By Dr David Laing Dawson
I have trouble getting my head around infinity, the ever-expanding universe. Eternity troubles me as well. And the speed of light. One tiny copper telephone wire brings me moving images on my big screen TV, and surround sound at the same time. I understand this copper wire is transmitting simple binary code, zeros and ones, but think of the speed required to refresh 1080 pixels per inch every two hundredths of a second. (or whatever that calculation might be). I just don’t have the capacity to imagine, to picture these things in my “mind”. Perhaps Stephen Hawking can. I can’t.
And then we have the problem of duality, mind and body, or mind and brain. How can one imagine the brain constituting the I, without a homunculus inside it, a spirit, a ghost, an identity, a me? As difficult as it is to imagine infinity and eternity, it is equally difficult to imagine the “I” as simply a product of the brain. We don’t want to think of ourselves as simply biological beings with limited lifespan, and our consciousness being merely an expanded version of the self-awareness of a lobster.
Hence the struggle many of us have to accept that something gone wrong with the brain, the biological information machine we call the brain, can affect the “I”. And the corollary to this, that some medicines, some psychiatric drugs, can alter the biochemistry of this broken brain and affect the “I”, and perhaps return it to a more usual state. And that this can be a good thing.
Thus the battle lines are drawn. Mental illness can’t be an illness affecting the brain, the neurotransmitters and receivers of the brain, improved with pharmaceuticals that alter perception and cognition because this would imply that there is no “I” separate from the brain. And we don’t want to imagine that. At the very least we want to imagine that the “I” can influence the biological brain, rather than vice versa. (To say nothing of those who want to believe that the “I”, our attitudes and beliefs, can influence the course of cancer).
Curiously, with recreational drugs we have no problem thinking that they work on the brain and yet alter our perception, our cognition, our awareness, our sense of time, our sense of humour, our sense of urgency, our volition, and our interpretations of reality. Though even here there are those among us who think cannabis, mescaline, peyote, LSD, can cause the “I” to experience an alternative, more spiritual reality. No. They are simply altering the chemistry of our electrochemical transmitters and receivers, and thus altering the manner in which our brain processes information coming to it through our sensory organs and from our memory banks.
I think those are the struggles behind what seems obvious to the rest of us: The best treatment of severe mental illness combines medication(s) that work, and a good, compassionate person “working with” the sufferer over time. That person can be the same one prescribing the medication, or someone else on the team. And I say “working with” that person, meaning being there for him or her, meeting regularly, talking and supporting, counseling and instructing, accepting and directing.
Many would like to define that part, “working with”, in such specific terms that it can be patented, marketed, and promoted, and even promoted as something more wholesome and natural than medicine. So we have a proliferation of mindfulness therapies, CBT, DBT, and onward. In fact, if you check Wikipedia you will find there are, on average, about 5 kinds of psychotherapies per letter of the alphabet.
We need to get past this dichotomous thinking, once and for all. I have been listening to these arguments now for about 50 years.
Someone who is ill, be it of the body, brain, or “mind”, can be helped with medications that work, proven scientifically to work, and by having someone in his or her corner.