Emergence is where it's at (as they used to say in the 1960's) not reductionism in our understanding of nature. Reductionism is a first step, but a woefully incomplete one. Much of our popular thinking on mental illness remains entrenched at this level.
I have long been interested in why the field of psychiatry, psychopharmacology, some branches of clinical psychology and neuroscience (except for the fields of affective & social neuroscience), particularly cognitive neuroscience, have been, and continue to remain stuck in a radical reductionistic framework. I see and experience evidence of this in my daily clinical work as well as in teaching graduate students at New York University. In regards to the former, for example, a patient of mine is receiving peer advocacy training, and is being taught that mental illness is caused by genes which result in "chemical imbalances" and that there are neurological signatures to the different disorders. In regard to the latter, I am amazed to hear from my students such poppycock as the following: professors have told them not to waste their time trying to do psychotherapy with persons with severe mental illness, the mainstay of treatment is psychopharmacological; I read their responses on exams in which they describe bipolar and schizophrenic disorders as "brain diseases," etc.
One of the intriguing aspects to this is that while other disciplines, including such 'hard' sciences as physics have departed from reductionistic models and moved to emergence (e.g., the von Klitzing discovery, the quantum Hall effect, the fractional quantum Hall discovery, etc.), why is our field entrenched in older scientific worldviews, e.g., continuing to conflate and describe isomorphic relationships between neural structure/function and complex psychological/sociocultural 'phenotypes.' For an insightful analysis of emergence (how nature organizes itself) see Robert Laughlin (2005) A Different Universe: Reinventing Physics from the Bottom Down. Laughlin is a professor of physics at Stanford University and has won a Nobel Prize for his work on fractional quantum Hall effect. Laughlin noted:
"What we are seeing is a transformation of worldview in which the objective of understanding nature by breaking it down into ever smaller parts is supplanted by the objective of understanding how nature organizes itself" (p.76). Laughlin proceeds to explicate the fractional quantum Hall effect reveals that seemingly indivisible quanta (e.g., the electron charge e) can be broken into pieces through self-organization of phases, in other words, the previously held fundamental reality is not necessarily fundamental. We can apply this to our field, e.g., which is more fundamental in delusions, parietal cortex activation (an area thought to be involved in discriminating internal & external stimuli) or the degree of loneliness and annihilation anxiety a person experiences? Personally, I believe it is the latter. The parietal response is a functional correlate not a primary causal factor.
Perhaps the entrapment in reductionism and Cartesian splitting can be partly attributed to political and economic forces, as well as psychologically regressive forces reactive to the historical trends in psychoanalysis and sociocultural analysis which tend to hold us (or our 'unconscious') and our societies as responsible for our difficulties. Biology is extremely important, and certainly a factor to contend with and understand, but to not see how neurogenetics, neurobiology and neurophysiology are resonating to emergent frameworks of nature at all levels of organization, is to engage in a form of 'negative hallucination' in which our theoretical presuppositions cloud our vision of what stands before us in all of its complexity.
"Not only is the universe stranger than we imagine, it is stranger than we can imagine"
Sir Arthur Eddington
For me this quote by a highly respected scientist helps and reminds me to be less intellectually arrogant and hubristic and keeps me more in touch with the mystery and complexity of nature, including the mystery of the human being.
When I was interviewing David Feinsilver (this interview is published in our ISPS-US Newsletter) in his home just prior to his death, he and I agreed that there is no clear-cut answer to the question of what 'schizophrenia' is, or to put it more existentially, persons who think, feel and act in ways which result in their being categorized by their fellow human beings as "schizophrenic." Perhaps, Martti Siirala's view that schizophrenia is the human condition crying (I would add panicking as well) itself out, is close enough. But then again, we could be wrong.
Brian Koehler PhD
New York University
