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Unauthorized Online Supplement to
A Companion to the Philosophy of Mind
Samuel Guttenplan (ed.)
(Oxford: Basil Blackwell Ltd., 1995)
Unauthorized Online Supplement editor:  Larry Hauser


Psychotherapy, Psychopathology, and the Mind Body Problem The functions of the mind are complex enough to make sense of, but when considering various states of the minds functioning, and more specifically, malfunctioning, the complexity increases greatly.  Taking into consideration the possible alterations to the normal functioning of the mind and mental processes, a definition is necessary to ascertain the difference between insanity and sanity and the role the mind as viewed by psychology plays.

A purely behavioristic view of mental functioning would consider most if not all mental processes to be directly correlated to physical phenomena.  In this way any mental malfunctioning would be due to some physical disorder (based on the medical model theory of psychology).  Many psychological disorders have been treated successfully due to this type of diagnosis.  The corresponding physical cause is found for the mental disorder and when this is treated, it will lead to the diminishment or disappearance of the mental disorder.  Although oin cases where the disorder is related to chemical abnormalities (low seratonin in depression and mood disorders) or in physical problems (vitamin deficiencies or organ problems) or in chemical dependencies, or developmental disorders it is not always as easy to make changes.  In some cases, a physical cause is not easily found to be the cause of a disorder, or it can be the result of multiple physical causes, or interactions.  Interacting medications and side effects of medications can cause abnormal functioning as well as misdiagnosis and prescription of drugs.  In other cases, the mental disorder can be of such a nature that finding a physical cause can be near impossible.  In certain somatic disorders, patients can feel specific pain or discomfort with no apparent physical cause.  In many anxiety disorders there are conflicting theories relating to the cause, from improper breathing techniques to maladaptive thought processes to imbalanced neurotransmitters.

In both cases, a patient can feel pain or discomfort that is very real to them, but to the physicians it is something "in their mind (or mental processes)" not a problem with their bodies (excluding the brain).   In some cases a neurologist may be able to find some cause for the disorder, but in many cases a psychologist or similar professional is needed. If and when these patients get to a mental health professional, they have a possibility of finding relief, if the problem truly is "in their mind".  In somataform disorders the cause can be something "in the mind" but may also be viewed in other ways.  In the case of Munchausen syndrome, an individual may cause harm to themselves to get attention from health care providers.  Some somataform disorders may be similar to this, without the presence of self-injury.  It needs to be determined then if the patient is choosing to feel ill, such as the case of the hypochondriac, or else the person may feel pain or discomfort due to a psychological event (post traumatic stress disorder) and desperately wish to be well, and without the presence of any health care providers.  The issue then becomes how to distinguish between the disorders of the brain, and the disorders of the "mind".

Taking a step in the same direction as post traumatic stress disorder, there are many lesser stress disorders relating to divorce, loss of a loved one, etc., that can cause someone physical pain without any obvious physical causes.  A further step takes us to individuals who feel any degree of discomfort for no physical reason.  These disorders are generally neurotic in nature, so named because they involve some type of thinking process and its manifestation in behavior as their recognized cause.  The most notable of these is obsessive compulsive disorder, which in extreme cases can cause an individual to alter their day to day functioning to the degree that many rituals must be preformed before certain activities can commence, or as a result of a unjustified fear such as being dirty (mysophobia).  Other obsessive disorders can cause a physically normal person to stalk a former loved one, or famous person.  Phobias also fall intothis area, as someone can behave perfectly normal and be physically perfect but in certain specific situations they can  feel great discomfort.  Depending on the phobia, it can be experienced once in a while or once in a lifetime.  I any case, it causes a physical discomfort for no obvious physical reason.  This brings to bear the theories of the evolutionary psychologists.  In this realm, some phobias of current humans are behavioral traits that have developed over thousands of years.  This explains why people fear spiders or snakes, as ancestors probably learned some were poisonous, and lacking science, they generalized to all type spiders and snakes, and avoided them for fear of death.  But some phobias are related to exclusively present day situations and object, and do not seem to have any cause to be prewired.

The issue to be addressed then is why is discomfort felt when there is no physical malfunction?  Where is the malfunctioning located, or if there is no malfunctioning as we know it, what is the cause of the disorder.  One answer is that current technology such as x-rays, EKG, EEG, and others cannot determine bodily dysfunctions specifically enough to detect the minute aberrations causing the discomfort.  It may be a microscopic malfunctioning within the neurons or relating to a delicate electrical or chemical balance.  In the future it may be possible to deterring the exact nature of the physical malfunction causing the "mental illness".  The other view is that it cannot be detected by physical means, as in the view of some dualists, is exclusive to the mind.  In this way the mental illness is truly mental and not physical. The problem here being not physical, and in the realm of the mind, the dysfunction must also be exclusively in the mind.  The dysfunction must also be related to the processes of the mind, as the bodily processes and dysfunctions of processes are responsible for other physical ailments.  Understanding the processes of the mind is necessary then to determine exactly what process is malfunctioning, and how it is doing so.  To do this is almost an impossible task as there is no seemingly physical object to manipulate using the scientific method.  It then becomes an issue of subjective ideas and techniques, relating to what should be manipulated and how.  By using patient feedback and other
self-report methods, it becomes possible to gain insight into the workings, or the perceived workings of the mind.  By manipulating these perceptions, it then becomes possible to use therapeutic techniques to diminish the discomfort and pain the patients are feeling.  In the cases of maladaptive thought processes, it is first necessary to determine the point at which the thinking process is becoming dysfunctional. Cognitive therapists focus on the idea that mental disorders are caused by thought processes that do not follow rational reasoning, or logical thought progressions.  (Note: Cognitive psychologists, as opposed to the therapists who focus on cognitive issues, also concern themselves with the workings of the brain, and with non-brain identities operating in fashions similar to that of the human brain.)  Therapists believe this
is due to a focus on negative thoughts, or harmful or traumatic events.  Self-fulfilling prophecies also cause dysfunctional thought processes by causing the thinker to predestine failure and look forward to not achieving positive goals.  Altering these thought processes can then allow for a more functional thought process, and after a certain time of effective practice can lead to the elimination of the discomfort or problem. In the case of phobias, desensitization can be used to alter perceptions and lead to more normal functioning.  By altering these perceptions, and allowing for new perceptions to take their place, it is possible to recondition the mind to operate in a new healthier way.  With mood disorders, it becomes necessary to focus not only on the internal perceptions of the thoughts themselves, but also the altered perceptions of the individuals' environment.  It is similar to someone wearing a pair of tinted eyeglasses-everything will appear essentially the same, but with an overall change in perception. By focusing on the mental thought process first, it becomes possible to alter the thinking so that it is more positive and less stressful.  It will then usually follow that the perceptions of the environment are also changed, but if not, they can also be conditioned to appear differently to the viewer with therapeutic and behavioristic techniques.  With the tinted glasses off, these mental dysfunctions are also repaired. The same, but different. These changes can take place without any percieved physical change in the patient or client.

With more serious disorders such as post traumatic stress disorder, it becomes necessary to recognize not only mental perceptions but also physical functions affected by these processes in the form of long term sympathetic nervous system conditioning.  With a combination of therapudic techniques, relaxation techniques, and medication designed to cause tranquility, these types of disorders can also be effectively treated once the nature of the combined causes (physical and seemingly non-physical) is realized.  In more serious cases such as schizophrenia and other disorders it is a complex interaction between purely physical causes, purely mental causes, and innumerable gray areas in between.  The field of psychology, and more specifially therapy is somehow dodging the issues of the mind-body problem.  The science and scientific proponents of psychology would argue that everything is physical and in time will be found to have physical couases.  But those who deal with the mentally ill are usually of a more liberal view of dysfunctions, and allow for there to be mental disorders with no corresponding physical dysfunction.  While not attempting to define the mind or its bounderies, they deal with the (dysfunctioning) mind on a pragmatic level, manipulating thought processes until they no longer cause discomfort to the thinker.  Although not dismissing the physical brain as the seat of basic mental
drives and functions, therapists understand that there is something seperate from the brain as we know it that drives the thought processes and mental functions.  It is true that manipulation of the brain can cause gross losses of functioning of  mental processes, suggesting that the mind is only the physical brain, and thus not seperate from the body.  But in areas where the cause is not clearly defined, or is reluctantly, or perhaps only temporarily attributed to the nonphysical mind, there is no corrosponding area of the brain that can be manipulated in a way to only affect the area of functioning.  To state more clearly, there is no exact area of the mind that can cause a specific phobia or obsessive disorder that is relative to a persons environment.  Removing certain areas of the midbrain, such as the amydala, or altering seratonin levels may cause a change in levels of tolerance for certain situations or moods, but it will be generalized, and not specific to a person or thing in the patients environment.  In this way it is not possible to determine an exact correlation between every human behavior and a phsycial cause.
By defining the exact nature of the causes of mental disorders, it becomes possible to determine how to "fix" them, and how they fit in the scope of the mind, as seen by psychologists.  Philsophers and psychologists would have a difficult if not impossible task to define the mind and each and every mental disorder.  That is why in the field of psychology, the issue of the mind body problem is avoided, although it is relevant to most therapudic practices.

See also cognitive psychology, dualism, psychoanalytic explanation, psychology and philosophy

BIBLIOGRAPHY

Churchland, Paul. _Matter and Consciousness_, MIT press, Cambridge MA 1988
Gutenplan, Samuel. _A comanion to the philosophy of mind_ BlackwellPublishers, 1984

ANDY GOODMAN
1998

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