Is There Room for a Human Spirit?

A reader sent a link to an article on teaching social accountability to medical students, and asked:

Given that most psychiatrists are taught a pure materialist approach and deny the mysterious nature of the mind are we (medical educators) failing in accountability to society where only about 10% of society (e.g. Australia) identify as atheists?

As described on July 16^th, from Day 1, medical training is exclusively restricted to a materialistic or physicalist ontology. Just briefly, your ontology is a short statement of your basic perception of the universe. At present, there are really only two choices, physicalism or dualism. According to historian and naturalistic philosopher, Richard Carrier, physicalism means “Everything in the universe is matter-energy in space-time with no questions unanswered” [1]. Dualism says: “There is a physical universe with one set of laws, and there is a mental universe with another set, where the laws of each universe will never explain the other as they do not apply.” Your choice of ontology is personal; it can’t be argued. You’re either a physicalist or a mentalist, and there is no conceivable positive argument you can use to convince somebody to change ontologies. It does you no good to point out the faults in another person’s ontology because they can do the same to yours.

All science training in the world today is firmly fixed in physicalism but hardly anybody knows this, or why. This is a real problem, as philosopher Daniel Stoljar (ANU, Canberra) points out:

The first thing to say when considering the truth of physicalism is that we live in an overwhelmingly physicalist or materialist intellectual culture. The result is that, as things currently stand, the standards of argumentation required to persuade someone of the truth of physicalism are much lower than the standards required to persuade someone of its negation (the point here is … if you already believe or want something to be true, you are likely to accept fairly low standards of argumentation for its truth) [2].

Hang on, didn’t we just read that 90% of the population hold religious beliefs of some sort, that they believe there is a superior being? And isn’t it true that if something goes wrong, especially when it affects us, we do not say “Oh well, that’s chance” but immediately blame conspiracies? Yes, and yes. I’d suggest Prof. Stoljar is generalising from the polite intellectual company he keeps in universities, and is a bit out of touch with the common herd (especially the very common herd just across Lake Burley Griffin who see conspiracies everywhere *). But it’s true, we do think of physical causes before we start worrying about hexes, and the standards of proof in most circles are simply woeful. Carrier makes his bold assertions about reducing the mind to matter and energy without offering any proof, and nobody actually notices. How do they get away with it? Because 99% of people in the circle keep repeating “I’ve just heard it’s all physical, pass it on.” The 1% who want to object can’t be heard because of the din in the echo chamber.

But back to medical education. Very early in their careers, students learn not to talk about minds or, perish the thought, the spirit. Needless to say, nobody asks students what they believe nor does anybody give them a reasoned argument for our “overwhelmingly physicalist or materialist intellectual culture.” How come? Because fish don’t know they live in water. The reason for this glaring omission is that practically nobody in the entire biological/medical world knows there could be an alternative. As far as they’re concerned, you’re either learning science or you’re guilty of the thought crime of spirituality. Of course, there are religious people in medicine but they compartmentalise their thinking, albeit not always effectively.

The origin of this physicalist ideology, as mentioned two weeks ago, is the doctrine of positivism which says science is only concerned with observables. Essentially, it if can’t be measured, it can’t be considered, but too many people read this as “If it can’t be measured, it doesn’t exist.” The early American behaviorist psychologist, John B Watson, played a big part in institutionalising this error. In a paper published in 1913, he said:

I do not wish unduly to criticise psychology. It has failed signally, I believe, during the fifty-odd years of its existence as an experimental discipline, to make its place in the world as an undisputed natural science ... We have become so enmeshed in speculative questions concerning the elements of mind, the nature of conscious content that I, as an experimental student, feel that something is wrong with our premises and the types of problems which develop from them ... I can state my position here no better than by saying that I should like to bring my students up in the same ignorance of (the mind-body problem) as one finds among the students of other branches of science [3, 163,166].

This call to arms excited his colleagues and he was soon elected president of the American Psychological Association. A few years later, concerned that there may still be some backsliders lurking in his parish, he fired another broadside:

Medieval tradition has kept psychology from becoming a science. Psychology, up to very recent times, has been held so rigidly under the dominance both of traditional religion and of philosophy – the two great bulwarks of medievalism – that it has never been able to free itself and become a natural science [4].

Science, as he made clear, is wholly rational while its enemies are irrational  and antiscientific. It’s interesting that Watson saw religion and philosophy as allies in their opposition to science – the philosophy of science was still to come. Philosophy was concerned with the mind, the mind is irrational, therefore philosophy is irrational (and can be ignored). His hostility lingers on, in that the words ‘spirituality’ and ‘spiritualism’ are generally seen as the same thing when they’re definitely not. Spiritualism is the idea that disembodied spirits exist and can interfere with the natural world. This is magic and therefore can’t be explained – you either believe in tree nymphs and messages from dear old granny on the other side, or you don’t. Spirituality means the same as mentalism, the notion that humans have a private, causally effective, non-physical mind. This is everybody’s experience and must be given a rational explanation. Watson, and everybody who followed him down the behaviorist rabbit hole, didn’t want to know about such things. Trouble is, there are plenty of people today who believe that rational necessarily means physical and mental means irrational/nonsense, so they keep searching for a physical explanation of the mind, as in biological psychiatry.

When Watson threw down the gauntlet, the positivist movement in European philosophy was well under way but their main manifesto wasn’t published until 1929 [5], so he probably didn’t know about their early work, especially as it was only available in German. In any event, the positivist tradition remains extremely strong, both in psychology and in medicine as a whole. Psychiatry’s headlong rush to be “more biological than thou” is partly because they have no theory of mind and don’t know where to start, and also trying to make amends for daring to think of humans as creatures with mental lives. If you don’t have a theory of mind, as psychiatry doesn’t (and psychology, and all the rest), you’re stuck with biology since you can’t understand how the minds of people with a healthy brain can suffer primary mental disorders.

This means that if you think “private mental life = spiritualism,” then there is no place for religion in your “science of mental disorder.” But is religion important in human affairs? Er, are kangaroos good at hopping? I had the interesting experience once of sitting through an important, medicolegal psychiatric interview conducted by a senior psychiatrist who had been flown from interstate for the purpose. I was there at the patient’s request so didn’t say anything. The visiting psychiatrist spent several minutes telling us how senior s/he was and how many such important assessments s/he did, then got started. It soon became absolutely clear that the eminent professor didn’t know how to take a psychiatric history. All s/he was doing was what we call “chasing butterflies.” This means that as the patient said something interesting, the professor chased after it, scribbling copious notes in longhand but completely losing the thread of the interview in the process. The patient answered questions honestly but, quite correctly, didn’t offer anything that wasn’t asked. It was clear to me what he thought of the professor’s style.

After two hours, the professor seemed to have run out of steam and ended the session. S/he hadn’t asked the standard questions: “Were you raised in a religious household? What was your experience?” because if s/he had done so, the full history of the patient’s adolescent turmoil and of his parents’ madness would have been clear. In due course, the report came back: “No mental disorder present,” which was correct but totally misunderstood the patient. In answering just those questions in our first session, he had said: “My parents are religious maniacs. They fooled everybody, schools, welfare, police, the lot. Everybody thought they were wonderful, everybody saw me as the trouble. That’s why I was so angry and depressed at school and university, always in trouble.” None of this came out in the interview (the professor is now a Big Wheel in academic psychiatry, studying the genetics of bipolar disorder, of course). As Yogi Berra said: “It's amazing what you don't see when you don't look.” That’s what’s happened to psychiatry: when you want to see everything through a biological lens, it’s amazing how much psychology you don’t see. Since religion only exists for creatures with mental/spiritual capacities, ignoring mentality means ignoring one of the major motivating factors in human affairs.

What about religious psychiatrists, how do they manage? I don’t know, you’ll have to ask them but my limited experience says they see things in a very biological way. The soul is perfect, it’s the body that lets people down, and this is especially the case where the religion is messing the child. It would have taken, I think, a very brave religious psychiatrist to have told my patient’s parents: “You have to back off, you’re the cause of your son’s troubles.” It was so much easier to say “He has a genetic disease called ADHD and another called Major Depression and also Social Phobia and ODD and ASD and Bipolar II so it’s definitely not your fault.”

In his book, The God Delusion, biologist Richard Dawkins said the main functions of religion are explanation, inspiration, exhortation and consolation [6]. Religion can explain why we’re here; it can inspire people with a sense of awe; it can exhort people to do better; and consoles them when life sucks. In his view, non-religious systems do a better job of all four roles. Be that as it may, religion is and will remain a major factor, probably as long as humans exist. Bad luck then that psychiatry simply doesn’t have the intellectual means of coming to terms with it. In order to do so, what would it need? First step: an admission that biology can’t explain everything. Spoiler alert: Forget it, that will never happen. The current generation of “Key Opinion Leaders” in psychiatry have built their careers on the idea that mental disorder always reduces to brain disorder: a full explanation of the brain will explain all mental disorder with no questions remaining. There is no conceivable chance any of them will recant, there’s too much ego involved. A big part of that is because they don’t actually have an argument for physicalism. They believe reductionism is the answer but they can’t prove it so, whenever they’re challenged, they resort to bluster and quoting big names – and to threats.

Some psychiatrists say “Oh no, that’s not right, our psychiatry is based on the biopsychosocial model. We think mental and social factors also play a part in mental disorder.” Sorry, you don’t have a biopsychosocial model, it doesn’t exist [7] but, in any event, how can you talk about mind-body integration if you don’t have a theory of mind? That’s all hollow talk, window dressing to fool the patients, the taxpayer, the regulators, and themselves.

Going back to JB Watson, his hostility to religion was because it licenses “anything goes” and so it goes nowhere. If you allow any talk of unobservables into your model of psychology, if you open the door to even the smallest spiritual element, you can’t stop them all stampeding joyously through. That brings us to the second step for psychiatry if it wishes to incorporate religion: a formal, natural account of the non-physical mind as an emergent fact. Emergent means a complex physical thing has non-physical properties or powers which its individual parts don’t have. Natural means the properties or powers only emerge depending on how the physical parts are put together and how they function in the natural universe. There is no magic involved, the parts obey all the laws of physics but, depending on how they’re arranged, they can achieve unexpected, non-physical results. The crucial point, however, is that there must be a natural mechanism that explains how the emergent properties arise. Without a demonstrable mechanism operating according to valid laws, the whole thing is just recycled magic. For example, for all his mathematical genius, Descartes didn’t have a mechanism of emergence, so people down the ages have sneered at him, especially those who haven’t read him.

The concept of emergence is so fundamental that most people don’t even notice it. The emergent performance of transport, for example, depends entirely on whether the car’s wheels are fixed on the corners or dumped in the boot. Similarly, no music emerges from a piano if the keys aren’t connected, birds can’t fly if they lose their feathers, and so on. This is elementary, so why should the mind be any different? On one level, it isn’t. If neurons aren’t working in their tight synchrony, the owner of the brain will be in an untreatable seizure and will soon die. On the other level, and unlike a car or a bird, the mind functions in an informational realm, not the physical. The physical constraints are very much tighter than simply tightening the wheel nuts on a car but the principle is the same: depending on how the machine is put together, all sorts of wonders emerge.

So far, the most wondrous thing we know in the universe is the human mind, but it isn’t magic. As long as people understand that the emergent mind is the result of how the physical brain is put together, and when the brain is sufficiently damaged, the mind ceases to be, then there is no problem with saying: “Humans have non-physical minds.” That means humans have spiritual lives but it is not the same as “spiritualism,” which definitely means magic. If psychiatry accepts this point, and only prejudice stands in the way, instead of saying “Oh, he’s ADHD, put him on drugs for life” or “She’s borderline, tell her to go away,” then it will be able to solve real mental problems. BTW, the concept of emergence says that animals, whose brains are very similar to ours, also have minds.  

The question of how the mind emerges from the brain is one issue; my suggestion is that it is the result of data processing by neurons utilizing a dual-valued calculus [7]. The question of why, in evolutionary terms, this ever happened is entirely a different matter which may well be beyond us. It’s like asking: “Why is there anything instead of nothing?” Who knows? Quite frankly, who cares? Just working out how the universe works will keep us occupied for centuries to come. But there will not be any progress in psychiatry until it accepts that, a hundred years ago, John B Watson got it wrong. Fair enough, he tried, he set out his case for opposing mentalism but it was all negative and he got it wrong. That’s different from modern psychiatry, which hasn’t set out its case for biological causes of mental disorder. Watson got it wrong, but modern psychiatry is doing it wrong, and that’s unforgivable.

As a way out of this mess, the biocognitive model [7] says: The mind is a real, emergent (non-physical) thing that takes information from the environment, processes it and sends instructions to its organs so the body can survive in the world. Even though the mind can’t be seen or measured, what goes on in our heads, what we perceive and believe, is the most important factor in our behaviour. As an independent entity,  the mind can go wrong even when the brain is perfectly normal. The hunt for “the physical cause of mental disorder” is a waste of time and money. The biocognitive model also generates an explanation of personality, and an account of personality disorder, showing that mental disorder and personality disorder are not the same. Human beings just are spiritual beings.

As part of our system of beliefs, religion is of critical importance in governing behaviour. Unlike psychology’s doctrine of behaviorism, and unlike mainstream psychiatry, the biocognitive model provides both a mechanism by which spiritual experiences and religious beliefs emerge, and a means by which those beliefs interact with the body. This is the first model in the history of psychiatry that meets all those requirements. It says very clearly: Human spirituality is not “mediaeval thinking” but is an integral part of the human experience.

Back to the reader’s question: Should a medical education take religion into account? Yes, of course, it should take everything into account. However, it can’t take religion into account until it accepts the reality of the human mind as a mental (non-physical) thing. As long as psychiatry is stuck in the dogmatic position Watson defined a century ago, before the concept of information existed, then it will remain irrational and anti-humanist. But if we don’t lift our game and start to see other humans as minded beings, not as monsters to destroy, and accept that animals and nature have rights too, then maybe there will no longer be anything spiritual to contemplate the universe.

* Australian National University in Canberra is on Lake Burley Griffin, directly opposite Parliament House.

References:

1. Carrier, R. (2005). Sense and Goodness Without a God: a defence of metaphysical naturalism. Bloomington, IN: AuthorHouse. Also: Carrier R. About Dr Carrier. Available at: https://www.richardcarrier.info/about. Accessed May 29th 2023.

2. Stoljar D (2021) Physicalism. Stanford Encyclopedia of Philosophy. At:https://plato.stanford.edu/entries/physicalism/  Also: (2010). Physicalism. Oxford: Routledge.

3. Watson JB (1913). Psychology as the behaviorist views it. Psychological Review, 20:158-177.

4. Watson JB (1924). Psychology from the Standpoint of a Behaviorist. Philadelphia, PA: J. B. Lippincott.

5. Hahn H, Neurath O, Carnap R (1929).  The Scientific Conception of the World: The Vienna Circle. Ernst Mach Society, University of Vienna.

http://rreece.github.io/philosophy-reading-list/docs/the-scientific-conception-of-the-world-the-vienna-circle.pdf

6. Dawkins R (2016). The God Delusion. 10^th anniversary edition, London: Black Swan.

7. McLaren N (2023). The Biopsychosocial Model and Scientific Deception. Ethical Human Psychology and Psychiatry, 25: 106-118.doi:10.1891/EHPP-2023-0008

This material is copyright but can be copied or retransmitted on condition the author is acknowledged.