Lecture 3
      
                          Fundamental Philosophical Issues 
      
      
      Lecture Outline
      
      I.  Introduction
      II. Mind-Body relationship
      III.Determinism vs indeterminism
      IV. Value-free science
      V.  Mental health and morality
      VI. Autonomy vs conformity
      VII.Conclusions
      
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      I. Introduction:
           Adherents to the different theoretical orientations take sides on
      numerous philosophical issues concerning the nature of humanity.  These
      issues lie at the heart of some theoretical controversies and the
      conflicts between professionals.  These controversies and conflicts
      reflect implicit, unexamined, gut-felt metaphysical beliefs, in addition
      to scientific knowledge.  To understand the various theoretical
      paradigms and why there are different paradigms, we must understand
      these beliefs.  As we progress in this course, these issues will arise
      again and again in our discussions.  By way of introduction, we will
      make them explicit now.  (This discussion is based in part on Weckowicz,
      1984)
      
      II. Mind - Body Relationship
      
      A. Overview: Philosophy of Mind
      
           Numerous positions have historically been held and perhaps
      just as many positions are currently held, regarding the
      relationship of the mind to the body.  These include dualism,
      materialism, identity theory, and others (Churchland, 1984).
      
      1. Dualism (eg: Descartes): The mental and the physical are
      two distinct realities, composed of fundamentally different
      "stuffs" - irreducibility.  The real you is not your
      physical/material body, but a nonspatial, ghostly, perhaps
      spiritual thinking substance: "mind stuff" (Churchland, 1984). 
      (Descartes: "I think, therefore I am").  This does not
      necessarily mean that the physical world and the mental world
      do not interact.  But it does commit you to the position that
      the mental can not be explained or understood by reference to
      the physical.  This position is certainly consistent with
      various religious beliefs regarding the existence of a soul. 
      There is no way to understand the soul by looking at nerve
      cells and the organs of the body.  Cells and organs are
      something utterly different from a soul - as such, they
      certainly can't explain how the soul works or even what a soul
      is.
      
      2. Materialism (eg: Paul and Pat Churchland):  In contrast to
      dualism, this approach states that there is only one reality:
      the physical.  No matter how much we believe there is a soul
      or an otherwise nonphysical-something-about-us, there is not. 
      This position sees the only reality as that of the nerve cell,
      the organ, and other physical (ie: "material") things.  There
      are variations on this idea (eg: Classical (Skinnerian)
      behaviorism, where all that is actually real is the
      observable/physical behaviors of an organism); but they all
      argue that there is no purely mental, mystical or spiritual
      reality existing alongside the physical world.  Thus,
      psychological theories that talk about mental-type things
      (like beliefs, desires, love, unconscious conflicts, etc) are
      wrong - these things (beliefs, desires, etc) do not actually
      exist!  Some of the evidence for this position comes from the
      fact that theories that attempt to explain human behavior
      using these mental concepts often do a really poor job of
      predicting, let alone explaining, that behavior.  Materialists
      argue that this poor showing is because these theories are
      using concepts that have nothing to do with the real world.
      
      3. Identity Theory (eg: J.J.C. Smart):  Each and every type of
      mental state is identical with some type of physical/
      neurochemical state.  Eg: Just like "light" is identical to
      electromagnetic waves, "pain" (a mental state) is identical to
      stimulation of nociceptive fibers of the hippocampus (physical
      state).  NB: This is claiming more than mere correlation of
      states; there is an identity.  The identity theory is similar
      to eliminative materialism in its emphasis on the physical
      side of things, but here there is no need to throw out all our
      mental terms and theories that refer to them.  These theories
      and concepts can still be scientifically very useful.  In
      other words, mental terms can be "translated" into physical
      phenomena ("love" is actually the firing of these neurons).
      
      B. Abnormal Psychology
      
      1. Basic Question: Is the cause of mental illness in the mind
      or in the body?
      
      2. The Body: Medical Models of psychopathology.
              a) disease models - an altered state of the organism, a break
                 with its natural state caused by some etiological agent.
      
              b) constitutional models - inherited disorder, an inborn
                 characteristic.
      
              c) diathesis-stress models - a constitutional/inborn
                 vulnerability plus environmental factors (ie: general or
                 specific stress) (Meehl, 1962).
      
              d) combination - some combination of (a), (b) and (c).
      
              Sum: Psychopathology is caused by physiological and biochemical
                   activities of the body and especially the brain.  Mental
                   phenomena are a) symptoms, and b) epiphenomenal (for the
                   most part).
      
      3. The Mind: 
      The causal factors are in the mind: desires, conflicts,
      motives, attributions, delusions, dreams, plans, implicit
      theories; whether conscious or unconscious.  Thus,
      psychological phenomena are meaningful (causal) in their
      own right.  These inner experiences are necessary to
      explain psychopathology. 
      
      There are various theoretical orientations that see the
      mind as important:  eg - psychodynamic theories (Freud and
      others), where it is argued that unconscious psychological
      conflicts and the various psychological processes we engage
      in to deal with these conflicts accounts for who we are and
      what we do.
      
      Note: There are also theories that focus on neither the mindnor
      the body:
      
      4. The Environment: Behavioral models.
      The cause of psychopathology is unique sequences of
      environmental events: contingencies and conditioning.
      
      5. The Social: Interpersonal approaches.
      The roots of this orientation are with the school of
      Symbolic Interactionism (eg: G.H. Mead, Cooley).  The
      emphasis was on reflected appraisals and the "looking glass
      self" - we come to see ourselves as others see us.  Thus,
      the Interpersonal approaches today perceive the cause of
      psychopathology to be in our interpersonal communications.
      
      III. Determinism vs Indeterminism
      A. Basic Question: Do humans have free will?  Is there such thing
      as free will, or is it a myth?  
      
      B. Determinism: Medical models, Behavioral approaches.
           Events have causes, and by altering the things that caused the
      events you can influence the course of future events.  Behavior is
      predictable and controllable.  Typically, this position is
      expressed thusly: A combination of heredity and environment causes
      human behavior. (ie: Nature and nurture make us do what we do). 
      Therapy is therefore directed at discovering the underlying causes
      and changing them: through drugs, surgery, or behavioral
      engineering.
      
      C. Indeterminism:  Humanistic and Existential approaches.
           Human beings possess the capacity for free will and they are
      responsible for their acts - this is the essence of our humanness
      and dignity. (Sartre: "I am my choices".  Weckowicz (1984): "We are
      the architects of our own lives").  This emphasis on freedom and
      choice means people are unpredictable, and therefore
      uncontrollable.  Indeed, to control someone is to deny them what is
      essential to their humanness - their free will.
      
      D. Intermediate positions: Psychodynamic, Cognitive, Interpersonal.
           Behavior is caused by various events, but also their is to
      some extent a degree of indeterminism.
      
      eg: Freud:  On the one hand, there is determinism:
      psychological determinism (unconscious drives, motives,
      conflicts).  We experience this when we feel compelled by our
      compulsions and fears - our free will feels restricted.  On
      the other hand, psychoanalysis allows more conscious control
      and the ability to make free(er) choices.  The patient moves
      from being a slave to his/her passions to being a rational
      free individual.  However, Freud does admit that we are rarely
      completely free of the unconscious forces.  
      
      IV. Value-Free Science
           Abnormal psychology is a branch of Scientific psychology.  A
      science strives to be value-free so as to provide veridical accounts and
      explanations of reality.  However, it is increasingly recognized that
      values do influence the scientific process (Howard, 1985; Kuhn, 19  ;
      Weckowicz, 1984).  Different values are espoused by the various theories
      of psychopathology, either explicitly or implicitly.  This is especially
      important when the science is an applied one, such as Abnormal
      Psychology (Weckowicz, 1984).  
      
      The role of values in the science of psychology  George Howard, in
      American Psychologist, 1985:
      
      A. Making value judgments is an essential part of the work of
      science.  The question is not whether but how values are embedded
      in and shape science, and what that means in fields like Psychology
      where the subject matter is human beings.  Current beliefs,
      assumptions and values influence what you choose to study, the
      findings you expect, the results you actually obtain, and how you
      interpret the results.  For example: Shields (1975) reviewed sex
      difference research of the past century and found that instead of
      correcting society's misperceptions, the research findings
      reflected the dominant values of the period.  Howard is not arguing
      that science is actually just values in disguise.  But he is
      arguing that values play a part in the scientific process, even
      though scientist rightly control them as much as possible.
      
      B. Traditionally, the scientist is supposed to just observe nature. 
      Nature is not supposed to react to being observed.  However, as
      quantum physics has taught us, it isn't always so:  the nature of
      what the physicist observes depends on being observed and how it is
      observed - depending on the physicist's assumptions and methods of
      observation, he/she will either see a particle atomic phenomenon or
      a wave atomic phenomenon.  Or let's look at an example of this in
      the field of psychology:  Why do psychologists like to observe
      people through one-way mirrors?  Obviously it's because if the
      person being observed is aware of the observer, his/her behavior is
      likely to be altered.  [Of course, it's not so certain that the
      presence of the mirror and the person's knowledge that someone is
      behind it watching them doesn't also effect the person's
      behavior!].  So, when the "things" being observed are people, it is
      very possible that the mere act of observing them will influence
      them.  
           The role of values becomes particularly salient given the
      unique nature of psychology's subject matter - human beings. 
      Humans, argues Howard, are active agents in the world; as we watch
      them, they are watching, deciding and acting based on their own
      models, scripts, and implicit theories which they construct.  Given
      this unique nature of the human being (the watcher/actor/theory-
      maker), an interesting thing may be happening in our science: 
      There is a reciprocal relationship or interaction between the
      scientist-observer and the individual-object.  
           Analogous to the observations the physicist made of atomic
      phenomena, the observations psychologists make of humans and the
      theories psychologists construct will affect humans.  For example,
      humans may come to believe the results, the models and the theories
      and act accordingly.  If I'm observing you, and you are aware of
      that, and if you also know that I believe you are mentally ill or
      that I think being emotionally expressive is the best way to be,
      then after awhile you may come to act accordingly, especially if
      you believe me to be an Expert a scientist, psychologist, etc).  My
      beliefs and values can influence you.
      
      C. The issue is this:  If human nature is influenced by how science
      views it, not only should we consider whether values can be removed
      from psychological research (which is unlikely), but we must also
      consider if they should be removed.  There are many who argue that
      "yes, we must remove values from any science".  However, to do away
      with values (what's good/bad, the shoulds/oughts, ideals) we may
      run the risk, argues Howard, of constructing an impoverished,
      overly rigid vision of humanity, ignoring what humanity could
      become.
      
      D. Howard's solution:  Because values and thus theoretical
      orientations inevitably influence our findings, psychological
      research findings should be looked at not as demonstrating what
      necessarily occurs in the world (some objective reality), but what
      is possible if human beings are considered from a particular
      perspective.  Each perspective has something to offer; no one is
      the correct perspective.
      
      E.  The theoretical controversies we will confront in this course
      arise largely because each perspective is claiming itself to be the
      model of objective reality.  The controversies and debates are seen
      in a different light, perhaps less hot, when viewed from Howard's
      position.
      
      V. Mental Health and Morality
      A. The terms "mental health" and "mental illness" are entangled in
      moral and legal issues.  Can mental illness/abnormality be
      distinguished from sin, crime, and immorality?  "Mad or Bad?"  Here
      is the dark side of the humanist's coin: if people have free will
      and are responsible agents, then are they not accountable for all
      their actions?
      
      B. The Insanity Defense:  Freedom of choice/free will is
      constrained and distorted by mental illness - the person acts under
      duress and is therefore not responsible.  With most crimes,
      conviction requires proof of the particular act (actus reus) plus
      proof of a particular mental state (mens rea = culpable mind)
      (Ennis, 1982).  In other words, in addition to showing that the
      person did the crime, it must also be shown that the person had a
      conscious objective to commit the act.  This is the heart of the
      Insanity Defense used with people like John Hinckley, Jr. (Hinckley
      tried to assassinate President Reagan on March 30, 1981 - he
      succeeded in wounding both Reagan and an aide.  He was tried and
      found not guilty by reason of insanity.  He was confined to a
      mental hospital).
           The controversy is concerned with how you tell whether an
      adult has free will?  It is a highly subjective judgement - there
      is no clear criterion.  Expert witnesses contradict each other. 
      "One person's delusion may be another's religion" (Cohen, 1982); or
      in the words of Lily Tomlin: "If you speak to God, it's a prayer,
      if God speaks to you it's schizophrenia".  The question is: does
      mental illness impair free will?  This is an unresolved, inherently
      philosophical question.
      
      VI. Autonomy vs Conformity
      A. The basic question: What is the basis of mental health? 
      Autonomy of the individual or conformity to society?
      
      B. Conformity: A model of humankind and society which argues that
      the best world is one in which there are few disruptions, where
      conflict is rare or even nonexistent.  The best way to achieve this
      is for people to conform to particular ideals or ways of acting,
      etc.  The goal is for smooth, undisrupted functioning.
      
      C. Autonomy:  An "open system model", with a goal of growth,
      development and change.  (eg: humanistic psychology's emphasis on
      self-actualization; conformity leads to mental illness).
      
      D. A Combination:  Some people claim (C) is the "best" - especially
      in the U.S. where so much value is placed on individualism.  But
      imagine what life would be like if there was no conformity? 
      Imagine what your life would be like if you never attempted to
      conform.  Most theories of mental health (explicitly) take the
      position that a combination of conformity and autonomy is important
      for mental health.  However in practice (ie: implicitly) there is
      still much debate whether the various theoretical orientations are
      taking a combination approach (Rappaport, 1977).
      
      This leads us to the issue of the rights of individuals (especially
      mental patients) vs the rights of society.  Sometimes these may be
      incompatible.  What choice the clinician makes is crucial for defining
      his/her role as clinician.
      
      VII. Conclusions
           We have discussed 5 philosophical issues that are fundamentally
      intertwined in the topic of Abnormal Psychology: The relationship
      between the mind and body, determinism vs indeterminism, the place of
      values in psychology, mental health and morality, and autonomy vs
      conformity.  These issues will arise repeatedly throughout this course
      and it will be important to explore them as they do.  Such explorations
      may help us clarify some of the confusion across the different
      theoretical orientations.