This paper is interesting and ramifying for many issues we have discussed in this thread. Short enough to be posted as a whole. Suggestive enough to call for further research into the sources cited by the author, including his own.
"Confronting psychiatry’s occult ontology: A proposal for a new framework"
Louis S. Berger
Presented May 6, 2012 at the Twenty-fourth Annual Meeting of the Association for the Advancement of Philosophy & Psychiatry, Philadelphia, PA.
Abstract
All fields have their underlying ontologies. Usually they are swept under the rug because basically they are untenable – paradoxical, inconsistent, essentially incoherent and untenable. Mathematics is a prime example. When working, the typical mathematician is an informal Platonist, even though these days few take this view seriously. For mathematicians it is a useful fiction. But because it is widely seen as untenable, when others ask her about the nature of her beliefs about the discipline’s subject matter, she has to find a scientifically respectable response. So, she may say that she is a formalist, or a constructivist, and so on. This situation is paralleled in psychiatry. The field’s very label refers to the psyche and its healing, and that creates a nasty problem. For centuries, respectable scientific thought officially has banished the mental domain. So, if psychiatry is to be acceptably scientific, it cannot afford to admit that it is a Cartesian discipline. Yet, its object of study is the mind; psychiatrists continually refer to mental health and illness, mental disorders, concepts, thoughts, wishes, feelings, ideas, and so on. Typically, this conundrum is made to disappear from view by one or both of two strategies: either mind becomes brain and respectably physicalistic, or psychology is brought into the picture and supposedly integrated with the physical, resulting in what superficially looks like a scientifically acceptable nondual, non-Cartesian framework that does properly take account of the mental domain. I will not attempt to defend this judgment, but I think it is easy to show that both of these alternatives retain the essentials of Cartesianism. The severe problems and all too often noxious consequences that arise when one’s world view, one’s being in the world, is steeped in this dualism have been explored and debated in numerous contexts for centuries. I will insist that although they may be difficult to see, these costs are real; their extent depends on the particular context and application. For today I will take it for granted that the costs of operating within a Cartesian dualism are particularly high for psychiatry. And that is what motivates the search for a truly non-Cartesian kind of foundation for the field. Given the nature of the problem, it seems reasonable to assume that a radical approach is needed. A counterintuitive, unorthodox, ontogenetically-grounded, nondual ontology is proposed as the candidate. It draws heavily on elements of Margaret Mahler’s thinking about separation-individuation in early development – in particular, on her linked conceptions of normal infant autism and the “psychological birth of the human child” or “hatching”. Her work, suitably modified and extended, contributes greatly to this framework. The most striking feature of the result is a radical reconceptualization of what language is and does that incorporates ineffability (introduced via ontogenesis). The effects of this unconventional perception of language together with its accompanying worldview can be profound and far-reaching – for disciplines in general, and for psychiatry specifically. Although linguistic issues have been studied in a psychiatric context, the framework has been the conventional, dualist-formalist “received view” of language, and that necessarily restricted the range of possible outcomes.
What is proposed here is not another similar conventional examination of conventional linguistic issues (e.g., operationalization, terminological precision, meaning/sense dichotomy, categorization, nominalism, value terms) but an exploration of psychiatry’s ground via an ontogenetically informed and oriented consideration of the “ontology of language problem”. The outcome opens up previouslyf oreclosed, inaccessible vistas and possibilities for achieving profound shifts in perspective and focus. A fresh reexamination of psychiatry’s (and the cognate fields’) conceptions of its “objects” of study and treatment becomes possible; the kinds of topics exemplified in the “Call for Abstracts” listing of modeling problems can be seen in a new light.
In order to be seen as scientifically respectable and acceptable, most fields and professions cannot afford to let their true philosophical foundations come clearly into view. Mathematics is a prime example. In her daily work the typical mathematician is a casual Platonist, but when outsiders ask about the foundations of her field, she can’t admit that embarrassment, and so she claims to be a formalist or constructivist. Physics is another example. It must claim to be grounded in a respectable physicalist monism when in fact it is patently Cartesian, dualistic. Much the same can be said of psychiatry. It can ignore its actual Cartesian ground, or deny it in various ways. But the foundation remains, and is mightily at work, and although it is far from obvious, I am nevertheless convinced that many if not most of the field’s ills stem from that dichotomous, incoherent underpinning that thephilosopher of deep ecology, Freya Mathews, calls the atomistic arch-metaphysics of the substance-pluralism archetype of disconnectedness.
Psychiatry needs to find an alternative, but history says that will not be easy.Critiques and searches started already during Descartes’ lifetime and have continued ever since, but no acceptable alternative has emerged. This raises an important but rarely asked question: why is that? Why these chronic failures? To a significant extent it is because the consensus is that any respectable alternative must conform to the usual scientific and philosophical criteria. It must be systematic, rational, logically coherent, and so on. As early as 1978 I began arguing that these criteria raised major problems in certain fields. My first psychoanalytically-informed publication was entitled “the innate constraints of formal theories”. It used the vehicle of what I call state process formalism analysis to argue that conforming to these constraints restricts theories to those that are suitable only for use in the inanimate realm. Therefore fields such as psychiatry need to base their thinking and working on frameworks that conform to less restrictive criteria. The current version overtly incorporates and uses profoundly arational, alogical, aformalistic components or elements, derived from one particular version of ontogenesis, Margaret Mahler’s so-called separation-individuation model of individual human development. I use two of its assumptions, both about very early childhood.
One is about the infant’s state during the first few postnatal months, and the other about the child’s evolution out of that state, the uncanny phenomenon Mahler calls hatching or the psychological birth of the human being. The crucial feature I attributeto both is that they are assumed to be ineffable in principle. That is, neither phenomenon can or should be explained rationally, although of course its external manifestations can be modeled. I believe that by incorporating arationality the resulting framework can avoid some of Cartesianism’s costs; but that is also why it is likely to seem alien and implausible. Since the two Mahlerian premises are so central, let me say a bit more about each. The assumption about the newborn’s initial state challenges the findings of numerous mainstream empirical studies that the newborn is the so-called “competent infant” who already cognizes in all sorts of observable ways. I have argued elsewhere against this belief in some detail on the basis that it comes from questionable interpretations of the data. I want to be very clear, though. I am not claiming that during this first era the infant has no experiences, but only that we do not know and in principle cannot ever know or even imagine what it would be like to be a newborn. We can model the infant’s behaviors, but there is no conceivable way to find out “What is it like to be a neonate” – the human analogue of Thomas Nagel’s famous poser about bats. I submit that the neonate’s way of being in the world is and must remain enigmatic.
Now to hatching. If we assume that the initial postnatal state is ineffable, then we cannot legitimately explain the products of hatching in terms of some mechanism or faculty that already is present. Take the infant’s beginning to acquire language. It is a phenomenon that in my scheme of things is crucial but also totally inexplicable. Under the first assumption no formalized model such as Chomsky’s learning acquisition device can explain the mysterious shift that the philosopher Charles Taylor calls the child’s entry into the linguistic dimension.
So, what does this framework tell us? A couple of things. If everything in our experience precipitates or congeals inexplicably out of an inexplicable initial state, then everything about our way of being in the world -- and I do mean everything – is derivative, secondary, a crystallization out of a mystery. In that sense, then, our usual, consensual, common-sense view of ourselves as separate beings living in an external world is an illusion, something that many scholars and sages have been trying to tell us for thousands of years in numerous ways and in various contexts. However, their conceptions have rested on notions that were mysterious and foreign to our experience. Leibniz’s monads, Heidegger’s fourfold, and the failure of locality in quantum theory may be good examples. In contrast, this conceptualization of a nondual world rests on assumptions about early individual human development, a phenomenon that surely is commonplace and familiar. The assumptions may be outlandish, but we all have first-hand experience with infancy, as spectators as well asparticipants. This conception of nonduality should therefore be less alien, more palatable than its predecessors.
It seems reasonable to infer from this common origin that all the derivatives, all the logical and individual substances that we normally think of and take as ontologically autonomous, actually are tacitly intertwined and remain so throughout one’s life, at least to some unknown extent – another important implication. The dominant thing about this framework, then, is that it calls into question just about everything that we think we know for sure, understand, believe, perceive. So, in one sense it, like any other via negativa, doesn’t tell us very much. However, in this case its grounding can suggest a very great deal indirectly. A productive way to see this is to look more closely at language, the hinge on which virtually everything turns. By highlighting the problem of first language acquisition, this nondual framework invites us to raise what the philosopher Frederick Olafson calls the ontology of language question. By this novel ontogenetic route we come to challenge the usual but also usually tacit, informal constellation of beliefs that professor John Ellis calls our received or default view. Olafson tells us that this view takes for granted that language use is an overt and observable function of the human organism and thus takes its place unproblematically within the same natural milieu as all the other processes with which the sciences are concerned.... It tends to be simply assumed that language, particularly its distinctive semanticand referential functions, presents no special problem for a naturalistic account of human nature.... Through an effective separation of language from its users and their distinctive mode of being in the world, all questions about the ontological status of language itself may be elided and even never raised at all.
This framework suggests that under its veneer language is not the autonomous semiotic system that it seems to be; it is not referential, not semantic, not grammatical, not a pragmatic tool – and not separable. I have tried to show elsewhere just how radical and far-ranging the effects of this unconventional view can be. What Heidegger says in general about this kind of a shift is that once we have moved into this new relation to language all is the same and yet all is different. Superficially the language might look the same, but now instead of implying a world of discreteness, of particulars and absolutes, the new language relation gives us a world whose character is to evade capture. Drastic consequences follow for any discipline or field, as I have tried to show elsewhere. Called into question are not only a field’s referents, that is, its objects of study, but also the very nature of anything else in the field that is involved with or dependent on language – and that includes just about everything. What about psychiatry? Here the new view of language can raise suspicions not only about, say, a particular nosology and its ingredients, or a particular technical concept, or a particular conception of therapy, but also about the very acts of observing, naming, classifying, referring, or conceptualizing. We enter a reflexively paradoxical, vertiginous, labyrinthine world where nothing will stand still. The implications are virtually endless and mind-boggling. I want to mention one important example: mental health and pathology.
Some, myself included, now reconceptualize pathology in terms of the basic disease of our civilization that the philosopher and Eastern scholar Alan Watts describes as our having “too much of a good thing. He says we confuse the marvelous facility of description with what is actually going on, we confuse the world as labeled and classified with the world as it is.” I now call it the Abstraction Madness. Heidegger warned us endlessly about the dangers of rational-technological, mechanizing thinking. Alfred Korzybski told us famously that the map isn’t the territory. Now this framework tells us that even the territory isn’t the territory. I have argued elsewhere that this disease of confusion is responsible for the terminally catastrophic psychological as well as physical depersonalized, fractionated wasteland in which we find ourselves. Although I cannot go into it here, I have argued that this pathology is interlocked with our received view of language and the way of being that it brings with it. We no longer know how to be in the world without constantly, unwittingly, automatically abstracting, paradoxically self-reflecting, talking to ourselves– in Heidegger’s term: chattering. At any rate, under this new perspective, health can be conceptualized as the absence of the abstraction madness, this destructive, gratuitous confusion between abstraction and reality. It means living in a nonfragmented world. Although his focus was quite different, the linguist Walter Ong unwittingly came close to conceptualizing such a state in hypothesizing what he labels as the state of primary or pristine orality. It is the state of a culture that is totally oblivious of literacy, still unaware of even the possibility there could be reading, writing, symbolizing. By the way, it is interesting that almost all of his peers either rejected, ridiculed, trivialized, or ignored his offering. Ong argues convincingly that for us such a state would be exceedingly alien, scarcely imaginable to us who have a 6- or 7-thousand year tradition of swimming in literacy. Try to imagine even just a culture where the expression ‘to look up something’ is meaningless, where there are no dictionaries, textbooks, clocks, calendars, sciences, grammars, signs, maps – and that’s just the beginning. Primary orality would be a very strange state indeed; I see it as faintly echoing the pre-hatched infant’s ineffable state. I am aware of one culture whose way of life seems to come close to exemplifying Ong’s vision of primary orality: the Pirahã, a small Amazon tribe that has been studied extensively for decades by the linguist Dan Everett. If one is open to it, then reading between the lines of Everett’s report one can see manifestations of what he and certain other linguists could not see because of what the French call professional deformation: they could not see evidence of a culture whose way of being in theworld comes close to being the state of primary orality. (Being the kind of linguist he is, the main thing that excited Everett was the discovery that the Pirahã languageseemed to lack recursion – a matter of great interest if one is interested in finding weaknesses in Noam Chomsky’s theorizing.) Read in this way, the implications of his report are staggering. I think that the Pirahãs’ integrated, minimally abstracting, close to nondual ways of being in the world have much to teach psychiatry, including suggestions for wonderfully sane, effective, unsentimental child-raising practices.
1. Mathews, F. For the Love of Matter.
Albany, NY: SUNY, 2003.
2.Berger, L. S. “Innate Constraints of Formal Theories.”
Psychoanalysis and Contemporary Thought
1,no. 1 (1978): 89-117.
3. Mahler, M.S., Pine, F. and Bergman, A.
The Psychological Birth of the Human Infant: Symbiosis andIndividuation.
Boston, MA: Beacon Press, 1964.
4. Taylor, C.
Philosophical Arguments.
Cambridge, MA: Harvard University Press, 1995, 79-99.
5. Olafson, F.
What is a Human Being? A Heideggerian View.
New York: Cambridge University Press,1995, 47, 49, 125.
6. Berger, L. S.
Language and the Ineffable: A Developmental Perspective and Its Applications.
Lexington Books, 2011;
Humanity’s Madness: Consequences of Becoming Literate.
Createspace,2011..
7. Berger, Language.
8. Watts, A. W.
Does it Matter? Essays on Man’s Relation to Materiality.
NY: Vintage Books, 1971, xii.
9. Berger, Madness.
10. Ong, W. Ong, Walter.
Orality and Literacy.
New York: Routledge, 1982.
11. Everett, D. L.
Don't Sleep, There Are Snakes: Life and Language in the Amazonian Jungle.
NY. Pantheon Books, 2008.
12. Watts, A. W.
The Wisdom of Insecurity: A Message for an Age of Anxiety.
NY.: Vintage Books, 1951,75.