Georg Ivanovas From Autism to Humanism - systems theory in medicine
2.3 The psychosomatic confusion
The neurophysiological approach sees mind mainly as a brain function (Zimmer 2003). “Minds are simply what brains do.” (Mobbs et al 2007). The activity of certain areas of the brain correspond to certain emotions and perceptions. Personality in this context is just a creation of the brain, allowing even different personalities (multiple personalities) to coexist virtually with their own neuronal pattern in one brain (Carter 2003).
Disorders as depression or phobia correspond to specific neurophysiological processes. Afterwards these patterns can be described as pathologic. In Edinburgh a research centre tries to establish a quick diagnosis by brain scan only, not depending any longer on human expertise which takes more time and is ‘not reliable’ (wissenschaft.de 27.4.2002). Deviate patterns found by brain research then can be corrected by changing transmitter metabolism or by electrical stimulation, even before a clinical diagnosis can be established (Schmidt 2007). It is regarded as a good tool for prosecution, as well. Some neuroscientists maintain that they are already able to detect liars (Yang et al 2005), terrorists (Wild 2005a) and future criminals (Mobbs et al 2007). This leads to the ethically problematic situation whether future criminals should be arrested in an early stage, that is, before they commit their crime just on the basis of a brain scan.
But all this stands epistemologically on no firm ground. What we see here is the metaphysical shift from description to prescription (chap. 4.6.b). Some observed patterns are called normal, others pathological. Next the pathological pattern is supposed to be causal for the defined behaviour.
For example, children with bigger amygdalas have more tantrums (Whittle et al 2008). Or hyperkinetic children have a different brain metabolism, e.g., diminished circulation in the frontal lobe and basal ganglia as well as a significant smaller corpus callosum (Semrud-Clikeman et al 1994). But these children probably might also have a different muscle tone and or a different level of catecholamines. There is no reason to see the changes in brain as the cause and the muscle tone as the effect. However, the strategy to influence brain metabolism in order to achieve 'normal values' is based on this kind of hypothesis, on the assumption that ‘mental diseases’ are diseases of the brain.
This biological model, introduced 1845, has as foundation an unobserved psychological disease that is explained physiologically or structurally and corrected by fighting its self-defined cause (Simon, 1995: 34-40). This procedure is not only highly doubtful from an epistemological point of view. It also does not stand up to observations. The Serotonin hypothesis for depression, for example, assumes that a lack of Serotonin in the brain or in certain areas causes the disease. But it takes weeks after the ‘correction’ of the Serotonin levels in the brain until the symptoms improve. Sometimes the symptoms persist despite the ‘correct’ level of Serotonin. Sometimes the medication has severe side effects or might lead to addiction. Moreover, it is possible to overcome the disease without the administration of neurotransmitters (Stutz 2007). That is, the relation of cause and substitution is inappropriate to describe the observed events sufficiently. This model has even been characterized to be rather an ‘advertising’ than a scientific description (Lacass/Leo 2005). In reality, Serotonin levels are just one parameter in an emergent process (chap. 4.10) and a therapy influencing brain Serotonin levels are but a stimulus (chap. 6.10) leading to an adaptation of the brain metabolism.
If neurophysiological findings would no longer be regarded as causes but as correspondences or correlations the whole understanding of regulation and disease would change (Weiner 2003). Visual perception might serve as an example: Many receptive areas in the visual cortex are known to respond to straight and diagonal lines, to corners and angles. We are told that a person sees these structures, ‘because’ these areas react. However, no receptive area for curve lines have been found (Zeki 1999: 116). That is strange, as the environment of ‘natural’ man consisted mostly of curves. As it is too obvious, nobody claims that humans do not see curves. But this would be the only logical consequence if a causality is postulated. And it is done in nearly all other cases if findings do not contradict too much our experience. Notorious is the statement of visual physiology that ‘in reality’ we see everything upside down.
Not only the ‘causes’ but also the proposed mechanisms do not correspond to observations. In visual perception the order of events is not at all as depicted in most textbooks of neurophysiology. “The behaviour of the whole system resembles a cocktail party conversation much more than a chain of command” (Varela et al 1993: 96). There exists a “patchwork architecture of cognition” (Varela et al 1993: 105) with different receptive areas but without a centre bringing the signals together, no mind, no homunculus (Varela et al 1993: 49, Comfort 1984: 3) doing the job. Cognition ‘emerges’ from physical processes in neuronal networks where no self can be identified (Metzinger 2003). But to use expressions like emergent or other figures of speech only obscures the fundamental disability to describe brain function with the current epistemology. Therefore doubtful conclusions are drawn such as: “The self thus turns out to be identifiable not with a non-physical soul, but rather with a set of representational capacities of the physical brain” (Churchland 2002). The problem is that intuitionally we think of the brain, the mind or the self as a linear, centrally organized system although it follows the principles of a distributed control (chap. 6.5) (Singer 2009).
Taking the findings of neurophysiology seriously, something that few scientists dare, leads to the assumption that there is no self. Maintaining the idea of an existing self leaves us, therefore, in a state of schizophrenia (Minsk cited in Varela et al 1993: 107) as scientific findings contradict our every day and philosophical beliefs.
That is, the current epistemic concepts are insufficient to describe what is observed. A concept which came lately under scrutiny in systems science is the discrimination between central and distributed control (chap. 6.5). Although the idea of a distributed control is rather successful in engineering and artificial intelligence, it did not enter biology or even psychology to the same extend, despite the fact that biological functions are mainly organised according to the principles of distributed control.
May be the idea of a self, which is nothing else than a central control in its purest form, is the main obstruction to the understandimg of mental processes.