[Based on Class Notes of Introduction to Philosophy for Residents of Clinical Psychiatry, given by this blog's author at the Institute of Psychiatry FMUSP, some years ago.]
We try now to elucidated some previously mentioned issues related to methodology, we will deal with the uncertainty principle of quantum mechanics trying to bring it to our neuropsychiatric sciences, and finally we'll speak of a criterion for distinguishing scientific from nonscientific statements. Never no philosopher worthy of this name has doubted the existence of the outside world! There has never been any philosopher who could be called properly as an ontological solipsist. Those who at first doubts about our ability to say something with certainty about any empirical object, like Descartes, are seeking the limits of our capacity to know and the limits of the scientific method. Nevertheless, metaphysical materialism or realism, as beliefs affirmed as obvious in themselves, or even by acquaintance, should never enter the luggage of a good scientist, whatever your area. As I wrote to Thomas, your colleague, no belief should contaminate the scientific attitude, not even the most consensual. Here's why:
1) Ontological or metaphysical realism assumes as unquestionable that things have an existence in themselves, independently of the observer, and that as such may be perceived by our senses . This implies to assume time and space as objective physical entities, captured by human sensory perception. It assumes also that we are able to grasp, either directly or through inductive inference, something of the true essence of the external world. There are even colleagues who still prefer to say they are 'materialists', because they only "believe in the materiality of the brain and see the soul as an ancient illusion." Materialism here would be a development of this kind of ontological realism, but to give some validity to it, we need first to define and clearly delineate what is matter! It would be everything that comes through the senses? Even the energy? The "dark matter" would also be matter, albeit undetectable to date? And dark energy? A field of energy is matter? And a black hole? And the big bang before exploding? And what about Einstein's equation, E = mc2? And the time travel, that physicists are prone to assert as possible, leading us to parallel universes? Material parallel universes? The twentieth century brought the denial of these naive assumptions: time and space are no longer absolute in any sense, as demonstrated by Albert Einstein. And quantum mechanics put in question, also a blow, not only our common-sense notions of time, space and causality, but also the human capacity to know something with certainty: the electron can only be described as a cloud of probability since the determination of its exact location is impossible, whenever we try to get it the instrument of measurement interferes with the same location of the particle! As you know, I just state the Heisenberg uncertainty principle. In other words: it is an inevitable failure, rather than limit our current method of trying to find exactly the space-time coordinates of the particles. In the subatomic world is inexorable law: to determine the coordinates, only with interaction, which leads unavoidably to interference with the position of the particle itself. In our area, neuroscience and psychiatric clinical areas, where there have been huge advances in recent decades. Our ultimate object is the human brain, which may have disorders, said a neurological, psychiatric others said. But what is the mind? There is no mind without a brain, a peaceful spot for us in this room, isn't it? But neither without another human being, and social interaction is what makes us wholly persons.
An extremely important point: All that concerns the human being, the psyche, be it 'disturbed' or 'normal', is associated with brain states. This point generates controversy and misunderstandings of all sorts!
Thus, I must recall the non-dualistic postulate basics: every mental event (state or event) has to match up a neurophysiological event, be it 'comprehensible' or 'incomprehensible', 'explicable' or not, 'normal' or 'abnormal', 'pathological 'or not, etc... So WARNING: to demonstrate that there is a neurobiochemical finding in a given psychiatric clinical picture is not enough to exclude a possible psychogenesis or even socio genesis of such a disorder. It's scary to see how often this logic mistake has been present in international neuropsychiatric literature.
We have no right to ignore that all mental content has a story that begins at birth, and which is registered in the brain, biologically. And the experiential interactions also end, of course, manifest itself in and through the brain. Another crucial, for which clinicians often do not give due attention: There isn't any neuron nor brain disconnected from the outside world ( totally isolated ), be they said 'sick, normal or healthy'. And to watch any kind of their manifestations, i. e., using any of our methods ( neurobiological or psychological ) interfere with them, in a way similar to uncertainty principle of quantum physicists that states we change the electron position whenever trying to get its exact coordinates. 'In a similar way' here means that such is a unsurpassable methological bias: if you interact with any neuron in any way, you make changes in it. It is easy to see that here also holds an uncertainty principle in neuroscience and behavioral sciences! I dare say that the traditional approach, in which mental disorders are said sociogenic, psychogenic and neurogenic, which can not go beyond a didactic division, could be dissipated by the simple refusal of metaphysical, naive realism! ( We have considered the idealistic option ruled out here). Our knowledge is partial and finite, not about the being-in-itself of brain, mind or society, but it suggesting to us a complex interaction of those entities that we partition according to our own approach limitations. The meaning of Kant's transcendental idealism is summed up well in the following sentence: human beings will never achieve absolute knowledge. We are finite beings, relative, ephemerous, and so our knowledge of things, of the whole world, of ourselves! It means for me the same as the biblical account of Adam and Eve while tasting the fruit of the tree-of-wisdom, and thereafter being expelled from Paradise: Because Human Beings live under the illusion that they are capable of achieving absolut knowledge, they are doomed to suffering like hell.
2) Instrumental Realism and the distinction between scientific and non-scientific assertions: Our contemporary medicine, not only psychiatry and psychotherapy, gains a lot here! An image that well describes this approach would be to see scientific theories as fishing nets to capture the world, analogy that we owe to the great Karl Popper, Austrian philosopher of the twentieth century. We must preserve a theory as long as no given fact emerges that refutes it. But if 'fish escapes the net.' After checking 'where on the net did fish pass', the scientist must look for another theory best suited to the phenomena, but this one shall also be refutable. If any assertion is not subject to refutation, it is not part of a scientific theory. This, the criterion of demarcation between science and non-science of the same Karl Popper. Brilliant and very useful in scientific practice.
Thinking a bit in this story of a replacement by a better theory, we will soon realize that it must be an infinite process. We will never reach an absolute truth in science.
My answer the question about Social History of the Clinic: Yes, Isabel, everything you told us about the history and clinical classifications of diseases, mental or not, it seems quite right.
Thomas puts a question:
Dear Professor, you have said that the true scientist can never carry their beliefs among his cognitive tools. But what is your concept of belief? It seems that whenever we see something, the remark will become part of a belief. Our mind is never a tabula rasa. The 'nontheoretical' DSM-III, IV, IV-TR, are actually theoretical. For example, in the diagnostic criteria for schizophrenia there is a clear Kraepelinian conceptualization in the need for the appearance of a 'defect', without which the diagnosis is not made. Regarding your comment on the neuron, I can not remember our conversation so many years ago (congratulations on your memory!), but yes I think, really, neural networks can only be studied in relation to the environment if we are to understand the mind.
Dear Thomas, the kind of belief to which I refer to as unscientific, that should stay out of our luggage, is the irrefutable dogma, that is, any assertion or set of them whose holder takes by principle for true and beyond the limits of any test or refutation. Its refutation may be impossible just by an option not to test it, or even by its logical structure.1) Examples of option not to test it: a) of the "dialectical materialism" in "science" Soviet, b) the infallibility of the pope, c) the Freudian unconscious in some circles that would have appropriated the work of Freud. 2) Examples of impossible refutation by its logical structure are all interpretations of the "they refuse to believe in Freudian ideas because of their inability to handle their own Oedipal conflicts," or "reject religion because they have incurable moral faults", or "are Freudian because they are morally degenerate ", etc ... As for your assertion that our mind will never be a blank slate, I completely agree! What we need is just to be aware of such a limit, making our postulates ( which are not exactly 'beliefs') always keeping our critical sense, i.e., never built in order to become unfalsifiable by their logical structure. Anyone in search of non-falsifiable theories should not be wasting their time in science, whatever his major interest.
1) Ontological or metaphysical realism assumes as unquestionable that things have an existence in themselves, independently of the observer, and that as such may be perceived by our senses . This implies to assume time and space as objective physical entities, captured by human sensory perception. It assumes also that we are able to grasp, either directly or through inductive inference, something of the true essence of the external world. There are even colleagues who still prefer to say they are 'materialists', because they only "believe in the materiality of the brain and see the soul as an ancient illusion." Materialism here would be a development of this kind of ontological realism, but to give some validity to it, we need first to define and clearly delineate what is matter! It would be everything that comes through the senses? Even the energy? The "dark matter" would also be matter, albeit undetectable to date? And dark energy? A field of energy is matter? And a black hole? And the big bang before exploding? And what about Einstein's equation, E = mc2? And the time travel, that physicists are prone to assert as possible, leading us to parallel universes? Material parallel universes? The twentieth century brought the denial of these naive assumptions: time and space are no longer absolute in any sense, as demonstrated by Albert Einstein. And quantum mechanics put in question, also a blow, not only our common-sense notions of time, space and causality, but also the human capacity to know something with certainty: the electron can only be described as a cloud of probability since the determination of its exact location is impossible, whenever we try to get it the instrument of measurement interferes with the same location of the particle! As you know, I just state the Heisenberg uncertainty principle. In other words: it is an inevitable failure, rather than limit our current method of trying to find exactly the space-time coordinates of the particles. In the subatomic world is inexorable law: to determine the coordinates, only with interaction, which leads unavoidably to interference with the position of the particle itself. In our area, neuroscience and psychiatric clinical areas, where there have been huge advances in recent decades. Our ultimate object is the human brain, which may have disorders, said a neurological, psychiatric others said. But what is the mind? There is no mind without a brain, a peaceful spot for us in this room, isn't it? But neither without another human being, and social interaction is what makes us wholly persons.
An extremely important point: All that concerns the human being, the psyche, be it 'disturbed' or 'normal', is associated with brain states. This point generates controversy and misunderstandings of all sorts!
Thus, I must recall the non-dualistic postulate basics: every mental event (state or event) has to match up a neurophysiological event, be it 'comprehensible' or 'incomprehensible', 'explicable' or not, 'normal' or 'abnormal', 'pathological 'or not, etc... So WARNING: to demonstrate that there is a neurobiochemical finding in a given psychiatric clinical picture is not enough to exclude a possible psychogenesis or even socio genesis of such a disorder. It's scary to see how often this logic mistake has been present in international neuropsychiatric literature.
We have no right to ignore that all mental content has a story that begins at birth, and which is registered in the brain, biologically. And the experiential interactions also end, of course, manifest itself in and through the brain. Another crucial, for which clinicians often do not give due attention: There isn't any neuron nor brain disconnected from the outside world ( totally isolated ), be they said 'sick, normal or healthy'. And to watch any kind of their manifestations, i. e., using any of our methods ( neurobiological or psychological ) interfere with them, in a way similar to uncertainty principle of quantum physicists that states we change the electron position whenever trying to get its exact coordinates. 'In a similar way' here means that such is a unsurpassable methological bias: if you interact with any neuron in any way, you make changes in it. It is easy to see that here also holds an uncertainty principle in neuroscience and behavioral sciences! I dare say that the traditional approach, in which mental disorders are said sociogenic, psychogenic and neurogenic, which can not go beyond a didactic division, could be dissipated by the simple refusal of metaphysical, naive realism! ( We have considered the idealistic option ruled out here). Our knowledge is partial and finite, not about the being-in-itself of brain, mind or society, but it suggesting to us a complex interaction of those entities that we partition according to our own approach limitations. The meaning of Kant's transcendental idealism is summed up well in the following sentence: human beings will never achieve absolute knowledge. We are finite beings, relative, ephemerous, and so our knowledge of things, of the whole world, of ourselves! It means for me the same as the biblical account of Adam and Eve while tasting the fruit of the tree-of-wisdom, and thereafter being expelled from Paradise: Because Human Beings live under the illusion that they are capable of achieving absolut knowledge, they are doomed to suffering like hell.
2) Instrumental Realism and the distinction between scientific and non-scientific assertions: Our contemporary medicine, not only psychiatry and psychotherapy, gains a lot here! An image that well describes this approach would be to see scientific theories as fishing nets to capture the world, analogy that we owe to the great Karl Popper, Austrian philosopher of the twentieth century. We must preserve a theory as long as no given fact emerges that refutes it. But if 'fish escapes the net.' After checking 'where on the net did fish pass', the scientist must look for another theory best suited to the phenomena, but this one shall also be refutable. If any assertion is not subject to refutation, it is not part of a scientific theory. This, the criterion of demarcation between science and non-science of the same Karl Popper. Brilliant and very useful in scientific practice.
Thinking a bit in this story of a replacement by a better theory, we will soon realize that it must be an infinite process. We will never reach an absolute truth in science.
My answer the question about Social History of the Clinic: Yes, Isabel, everything you told us about the history and clinical classifications of diseases, mental or not, it seems quite right.
Thomas puts a question:
Dear Professor, you have said that the true scientist can never carry their beliefs among his cognitive tools. But what is your concept of belief? It seems that whenever we see something, the remark will become part of a belief. Our mind is never a tabula rasa. The 'nontheoretical' DSM-III, IV, IV-TR, are actually theoretical. For example, in the diagnostic criteria for schizophrenia there is a clear Kraepelinian conceptualization in the need for the appearance of a 'defect', without which the diagnosis is not made. Regarding your comment on the neuron, I can not remember our conversation so many years ago (congratulations on your memory!), but yes I think, really, neural networks can only be studied in relation to the environment if we are to understand the mind.
Dear Thomas, the kind of belief to which I refer to as unscientific, that should stay out of our luggage, is the irrefutable dogma, that is, any assertion or set of them whose holder takes by principle for true and beyond the limits of any test or refutation. Its refutation may be impossible just by an option not to test it, or even by its logical structure.1) Examples of option not to test it: a) of the "dialectical materialism" in "science" Soviet, b) the infallibility of the pope, c) the Freudian unconscious in some circles that would have appropriated the work of Freud. 2) Examples of impossible refutation by its logical structure are all interpretations of the "they refuse to believe in Freudian ideas because of their inability to handle their own Oedipal conflicts," or "reject religion because they have incurable moral faults", or "are Freudian because they are morally degenerate ", etc ... As for your assertion that our mind will never be a blank slate, I completely agree! What we need is just to be aware of such a limit, making our postulates ( which are not exactly 'beliefs') always keeping our critical sense, i.e., never built in order to become unfalsifiable by their logical structure. Anyone in search of non-falsifiable theories should not be wasting their time in science, whatever his major interest.
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