Summry

It is very important for psychiatry to state clearly what is “science” and what is “philosophy”. This seems to be the only way to prevent non-scientific leakages into psychiatry from closely related fields like mainly psychotherapy but also human sciences, philosophy, art, religion and other so called “humanities” activities. Philosophy could guide us in our scientific studies as long as we know that we really do it as “philosophy” and we don’t attempt to make it be believed as “science”. Besides contributing to all science branches by determination of “scientific” limits of and by methodology, philosophy has a very special proximity to psychiatry.

Though there is no simple theory in psychiatry and psychology to express emotions, many diagnostic and therapeutic interventions are made in the “psychopathology” field; while efforts are made in order to avoid “doing philosophy” (philosophying) a primitive philosophy and popular views are entered. In the clinical practice, for example, many clinicians effected by the popular concept regard emotions and feelings as produced by sub-cortical structures and put them in opposition to cortical products of cognitive. Thus, by creating an “emotion-logic contradiction” they actually become one of their supporters.

By making use of philosophical critics and resisting popular knowledge, real creators of science choose the way of creating a theory and are trying to extensively investigate what emotions and ideas (thoughts) in reality are.

*Associate Professor, MD, Ankara Research and Educational Hospital, Chief of the 1st Psychiatry Clinic

****This paper was be presented on “Philosophy of Science” session in XXI. World Congress of Philosophy

Conceptual Problems Related to the Psychiatric View of Emotion**

The best way to avoid the criticism and tiring of philosophical knowledge is to act as if it doesn’t exist. That’s why the contribution of philosophers to psychiatry is pretended not to be seen; the reason for this in our community being the negative results that the curiousity for philosophy had brought us in the past. Efforts exist, however, opposite to this neglectance, both all over the world and in our country. Those efforts deal very fastidiously with the probable interactions and intersections between philosophy and psychiatry.

It is very important for psychiatry to state clearly what is “science” and what is “philosophy”. This seems to be the only way to prevent non-scientific leakages into psychiatry from closely related fields like mainly psychotherapy but also human sciences, philosophy, art, religion and other so called “humanities” activities (1). Philosophy could guide us in our scientific studies as long as we know that we really do it as “philosophy” and we don’t attempt to make it be believed as “science”. Besides contributing to all science branches by determination of “scientific” limits of and by methodology, philosophy has a very special proximity to psychiatry (2).

The “emotional” field dwelled upon in this paper is a good example of how philosophy could be a guide for us. Modern psychiatry does not possess nowadays a sound knowledge of the “emotional” field. We know that emotions are rather related to subcortical structures. We have to admit that though many disorders are described and are being treated in the “emotional” field, it is the least known field of psychiatry and has the weakest scientific texture. Even conceptual level problems couldn’t have been solved, not even could they have been recognized by many scientists.

On behalf of science we accept some events to be an “all-or-none” phenomena.

In the “emotional” field of psychiatry the most significant problem arises from the avoidance behaviour against the experience-world which is thought to be empirically undeterminable. There are two ways in science to avoid the experience world: you either behave as if that phenomenon doesn’t exist like the way our professional society behaves against philosophy; or you create an atmosphere where the suggested concepts pretend to explain all experiential phenomena.

The most typical example for the fýrst behaviour is our “state of mind”. We don’t deal in nowadays’ psychiatry with the “state of mind” – the german for this is “befindlichkeit”. Many people in our professional community, however, are sensing the existence of the “state of mind”, but they are not making any efforts to include this term into their vocabulary of scientific concepts, because they don’t have the philosophy concept that emotions in the form of “mood” or “affect” can be related to mentation processes. According to the great German philosopher Heidegger uneasiness, sorrow, joy, fun, fear and anxiety are all affectional inferences of the temperament of the Dasein (existence) and are in general getting experienced as “given”. We are constantly in a “state of mind” according to Heidegger who told us very important things related to the emotional field. That’s why emotions are states emerging within the “state of mind” where we are launched into, rather than being products of our minds. The origin of the “state of mind” comes neither from our inside world, nor from the surrounding outside world; it is the sine qua non style of the Dasein’s “being in the world”. By means of our state of mind we do our adaptation and tuning to the world (self-attunement). Our states of minds and emotions are never produced by the subjective-inside production alone (as it is in the biological approach) or objective-outside effects alone (3).

Another problem in the “emotional” field of psychiatry is the mistake that the used concepts are covering all experiential phenomena which sentence science to shortage of concepts. The same Psychiatry which possesses volumes with knowledge about “depression”, “mania” and clinical states where pathological mood is dominating, is not able to say even few words about community sorrow and intensive pleasure sense arising from erotic excitement, and this pictures our tragic state concerning emotions. Attempts to express the experience of so many “emotional phenomena” as “emotion”, “affect” and “mood” present by no way a careful scientific differentiation of concepts but just a non-scientific wholesaling.

Wouldn’t we got stuck into a professional narcissism and could we have looked carefully to the rich ideas in philosophy, we would both be free of the mistake to regard the “amateur philosophy” we were doing as science and could eventually find in philosophy inspirations for the “emotion” field in the same way as Kierkegaard once did. The philosophical view would have not only supplied us with the ability to benefit from concepts like “state of mind”, which we felt to exist but couldn’t introduce into the scientific field, but also would have evaluate all our concepts which were mostly and simply generalizations resulting from our empirical concerns. This view would make clear the need to differentiate between different emotions provoked by similar states of mind, the same way as Kierkegaard differentiated between “fear” and “anxiety”. It tells us: “what exactly do you mean with anxiety – is it (besorgen) concern; is it (sorge) care -the basis of human existence; or is it (angst) dread – which appears (is felt) in instants where man faces the always avoided truth to be “being running towards death”? Or you mean solicitude (fürsorgen) – which is one of the daily forms of basic anxiety; or worry (besorgnis)?... Philosophers wouldn’t be satisfied with an answer like “we mean by this the things having all those colloquial names” or like we do in the investigations of anxiolytic drugs “some animal reactions observed during trials” – and they would have real concerns about us and about what we are actually doing.

New views

Actually, there are attempts which try to improve this shallowness in the “emotional” field of psychiatry and which could eventually be useful in listening to the critics coming from philosophy. Realizing the poverty of psychiatry in the “emotional” field the famous psychoanalyst Otto Kernberg evaluated emotions and proposed a new model which would eventually be useful in the development of the drive theory, too (4).

According to Kernberg, though being still regarded as a discharge process of instincts – a Freudian habit, affect is actually a bridge between biological instincts and psychic drives. Taking also into consideration the results of the empirical neuropsychological studies carried out in recent years, Kernberg describes affect as “certain cognitive characteristics, certain face shapes; certain rewarding/pleasant or punishing/unpleasant subjective experiences; behavioural stereotypes which include muscular and neurovegetative discharge channels”. According to him, face shapes possessing a certain expression can differentiate between every affect concerning general channels of communication; furthermore, the origin of affects has a cognitive aspect which classifies the stimuli provoking them as “good” or “bad”. Such a characteristic grants the infant the motivation to avoid certain stimuli and to approach others.

One contribution to the emotional field similar to that coming from the psychanalysis is the one coming from Antonio Damasio (5) – a scientist working in the neuropsychology field. Damasio is defending the concept thet human mind’s basic feature is “symbolization”. The magnificent cognitive, memory and judgment activities of man are supplied by the interaction of the neural ignition models of the early sensory cortex. The physiological functions described as “mind” are derivatives not only of the brain but also of a continuing structural and functional integrity between the brain, the body and the environment.

“The previously arranged mechanisms” are important not only for the basic biologic order, but they are also needed by the organism to classify things (objects) as “good” or “bad” in order to survive. “The previously arranged mechanisms” form the biological basis of object relations. But, the description of the objects as “good” or “bad” for the organism to be able to survive is only possible by means of inborn, previously arranged representative neuronal networks or image sources. No doubt that such inborn survival strategies exist in many animal species too, but in humans this function is so complicated that it cannot be performed by the philogenetically old brain, anymore. For humans too, the aim is to insure continuity of biological existence, but within the ethic rules and social traditions this is enriched by the image-based (mental) coordination activity of the new brain (6).

Just like Kernberg, Damasio considers that to differentiate objects as “good” and “bad” is an existential necessity but this is not the only similarity between him and Kernberg. Though using a different conceptualization, he is telling the same things about the functional roles of affects as Kernberg. According to Damasio, for the image production of the mind, the cooperation between the neocortical equipment where rationality is located and the subcortical biological arrangement equipment is mandatory. But for this cooperation a mediator is needed which is nothing else but emotions and senses. Whereas Kernberg considers affects as mediators between biological instincts and psychic drives, Damasio considers them to be mediators between the neo-cortex and the sub-cortex. According to Damasio, because of their unbreakable ties with the body emotions dominate our mental lives. It is because the brain is the passive spectator of the body, that the emotions are the victorious part.

Result

Though there is no simple theory in psychiatry and psychology to express emotions, many diagnostic and therapeutic interventions are made in the “psychopathology” field; while efforts are made in order to avoid “doing philosophy” (philosophying) a primitive philosophy and popular views are entered. In the clinical practice, for example, many clinicians effected by the popular concept regard emotions and feelings as produced by subcortical structures and put them in opposition to cortical products of mentation. Thus, by creating an “emotion-logic contradiction” they actually become one of their supporters.

By making use of philosophical critics and resisting popular knowledge real creators of science like Kernberg and Damasio choose the way of creating a theory and are trying to extensively investigate what emotions and ideas in reality are. Their ideas which were in harmony with the newly developed trend in philosophy against Descartesianism (7,8) seem to be candidates for both the improvement of the shalloweness of our view regarding “emotion” and for the contribution to our understanding of psychopathology and the way we treat psychotherapy. Ýf we want to overcome the present situation we’re in and to avoid its tranformation into a tragedy, we have to immediately listen to the new voices and to think extensively about the issue of scientific methods.

References

1. Göka E. (1999) Bilimlerin Vicdaný Psikiyatri. Ankara, Ütopya Yayýnlarý.

2. Kaufmann W. (1997) Ýnsaný Anlama(ma)k. 2.cilt. Yardýmlý A. Çeviren. Ýstanbul, Ýdea yayýnlarý, s.31

3. Heidegger M. (1962) Being and Time. Macquarrie J, Robinson E. Çevirenler. Oxford, Basic Blackwell, s.172-182.

4. Ardalý C, Erten Y. (1999) Psikanalizden Dinamik Psikoterapilere. Ýstanbul, Alfa Yayýnlarý, s.102-106.

5. Damasio A. (1999) Descartes’in Yanýlgýsý. Ýstanbul, Varlýk Yayýnlarý, s.91-165.

6. Göka E. (1999) Bir semptom florasý ve dil olarak beden. Türkiye Klinikleri Psikiyatri Dergisi. (baskýda)

7. De Sousa R. (1991) The Rationality of Emotion. Cambridge, MA: MIT Press.

8. Johnson-Laird PN, Oatley K. (1992) Basic emotions, rationality, and folk theory. Cognition and Emotion 6:201-223.