Psychiatry’s dark secret
by Sheldon Richman
2/28/03, Manchester Times
Time magazine recently published its annual cover story on health, focusing on the relationship between mind and body. To its credit, it contains some rarely heard criticisms of the mental-health laws, which nearly everyone accepts as appropriate in the land of the free.
But as John Cloud writes, "[Psychiatric] diagnoses can be used by courts to lock you up in a mental hospital." He should have added: " . . . even if you have never harmed anyone." Cloud goes far in exposing the mere mortals who impersonate imposing psychiatric wizards: "Though it's fashionable these days to think of psychiatry as just another arm of medicine, there is no biological test for any of these disorders."
This is psychiatry's dark secret. But it's true. "Diseases" of the mind - a metaphorical organ -- must be metaphorical diseases, as psychiatric critic Thomas Szasz has been saying for half a century.[1]
Cloud also quotes Paul McHugh, chairman of Johns Hopkins medical school's department of psychiatry and behavioral sciences, saying that the profession's vaunted "Diagnostic and Statistical Manual" (DSM) has "permitted groups of 'experts' with a bias to propose the existence of conditions without anything more than a definition and a checklist of symptoms. This is just how witches used to be identified." Szasz said that years ago, too.
But Cloud ends on an ominous note: "Unless brain researchers discover exactly how neurological mechanisms become abnormal, the DSM will always include more hypotheses than answers." The problem with that sentence is the premise that neurological mechanisms control behavior.
There's the rub. It is the fashion to believe that behavior is the product of brain activity, and that's the dominant message Time delivers.[2]
Indeed, the special issue begins with this: "Mind and body, psychologists and neurologists now agree, aren't that different . . .. The thoughts and emotions that seem to color our reality are the result of complex electrochemical interactions within and between nerve cells.... [The] mind [is] like the rest of the body...."
This is scientific and philosophic balderdash. The "mind," Szasz writes in contrast, is a metaphor for the internal conversation about our surroundings and ourselves that each of us conducts throughout our lives. To be sure, thoughts and emotions require electrochemical processes -- we're not ghosts -- but to reduce them to such processes is to make robots out of persons. I laugh at a funny experience, not at a funny electrochemical interaction. All the positron-emission tomography, functional magnetic resonance, and magneto-encephalography in the world can't refute that.[3]
The Time issue sinks deepest into the muck of reductionism with an article by Steven Pinker, the psychologist who has done so much to popularize the reduction of mind to brain. Pinker's article is a dissent from those who see genes as controlling our behavior.
But what he gives with one hand, he takes away with the other: "Behavior is caused by the activity of the brain, and the most genes can do is affect its wiring, size, shape and sensitivity to hormones and other molecules. Among the brain circuits laid down by genes are the ones that reflect on memories, current circumstances and the anticipated consequences of various courses of action and that elect behavior accordingly -- in an intricate and not entirely predictable way."
For Pinker, persons don't reflect, anticipate, and select. Circuits do.[4] Behavior is caused, not unlike the movement of billiard balls. Nevertheless, he writes, "These circuits are what we call 'free will,' and providing them with information about the likely consequences of behavioral options is what we call 'holding people responsible.'"
This is gobbledygook, which, unfortunately, unreflective people will assume is based in good science. But any theory, which denies that persons choose, is self-subverting. To speak is to carry out an intention to communicate thoughts and experiences by freely choosing suitable words and sentences. To announce that one cannot freely choose is to announce that one is not really speaking but only making random noises by electrochemical necessity. Let us take him at his "word."[5]
This isn't just inconsequential ivory-tower science. If we come to believe that metaphysical freedom is impossible, we will hardly be in a position to complain when our political freedom is taken away.
- Sheldon Richman is senior fellow at The Future of Freedom Foundation in Fairfax, Va., author of Tethered Citizens: Time to Repeal the Welfare State, and editor of Ideas on Liberty magazine.
Commentary on Richman
[1]. Re Thomas Szasz, see my 4/03 letter to Reason critiquing his mistaken supposition that there's a conflict between a scientific understanding of behavior on the one hand and choice and responsibility on the other.
[2]. It's not a passing fashion to believe that behavior is the product of brain activity, but simply what science shows is the case. What, one wonders, does account for behavior if it isn't the brain and its connections to the body? The radically autonomous soul, presumably. But is there such a thing?
[3]. Richman suggests that if thoughts and emotions and other experiences are reducible to electrochemical processes, then we are mere robots. Therefore, to avoid the apparently nasty conclusion that we're robots, experience must be something non-physical. (This is what might be called the "argument from unacceptable consequences," and of course it's fallacious.) To say, as Richman does, that no amount of evidence could show that experience is reducible to physical processes, is really to claim that science isn't the final arbiter of what we should believe about the human person. In which case, one wonders on what basis does Richman make the claim that experience is non-physical?
[4]. Richman supposes that the person must be something over and above the neural processes that instantiate experience, consciousness, personality, and behavioral dispositions. We behave, not our circuits. It's true that we behave, not our neural circuits, but where in the world is the self or person that exists over and above the brain and body, in all their complex configurations and capacities? Nowhere that science can see. We don't, as a matter of fact, need to posit something non-physical riding herd on the brain and the body in order to count as an effective, identifiable, reliable, and responsible selves.
[5]. It's false that we must in some sense be radically free in order to "make sense" and be rational creatures. If indeed we were causally disconnected from the world in some respect, freely choosing our words without being determined how to choose them, how would this help us be more rational, or help us better understand reality? Animals, presumably without free will and as a result of natural selection, got to be better and better at predicting the outcomes of their behavior and other events, and so arrived at more accurate views of the world than those that didn't make the evolutionary cut. As rather sophisticated cognitive systems, we're very good at modeling the world, and any causal disconnection from the world would worsen, not improve, our ability to model it. Stepping outside of determinism, an impossibility, can't give us a more correct view of things. Any part of us outside the causal network, anything radically free to choose its words, would be uninfluenced by the world, and so this part couldn't know anything about the world. There's no conflict between being influenced or determined to have a view of the world and having a truer, more accurate view of it. Some deterministic systems (e.g., scientists) simply do a better job of modeling the world than others (e.g., Richman, astrologers, palm readers).
© TWC, April 2003