Note: This is an opinion based on my experience and verifiable facts. I am not a psychiatrist. You should not diagnose yourself or anyone else based on this blog entry. If you are experiencing symptoms of mental illness, please see a qualified clinician immediately. Any potentially identifying information such as names, places, etc has been changed.
Here's a question that could be the basis for a PhD thesis or even a novel. Instead i'm just kicking it around in as a blog entry. This is it: Where does the brain end and the mind begin? Take a few minutes, talk among yourselves, then submit your answers. (Not really, I don’t want to engage in an on-line or email debate.) The simplest and most honest answer to the questions is "who can say?" A related response would be "who even cares?" At one end of the spectrum, we have those individuals who believe the brain and the mind are the same thing, two interchangeable words for the same entity. Or two parts of one whole that we interpret as "I" or "me." At the other end of that spectrum are those who see the brain and the mind as distinctly different entities, each intended for a different purpose and working independently of the other. These folks see the brain itself as a mechanism, a computer, a bunch of neurons and synapses that processes data and issues responses and commands. They view the mind as a vague and nebulous unknown that encompasses things like personality, preferences in art, music, food, sexual proclivity, the ability to analyze, a sense of humor, creativity, etc. OK, fine. Sure, the mind is intangible and abstract and is the point of origin for all abstract and intangible things, but its' existence arises from the very tangible brain and is influenced by the way the brain processes information that comes in through the eyes, ears, etc. You can have a brain without a mind, but not a mind without a brain. These arguments play out in the field of mental health when it comes time to 1. diagnose a patient and B. suggest a treatment. Let's say an individual is hearing the voice of Jesus arguing with the voice of Allah and they both want to destroy the world and the patient can't decide what to do about it. Clinically, we ignore the nature of the voices, because that type of detail is part of the mind. The psychiatrist is concerned with what appears to be a malfunction of the brain - auditory hallucinations. In this scenario, the mind has nothing to do with the problem. Find the right antipsychotic medication and the right dose and the problem goes away because the brain's chemical imbalance is rectified. Now, a therapist or psychologist might focus solely on what, to them, appears to be a conflict contained within the mind and expressed by the existence of auditory hallucinations. After speaking with the individual, they might decide, for example, that Jesus represents a western/christian voice while Allah symbolizes a non-christian/eastern voice. Perhaps Jesus’ voice represents the patient’s father who was a strict catholic and Allah the patient’s mother who was a Lebanese christian. The clinician might conclude that the voices emanate not from the the brain, but from the patient’s conflicted feelings toward his or her highly dysfunctional childhood. This is the kind of stuff, they would say, that has to do with a damaged ego, a busted superego, the id, self image, self esteem, integrity of the personality, etc. No drugs necessary, just a lot of talk therapy to help the person get to the root of the conflict that's causing the problem (the voices). Who's right? You decide. I have English friends. I have long noted that they tend to cringe when they hear me talk about the scientific aspects of mental health treatment. From my (admittedly limited) experience, the English tend to be very forgiving in terms of symptoms and view Americans as too quick to classify aberrant behavior as something that needs to be fixed. A patient we would describe as "overtly psychotic and delusional" is described by my English pals as "a bit off" or "eccentric" or "charmingly loopy." If this loopy individual hears voices telling him to set the house on fire, well, so what? What's the difference between someone who doesn't hear voices and sets a house on fire for revenge or to collect an insurance payout, and someone who does it because God told them to? People do inexplicable things, that’s life, houses burn and the result is the same regardless of the cause: a burned house and a tragedy. In this view of mental health the mind is seen as sacred territory, hallowed ground - you don't mess with it, period. My mind is what makes me 'me' and your mind is what makes you ‘you’,’ and fiddling around with someone's mind is like having an affair with their spouse or hacking into their bank account: it's wrong, it's immoral, it’s arrogant, it’s too much like playing God or Dr. Frankenstein. If someone wants to walk around naked with a dead fish hanging around their neck while reciting the alphabet backwards, so what? That's just 'who they are' and who the bloody hell are you to say it's wrong? OK, but what if they get too cold in the winter - being naked - and die of hypothermia? Aren't we being neglectful by allowing them to live in a manner that we're almost sure will result in a preventable death? Again, the philosophical/psychological argument would be something like, "Well who are you to play God and interfere with their destiny or their life in general? If their lifestyle hastens a premature death, well, so be it. Lots of supposedly sane people put their life and health in jeopardy regularly such as boxers, NASCAR drivers, demolitions experts, people who work with hazardous chemicals, smokers, alcoholics, heroin addicts, prostitutes, etc. So who the hell are you to make judgements, you self righteous twit?" There's no secret knowledge or brilliant answer I'm going to reveal in the closing paragraph that resolves these questions and issues. People who love the mind will make allowances (some might say excuses) for weird behavior and mental illness. People who admire the functions of the brain will continue to do research and suggest treatment for mental illness based on neurological and other types of research that suggest targeting receptor X or neurotransmitter Y will fix the problem. Some people will see mental illness as a problem that needs to be addressed while others will see it as no problem at all, just an alternative state of being, something other than what society calls "normal." Societies and cultures will continue to respond to mental illness based on whether they value the brain approach or mind approach and whether they see controlling someone's mind and brains as a good or bad thing. My people, the Irish, are all totally nuts and they know it. And when a whole country is nuts, there's no problem at all. Except for the few who aren't nuts, but become so alarmed by the large number of nuts walking around that they pack up and leave. Which leaves all the nuts to themselves, saying "Good riddance, let's go do something nutty." A naked guy with a fish around his neck reciting the alphabet backwards in Ireland wouldn't be called crazy. He'd be called by his name and someone would ask “Hey Jimmy…can I buy you a pint, and one for the fish as well?" |
charles o'meara, r.n.I have worked as a registered nurse for more than two decades, ninety percent of that time as a psychiatric nurse. Archives
June 2017
Categories |