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.