As I’ve noted in a couple of essays on this blog, schizophrenia is a terrible disease, even by the standards of psychiatric diseases. Yet, there’s something odd about even calling it a disease. See A Thomistic Take on Madness and Modernism for a discussion of schizophrenia in light of modern thought and aesthetic styles, which consciously respond to reality in ways which resemble some of the symptoms of that disease. That suggestion comes from the book, Madness and Modernism by Louis Sass, a psychologist with deep knowledge in clinical practice and its history, brain research, art, literature, and other domains of culture. He casts some doubt on the ‘reality’ of schizophrenia, presenting historical and other arguments that it’s a set of symptoms which are responses to modern, industrialized conditions on the part of deeply disturbed human beings. And he argued that the same symptoms are displayed, at least for aesthetic reasons, by modern artists and probably many others. I’m probably one of those — see my freely downloadable novels: A Man for Every Purpose and The Open Independence of the Sea.
I once had a golden retriever who was very sensitive to human emotions or — shall we say — mental and emotional conditions in general. He didn’t like to go near anyone who was drunk, even if he knew that fellow and would run up to him in a sober state. He once strongly shied away from one of his human friends and it turned out the fellow was on strong pain medication after the extraction of an impacted tooth. He also stayed away from a friendly woman we’d encounter sometimes on our walks. She was schizophrenic and, when I first met her, she was either not taking her medicine or it wasn’t working. Big friendly Rebel didn’t want to go near her when she was telling fantastic stories nor was he willing go near her when she seemed relatively calm. Then her treatments started working in a major way, for whatever reason. Her enthusiasm was strongly suppressed and it seemed her metabolism was generally slowed down. My retriever was not quite so reluctant to go near her but he still didn’t exactly rush toward her.
The point is that her system was upset in an objective way detectable by a golden retriever’s nose, whether she was in her schizophrenic state or one of her medicated phases. But that doesn’t necessarily mean she had something called ‘schizophrenia’. Nor does it necessarily mean her medications had brought her closer to some sort of normal state. She was disturbed, but did she have a specific set of wrongful brain activities? Maybe she was acting out her disturbance in a way she’d learned by her experiences? We shape our minds by our responses to our environments, but suppose there is some sort of a mismatch so that our minds won’t be shaped properly or so we refuse to let our minds be shaped in a certain way?
In the fore-mentioned book, Professor Sass speaks of anecdotal tales of treatments for mentally disturbed human beings in pre-colonial Africa — these treatments disappeared before they could be studied. Native doctors provided havens for those who felt great stress inside of their selves. Inside those havens, the patients would ‘act crazy’ for a week or two and then rise, collect their belongings, pay their fees, and return home, supposedly at peace with reality.
In another problem domain, climate studies, which also deals with quasi-stable systems, Roy Spencer, professor at the University of Alabama in Huntsville and former climatological researcher for NASA, has questioned if we have a good cause-and-effect understanding of the relationships between carbon dioxide build-up and cloud cover changes or between cloud cover changes and temperature changes. See Roy Spencer’s website for his discussions of the issues and for some of the to-and-fro involving Dr. Spencer and those colleagues willing to deal with challenges to the mainstream view. You can also see his postings about increases in atmospheric temperatures related to his ongoing work with NASA. His bio on his website tells us: “Dr. Spencer’s work with NASA continues as the U.S. Science Team leader for the Advanced Microwave Scanning Radiometer flying on NASA’s Aqua satellite.” That is, he’s in charge of one set of measurements of those atmospheric temperatures.
I’m taking no position on the actual cause of increased atmospheric temperatures in recent years — carbon dioxide or cloud cover changes or mere chance or something we haven’t even noticed. I am siding with Dr. Spencer completely on his main point — we need to be sure about the entire chain of causal factors and correlations on this globe with so many complex and intertangled systems. My position on mental illnesses is similar.
If brain-researchers, or climate-researchers, think to have already a good understanding of cause-and-effect relationships, they will have no problems finding evidence in support of some theory consistent with that understanding. If the assumed cause-and-effect relationships aren’t at least in the right direction, involving the right entities or systems, it’s hard to see how the research will converge on a more correct view anytime soon. Natural philosophy, and its more specialized children — physics and biology and so on, have a family history filled with theories that were plausible when proposed but proved to be quite wrong when further empirical information was gathered, and, yet, it took generations before thinkers educated to accept new theories which could deal with the facts of the matter. I’ve seen no evidence that scientists of the modern sort are more creative, more flexible of mind, or more responsive to the best available view of reality than were the traditional natural philosophers of pre-modern times. Nor is there much reason to believe modern scientists are superior in those ways to theologians and philosophers, poets and businessmen. Just give all those thinkers in all fields time to carve ruts and they will try to travel them for time without end. It’s a human weakness.
If we assume the climate has cause-and-effect relationships such that it can be disturbed by human intervention beyond the power of its own stabilizing mechanisms, then, in a time of a warming atmosphere, we’ll find evidence that human changes to atmospheric gases can disrupt the atmosphere’s self-stabilizing mechanisms. We’ll be sure that quasi-stable system, the climate, will continue to warm up with the continued human output of what’s really a modest amount of carbon dioxide for that quasi–stable system. If we assume the brain-mind complex is the same sort of entity, we’ll find evidence that chemicals injected into the arm or psychotherapeutic treatments, will bring the brain-mind into a different and stable state.
That can be true but the atmosphere and brain have evolved over eons to be the sorts of entities capable of maintaining their own stability pretty well. And both can stabilize, and have stabilized, in a disturbed state which is recognizably quasi-stable on short time-scales. A brain, or the atmosphere of a planet, which is disturbed in some significant sense might be able to do a good job of maintaining that disturbed state, which would have become the ‘preferred’ state in some sense. Researchers might better spend their time asking: Why has this system suddenly begun to change, perhaps to destabilize? Roy Spencer did this and realized he couldn’t answer some questions about fundamental cause-and-effect relationships involving different gases in the atmosphere, cloud-cover, and temperature.
In any case, it remains true that schizophrenia is a horrible disease and we should welcome any important results even if we seem to be missing a general understanding of the relationships between brain disruptions, poorly or wrongly formed minds, and behavior. It’s only in the past couple of decades that major brain-scientists such as Gerald Edelman, Antonio Damasio, and Walter J. Freeman have begun to produce a solid understanding of what the mind is and how the brain, indeed the entire human organism, generates it. The interested reader can read Professor Freeman’s How Brains Make Up Their Minds for a short but idea-packed explanation from the viewpoint of one highly-regarded brain-scientist.
If I’m right, how can we tell if a disease exists if we only consider behavior or other external evidence, phenomenon at the interface with the environment which may be masking the true conditions in that brain? Perhaps we could find disruptions in the metabolism of brain-cells?
We see some possibly important results in this article: One Step Closer to a Diagnostic Test for Schizophrenia, where the claim is made they have found reliably testable metabolic changes in the brain-cells of schizophrenia. The advances of those Finnish scientists is good. They’s identified some changes to the brain’s metabolism which — if verified by other scientists and perhaps other research techniques — can lead to better diagnoses of schizophrenic conditions and perhaps to better understanding of the changes in the brain which are part of the disorder. The question remains: what is cause and what is effect? How could an organ so well-adapted, in most cases, to dealing with our environments in a human way, sometimes be so out of sorts and in such a strange way, as if a character in a James Joyce novel found himself unable to escape from his surrealistic dreamworld? Professor Sass tells an anecdote in which James Joyce took his badly psychotic daughter to Carl Jung. Jung could do nothing for the poor young woman and Joyce couldn’t understand why she couldn’t be helped. After all, she talked like one of the characters in his novels and those were works of genius — if a bit difficult to read. Surely, his daughter must be… Jung told Joyce that he, as a creative writer, dived into the river of madness but his poor daughter was chained to the bottom. Can I put it this way: James Joyce and his daughter, were diving into the same river known too well to modern men. Did earlier generations of man know much of this particular river of madness? Did they know it at all? Did they have their own rivers of madness or perhaps caves or deserts of madness?
If we think of the brain as being a well-determined and independent system, as a first approximation, then we see it will be interacting at an (somewhat abstract) interface with a similarly regarded — that is, well-determined and independent — environment or set of environments. That interface, at least the part which we could consider ‘personal’, is the mind. As the philosopher Stephen Toulmin pointed out in the early 1960s, the so-called ‘randomness’ of biological evolution is really the unpredictability of events at the interface of two well-determined and independent systems, an organism (or family line with proper complicated language) and its environment. This sort of view would lead to an immensely complex understanding of the human mind, its workings and its disturbances. I strongly believe such an understanding would be more realistic than the ones which come from the current understandings of the mind, dualistic or monistic, found in the most modern thinkers.
I’m also going to point to an article about diagnosis of Alzheimer’s, Alzheimer’s Diagnostic Guidelines Updated for First Time in Decades, which seems deceptively similar to a possible diagnosis of schizophrenia, but it speaks of progress which can — in principle — be more certain. Alzheimer’s is a destruction of the brain which underlies the mind and is a progressive and clearly identifiable physical disease; at least it is identifiable by way of an autopsy and scientists seem to be developing more reliable means, biomarkers in blood and brain-fluid or brain-scans, to diagnosis it in a living patient. Alzheimer’s is clearly a disease of the brain which is, in principle, subject to accurate diagnose and can be eased or somewhat cured by technical medical treatments after we come to a technical understanding of the biochemical changes in brain-cells as the disease progresses.
The psychiatric diseases, such as schizophrenia and bipolar disorder, involve complexes of underlying brain-events and mind-events which are interactions at that interface with the ‘outside’ world that I discussed above. Without having a good understanding — however tentative — of the brain-mind-environment system, I don’t see how we can even know if schizophrenia is a disease, many diseases pretending to be one, or one form of a more general disease which is just the brain-mind complex out of synch with its environment in a general way which can’t be usefully split into smaller categories.