Epistemontological Synthesis of Psychopathological States.
According to the current ‘practice of psychiatry’ one often wonders why should psychiatrists be required to have a medical degree where training emphasis is made on the molecular, cellular, histological and organ level and their phenomenologically ‘observed’ neurobiological variations in a physical brain leading to measured behavioral malfunction? The current symptomatic handling thereby makes no commitment as to the underlying causes of mental illness. After all psychopathology is an account of bodily processes especially in, but not restricted to, the morbid anatomy of the brain, i.e., no brain no mind! Why restrict the understanding of such body processes to first person narratives where patient confabulation may blur the real causal dynamics of the underlying processes?
On the other end of the diagnostic spectrum we find those unfamiliar with the physical human brain cyto-architecture using diagnostic physio-pathologic labels as convenient heuristics to compose a metaphysical model poem of brain dynamics. Neither the exclusive ontologically based scientific methodology of the current practice nor the exclusive epistemological symbolic and/or sentential representations of metaphysical logic will do. We need to hybridize the perceptual phenomenology with the conceptual and inferential to get the optimal results. To fix our car we prefer to have the most experienced hands-on mechanic ‘practitioner’ of the ‘how’ than can apply the latest technological understanding of the relevant theoretical physics applicable to predict and explain the most probable ‘what’, ‘when’, and ‘where’ is the causal agency of the car malfunction. We deliberately leave aside what we consider the most important element controlling the trans-generational survival of the human species, i.e. metalogic ‘why’ as yet another level of understanding. In what follows we attempt to synthesize both extreme approaches as one unit whole in dealing with the unit whole brain in its different manifestations.
Should psychiatry be considered ‘exclusively’ as a theory driven classification, cognitive neuroscience effort providing an objective understanding of mental illness? Or as an ‘practice’ where the identification of symptoms to particular pathologies as departures from normal function exclusively define brain disease and its pragmatic, empirically-based therapeutic handling? We think that, because of its complexity, both aspects should be handled as a team effort of subspecialists. An accurate prediction rooted on objective and accurate phenomenological measurements resulting in a causally efficient identification of the culprit and its effective control should guide any attempt to restore and improve on the the human species biopsychosocial equilibrium, as defined elsewhere (http://delaSierra-Sheffer.net). It is true that the metaphysical logic models speculations with high probability of certainty only provide a convincing heuristic poem for further etiological enquiry into the quasi objective identification of causally efficient factors but –if reliable- it adds another dimension in our knowledge of the health problem to be resolved. A case in point is to admit the role of the genetic and environmental –external and body proper- influences and their causal interactions may play in quotidian existential coping with ongoing reality. Kandel already recognizes in his molecular reductionism view of psychiatry that the symptoms of mental illness involve both the disruption of biological and cognitive processes without elaborating. However most of these approaches are premised exclusively on viewing the brain as a digital computer carrying out the symbolic or sentential representations to develop algorithms to carry out a programmed goal. We believe there is still much more to brain dynamics than the execution of information processing tasks. Multilevel approaches should not be construed as multiple etiological causations. We gain more by considering mental illness as one cause with multiple manifestations. The classical practice of relying exclusively on the phenomenological symptoms, signs and morbid pathology assumes certainty and transparency in what the specific causation is. While we emphasize in our biopsychosocial (BPS) model the importance of reliable and falsifiable information input and the excesses of self serving epistemological model poems, we’d rather question that phenomenological certainty and empirical adequacy strategy and rather settle for the quasi determinism of quantum probabilities and other statistical methods. It is not that simple when we have to reconcile two coexisting conscious views of the same reality as expanded in Volume V of our series on Neurophilosophy of Consciousness where we distinguish the coexisting conscious realization that we have simultaneously at our disposal in the decision-making process both a metaphysical, rational ‘pathogenic’ and a material physics-based ‘pathoplastic’ choice as amply discussed elsewhere as often giving rise to contrasting choices between being driven by emotions (related to plasticity of me and my personal existential circumstance) or driven by a rational logic model poem. It is the latter that will explain the historically recorded cases of altruistic acts against self bps equilibrium interests as experienced by the historical prophets in the JudeoChrIslamic tradition. Furthermore, from a philosophical point of view, why be content with saving the human species until evolution brings in the next successful species to replace us? We are here to stay as the supreme species by adopting adaptive strategies to harmonize with the constantly evolving/changing environment. Recorded human history is our best witness in the defense of an integrated pluralism where the individualized existential reality can be reduced to a credible model poem that considers what we have in common with evolved subhuman species (BPS adaptive equilibrium) and what distinguishes us as an unique ‘creation’ to lead the way into the trans-generational evolution destiny, whatever that may be. This ‘philosophical psychopathology’ strategy is usually derogatorily considered by ‘psychiatric practitioners’ as irrelevant to their current practice specifically when it had to borrow the rational concept of intentionality (See Fodor) to explain the characteristic disturbances of intentionality and consciousness that characterize mental disorders. In reality both the theosophic and the empirical approach are both ultimately different types of beliefs common to our human species trying to deal with its known ontological perceptual and epistemological conceptual limitations.
Perhaps the most difficult element to understand by the psychiatric practitioner is morality and ethics. We have almost exhaustively discussed what we considered as the best explanation of this issue, Kant’s Critique of Pure Reason because in our opinion it represents an integration of the sensory based phenomenology and the relevant quotidian, extrasensory existential reality. In our BPS model we assigned a priority to the unconscious biological imperatives of life preservation as guiding the subconscious drive to adopt viable psycho-social behavioral strategies. Recognizing that moral judgments are simultaneously guided by rational and affective feelings we understood the importance of adaptive BPS equilibrium with existence, something we share with evolved domesticated subhuman species that stay alive, are happy and like to be convivial as a matter of sheer biological survival. But this would not be enough when trying to explain historically backed altruistic acts of prophets against self interest, i.e., contra natura. So we felt the need to conceptually explain, if not perceptually identify the putative source of righteousness, located somewhere in transfinity spacetime coordinates. After all, we have fairly successful molecular models for autism and other mental aberrations the current psychiatry practitioner won’t hear about notwithstanding the dramatic insights into brain dynamics by fMRI and other high tech measurements.
Summary and Conclusions.
It should be clear from some of our previous publications on the “Neurophilosophy of Consciousness” that the welfare of the neuropsychiatric patient is of the essence as evidenced by the intervention of the triage personnel during a visit to the Emergency Room to stabilize the patient according to the signs and symptoms and laboratory evidence. This handling is premised on the assumption that symptomatic treatment according to a standard DSM psychiatric protocol is exclusively all there is to be taken into consideration by the current psychiatry practitioner about the causally efficient elements involved. The complexity of the human being makes any search for etiological causation becomes irrelevant at any other cognitive level notwithstanding the many successes of modern technological measurements that dig deeper into probable causation. This is the difference between certainty based on incomplete and limited information to make judgments and the probability of getting a better defined etiology based on more reliable and falsifiable data at the molecular, cellular, histological and organ. Modern psychopathology is a team effort because of the complexity of the human patient that includes the static current practitioner and the dynamic theorist for the ultimate welfare of the patient.
Dr.Angell O. de la Sierra, Esq. In Deltona, Florida Winter 2013