Thursday, November 17, 2005

Can you lobotomize the soul?

Accompanying this post is the image of a Holocaust survivor holding the photo of Dr. Josef Mengele, who is the symbol of the physician torturer for all victims of psychological torture throughout the world. (See "A Letter From a Condemned Man" and "Terry Tuchin, Diana Riccioli, and New Jersey's Agency of Torture.")

This essay is "for" Terry and Diana.

The short answer to this question is "yes." It is possible to lobotomize the soul, and in more ways than one. For example, by becoming an adherent of "scientism" (which is a kind of ideology and not science at all) and/or a much-dreaded "behaviorist." Anyway, the soul does not exist according to many scientists, so there is no need to worry. I like to think of believers in scientism as the "flat earth society" of the scientific community.

One may abandon one's humanity and see others only as animals in an environment. This will make it easier to do terrible things to them "for their own good." The category mistake involved in searching for the mind (as distinct from the brain) and seeking to repair it, in strictly anatomical ways and without bothering to consult the persons involved, results from a failure to appreciate what the mind is and the ways in which it differs -- both conceptually and necessarily -- from the brain to which it is linked. The mind exists "in society," linguistically and culturally, not just neurochemically, "in the brain."

Wishes, fears, desires do not have a physical location in the brain -- although cerebral processes linked to such subjective states do have locations and can be mapped -- because desires and fantasies, wishes and hopes are "conceptual entities." By the same token, melancholy, sadness, yearning, emotional suffering and many other subjective states emerge only socially, from our relations with other people and are defined culturally, only then do they become amenable to objective analysis and examination. Any real meaning or recovery from emotional suffering will have to be social too. Colin McGinn summarizes the point better than I can:

Even to ask for [the mind's] spatial properties is to commit some sort of category mistake, analogous to asking for the spatial properties of numbers. [Consciousness] seems not to be the kind of thing that falls under spatial predicates. It falls under temporal predicates and it can obviously be described in other ways -- by specifying its owner, its intentional content, its phenomenal character -- but it resists being cast as a regular inhabitant of the space we see around us and within which the material world has its existence. Spatial occupancy is not (at least on the face of it) the mind's preferred mode of being.

I know that this is difficult because we are accustomed to thinking atomistically and reductively. So let us try another approach.

Emotions cannot be removed surgically with the extraction of a portion of the brain, unless we simply erase the person as a subject entirely, by eradicating the organic basis of consciousness. If you anesthetize someone, then you may be sure that the person will not suffer from depression while unconscious. Murder also works in this regard. A dead person tends to have few emotional problems or unpleasant memories. To the extent that a person is capable of human subjectivity or experience at all, emotional states or "conditions of affect" (feeling states) will arise, which are connected to "being-in-the-world-with-others." (Heidegger, Sartre, Laing.)

Writing in the New York Times, November 16, 2005, at p. E5, Charles McGrath comments on the popularity of lobotomy as a treatment for mental illness up to the mid-sixties:

Dr. Walter J. Freeman, a central figure in "My Lobotomy," a radio documentary that will be broadcast this afternoon on the National Public Radio Program "All Things Considered," believed that the source of many mental disturbances was the Thalamus, in which overabundant emotions tended to congregate. The solution, in his view, was simply to sever that part of the brain from the frontal lobes. ...

Well, for Descartes, it was the pineal gland that we had to worry about. The error is similar in both men's thinking: it is the assumption that mental realities, "qualia," have physical locations, like the cerebral functions which make them possible, which do have physical locations.

For medieval theologians, similarly, madness was the result of demons invading the mind and could be removed by exorcism. Incidentally, their success rate was about the same, probably, and maybe better than that of American lobotomists in the twentieth century, who were mystified by the dearth of long term "fortunate outcomes."

In many instances, tragically, patients who underwent a lobotomy emerged as human vegetables. Today, chemical lobotomy is on roughly the same level of incompetence and absurdity. No medication will alleviate my existential worries. Thank goodness. Behaviorist methods that seek to impose emotional states or outcomes upon persons, externally, often against their will, are also forms of legalized torture, with equally horrendous results. Often the tortures are illegal and done secretly, or not reported in institutions or in society, where persons are selected for such horrors based on how "interesting" they are to state torturers. These crimes are then covered-up by judges and politicians.

In one society that classified homosexuality as a form of "insanity," behaviorist psychologists developed a method of treatment in institutions that involved showing gay men films of desirable naked women, but the practice was halted when the gay men (the "patients") were found having sex while the lights were out. The scientists regarded the experiment as only a "partial success." (See the film "Improper Conduct.") The gay men thought much more highly of it and were quite willing to continue the experiment. You cannot "condition" happiness into people based on values external to them.

... lobotomy now seems like a medically sanctioned form of torture. The main theory behind it was that anxiety and agitation could be quelled by severing the emotional center of the brain from the part that controls the intellect, but the evidence to support this idea was [and remains] meager. ...

Allison Xantha Miller, "Better Living Through Lobotomy," Stay Free (Psychology Issue), Fall, 2003, at pp. 13-14.

In his book Great and Desperate Cures; The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness (Basic Books, 1986), Professor Elliot S. Valentstein states: "Even a surgeon who seldom obtained good results rarely gave up lobotomy." It is difficult for scientists and physicians to recognize their philosophical errors in the absence of any philosophical education that would allow them to do so, with the consequence that patients suffered and sometimes died. They still do. Here is Colin McGinn again:

Considered in themselves, intrinsically, we do not regard mental events as having location. The imprecision of our locational judgments here is a mark of this. Second, to allow that consciousness can be roughly located is not to grant it the full panoply of spatial predications. We still do not get predications of shape, size, dimensionality and so on. And this shows that such spatiality as we do allow to mental matters is of a second-class and derivative nature.

One would think that a person claiming expertise in the understanding of human subjectivity would take some interest in the products of that subjectivity -- like philosophy, literature, music and the other arts, but many scientists are too busy playing with rats in their laboratories to be bothered with such trivia. One psychoanalyst-torturer asked me, in all seriousness: "Kierkegaard, who's that?"

As for humility and a willingness to admit errors, these things are lost by doctors before their third year in medical school. Humility training should be available to physicians, lawyers, judges and politicians (maybe to all of us) for life. Perhaps we might be shown films of attractive naked people. It couldn't hurt. Here is what genius in the understanding of people looks like:

We all know from our personal experience that we can be ourselves only in and through our world and there is a sense in which "our" world will die with us although "the" world will go on without us. Only existential thought has attempted to match the original experience of oneself in relationship to others in one's world by a term that adequately reflects this totality. Thus, existentially, the concretum is seen as man's EXISTENCE, his BEING-IN-THE-WORLD. Unless we begin with the concept of man in relation to other men and from the beginning "in" a world, and unless we realize that man does not exist without "his" world nor can his world exist without him, we are condemned to start our study of schizoid and schizophrenic people with a verbal and conceptual splitting that matches the split up of the totality of the schizoid being-in-the-world.

R.D. Laing, The Divided Self (London: Tavistock, 1960), p. 19. Do not, Laing insists, neglect to see the impact that you (as a therapist) are having on the dynamics of the subject's relations and relating capacity. Above all, Laing cautions, do not seek to serve two masters and do no harm.

If you wish to understand or communicate with another human being, then do not turn that person, man or woman, into a reified category, into a "patient," "subject," or "file number 4768." Do not reduce him or her to the contents of a police report or to your professional jargon or some trendy jargon, but open yourself up to the subjectivity of another experiencing agent, who is in pain and mortal just as you are. If you succeed in seeing, really seeing him or her, then you will also be seeing yourself. Is that possibility of seeing yourself, in all of your comical ludicrousness and mediocrity, as a therapist, what frightens therapists? ("Errors" were inserted in this last sentence since my last reading of it, which are not found in my printed copy of this work.)

Actors and all artists are the "master intelligencers" (George Steiner) in this regard. They teach us to see ourselves by "enacting" for us, the sometimes tragic comedies (think of the etymology of the word "comedy") in which we are all players. In our century, God is a Samuel Beckett-like ironist, savoring ambiguity. The goal of genuine actors is to allow us, through their performances, to see ourselves. This art requires great talent, but it also demands enormous courage from its best practioners. Actors and all artists demand that we look at ourselves, by showing us the truths of what we are. Every great actor is a magnificent therapist.

Maybe, it is this "seeing" -- taking a good look at ourselves -- that is the most frightening possibility of all for physicians ... or for any of us.

Labels: ,


Post a Comment

Links to this post:

Create a Link

<< Home