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The Mind-Body Dualism and Mental Health: A Philosophical Update

Dr. Praveen Khairkar*

Introduction:
By now most of us understand that there are no clear temporal association linking mental disorders with single etiological factors and this leads to pouring of conundrum of hypothetical views by mental health practitioners including psychiatrists and psychologists, neurologists, researchers in neurobiology and philosophers for many neuropsychiatric disorder(s). Historically, philosophy and general psychology were not sharply distinct. Wilhelm Wundt, for example, who founded the first experimental psychology laboratory at Leipzig (Germany) in 1879, was a professor of philosophy. However, abnormal psychology, madness has nearly always been very much at the fringes of philosophical interest of many others like Anthony Quinton, Berkeley, Locke & Kant, Kenny and Karl Jasper. Their work reflects deep points of contact between philosophical theory and mental health practice. Psychopathology and psychotherapy presents a challenging set of test cases for philosophical understanding. Mindfulness and Mentalizing are the two core examples of integral model of intervention which are very close to spirituality stems from central discipline of philosophy. In the present review author would like to discuss the flow of philosophical mind-body dualism critically important for fundamental mental health care and research perspectives.

Origins of the Philosophical problem of mind and body:

The problems with which the philosophy of the mind is concerned have occupied philosophers since classical times. Rene Descartes is supposed to be a man responsible for the mind-body problem in its present form who speculated that mind and body might interact through pineal gland. This is often treated as philosophical joke, but it was a reasonable hypothesis. The pineal is a pea size organ situated more or less in the centre of head with cord or stalk of nervous tissue connecting it directly to the deeper parts of the brain. In Descartes time, it had no obvious functions and to all appearances, it could well have been a mind-body transceiver. The pineal is now known to be an important conduit between the brain and the rest of the body secreting wide variety of hormones under the control of higher centres in the brain that influence the state of body and mind. It was the beginning of shifting of general philosophy from metaphysics (the inquiry into the fundamental basis of reality, or, alternatively, the exploration of what lies beyond our sense experience) to epistemiology (the inquiry into the limits, and possibility of knowledge) to empirical investigations of the brain exploring role of neuropeptides and neurotransmitters in various neuropsychiatric behaviours/disorders. Descartes wanted to find a secure foundation for knowledge. His key works on mind and body were done from 1628 to 1649, (while living in Holland) and they were ‘The Discourse on Method’ (1637), and ‘The Meditation’ (1641). He embarked on an entirely novel course of subjecting every possible claim to critical inspection. This is his famous ‘method of doubt’ adding veracity to the whole process. Many modern philosophers could learn from Descartes the value of contextualizing their work, of embedding it in a concrete situation/theory. The philosophical influence of the mind-body problem as set up by Descartes, is reflected in the extent to which it has continued to inspire debate over the centuries. As you might expect, the range of theories produced by so many ingenious minds can be somewhat bewildering. A good way to think about them, to get sense of order, is in terms of one of the most widely used pairs of ‘ISM’, dualism and monism. While dualists believe that there exist two distinct sorts of substance in the universe, matter and mind; (Descartes was the original ‘two-substance’ dualist. Malebranche, Geulincx and Leibniz were other proponents) monists hold that there is only one sort of substance in the universe, usually either mind (Berkeley’s idealism) or matter (Thomas Hobbes, a contemporary of Descartes). Thus, Hobbes was another great polymath who wrote extensively on philosophy, ethics, religion, politics, mathematics, natural sciences and the law. Indeed, he dared and wrote a controversial set of objections to Descartes’ Meditation. Hobbes argued that Descartes identified the activity of thinking with the thing that thinks and then claimed, on this basis that thinking entails the existence of a thinking thing, and further that this thinking thing is a different substance from that which does not think. Further Hobbes objects, unless we subject ‘I think’ to an iterative thought ‘I think that I think about..’ we cannot make the subject the object of thought. In fact, says Hobbes, the knowledge afforded by ‘I think’ is derived from knowledge of the act of thinking and the knowledge we have is derived from our senses and extrasensory perception.  This view of Hobbes takes us to deeper realization as he contends that Descartes has gone further than logic will support with his argument and this reflects his (Hobbes) exquisite level of intelligence in penetrating the philosophical understanding of mind (thinking thing) and therefore mental processes/pathologies.   On the other hand a group of neuroscientists argues that evolution of cognitive component occurs because of redeployment of various brain areas. There are obvious evolutionary advantages to such redeployment, and the data presented here confirm three important empirical predictions of this account of the development of cognition: 1) A typical brain area will be used by many cognitive functions in diverse task categories, (2) evolutionarily older brain areas will be deployed in more cognitive functions, and (3) more recent cognitive functions will use more, and more widely scattered, brain areas. These findings have implications not just for our understanding of the evolutionary origins of cognitive function but also for the practice of both clinical and experimental neuroscience. Arshavsky advocated the hypothesis that the performance of cognitive functions is based on complex cooperative activity of "complex" neurons that are carriers of "elementary cognition."

Types of Dualism:
There are various ways of dividing up kinds of dualism. One natural way is in terms of what sorts of things one chooses to be dualistic about. The most common categories lighted upon for these purposes are as follows:

1. Predicate Dualism: Predicate dualism is the theory that psychological or mentalistic predicates are (a) essential for a full description of the world and (b) are not reducible to physicalistic predicates. For a mental predicate to be reducible, there would be bridging laws connecting types of psychological states to types of physical ones in such a way that the use of the mental predicate carried no information that could not be expressed without it. An example of what we believe to be a true type reduction outside psychology is the case of water, where water is always H2O: something is water if and only if it is H2O. If one were to replace the word ‘water’ by ‘H2O’, it is plausible to say that one could convey all the same information. But the terms in many of the special sciences (that is, any science except physics itself) are not reducible in this way. These states are defined more by what they do than by their composition or structure.

2. Property Dualism: Whereas predicate dualism says that there are two essentially different kinds of predicates in our language, property dualism says that there are two essentially different kinds of property out in the world. Property dualism can be seen as a step stronger than predicate dualism. The irreducible language is not just another way of describing what there is, it requires that there be something more there than was allowed for in the initial ontology. Until the early part of the twentieth century, it was common to think that biological phenomena (‘life’) required property dualism (an irreducible ‘vital force’), but nowadays the special physical sciences other than psychology are generally thought to involve only predicate dualism. In the case of mind, property dualism is defended by those who argue that the qualitative nature of consciousness is not merely another way of categorizing states of the brain or of behaviour, but a genuinely emergent phenomenon.

3. Substance Dualism: There are two important concepts deployed in this notion. One is that of substance, the other is the dualism of these substances. A substance is characterized by its properties, but, according to those who believe in substances, it is more than the collection of the properties it possesses, it is the thing which possesses them. So the mind is not just a collection of thoughts, but is that which thinks, an immaterial substance over and above its immaterial states. Properties are the properties of objects. If one is a property dualist, one may wonder what kinds of objects possess the irreducible or immaterial properties in which one believes. One can use a neutral expression and attribute them topersons, but, until one has an account of person, this is not explanatory. One might attribute them to human beings qua animals, or to the brains of these animals. Then one will be holding that these immaterial properties are possessed by what is otherwise a purely material thing. But one may also think that not only mental states are immaterial, but that the subject that possesses them must also be immaterial. Then one will be a dualist about that to which mental states and properties belong as well about the properties themselves. Now one might try to think of these subjects as just bundles of the immaterial states. This is Hume's view. But if one thinks that the owner of these states is something quite over and above the states themselves, and is immaterial, as they are, one will be a substance dualist.

The Aristotelian Argument in a Modern Form
Putting his anti-materialist argument outlined above, in very general terms, Aristotle's worry was that a material organ could not have the range and flexibility that are required for human thought. His worries concerned the cramping effect that matter would have on the range of objects that intellect could accommodate. Parallel modern concerns centre on the restriction that matter would impose on the range of rational processes that we could exhibit. Godel, for example, believed that his famous theorem showed that there are demonstrably rational forms of mathematical thought of which humans are capable which could not be exhibited by a mechanical or formal system of a sort that a physical mind would have to be. Penrose (1990) has argued that Turing's halting problem has similar consequences. In general, the fear is that the materialist monist has to treat the organ of thought as, what Dennett (1987:61) calls, a syntactic engine: that is, as something that operates without any fundamental reference to the propositional content of what it thinks. It works as a machine that only shadows the pattern of meaning. But it is hard to convince oneself that, as one, for example, reflectively discusses philosophy and struggles to follow what is being said, that it is not the semantic content that is driving one's responses. But if we are truly semantic engines, it is difficult to see how we can avoid at least a property dualism. These issues are, of course, connected with problems raised by Brentano, concerning the irreducibility of intentionality. Despite the interest of the arguments for dualism based on the irreducible flexibility of intellect, most of the modern debate turns on arguments that have a Cartesian origin.
Brain-only and Mind-only: Emphasizing the tractable
Epiphenomenalism is one of the dualistic theories which agree with other theories that mental events and physical events are different. Some of the proponents believe that a mental event precedes physical events but since brain ignore and does not remember mental events seem causally efficacious.  Gottfried Wilhelm Leibniz, a 17th-century German rationalist and mathematician, saw mind and body as two perfectly correlated series, synchronized like two clocks. The Sunday Times, once described the discovery of a ‘trigger’ for anorexia in the brain, opts in effect for a brain only solution. This makes anorexia a ‘real’ disease, caused by something wrong in the brain, and hence, outside the moral world of person. The New Scientist is tackling a problem that has taxed the best minds for over two thousand years.  The New Scientist editorial, jumping the other way, opts in effect for mind-only solution. Brain-only is the position of the more triumphalists among ‘biological’ psychiatrist and neurologist, but clinically, scientifically and conceptually there is no getting off the cusp of mind-body problem. Again, both dogmas are widespread in thinking and there is no easy way with these issues; in general they are equivocally placed. The mind-brain problem, then, filtered through the concept of mental illness, comes down to philosophy of action. Now with the rise of cross-disciplinary work between philosophy and neuroscience, it is seen as part of philosophy of mind hybridly connected with brain sciences, for e .g. abnormal aspects of consciousness such as delusions and hallucinations.
Five-Signals of the mind-body Problem
There is no easy way with mind-body problem. Indeed, a function of philosophy for mental health practitioners is to show just how difficult- intellectually and practically- the problem is. The inherent difficulties not only leave the mental health practitioners and philosophers, to spurious criticism but also for avoidable errors in practice and research. Roy Porter was a Professor of the History of Medicine at the prestigious Wellcome Institute in London. He has often been identified by psychiatrists as a member of the opposition as an antipsychiatrist. He made number of trenchant criticism of psychiatry but also recognizes the importance of psychiatry as a brain based science. In his short punchy piece of scientific review, he discussed five signals of mind body problem which are as follows:

  1. Concept of illness and disease: This contrast (‘mind’ = not real; ‘body’ = real) is embodied in a medical /psychiatric context in the distinction between illness and disease. Much of the debate about the validity of ‘mental illness’ turns on this. Here we get a clear signal that part of the rhetorical power of this conflation stems from an implicit reference to the body (disease = real) and mind (=illness=unreal)
  2. Anti-psychiatry: Its link to the mind-body problems is clear at number of points. E.g. if someone asks whether mental illness is ‘real’ like smallpox or cancer or ‘it is everything in mind’, if we link everything of psychiatry to mind and not brain then antipsychiatry implies that psychiatry is dealing with something that is not real (Szasz)
  3. Diagnosis, treatment and research: This is another signal where structural and functional causality comes into play for diagnosis, investigations as well as treatment is concerned in mental health. Psychiatry is developing its treatment in two different ways/directions, with physical treatments (ECT, TMS, Drugs, Lobotomy) and ‘Talking Cure’
  4. Eliminative Materialism: As we began to understand the hard science behind the talking therapies is ‘neurophysiology and neurochemistry’, all that is important to psychiatry then, concerned as it is with mental disorders, is to be had from studies of the brain (and of the rest of body). The talk of the mind, then, can be eliminated once we have an adequate account of the brain and hence eliminative materialism.
  5. Practical Significance: But is this really as ‘hopeful’ a message for mental health practitioners? History warns us against such retreats to any one overarching approach in psychiatry, but there are philosophical warnings too. When physical treatment fails, it is conveniently forgotten that they were based on the ‘hard science’. Psychoanalysis or other forms of therapies as preliminary to neuroscience is dismissed as ‘aimless chat’. Even therefore, within a body-only solution to the mind-body problem, it is merely today’s neuroscience that is acceptable to Porter. A view as narrow as this, promoted, in an upbeat, even euphoric tone, signals dogma.

Problem(s) of dualism:

The construct of dualism is laden with many philosophical and scientific criticisms. Let us consider two other facets of dualism that worry critics most. First, there is what one might term the queerness of the mental if conceived of as non-physical. Second there is the difficulty of giving an account of the unity of the mind. We shall consider this latter as it faces both the bundle theorist and the substance dualist.

  1. The Queerness of Mental: Mental states are characterised by two main properties, subjectivity, otherwise known as privileged access, and intentionality. Physical objects and their properties are sometimes observable and sometimes not, but any physical object is equally accessible, in principle, to anyone. From the right location, we could all see the tree in the quad, and, though none of us can observe an electron directly, everyone is equally capable of detecting it in the same ways using instruments. But the possessor of mental states has a privileged access to them that no-one else can share. That is why there is a sceptical ‘problem of other minds’, but no corresponding ‘problem of my own mind’. This suggests to some philosophers that minds are not ordinary occupants of physical space. Think instead of energy and force-fields in a space-time that possesses none of the properties that our senses seem to reveal: on this conception, we seem to be able to attribute to matter nothing beyond an abstruse mathematical structure. Whilst the material world, because of its mathematicalisation, forms a tighter abstract system than mind, the sensible properties that figure as the objects of mental states constitute the only intelligible content for any concrete picture of the world that we can devise. Perhaps the world within the experiencing mind is, once one considers it properly, no more—or even less—queer than the world outside it.

  2. The Unity of Mind: If the mind is only a bundle of properties, without a mental substance to unite them, then a9n account is needed of what constitutes its unity. The only route appears to be to postulate a primitive relation of co-consciousness in which the various elements stand to each other

There are two strategies which can be used to attack the bundle theory. One is to claim that our intuitions favour belief in a subject and that the arguments presented in favour of the bundle alternative are unsuccessful, so the intuition stands. The other is to try to refute the theory itself. Foster (1991) takes the former path. This is not effective against someone who thinks that metaphysical economy gives a prima facie priority to bundle theories, on account of their avoiding mysterious substances.

The core objection to bundle theories (see, for example, Armstrong (1968), is that, because it takes individual mental contents as its elements, such contents should be able to exist alone, as could the individual bricks from a house. Hume accepted this consequence, but most philosophers regard it as absurd. There could not be a mind that consisted of a lone pain or red after-image, especially not of one that had detached itself from the mind to which it had previously belonged. Therefore it makes more sense to think of mental contents as modes of a subject.


Dissolving the mind-body Problem: Is there any reason to believe in supervenience?
The mind-body dualism problems thus suggest how it is subjected to endless philosophical scrutiny. The traditional debate may be an illusion to be assimilated to mass delusions and this may be a false picture of mind, but in its place modern neuroscience offers us the brain with some challenging findings for example that brain activity may precede awareness of that activity (e.g. the tennis ball being back over the net before the player is aware of hitting it, it happens in real life many times!) and a series of ‘deficit states’ show that our conscious awareness is not as indivisible as we normally suppose (e.g. in blindsights, subjects can identify objects correctly even though they have no conscious visual awareness).

Moreover, as Descartes exhorted in the case of one mental revolution (and many teachers of philosophy today also do) these discontinuities in mental operations are sometimes done intentionally, deliberately, as a project to be fulfilled. What is further wondrous is that we sometimes evaluate two or more of these processes and their contents and judge that some are to be abandoned in favour of one. This means that we take these constructs to be objects to be assessed and seem to be able to stand as a One supervising them.

The time now has been changing when the insights from neurophysics and neuroimaging is failing to make this dichotomy clear about mind and brain in the constructs like consciousness, freedom of the will, purpose of life, and role of higher mental functions in responsibility such as volition, desire and belief. So what is the error according to Ryle, which lies at the heart of mind-body dualism? It is what he calls a ‘catagory mistake’- a confounding of one logical type with another. Ryle argued that our mental and physical concepts belong to different categories, Cartesian claim that there is mind-stuff and body stuff, each being radically different and distinct from the other. Cartesian introspection is myth and misconception which have arisen because we have been systematically misled by language into asking the wrong sorts of questions about the mind. We can analogically summarise Ryle’s wisdom laden example of category mistake thus: imagine a foreign visitor to Harvard University who is taken on an extensive tour of colleges, libraries, faculties and so on. After this the visitor asks: ‘Where is the University?’ This question reveals that he has misconceived what sort of things the University is. In fact there is no one building or facility that can be called ‘the University’- the concept rather combines all the diverse elements, which together form the functioning academic institution. The same sort of conceptual muddle lies behind our talk of mind and body as two separate things as a consequence of linguistic illusion. There need be no event at the physical level that corresponds to a mental event. It is easiest to think of supervenience in the context of an identity theory of mind and body and identify with the tools of science the soundness or correlation between them. Do the brain scans show the brain in action or mind in action or the connection between them? Is the answer obvious? Honestly, empirical or rational thinking is both strength and limit of science and science becomes dangerous only when it imagines that it has reached its goal. The question “why” does not have an answer in all the powerful science today. Charles Sherrington, a Nobel Laureate physiologist, said in 1899 that “positive sciences do not and cannot answer the question ‘why.’ They can at the best, answer “how” or “how much” but not “why.” So the ultimate question is answerless in scientific “fish net hypothesis.” Human body being energy, which is seen as vibration of varying frequency, the future treatment of mental illness should logically use energy methods to heal. This would be the light lit in the land of conundrum of dualism by spiritual medicine.

References/Bibliography: (Harvard Style)

  1. Aristotle, De Anima, Bk III, D.W. Hamlyn (trans.), Oxford: Clarendon Press, 1968/1993.
  2. Almog, J. (2001): What am I? Descartes and the Mind-Body Problem, Oxford University Press, Oxford.
  3. Arshavsky, Y. I (2003). Cellular and network properties in the functioning of the nervous system: from central pattern generators to cognition. Brain Res Brain Res Rev. 41(2-3):229-267.
  4. Broad, C. D. (1925): The Mind and its Place in Nature, Routledge and Kegan Paul, London
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*Dr. Praveen Khairkar is presently working as Professor, Dept of Psychiatry, MGIMS. He loves teaching and his area of research is Neuropsychiatry, Adult Psychiatry, Consultation-Liaison Psychiatry, and Neurobiology. He received his non-invasive brain stimulation intensive training for various neuropsychiatric disorders at Beth Israel Deaconesses Medical Centre affiliated to Harvard Medical School, Boston, USA in 2012-13. He became the youngest fellow of Indian Psychiatric Society, Postgraduate guide and university recognized associate professor in country in 2010. He has worked in collaboration with ICMR, IPS, WHO, USAIDS, WSEAS, Centre of Neuroscience, California, USA, and NIMHANS Bangalore. He has published more than 30 articles in National & International Journals and also serves as reviewer in three prestigious European journals. He was the only Indian in the 10 best scientific paper award acclaimed in 19th European Congress of Psychiatry held in Vienna, Austria in March 2011.

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