Although measurable progress has been exhibited and successful treatments rendered to patients suffering from mental health afflictions, most if not all of the clinical parties involved agree that much remains to be done. In fact, it might be stated without much fear of contradiction, that to date, little about the psychical and physical causes of psychological disturbances is clearly understood at all.
The interventions applied take the form of educated guesses and the outcomes resulting are more often hit or miss. This distressing situation and negative commentary on the discipline of psychiatry is not delivered lightly or without a sense of regret concerning the bad tidings. But something must be done to begin the process of changing hearts and minds and of facing the facts. Psychiatry’s theoretical platform is shaky at best.
Thus, we find ourselves at a crossroads of sorts. Is there enough dissatisfaction with the analysis and treatment methodologies in place to date, that they should be scrubbed and re-oriented or should a new beginning be attempted to uncover and implement some new, as yet undiscovered paradigm of human psychology?
Or might it be time to form a new multi-disciplinary collaboration which might forge the new, by cherry picking the established, gleaning what’s proven most successful and melding it with something heretofore untried? In this essay, an effort will be made to weigh the alternatives in light of certain flaws discovered in the behavioral stimulus/response theoretical platform with its attendant search for environmental causation for mental afflictions.
In order to investigate what would prove the best route to take, it might be an amenable starting point to outline the difficulties faced by contemporary practitioners and to enumerate what appear to be the sticking points or empty spaces in the knowledge about the human psyche, which knowledge if it were available might, if conjoined with those best practices mentioned above, could serve as a bridge in the formation, in its initial stages, of a new paradigm and mental health regimen.
What follows will be delivered from the philosopher’s perspective, not from the experienced practitioner’s point of view. The reason for this is that murmurs are beginning to be heard in a number of cognitive scientific, clinical psychologist and system philosophical circles that hint that some sort of bridge might possibly be erected between, on the one hand, the existing and in some measure validated/measurable experience of the cognitive scientist and the psychiatrist, and on the other hand, the as-yet underappreciated understanding gleaned from one early modern philosopher’s discoveries in human psychology, metaphysics, and philosophy of mind: namely, those recorded in Baruch Spinoza’s Ethics. This in turn amounts to what I’ll call, borrowing a controversial term from Jonathan Israel,[i] radically enlightened psychiatry.
What this essay will not be, is a survey of all the clinical methodologies currently in application among mental health professionals, with an eye towards ferreting out what is best by culling from known methodologies. On the contrary, what this paper must be is something of an eye opener to the gaps in our current understanding of mental illness, why those gaps exist and what type of a corrective needs to become coalesced with the important understandings which have been gained and established as effective practice and workable knowledge to date.
To accomplish this task, it will become necessary to follow the pathway of radically enlightened psychiatry, in the sense that in order to make way for the new, some of the classical misapprehensions concerning human nature will need to be cast aside.
To accomplish this, it will be necessary to bring to light the flaws in the presupposition that human beings are no different than other animals and that like unself-conscious sentient animals, human behavior can be observed and analyzed in the clinical mental health environment. In this respect, the justification for the stimulus/response model of human passivity must be called into question and replaced with a recognition of human self-conscious agency and reflective thought as a prime element in any clinical appraisal, analysis and diagnosis. For this purpose, I’ll consider Errol Harris’s views on the nature of consciousness.
Equally as important, we must challenge the currently held assumptions concerning psychological cause-and-effect, specifically within the assumptions in neuroscience concerning the brain. It must be seriously considered that the cause of psychological imbalance is not resident in the brain, although the markers of its presence are evident within the neural pathways. It may just be the case that the psychiatrist’s frustration results entirely from looking in the wrong human function for answers. By coming to grips with the self-evident value in Spinoza’s psychological profile as described in his Ethics, parts 3-5, it may become possible to consider how his understanding of how memory, emotional affection and thought patterns merge to form the cause of many if not most diseases of the psyche and mind.
From there and once a sampling of preliminary conclusions are drawn, the groundwork for a new approach toward recognizing the primary role played by the emotions in shaping the psyche and therefore precisely how these emotions affect the formation of the bedeviling thoughts and resultant behavioral patterns which have become recognized as signs of mental disturbance.
(2) Neuroscientists’ Confusion Concerning Cause-and-Effect
In 2003, one of our most capable and respected neuroscientists, Antonio Damasio, went looking for Spinoza.[ii] What he found is both interesting and yet at the same time alarming. It is laudable that an empirical scientist had the interest, care and capability to analyze the sequencing and behaviors associated with what Spinoza terms “the emotions.” This is clearly a positive development. When our neuroscientist friend recognized that something about emotional response is measurable, he made scientific progress. But by focusing his analysis only on chapters 3 and 4 of the Ethics, he totally sidetracks Spinoza’s metaphysics in chapters 1 and 2, while presenting Spinoza as some sort of intuitive materialist. The alarming part in all this is that chapters 3 and 4 are linked inexorably to 1 and 2 wherein Spinoza insists that our thoughts and our emotions are as physically real as our environment (although many still doubt this supposition).
As notable as Damasio’s respect for Spinoza’s psychology may be, there is a tremendous distance from his awakening to the import and physical reality of the emotions to an adequate understanding of the full impact of Spinoza’s discovery; that the human mind has the ability to form replications of objects so accurate that these ideas are essentially the same thing as the objects they represent. And crucial to understanding the role which the emotions play in our lives is their involvement in acting as triggers which fuel the thoughts which become memories in our minds.
These are astounding claims which Spinoza makes and observations on humanity that to this day have been overlooked or dismissed in light of the advances in contemporary science and its perceived ability to reduce everything in its purview through observation and measurement to natural, mathematizable facts. Lost in this reduction and conjoined where no intersection between them exist, sit cause and effect. Many of the origins of mental health disturbances continue to elude as we remain incapable of recognizing that the elements which cause an event to occur, in most cases do not occupy the same chronological and spatial plane. Simply stated, they are not observable in the same time and space.
When the neuroscientist-researcher connects electrodes to a patient to monitor brainwaves there is no question that the observable patterns that emerge are exciting and are indicators of some type of brain activity related to neural patter stimulations that occur simultaneously with the patient’s emotional state and mood changes But to conclude from this that the patterns and their location in the brain somehow indicates the cause of the mental perturbation is a leap that indicates faulty reasoning and leaping to conclusions.
Perhaps an illustration might shed some light on what is being suggested here.
To draw a conclusion about the source of the mental process and to claim that it is sourced in the brain from observing the results from an electro-encephalogram is akin to a person who while standing atop the tallest building in a large city before dawn observes the pattern of traffic lights below and concludes that the pattern of lights is the cause of the flow of pre-dawn traffic. Because it is clear from the commanding height of the observer, that the vehicles within the flow of traffic move only when commanded to do so by the control devices and that the entire flow is completely synchronized, the only conclusion to be drawn is that the electronic signals constitute the proximate cause of the flow.
But in point of fact that is not the case at all. No matter how many thousands of lights make up the discernable pattern of the flow of traffic, the actual cause of the traffic is not observable. In fact, the cause of the flow resides in an entirely different plane and chronology than its resultant flow or traffic.
And what is more significant than that, no generalized causality can be attributed to the flow of traffic which would enable one generalized conclusion to be drawn concerning the cause covering all of the vehicles involved. Drawing conclusions from generalizations and framing abstractions from this process is one of the major components in the current scientific paradigm and the displacement of cause and effect.
The cause of the traffic lies outside of and distinctly prior to the actual physical flow and its proximate cause originates solely on a case by case, or strictly individual basis. Indeed, the fact of this individuality will have serious implications for drawing conclusions in determining the causes of mental health disturbances for the new clinical approach, once the Spinozan methodology is outlined below.
The flow originates in the reasons that each individual driver leaves home and enters the flow: going to work, driving a friend to the hospital, making deliveries, police responding to emergencies and countless other actions are the actual cause of the traffic and they are entirely disconnected from one another. There is no common cause to be observed and reported on here.
This analogy marks a simple demonstration of the confusion inherent throughout the empirical process as it relates to human actions. And as brief and sketchy as it may be, begins to point up why no paradigm exists in psychiatry. Looking in the wrong place has led to a complete dead-end.
There is no argument about what the scientist sees during the study. But there is a strong argument against what is claimed to have been observed. If this mistaken insistence that causality must be observable resided solely in speculative neurobiology the harm might be negligible. Unfortunately for patients, this curious misunderstanding of cause and effect permeates much of our scientific theory and practice, including applications in mental healthcare diagnosis and treatment. Descartes, Hobbes, Hume, Locke and all of their materialist followers did humanity no favors when they declared the human dualistic experience as that of the person trapped inside their mind, like a stranger in a strange land. The confusion continues today into the bizarre meanderings within professional academic Analytic philosophy and its preoccupation with playing hypothetically situated word games, which carry no significance for the challenges that we face in the real world.
The upshot of all this is that our current empirical/materialist scientific system that has brought about some of the most significant advances for humanity in agronomy, manufacturing, engineering with its civil and industrial applications, and other sophisticated technologies contains a seriously flawed view of cause and effect. And by insisting on a research focused only on the world of external experience and the observably measurable, it ignores the rich world Spinoza captured, of experience’s counterpart and co-equivalent agency-in-act, the human mind, where the source of the problems resides.
This now outmoded way of explaining human behavior and psychology must give way to a more sophisticated view. This view will credit the mind and its self-reflective intellectual prowess as the source and wellspring of any and all scientific achievement which has ever been accomplished and that it is the mind which provides science with the most magnificent tool at our disposal for unraveling nature’s mysteries.
(3) The Impossibility of Meaningful Analysis In Strictly Third-Personal or Impersonal Psychiatric Assessment
In this section, three seemingly disparate concepts will be pulled together in order to form an amalgam which attempts to begin to shed light on the conundrum within which the behavioral sciences have placed themselves. Those three concepts are:
(i) consciousness and self-conscious reflection,
(ii) psychiatric diagnosis and treatment, and
(iii) Spinozan psychology.
As disparate as these concepts may at first appear, the unification of these three conceptual frames will yield a new mental health paradigm and regimen to affect treatment for positive outcomes.
One of the longest running and apparently irresolvable disputes in the cognitive sciences and philosophy is the question concerning consciousness. Some schools of thought have determined it to be both non-existent and a non-question; this is a convenient attempt at dismissal but the question of consciousness cannot be answered by handwaving it away.
Others maintain that consciousness cannot be separated from perception.
The third grouping’s take on the nature of consciousness range from it being a separated state of being, existing somehow above perception, to its comprising and denoting the actuality of the mind.
In any case, it remains a fundamental issue.
But one recent scholar—Errol Harris—I believe, has succeeded in shedding light on what appears to be a major contradiction in place in the basic assumptions and theoretical platform of behavioral psychology.
Harris’s point consists first, in the observation that it’s an impossibility for anyone to forthrightly deny that they, as an individual, can claim ignorance of the self-observant nature of their own private thoughts. This leads him to conclude that to deny consciousness is acting in bad faith and represents a self-refuting, self-stultifying form of denial.
Let us examine what Harris claims about the circular argument and the built-in contradiction within contemporary clinical psychiatry’s paradigm and methodology.
(4) The Built-in Contradiction in the Psychiatric Assessment Model
It is, therefore impossible to deny its occurrence [consciousness], and consequently it is equally impossible truthfully to deny that consciousness ever occurs. In an extremely philosophical form, behaviorism is self-refuting.
Oddly enough, behaviorism in its attempt to admit as evidence only what can be publicly observed, and to exclude the report of any private experience, commits itself by implication to the very solipsism of which it strives to be the opposite. For all observations are the perception of observers and every perception is a conscious experience immediately open only to the subject experiencing. To be imparted it must be reported and the report is of a private experience. Reports can be compared of several different observers perceiving the same objects, but not only is each of them a report of private experience but the comparison must be made privately by the investigator and its result can become publicly available only as the report of a private operation. If then all reports of private experience are to be excluded from science, then there will be no science whatsoever, save what will result from the enjoyment by the inquirer of his own private observations and the comparison he makes between them. These will include his observations of the behavior of other persons observing the same or similar objects, but all of them will be private and, if the behavioristic prohibition is to be strictly observed, none will be admissible as public scientific evidence. Each observer will then be confined to the unbreakable circle of his own experience within which the behavior of others will figure only as his subjective perception.
Consciousness cannot be excluded from science- not even from physical science, although it is not its subject matter. There can be therefore no reason to exclude it from psychology for which it is, a legitimate object of investigation. (E. Harris, The Foundations of Metaphysics in Science [London: Unwin, 1965], pp. 293-294)
(5) What Does All of This Signify and What Effect Should It Have On Current Delivery Systems?
Even supposing that everything stated above is absolutely true, what is the point? Is it to be expected that psychology and the cognitive sciences should now abandon the work that has been accomplished to date, throw out all of their basic assumptions and begin again, from scratch? And if the answer to these questions is yes, then what would replace the landmark discoveries and the inroads already accomplished concerning the establishment of a prescribed methodology for extracting successful clinical interventions from observable behaviors? And further, due to this inherent theoretical flaw, should all scientific investigation come to a halt, and if so, to what end?, and where would the benefit lie in this mad endeavor?
The answer to these questions is in the main, no. Nothing needs to be abandoned, or deconstructed, or halted. And yet there is an important and vital corrective which should come under consideration, and for two very justifiable reasons.
First, the exclusion of and refusal to recognize the leading role which the human mind or conscious attribution played in the development of these disciplines within the cognitive scientific frame does a tremendous disservice to science and humanity. By subscribing to a commitment to derive all scientific judgements strictly and solely from observable behaviors, psychology is constricting its reach. And by negating and/or denying the observer/clinician’s self-conscious reflection and the thought process which undergirds these judgements, this very capable discipline within the cognitive rubric handcuffs itself and delimits its effectiveness.
If practicing psychology can give entry into its theoretical framing the proven capability within metaphysics/epistemology of Spinoza’s type, to assist in laying out the role of the human mind and its capability to gather, analyze, synthesize and draw conclusions on psychology’s proven data-bank of observable measurement, then that conjoining will surely bear fruit and help to move clinical interventions into a more meaningful and demonstrable paradigmatic posture.
Second, the exclusion from consideration within the practice of psychology and psychiatry, which practitioners readily admit has severe limits—that is, that the exclusion of any consideration of the proximate causality role played by human emotions in any mental health affliction—has reduced current practice to be essentially locked into superficial symptom-oriented guesswork and chemical doping of patients.
In the interest of making a beginning of bridging this gap between the two disciplines, let us consider the following.
(6) Spinozan Philosophical Psychology
What follows is both exploratory and highly speculative. Yes, it is indeed early days, and yes again, this will not be the first time, nor the first attempt to search for conjunctions and intersections that might work to form a bridge between philosophical psychology and psychiatric practice. But there are a number of practitioners who see not only the value of such an amalgam but further the need for support which the theory and practice in one of these disciplines can stand in support of the other.
With the re-emergence of Spinoza’s Ethics in recent years from its consignment to the dustbin of history, comes a reawakening.
In the Ethics, parts 3-5, he describes the inner workings of human psychology and the pivotal and primal role played by human emotion in the mental and emotional lives of all people, regardless of cultural affinity or geographical location.
Here are some excerpts, in each case followed by my critical commentary.
By emotion I mean the modifications of the body, whereby the active power of the said body is increased or diminished, aided or constrained, and also the ideas of such modifications.
A “modification” consists in a measurable physical or emotional change brought about either from within or external to a human body. It involves real-time physicality; this process of modification results in real time, measurable emotional change to our bodies.
Bearing a strong similarity to any bodily ache, pain or pang of either pleasure or pain, an emotional modification either adds to or subtracts from the body’s ability to persevere, that is to act, and therein lies its potency to serve as influencer and driver of our behaviors and actions.
The idea which formulates itself within the mind becomes a remembrance [file] of the event which caused the emotion.
Unlike our current usage of the word ‘emotion’, which conjures for us some type of bothersome, will-o-the-wisp, and fleeting sensation, Spinoza’s notion of emotion is nothing less than a physical entity which is active and very real. When an emotional trigger emanates from within our bodily nervous system its impact leaves an impression on the brain, which in turn evinces an immediate reaction to occur in the mind. This impression, depending upon how it is received, imparts either a positive or a negative impact on our thinking process and thereby affects our behavior.
This imaginatively prompted and inadequate idea exerts the same potency-in-act as any other type of idea.
The implacability of the spur of emotional impact and its direct impact on our thought processes and self-image as it pertains to every human life cannot be overstated. The increase or decrease in our power to successfully manage our way towards a depth of understanding of ourselves and our place in the world hinges entirely on how we navigate through this concatenation of the affects.
The human body can be affected in many ways, whereby its power of activity is increased or diminished, and also in other ways which do not render its power of activity greater or less.
Spinoza is saying that each and every impulse that impresses itself upon and inside of our bodies induces a quantifiable alteration within our mental structure and psychological profile which either enables or impedes our ability to deal with the vicissitudes of everyday life.
If we take “affected” to mean inclusively physical and mental and emotional inputs, it is fairly easy to recognize that some changes, like studying a language, or performing physical exercise, or losing a loved one, will either strengthen or weaken our capacity and resolve.
Reading the newspaper or eating an apple or feeling the rain all appear to be rather neutral though noticeable affects.
If the mind has once been affected by two emotions at the same time, it will, whenever it is afterwards affected by one of the two, be also affected by the other.
Spinoza is saying that emotional memories are totally asynchronous. They are blind to time and yet so potent and vivid that once recalled into the present, within the purview of our mind’s eye, appear as fresh as at the moment they occurred.
There come to us at various points in our lives, times when in reverie we recall to mind a pleasant memory which for some unknown reason almost simultaneously evokes alongside it a sadness. We often feel embarrassed at what feels like a personal psychological weakness in us which allows these two diametrically opposed emotions to piggyback upon each other, and are happy that no one else can read our minds and witness our confusion.
Perhaps it happens when we recollect memories of a fond friend and the good times we shared. While in the midst of that reverie and almost simultaneously, our mind’s eye then shifts to the memory of when we drifted apart from this friend and the sorry fact that we never have seen or heard of them since.
Now, today when that pleasant past time sensation comes into focus, it is almost immediately accompanied by sadness. But in today’s memory the circumstances are no longer present to the mind’s eye and only the pleasantness and sadness and their odd admixture remain. This is what Spinoza is referring to when he speaks of
whenever it is afterward affected by one of the two, be also affected by the other.
Simply from the fact that we conceive, that a certain object has some point of resemblance with another object which is wont to affect the mind pleasurably or painfully, although the point of resemblance be not the efficient cause of the said emotion, we shall still regard the first-named object with love or hate.
The mind’s memory function is configured or hardwired in such a manner, that first time exposure to an object or person which stimulates a potent emotional response will lock itself in so that when a new encounter with a new object or person occurs which bears a resemblance to the initial stimulus, it will cause the mind to re-register the exact same reaction of either love or hate. Often, we will see an older model car in passing and immediately, someone we knew who owned that same model and year of automobile, comes unbidden into our mind’s eye.
The emotions connected to any one person’s life and experience have such a potency that they exist virtually outside the bounds of time and almost virtually beyond our bidding or control. They are, as far as we are concerned, endless and concomitantly attached to our entire duration on earth.
These emotional reactions can so affect us as to numb our sense of clarity in our thinking, that we become effectively hypnotized by their power.
In this connection, recall Spinoza’s comment about the person whose imagination so controls their thought processes and behaviors that they are essentially sleep walking.
A man is affected as much pleasurably or painfully by the image of a thing past or future as by the image of a thing present.
He who conceives that the object of his love is affected pleasurably or painfully, will himself be affected pleasurably or painfully; and the one or the other emotion will be greater or less in the lover according as it is greater or less in the thing loved.
In these propositions, Spinoza draws our attention to the symbiotic and magnetic relationship between any individual and their object of affection. Notice his mention of how both “the lover and the image of the thing loved” are equally affected. There persists an inverse proportional connection in the intensity of feeling between the two; that is the reverie and the emotion.
Much of this discussion may mark new territory for many of us. To realize that even picturing in our imaginations any change which might affect our loved one; that this image will cause a potent emotional charge to affect us is somehow startling, not to mention eye-opening.
As we will now begin to discuss the degree of difficulty that we all encounter as we attempt to wrest control of our psychological stability away from external forces, the realization of the extent of our helplessness is mind-numbing indeed.
Notice that here in particular Spinoza is denoting how simply imagining an affect of joy or sadness increase or lessens the physical manifestation of that emotional state in real time, in the mind of the day dreamer.
(7) And Its Implications for Psychiatric Practice
My claim is that the application of Spinoza’s understanding of the human emotions and the role that these passions play in mental health will form the basis of a new paradigm for psychiatric practice.
In this connection, see also Donald Robertson’s landmark essay, “Spinoza’s Philosophical Psychotherapy,” in which he claims that the entire Ethics can be interpreted as a psychotherapeutic pathway to emotional well-being and towards living a psychologically well-balanced life.
And here are excerpts from two letters written by practicing psychiatrists in response to a book review in the Economist on the state of psychiatric treatment and the lack of any workable paradigm for identifying ailments.
Your review of two psychiatry books made so many assertions in need of contextualization that I must condense my points (“The Wisdom of Sorrow”, April 13th). Diagnostic thresholds are falling, and the prescription of contested medications (statins, aspirin) are increasing, across all areas of medicine, not just psychiatry; the harm wrought by missteps in medicine’s history are by no means confined to the 1800s and greatly exceed the equivalent in psychiatry; the Diagnostic and Statistical Manual of Mental Disorders explicitly warns against the “checklist approach to diagnosis” of which you accuse it; and, despite being a psychiatrist myself, I have yet to meet a single one who says we understand the “chemical imbalance” that you say we say causes mental illness: humans are clearly vastly more complex than that.
Here are some facts. Suicide is falling globally; numerous studies and millions of patients confirm the usefulness of psychiatry treatments; we don’t know the biological basis of mental illness because we don’t know how the brain works on a good day, let alone a bad one; and—guess what?—psychiatry, like all areas of medicine, is imperfect and we must do better. We will.’
Would these goals have been achievable in the days before Big Pharma stepped in? In the case of the man with the mood disorder and the meth abuser, definitely not. In the other two, [whose symptoms did not require an immediate and drastic intervention] yes, with a great deal of patience and determination.
Big Pharma has serious drawbacks. There is a risk of over-reliance on medication at the expense of relationship-building and exploring emotional conflict [boldfacing added]. But meds have earned a place in the fight against disabling illness.
These quotations excerpted from these two letters are not intended as some type of broad incrimination of practices within psychiatry, but rather as evidence that even practitioners admit of the need for better attempts to rework or replace the current platform or paradigm.
Both letters describe how the use of medications has resulted in a less than optimum state wherein the bulk of treatments derive only through recognizing and treating symptoms. This lack of any paradigm-based assessment leaves mental-health specialists operating without any solid foundation or baseline.
Additionally, no consideration is made for the emotional states which always accompany psychological distress. Medical students specializing in psychiatry neither study the feelings of the well, nor consider what feelings are for. Of the 4,500 pages in America’s most popular psychiatry textbook, normal emotions get half a page. Moreover, when it comes to diagnosis, they fail to consider underlying causes.
It would not be incorrect to state that when searching for causes for mental affliction more emphasis is placed on the effects of external pressures than on the inner psychological state and condition of the patient.
The current version of the American “Diagnostic and Statistical Manual for Mental Disorders” (DSM-5) defines hundreds of disorders solely by their symptoms. Depression, for example, means at least two weeks experiencing five or more of eight symptoms, such as loss of pleasure in life, loss of appetite and feelings of worthlessness. The diagnosis is the same if you have just been bereaved or divorced or lost your job. In short, these alarming shortcomings clearly indicate a mental health discipline in crisis mode.
Drawing attention to the acknowledged shortcomings in treatment and absence of any coherent theoretical underpinnings for treating mental health afflictions in psychiatry does not mark the beginning of some diatribe against the discipline itself. It is merely to serve as an introduction to a new methodology based upon the crucial and pivotal role played by human emotions in every and all psychological disturbance.
Here is another quotation from The Economist:
Of the 4,500 pages in America’s most popular psychiatry textbook, normal emotions get half a page. (The Economist, 6 April 2019)
This sentence speaks volumes about the current state of assessment and treatment of psychiatric illnesses today. To have virtually no interest or understanding whatsoever of the potential impact of a patient’s emotional profile and the role that these emotions play in the condition presenting itself is tantamount to admitting that other than dulling someone’s sensibility with chemicals or attempting to diagnose a malady by searching for repressed anxieties, clinical practice has little to offer by way of palliative or treatment for the array of mental afflictions which affect many millions in the world today.
Meanwhile, sitting on a library shelf in every university in America sits a potential antidote to this dismal circumstance, namely a copy of Spinoza’s Ethics, gathering dust and biding its time, waiting for the moment when someone or something awakens this sleepy world to the brilliant insights on human psychology and the human emotions waiting inside this book.
The thinking goes that thinkers from earlier eras, no matter what their message may have been, that is, that their thoughts are outmoded and have been superseded by contemporary advances over whatever came before. Without concerning ourselves over the authenticity in this belief or of performing some type of comparative analysis between now and then, we do know for certain that we live in challenging times. In the OECD world, of countries with advanced economies, distrust in Government and in one another, whether at the National, Federal or local level is widespread, and with good reason. That same distrust holds even more certain for the less developed economies, where old fashioned tyranny and dictatorship has been replaced but not upgraded. Tyranny’s replacement is a new form of repression termed “illiberal democracy”: there is a voting process, but typically only one candidate who cannot lose. No opposition is permitted and individuals are repressed and their rights violated.
These conditions have brought about a widespread sense of despair with its accompanying loss of hope for the future. That’s the one thing that both rich and poor have in common world-wide.
As far as the individual’s psychological balance is concerned, many types of psychological affliction are evidenced; mental illness, domestic abuse, suicide rates, addictions of all sorts and just a general sense of malaise seem to be on the rise everywhere.
It’s not as if life is not good in the main and that living conditions including sanitation, healthcare and nutrition have stretched life-spans literally dozens of years beyond what was once thought imaginable.
But many people are comforted little by these advances.
Many people have been forced to seek assistance either in mental health counseling or in full-fledged psychiatric care. Many others remain lost and without ministration or care. One example, in this year, 2019, the state of Oregon records the highest percentage number of citizens suffering from some type of mental health issue coupled with the lowest number of treatment facilities in the United States.
Meanwhile, we continue to believe that our modern take on psychological assessment and treatment must surely have brought us to the leading edge and to a high point in what has been garnered and accumulated from the best that history has had on offer.
In Spinoza’s psychology everything begins with an awareness of the basic psychological core and essence of an individual’s existence. He termed it “conatus” or the non-conscious urge to continue to persist-in-existing. This driver acts on the nervous system in conjunction with external impulses which originate in impressions or signals emanating from other people and the objects which surround us. These signals are converted inside the body into electronic impulses which trigger what Spinoza terms either “desire” or “appetite.” These terms describe fluctuating states which, when responded to, result in either and increase or decrease in a person’s power to survive and mental stability. These fluctuations accompany mental states which exhibit in the individual either psychological maturity, evidenced by a peaceful composure and even-tempered demeanor or in recognizable distress and instability. These fluctuations vacillate in each of us and cause the mood swings which disarm and worry us concerning our mental health. These symptoms of distress are kept under-wraps and remain unspoken or given voice; the fear of being stigmatized leaves us alone in our distress.
Once reaching a tipping point these perturbations completely upset an individual’s balance and result in some type of mental affliction. At that point a typically tentative reaching out occurs which often drives mixed results.
Of course, in this brief essay, time and space will not allow for any detailed expansion of these clearly generalized observations. That work will come later and will require the ablest among our psychologists and psychiatrists working together with Spinoza specialists to flesh out this abstract, by employing Spinoza’s psychology as a template of the emotions and as a guide for establishing normative treatment regimens.
But for now, I will conclude with a brief sample of Spinozan psychiatric practive.
(8) Spinozan Psychiatric Practice: A Preliminary Sketch
Above I’ve mentioned the psychological discomfort that has become a salient feature and side effect of living in our contemporary world.
Mentioned was made above of an early stage alternative to the applied behavioral psychological paradigm that serves as the platform today for most evaluation and treatment for mental distress.
Here is a preliminary sketch of a Spinozan alternative.
At first its simplicity seems completely disarming, and nearly impossible to believe. Compared with all of the complexity and multilayered levels of contemporary psychology’s depiction of a person’s inner subconscious life and the thoughts that either threaten or compel us, Spinoza’s is disarmingly straightforward. Not only that but his understanding of human psychology far outstrips the modern one in accuracy and potential efficacy for traumatized minds.
Spinoza’s understanding of human psychology begins with exactly how each of our memories becomes captured and stored in the brain. It many respects, it is quite simple to grasp. At the moment an event is experienced, it simultaneously becomes recorded in our minds. Every aspect of that event becomes stored right along with it; every sight, smell, taste and sound which occurred at that moment collapses in together, as one cognitive file.
This means that any one individual aspect in that concatenation; one whiff of smoke, one flash of colored light, one aroma of perfume, no matter at what point in any given future time, will instantly recall to our mind’s eye the entire event as a whole and just as if it were happening now, alive in the moment. Except, of course, for the fact that it is no longer in the moment and may bring with it a flood of other memories, either formally or informally connected in some measure to that single event, causing a montage of distorted images to simultaneously appear and which may conspire to frighten us near to death.
This is how memory operates and what causes it to form the backdrop of each and every of our dreams, our reminisces and our greatest fears. In sum, along with Spinoza’s revolutionary discovery that memory contains no element of chronology; when it occurs, as it does without conscious bidding, it is always in the now, and it never produces an isolated reminiscence, it comes as a flurry of blurred happenstance. Every single event becomes concatenated with any other that may even slightly resemble it in its details. This is the subject matter of that never-ending chatter which goes on endlessly in our silent self-world. These are the thoughts which keep people awake at night and appear unbidden from seemingly out of nowhere at any time as daydreams.
Memory is completely asynchronous. It has no past or future, only an unrelenting present and presence. It has no beginning and will not end on its own, any finality to its control over our individual psyches, depends entirely on each of our own individual recognitions of its power over our lives. Once the source has been identified steps can be taken to wrest control away from the debilitating emotion and to replace it with its equal and opposite positive emotion.
In a word, then, it is this faculty of memory and its associated timelessness and reoccurring potency, which lies at the heart of all psychological malaise–whether the simple day-mare or nightmare, or all the way to the inescapable and mind destroying presence of neurosis and psychosis in people’s lives.
Once this unparalleled discovery of Spinoza’s is fully digested, the magnitude of the impact and potential for advance in psychiatric practice and more to the point, in patient recovery, can begin to come clear. No more will patients be deluded into thinking that their mental trauma has been induced by some subterranean subconscious demon or uncontrollable chemical imbalance in the brain.
Once they can be told and helped to see that everything which haunts their daytime and nighttime reveries and dreams is actually a congealed and out of time reproduction of events and scenes from their own lives, a peace of mind can begin to become accessible to them. Not only that but a new horizon for the hope of recovery and a return to normalcy will be revealed.
Now we can advance to a Spinozan assessment and treatment regimen.
A repeatable and reproduce-able normal psychological pattern and mental health profile would be sketched from the reveries, current dream sequences, and future anxieties of a suitable cadre of volunteers and ultimately drawn into a baseline or matrix of what can be termed a normal tracing or memoretic profile of normalcy.
No matter what form may eventually become the usable matrix, it must and will contain two elements, as follows.
(i) Positioning the event with respect to time: The proposed x,y,z axes should represent time as either past present or future with finer gradations to demarcate; recent past, immediate present, near future. The need for finer gradations in the time scale will come into play as the collection of reminiscences accumulate and call for accuracy in placement in time and intensity of a recurring disturbance.
(ii) Calibrating the event with respect to characterization of the emotional trigger: Was/is the effect positive, negative [pain], or neutral [no significant impact]?
Each individual matrix would comprise a montage of non-sequential events. Each fragment of which would be traceable only by the volunteer whose remembrance was recorded, into a readily discernible memory from past life. Only now in the dreamscape or reverie it would have become distorted and in the main would resemble taking a comic bus-ride through a harmless Fellini dreamscape. The harmlessness in this dreamscape refers only to participants in the exercise who are not, by definition, not currently living under any psychological distress. This typing of dreamscapes from the merely comic to the symptomatically distressing will serve as a baseline for placing any patients experiences on a similar scale.
Now picture this clinical setting. The physician and patient have worked closely together for nearly two months slowly compiling data on the subject matter of the dreams and daytime reveries which have been causing troublesome emotional trauma. They have recorded and listed the number, frequency and time element involved in each event, as accurately as possible, they have dissected each event to separate out the harmless dross cohabiting among the truly disturbing remembrances.
At this juncture they will convert these data points into a chart. This visual representation of the distress points, their timing, their past or present or anticipation in future time, along with the level and type of emotional reaction in the patient’s mind, will by then, have been charted by the psychiatrist’s assistant.
Together, the psychiatrist and patient will review the data and compare what has been plotted to ensure its accuracy. Now the psychiatrist’s expertise will be brought to bear on teasing out the precise (or as nearly as possible) event, emotional reaction and location in time, which will allow the patient and psychiatrist to drill down to identify the traumatic event which triggered the psychological discomfort.
From there the two will draw up a treatment plan applying the employment of combination of Cognitive Behavior Therapy (CBT), Rational Emotive Behavior Therapy (REBT), hypnotism and/or pharmaceutical support required to relieve the pressure and stress in the patient’s life.
Here are some sample charts.
Spinoza’s grasp of the nature and functional operation of human psychology is not an abstract theory. Its uniqueness lies in the fact that it is an accurate representation of real-time human experience. It must be experienced to be understood not as an intellectual reckoning but rather as an active identification with what Spinoza describes and the actual workings of every human psychological profile. It was as true in the year 1650 as it remains in 2019. And the key to mental health and psychological maturity also remains the same. It sounds remarkable at first but is quite simple; understanding melts away confusion and self-doubt.
Critical to any success with this type of assessment, the patient must play the lead role. Only the individual can accurately recall, capture and dissect the components of any individual reminiscence.
An individual must be made aware that the one and only key to any recovery from mental distress is understanding. Once the process of memory formation is understood and that the patient is the only one who can reconstruct the past and disentangle memories from concern about the future the system can be put into operation and a regimen can be organized. True, the patient cannot perform this task alone. The skilled and experienced clinician will always be an active and equal partner, but, and this is the crux of the entire memory process, it is understanding that your fate and mental health are in your own hands and that understanding the cause of your distress is the key to overcoming the pain of the affliction which will pave the way to a completely new approach to treatment and recovery from mental affliction.
And here is a sample treatment plan.
Together with the mind-mapping exercise I’ve described above, a metric would be developed for the individuals under observation for this baseline data.
This metric would involve plotting onto an x, y, z set of axes, the three factors of time of occurrence, along with the place and people involved, along with a third axis somehow capsulizing the content of the memory.
Once the quantity of data can be resolved into a usable matrix, this process would shift into the first stage of a consultation with an actual patient.
After the x-y-z diagram was plotted for the prospective patient and points of intersection and convergence are identified, the next step would ensue.
A scale would be mapped out to designate the level of self-doubt and image problems, if any, plus other psychological disturbances which could be associated with these dream sequences or memory sequences.
Most important in all of this measurement and analysis, a tutorial which would outline precisely how memory, with its timelessness and seemingly “forever” presence before the minds-eye accounts for the majority of disquiet in our lives would be presented to the patient. This briefing would provide the platform for analysis. From there, a regimen would be developed, which would deconstruct and compartmentalize the dream, along with reinforcing for the patient, the nature and relative harmlessness of the reminiscence, to make this affect lessen its daily impact until it would completely dissipate over time.
From there, the originally developed normal tracing template would be plotted on an ascending and descending scale of potential disturbance. This scale would then be employed as a sounding board and resonator which would then be compared on an ascending level of associated trauma to the memories and dreamscapes of someone afflicted with any given form of mental disturbance.
Once developed and replicated with the requisite number of individual mappings, this work will culminate in the production of a workable template for assessment and treatment. At the very least it might be deployed as a tool for teaching basic human psychology.
An extremely challenging element in the development of any assessment tool modeled on Spinozan philosophical psychology is that Spinoza’s philosophy does not tolerate the use of any generalizations or abstractions. This means that no matter how many individuals memories and reminiscences and future concerns are captured as part of the study, none of the data will be formulated into any generalization such as, “patients in general, seem to have a greater fear of the past as opposed to future concerns.” And there will absolutely no statistical analysis to determine means or averages. The information gathered will be gathered one person at a time, analyzed individually and any ensuing treatment devised from this study will be administered one person at a time.
This grouping of dreamscapes garnered from volunteers’ memories together with a concomitant table of the emotional profiles which instigated and which will serve to transliterate them, will inform a new approach to the interpretation of the meaning and causality of memories and imaginings and how these and the time scale which accompanies them, either from the past, in the present or anticipated in the future, will serve to place form and shape to mental disturbances.
What I’ve presented here is the sketch of a Spinozan alternative to contemporary psychiatric practice that is intended to assist practicing psychiatrists in beginning to understand and then develop a new profile and paradigm for the treatment of a wide variety of mental afflictions and psychological disorders.
As a sketch, and not in any way a treatise, it is intended to serve only as a Spinozan prompt for all the further detailed critical analyses and wide-ranging dialogues that need to happen if substantial progress is to be made towards improving clinical interventions in current psychiatry, and the eventual creation of a radically enlightened psychiatry.
[i] See, e.g., J. Israel, Radical Enlightenment: Philosophy and the Making of Modernity 1650-1750 (Oxford: Oxford Univ. Press, 2001).
[ii] A. Damasio, Looking for Spinoza: Joy, Sorrow, and the Feeling Brain (Orlando, FL: Harvest/Harcourt, 2003).
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