not only somehow maintain the same, recognisable
body form, they also transfer the same genes and by some means maintain the same
traits, thought patterns, characteristics and mannerisms that presented
themselves at birth or developed during a human being’s formative years. The
extraordinary thing is that these traits, characteristics and mannerisms may be
altered by life experience, with training or by self-will.
Is
this a case of some cells
telling other cells what to do?
For this to occur
a signal-integrating mechanism would be required. In particular, once a
cell in a multicellular organism is committed to differentiate into a specific
cell type, the consequence of this “choice” is generally maintained through
many subsequent cell replications, which means that the changes in
gene expression involved in the choice must be “remembered”. This
phenomenon of
cell memory is essential
for the creation of organized tissues and for the maintenance of stable,
differentiated, cell types. Epigenetics is certainly involved – this is when
modifications to
the proteins that help to pack the long strands of DNA into our cells are added
to or removed. These modifications may determine whether or not a particular gene
is active in a cell. This process is unlikely unless cells have an
element of consciousness (however this is defined).
First consideration:
In
this first consideration a reductionist approach is adopted to try and
establish, from an objective stand point, the difference between a person’s brain
and the associated mind.
It will be recalled that all observable forms of matter are
constructed from atoms and molecules. This becomes interesting if “Matter” (in
the form of the human body and brain) together with “Life”, are considered in
the light of quantum physics which states (basically) that Energy = Matter (remember
E=MC2?). Einstein, with this famous equation, revealed that the
Universe is not just billions of distinct items separated by inert space but in
fact is a dynamic construct in which matter and energy are so inextricably
mixed that it is not possible to consider them as separate elements. If this is
true, where does this leave ‘life’, the ‘mind/consciousness’ and
‘intelligence’? How can energy/matter be intelligent or conscious? What is
‘dead’ energy (i.e. some matter which was alive and is now dead) compared to
‘live’ energy (i.e. some matter which is animated and alive)? Furthermore, physics
tells us that there is no foundation for a view of life based on the
pre-eminence of matter. Energy is indestructible and outside of time, and as a
result the total quantity of energy is constant. This is known as the law of
conservation of energy. But one of the surprising results of relativity theory
is that there is no law on the conservation of mass (matter).
These questions,
relating to life, matter and energy, need to be seriously considered if the part
played by the brain in psychological/psychiatric theory is to be questioned. Consider,
now, the progression from Inanimate Matter to Human Awareness, with Mankind,
the last link in the chain, believed to have evolved with the widest range of
qualities.
Ø
Inanimate Matter. This consists of
atoms and molecules, which are the constituents of all matter in the known
Universe. This “inanimate” matter, as far as can be determined, has neither
life, nor consciousness, nor awareness. The atomic and molecular structure of
the subject matter may be examined and its physical qualities determined and
measured.
Ø
Inanimate
Matter + Life. This ranges from
single cell microscopic life (e.g. amoeba and bacteria) to plant life. The
physical structure of these will be found to consist of the same atomic and
molecular structure as inanimate matter (above). Yet they have something else –
a vivifying essence, an infusion, which we call “Life”. We know Life is present
because we can see the bacteria move, subdivide and replicate. We may also note
the growth of plants; we observe plants change to the rhythm of the seasons. We
also know when Life is absent, because a plant or a cell is dead. But we do not
know what the particular vivifying essence called “Life” is. No “Living” thing
has ever been “produced” from inanimate matter in a laboratory setting.
Ø
Inanimate
Matter + Life + Consciousness. This
is the next stage in the progression. Consciousness cannot be objectively
examined in a laboratory setting. It is assumed that to be conscious something
must be alive. It is always possible that Life and Consciousness are different
sides of the same coin, as it were, that one cannot exist without the other. If
so, by default therefore, consciousness is assumed to require a living organism
– something which, from the evidence, it may be inferred that consciousness is
present. This begs a range of (possibly unanswerable) questions – if plants (or
amoeba) are “alive” are they also “conscious” (e.g. an amoeba extending
and retracting pseudopods when searching for nourishment)?
Ø
Inanimate
Matter + Life + Consciousness +
Awareness. This is the final, most subtle stage – awareness of existence.
Human beings assume they are the only life forms aware of their own existence.
But this may not be so. Other life forms may share this ability – dolphins,
elephants and magpies are apparently able to recognise their image in a mirror.
This great sweep of the Cosmos from inanimate matter to Human
Beings, may be tabulated for clarity - see Table 1, below:
1 2 3 4
Subject Basic
Chemical Consciousness
Building
Blocks Life Awareness
|
|
Inanimate Matter
|
Yes
|
No
|
No
|
No
|
Lower Life – Amoeba) Plants etc )
|
Yes
|
Yes
|
?
|
No
|
Higher Life Forms – ) Animals etc )
|
Yes
|
Yes
|
Yes
|
?
|
Humans
|
Yes
|
Yes
|
Yes
|
Yes
|
Table 1. It should be stressed that these are not discrete items but are shown
in this form purely for descriptive purposes. Their interaction is accepted as
a “given”.
In the four
columns shown above, the first, the Basic Chemical Building Blocks, which form
the physical world as we know and see it, are common to all substances. These constitute
the only “parts” that may be objectively, scientifically and physically examined.
The remaining three columns represent concepts which are
defined only by their opposites and may be identified only by inference. There
is Life and Lifelessness; Consciousness and Unconsciousness; Awareness and lack
of Awareness. These do not conform to any current scientific laws or accepted
theories, and yet Life, Consciousness and Awareness exist and together with
Matter, constitute a Human Being.
It must be emphasised that all the “parts” are interrelated
even though they are qualitatively different. For instance while the physical attributes
of the brain are objective and may be verified independently (column 1, above),
the subject matter of the “mind” (presumed to be contained within columns 2, 3
and 4 above) – the thoughts, imaginings, emotions, desires, memories and
beliefs – are subjective and known only to the possessor. The objective brain
and the subjective mind, however, are assumed to be causally related in some
way as injury to the brain appears to impair the activity of the mind, just as
a “change of mind” may result in altered behaviour – facilitated by the brain.
It will be seen from Table 1 that matter is the common
factor in the observable universe – there are no exceptions. Using the same
logic and believing that Nature (which is not defined) does not “allow”
anomalies, it is reasonable to consider “Life” - the essence, whatever it is
and however defined - as common to all living forms. The same would apply to
consciousness and that likewise, there would be no exceptions. This gives rise
to the possibility that there is a common, “Universal Life” and “Universal Consciousness”.
But as we are not consciously aware of these they may be described as
“Unconscious” elements – a “Universal (or Collective) Unconscious”.
Furthermore humans presume to consider themselves the
epitome of the universe. As confirmation of this assertion the human brain has
been described as the most complex single object known to science, with an
estimated eighty six (86) billion neurons. The feasible connectivity of these
gives rise, literally, to an astronomical number of possibilities. But does
this connectivity explain the mind?
In
this regard it is interesting to note the curiously plaintive comment made by David Kupfer, MD, Chair of Diagnostic
and Statistical Manual version 5 (DSM-5) Task Force (American Psychological Association (APA) press
release No. 13-33, dated 3rd May 2013) wherein he stated:
“The promise of the science of mental disorders is great. In
the future, we hope to be able to identify disorders using biological and
genetic markers that provide precise diagnoses that can be delivered with
complete reliability and validity. Yet this promise, which we have anticipated
since the 1970s, remains disappointingly distant. We’ve been telling patients
for several decades that we are waiting for biomarkers. We’re still waiting.”
The majority of physical illness diagnoses may be verified
by objective clinical tests. The majority, if not all, of psychological or psychiatric
“mental illnesses” cannot be (those caused by alcohol, drug abuse, Alzheimer’s
and Huntingdon’s diseases are excepted). Many medical diseases have proven, verifiable
causes. “Mental illness” has none. Mental disorders are categorizations of
observed behaviours and the presenting person’s self-reported thought patterns
which are then given labels. As far as can determined there is no evidence that
DSM defined “mental disorders” are true medical conditions, but if such
evidence is ever confirmed, they would, presumably, by default, be treated as such.
Current
theories tend towards asserting that all mental disorders stem from aberrant or
faulty brain activity which can be best resolved only with pharmacological
products and/or electrical current (ECT). The efficacy and long term side
effects of such medications and procedures are subject to considerable
discussion which remain largely unresolved – the Psycho-pharmaceutical industry,
for instance, is notoriously reluctant to reveal all results of their research.
Similarly the actual manner by which applied ECT affects changes in the brain
is unknown. There are many reasons why all concerned should be critical
about psychotropic drug treatment, such as uncertain causes, the problematic
accuracy of the few diagnostic tests available, commercial conflict of
interest, poor understanding regarding the mechanism of drug action and their
side-effects together with the related problem of publication bias [Note:
The recent reanalysis of the –ghost written- GlaxoSmithKline Study 329 relating
to their antidepressant drug formulation paroxetine, Paxil, (also known as Serotax or Aropax)
provides an excellent, if unfortunate, example of these issues].
Furthermore it is all very well for neuroscientists to point
out that with the various brain imaging and scanning techniques now available
it can be seen that different parts of the brain are activated when a patient recalls
earlier events or when thinking about a problem. But HOW does the excitation of
neurons translate into memories of an experience or the solution to a problem? And
which comes first – is it the activity of the neurons which create the thoughts
and memories or do the thoughts and memories activate the neurons? These
questions remain unanswered. The nature of even the “simplest” thought has yet
to be determined.
Then there is a further matter, our freedom to choose –
known as the “problem of mental causation”. It is a fundamental fact of science
- a maxim - which states that nothing can happen that is not governed by
natural laws of material causation (i.e. physical things cause physical
effects). Thoughts are non-physical (they are subjective), therefore by
definition cannot cause anything physical to happen. How then is it possible
for subjective (non-material) thoughts of the “self” to so influence the
function of the (material) brain that they compel the brain to direct the body to
perform a particular action?
Similarly it is worth noting that prescribing mind altering drugs
to people already suffering mental disorders is counterintuitive. Yet this is
what happens. The issue, which has yet to be resolved, is that medications in
various formulations and strengths have been prescribed for mental “illness”
since the 1950s – some sixty years ago. Yet the problems remain. Logically this
leads to the conclusion that, ipso facto,
either the medications are ineffective or the causes of mental
disorders is misunderstood and therefore, by default, misdiagnosed – or all
three.
Is it sufficient, therefor, to claim that chemicals in the brain,
alone, are responsible for all mental disorders and all the attributes (good,
bad or indifferent) that make us human? Again, this assertion is greatly
disempowering. Is it simply a case of, “Doc, my brain chemicals are out of wack
– gimme a pill”? Is there not a possibility that there exists a dynamic unconscious
(or Life), beyond the physical, that must be considered and respected in
relation to every phase of Life and the Mind of every individual and which
affects the personality and gives testimony – for better or worse – to their
personal history? This, it is suggested, should be considered as a “Collective Unconscious”
– common to all.
Second consideration:
Adopting a more philosophical or holistic approach, the
three concepts of Life, Consciousness and Awareness (refer Table 1 above) are now
considered. The whys and wherefores of these three are unknown, yet they exist.
The millions of life forms comprising the flora and fauna of the world,
together with Humans, are a testament to their presence. As a “group” these
three concepts have historically been considered, collectively, as the Spirit,
the Psyche, the Metaphysical, the Soul, the Tao or, more lately (and possibly
controversially), as something dynamic, as the “essence” of Life and the
associated Consciousness (however these are defined) or a “collective unconscious”.
A belief in Spirituality and the
Divine/God/Allah/Creator/Supreme Being/Tao, is common to all societies through
all ages but is something which many people in today’s (Western) secular world
are uncomfortable discussing, and in fact, some deny exists at all. Yet such
beliefs presumably have a deep psychological purpose. They may bring comfort
and lend meaning to the question, “Why is there something rather than nothing?”
Furthermore they give credence to the need for kindness, compassion, morality, courage,
temperance, virtue and ethical behaviour in our relationships.
All the ancient devotional writings, known to us as
scriptures; all the philosophical texts from ancient India, China, Persia, Egypt,
Greece and Rome, through Confucius to Plato and many more recent contributors;
all great literature, great music, great poetry and all great art, start from
the premise that the basis of life is spiritual. They all attempt to inspire
the listener, reader or viewer to look beyond the immediate, apparent
existence, to something more; that a “Great Artificer” exists and that Humans
have souls and a higher purpose than mere existence. This was never questioned.
The quest for and the fulfilment of this purpose is (or was considered to be) a
Human Being’s guiding star.
In this context the possibility of a collective unconscious gains
traction. It is as if “Life” needs to be expressed, to be made manifest, to be
appreciated in all its beauty and variety of form. It must be remembered that there
has been no known break in the continuity of expressions of Life since
primordial times (many hundreds of millions years ago). In the Human context
three, possibly unanswerable, questions arise, “Who am I?”; “Who or What made
the Universe?”; “What is my relationship to that Who or What?”
It was the view of the ancients that the cause
of the Universe is the permanent and indivisible Divine, whereas the effects
(all matter, flora and fauna) are impermanent and decay over time. Be this as it may, the tenacity and
determination of all life forms in propagating and maintaining their existence
is phenomenal. All sentient beings will fight to stay alive; flora and fauna
persist in the most wretchedly harsh environmental and climatic conditions – in
fact there is no “corner” of the Earth that is totally lifeless.
Life (however defined) MUST be expressed – this is the
imperative – this is the charge placed upon all life forms. It is instructive to note that the Bhagavad-Gita
(an ancient Indian Hindu classic compiled over three thousand years ago)
states: “Wherever life is seen in things moveable or immovable, it is the joint
product of Matter and Spirit”.
All human life is bound to individuals who manifest it, and
is simply inconceivable without them. But every human is charged with an
individual destiny and destination, and the journey to that destination or the
fulfilment of that destiny is the only thing that makes sense of human life. The
individual journeys and destinations may differ but the fundamental purpose is
the same – the expression of Life.
It will be recalled that there is evidence, personal,
anecdotal and “unscientific” it may be, but evidence none-the-less, in the
power of prayer. Further, it has yet to be determined how positive thinking has
such a beneficial effect on a person’s well-being. Likewise, currently, there
is no acceptable scientific explanation for the medicinal benefits of the “placebo
effect”, or how it comes about that an extreme emotional shock, inducing stress
(emotional and subjective), may cause a physical death, or by what process this
(subjective) stress affects a person’s (physical and objective) immune system,
or to explain the immense influence of self will or will-power on an
individual’s desire to live.
Much is explained when it is remembered that Human
Beings are made or unmade by themselves.
In the armoury of our thoughts we fashion the means by which we build
for ourselves all that is necessary for happiness, health, prosperity and peace
of mind. Alternatively, we may forge the weapons with which to destroy ourselves.
The “Mind of Man” is, indeed, a powerful tool!
The Bhagavad-Gita also states, “Man is made by his
beliefs. As he believes, so he is.”
Further consideration must be taken regarding the
moral and ethical aspects of humanity. It may be safely stated that virtues are
at the core of both morality and ethics regardless of the society or culture
concerned. Virtues are defined as the qualities all people admire and recognise
in a “good person” - the qualities of kindness, compassion, courage, honesty,
temperance, humility, integrity and justice.
A person cannot be either ethical or moral without
also being virtuous; these are dependent on their set of values and their
beliefs; something that is at the core of their being. Values are not just
mannerisms or a set of preferences. They refer to something much deeper and
more subtle, to a line that cannot be transgressed. Values cannot be measured
and may be inferred only by the actions of the individuals under consideration;
they are on “display” with someone’s behaviour and general demeanour. A
person’s mind cannot be observed (their virtues, values or morals) but these
are all there for anyone to deduce from their ethical (or unethical) conduct. No
one can think one thing and do another (opposite to their thoughts) and remain
in their comfort zone for long without the impact of generally unforeseen
consequences.
It has been suggested (possibly unkindly) that human beings
as a species are neither intelligent nor creative enough to have invented
morality, virtues, values or ethics; that these are innate and part of the
human psyche. It is further suggested that these universal, core aspects of
human conduct are evidence of there being a dynamic unconscious or collective unconscious,
common to all.
Finally the following quote, from “Anatomica - The Complete
Reference to the Human Body” (Random House), further illustrates the
extraordinary qualities of Nature (not defined) and which transcends any known
neurological process and which may be considered as a working example of the “collective
unconscious”:-
“Women are characterized as the weaker sex but it is men who
need a helping hand from Mother Nature. The male disadvantage extends
throughout life. From birth, male babies are less likely to survive childhood,
while at the other end of life, on average men die younger. Nature maintains
the balance between men and women by ensuring more boys are born than girls. A
study published by the European Society of Human Reproduction found that ... the
usual ratio is 511 boys for every 489 girls in every 1000 births (statistically 104.5 boys for every 100
girls).”
Concluding opinion:
On one hand applying a
biological approach to Mental Health, focusing just on the Brain, does not explain how or why a person
is “alive” or how their individuality comes about. There is an inescapable
conclusion that all life forms are not just an agglomeration of matter – not
just ‘mechanisms’; that a human being is not just a watertight skin bag filled
with blood, flesh and bones; that there is something above and beyond the
observable Universe which affects all sentient beings in different ways
according to their kind. This something, this vivifying essence, it is proposed,
is a dynamic unconscious or a “collective unconscious” which is present in all matter
which somehow, when the conditions are suitable, has been “infused” with Life.
This collective unconscious is the bond between all living things, that allows
for the benefits of relationships between sentient beings (between humans, with
animals and between animals) and between human beings and plant life (the peace
felt in a wilderness setting or by someone who creates and tends a garden).
On the other hand a holistic consideration of all the
aspects of Life, Consciousness and Awareness which have been the subject matter
of Philosophical discussion since ancient times leads to the same conclusion.
That there is something above and beyond the observable which many term as the
Divine/God/Allah/Spiritual/Metaphysical/Tao; something which infuses all things
that are “alive” with Life; infuses all with the same emotional responses to
fear, anger and affection; the same essence that is withdrawn when something
dies; the same essence that requires, needs and thrives on nurture (love). This
essence, this Life, which is common to all living things, should be considered,
it is suggested, as a dynamic or collective unconscious.
Finally, in relation to the determination of Mental Disorders,
biology – neuroscience – should not be considered on its own. There is a need
to consider all aspects of Human Life in a balanced manner. Such consideration questions the inference
that “Life”, “Consciousness” and all the attributes that make us human are generated,
exclusively, within the confines of the dark, silent, recesses of the skull. Concentrating
on one (the objective Brain) and ignoring the other (Life and the subjective Mind)
is similar to a bird trying to fly only with one wing. Biology and Neuroscience
alone do not, and cannot, provide answers to all mental health issues. Trying to
reconcile matter (the body and brain) with the subjective Mind and Life
(however these are defined) – in a laboratory - will prove to be very difficult
if not impossible, but regardless, one is left in awe of the wondrous thing
that is a Human Being.
