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chrispell

Cartesian Dualism

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What do people think about the whole Mind/Body dichotomy? Is it a valid idea any more? Are there any diseases or disorders that are purely psychical in nature, or are all mental illnesses really physical ailments?

I have always wanted to reduce the mind down to a physical level because I find it difficult to see how it can be anything but the product of a (very) complicated elecrochemical network. With the major mental illnesses like schizophrenia and affective disorders which have occurred thoughout human history in all cultures this would seem a sensible approach. But what about the less easily reducible conditions like personality disorders or adjustment disorder, PTSD, social phobia?

Not that I think these problems have simple clear-cut answers, but I'd be interested in other peoples views...

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Mind Body dualism is no longer a sustainable concept. Mind is invisible body and body is visible mind , if that makes sense.

no disease is purely physical or psychical , we know all physical illness have psychological consequences and psychological distress leads to physical changes , hence the emergence of the so called holistic approach

Dualism has lead to a lot of confusing theories and had alienated psychiatry from main stream medicine , but with the advent of modern technological advances and potent psychopharmacological advancements, Biological (physical) underpinnings of most psychological disorders are being elucidated and we are not far from rejecting the Cartesian Dualism

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I find the last post by oceanic very interesting indeed .

'Biological (physical) underpinnings of most psychological disorders are being elucidated'

Just what are these?

As I am aware there has been an allmost pathetic failure throughout the last two hundred years to find concrete evidence of any biological underpinnings of any of the psychoses (never mind the neuroses).

CT, MRI, fMRI, PET scans have yielded virtually no reproducable evidence. Large ventricles (come on!), hypofrontality (not convinced). Lateralization seems to show something at least (but not much).

Chemically the situation is a joke. A collection of accidentally discovered drugs which seem to make people bareable in society at best. Based on that, psych geeks have attempted to work things out backwards without much success.

I think this biological paradigm has had more than its fair share of time to have a crack at the proverbial psychiatry egg. Maybe it should step aside and let someone else have a go.

Later

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Really its only in the last 50 or so years that we've had any inkling of the neurochemical processes that seem to be involved in the abnormal experiences reported by the mentally unwell. With the discovery that chemicals can ameliorate some of the distress caused by severe affective disturbance and psychosis, as well as some of the anxiety disorders we have begun to glimpse the workings of the brain as never before.

But when you consider that it's only in the last 10 years that we've been able to get detailed in-vivo imaging of the brain in action, it's no surprise that there are still gaps in our understanding.

Smithy - what other options would you consider, if biological explanations need to step aside?

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I find the last post by oceanic very interesting indeed .

'Biological (physical) underpinnings of most psychological disorders are being elucidated'

Just what are these?

As I am aware there has been an allmost pathetic failure throughout the last two hundred years to find concrete evidence of any biological underpinnings of any of the psychoses (never mind the neuroses).

CT, MRI, fMRI, PET scans have yielded virtually no reproducable evidence. Large ventricles (come on!), hypofrontality (not convinced).  Lateralization seems to show something at least (but not much).

Chemically the situation is a joke.  A collection of accidentally discovered drugs which seem to make people bareable in society at best.  Based on that, psych geeks have attempted to work things out backwards without much success.

I think this biological paradigm has had more than its fair share of time to have a crack at the proverbial psychiatry egg. Maybe it should step aside and let someone else have a go.

Later

well as you know the brain is hugely complex and it is just not psychiatry struggling with the answer with several ailments but neurology is also in that situation with various conditions. Just because we have not found out all the details is no reason to give up.

As for the mind body split this was mainly due to Descartes the french philospher not wanting to offend the church so he came up with this dualism.

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Rene Descartes lived between 1596AD-1650AD.his philosophy refused to accept the Aristotelian and Scholastic traditions that had dominated philosophical thought throughout the Medieval period; it attempted to fully integrate philosophy with the 'new' sciences

The two most widely known of Descartes' philosophical ideas are those of a method of hyperbolic doubt, and the argument that, though he may doubt, he cannot doubt that he exists. The first of these comprises a key aspect of Descartes' philosophical method. As noted above, he refused to accept the authority of previous philosophers - but he also refused to accept the obviousness of his own senses. In the search for a foundation for philosophy, whatever could be doubted must be rejected. He resolves to trust only that which is clearly and distinctly seen to be beyond any doubt. In this manner, Descartes peels away the layers of beliefs and opinions that clouded his view of the truth. But, very little remains, only the simple fact of doubting itself, and the inescapable inference that something exists doubting, namely Descartes himself.

More about his Dualism in the next post...........

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After reading Descartes, it is my view that perhaps his most significant contribution to Scientific Rennaissance was that his theory of dualism allowed Religion & Modern Science to co-exist.

Ofcourse, I can see some people disagree...

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well yes...................

..........MEDICINE SHOULD NO MORE BE MINDLESS THAN PSYCHIATRY SHOULD BE DISEMBODIED!! :-?

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The way I currently look at Mind/Body debate is, Boilogical,Psychosocial factors all produce biological changes in the end(like enlarged ventricles & reduced grey matter weight or hypofrontality etc.....). There was a report of how psychotherapy in depressed patients produced changes inn Brain Structure just like medication, in the BMJ Couple of years ago.(which could be noticed on radiological imaging)

Chronic Illness produces psychological changes which are profound( Arthritis,COPD, etc...) & we know people with psychological disturbances are more likely to suffer from physical ailments like weight gain & it effects, smoking & its effects etc.......

Mind/Body debate proposed by Descartes & through frued led to the separation of Neurology/Psychiatry may be losing its relevance. The American Goverment called the 1990's ' THE DECADE OF THE BRAIN' & we learnt a lot of the brain in that period.But thats just tip of the iceberg. I am certain we will learn a lot more in our life times to change our current views.

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I think the observations of the last decade have been very valuable to this debate. To discover that the brain and its networks are more plastic than we thought, that new neurones are created during adulthood, and that early trauma and psychotherapy can lead to measurable changes in volumes of brain structures is amazing. There was also a study which looked at the role of the temporo-parietal cortex in mediating 'spiritual' experiences, and some which have sought to identify the neural basis for synaesthesia. It seems that more and more of these abstract psychical experiences are being found to have structural underpinings, and one would expect that this continues. Eventually perhaps we will understand the mind as a series of circuits and chemical reactions, but I don't think that that would take away any of the awe of how this is acheived by a network of cells.

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Chris,

Can you quote me the reference on Spirituality & Role of tempero-parietal cortex. I am fascinated by that finding.

Cheers

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Having done liaison psychiatry, I think a lot of what we preach and do is lost in semantics. Words like physical, functional, mental, somatising...mean very little in practice when you have someone in your clinic who's been crippled by their illness.

I'm in no doubt that there are biochemical changes and there is a lot of biological evidence. It's very difficult to formulise a case in a purely psychodynamic way. Assisting someone back on to the road to recovery is crucial however we achieve it and by whatever methods we employ!!

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I can't remember the specific article I first heard this from, but I do recall there being talk of TLE being responsible for Saul's conversion on the road to Damascus. I think folk started looking from there. It was in the news a while back, and I think the BBC did a programme on it ?Horizon, ?Panorama. Here's a couple of similar things from a quick medline search, plus a Sci. Am. article on synaesthesia that's quite readable.

Spiritual experiences on mountains.

Neural correlates of religious experience.

Synaesthesia.

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Chris,

Absolutely fascinating stuff in the links you put in your message.

Thank You very much.

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wow..! such an interesting and informative thread.. thanks guys.

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Hmmm. Well I'll admit I'm a little surprised at the poll results. I was sure dualism was wane. But what a fascinating and informed thread! Thanks guys.

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Chris,

I remember Elliot Slater's study approximately around 1968 or so when they followed a group of patients

Slater revisited: 6 year follow up of patients with medically unexplained motor symptoms

British Medical Journal, Feb 21, 1998 by Helen L. Crimlisk, Kailash Bhatia, Helen Cope, Anthony David, C. David Marsden, Maria A. Ron

http://www.findarticles.com/p/articles/mi_m0999/is_n7131_v316/ai_20394339/pg_2

This is the link for a subsequent follow up study.

http://bmj.bmjjournals.com/cgi/content/full/316/7131/582

Thisis the BMJ Link !

The essence is they followed a group of people with a functional disorder namely hysteria & it turns out they had or atleast some of them had organic illness.

I would argue that most disease are social. For example Tuberculosis, an unquestionably organic illness, but it more common in populations of poor socioeconomic status, atleast in India anyway.

Take Cancers, if any individual was told he/she has cancer would they not go through Kubler Ross's stages of grief namely denial,anger,bargaining,depression & acceptance.

The days of either or is over in my view.

My arguement is all Predisposing & Precipitating causes whether Biological or Psychosocial finally cause macro/microscopic changes in brain structure or cause functional changes in neurohormones,neuro transmitter numbers or their uptake & also may or maynot cause changes in post synaptic receptor changes & these produce the changes

For example CBT improvement can now be seen radiologically.

here are the links:-

http://archpsyc.ama-assn.org/cgi/content/abstract/61/1/34

http://www.medscape.com/viewarticle/520659

Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy.

Goldapple K, Segal Z, Garson C, Lau M, Bieling P, Kennedy S, Mayberg H.

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Frankly, Even Health management has moved on from what causes a disorder to 'Needs Assesment & Needs Review'.

While I agree unless we know the causes we can't deal with needs, Finally 'being able to deliver cost effective management solutions in time' is the key to Modern Health Care.

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I think this topic is central to psychiatry- certainly in Britain, we've been practicing the dualistic approach for a long time. Psychiatry remains out of sight and out of 'mind'. It often feels like we're a curious 'different' appendage to the rest of medicine. Whilst I do not wish to inherit the narrow focus found in a lot of hospital medicine, we do seem to be out on a bit of a limb.

Descartian Dualism has set us back quite a bit, I think. We argue that it is reductionist to see things biologically, without including the psychological, but I would argue that the opposite holds as well- that by purely being psychological, we engage in a type of reductionism, as we fail to recognise the other.

Psychiatry, I think is very exciting- we now do have investigative tools which can bring the psychological, social and biological domains together in terms of their effects on the human brain. This must be good, as it then allows us to be more rational about our interventions, and to become eclectic about the nature of our interventions.

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