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Internship Report_Somatoform Disorders

The Mind-Body Problem in Psychology_Somatoform Disorders

Internship Paper

Hadeel Naeem

5/27/2012

Philosophy Research and Use Seminar PHIL499

 

The mind is what controls the mental processes, thought and consciousness and it is non-physical. The body is physical and has different structural complexities. We can see well enough that these two, components of self, interact with one another almost all the time. Now a bundle of questions comprises the mind-body debate. Is the mind and the body different components of self or are they one? Is the mind in charge of the body or the body in charge of the mind? How does a relationship of interaction develop between something physical and something non-physical? The basic question, however, is if the body and mind are one or two different components and this question is going to be discussed further in the light of philosophical and psychological investigations over the years and my experience at the Internship.

Different philosophers have given different and similar responses to the mind-body problem. The first viewpoint is Dualism, which means that mind and body are definitely different entities that perform different functions. The mind does the reasoning and thinking and the body does the movement. Within this branch there is a view that mind and body affect each other but there is also one that says mind and body do not interact at all. There are those that think mind controls the body and those too that believe matter has a stronger position. Descartes thought the soul could affect the pineal gland which made the brain work for movement and other material responses.[1]

The other popular view is that mind and body are not two entities but one is reducible to the other; this is known as Monism. For instance, George Berkeley thought matter could never be. Matter was only our perception of it in our minds. Hence everything is immaterial and in our thought. This view supports that there is no body, there is only mind; this is also called phenomenalism.  The contrasting view is of Materialists who believe everything is material and human beings are just very complex physiological beings.

In the light of psychology, we can consider the body as the brain that is made up of different types of neurons, junctions, chemicals, etc. Now thinking is a mental procedure but it can cause behavior. We can see that a thought that comes to our mind can make us move in a particular direction or produce a physical activity. But then there is a class of psychologists who call themselves behaviorists and believe that psychologists should concern themselves with behaviors, or stimulus and response. Their argument is that the study of mind is not observable, hence, not scientific. The radical behaviorists think mind does not even exist. They think thoughts and consciousness can be explained by physical phenomena. The argument they give for their stance is that different processes like depression that could be taken as mind’s work are actually imbalances of the brain chemicals. Therefore there is no such thing as a mind, there is only a brain that needs to be studied more deeply to explain thoughts, consciousness, ideas, etc. Hence a behaviorist is a Monist who believes in the physical world and not the non-physical.[2]

Humanists hold a belief that opposes the behavioral viewpoint.  They think that reality is not objective and cannot be studied behaviorally. Every human goes through different experiences and has a different soul which holds that a physical study will not help us much because there are subjective realities that are in different minds. Had reality been physical and objective it would have been easy to come to because matter is same in every human. However, the response is always different and it accounts for something non-physical.[3]

Wilhelm Griesinger believed that mental illness is a disease of the brain. This view was not very popular in his time and the argument he gave for it is that there is a character called the psychological tonus  and it is derived from a psychic reflex action. This reflex action is the result of a stimulus which is made of a person’s life experience. Mental illness occurred, for Wilhelm, only when the psychic reflex action failed to work properly. This could lead to mania and to depression. [4]

Henry Maudsley, an English Pysciatrist held the same view and gave a different argument for his belief. Maudsley said the explanation, when it comes, will not come from the mental, but from the physical side.[5] He called mind the sum of thought, feeling, and will. Maudsley  guessed that there might by undulations, of molecular origin, in the brain which would be responsible for consciousness.[6] Maudsley refutes the dualistic point of views in his book and says:

Consciousness, a crucial factor in the argument, is not coextensive with mind since it does not give any account of a large and important part of our mental activity; the unconscious action of the mind is now established beyond all rational doubt. It is the essential process on which thinking depends, and it has its basis in the organic life of the brain.[7]

Looking at the dualistic side of this debate, we have Ernst von Feuchtersleben who thought  physicians had the most occasion to see the importance of mind and to believe that matter always perishes sooner or later.[8]

Men have always recognized something which is termed spirit as distinct from body. The facts of consciousness, as well as those higher manifestations of the mind; its relation to the Good, the True and the Beautiful; the law of duty; the belief in something more exalted than that which is earthly, existed, and that in their fairest form, long before the thought was conceived of seeking the source of such wonderful effects on the organization of the human frame.[9]

Ernst gave an argument that can be put this way. Even though we know the what protoplasm is made of, we know the chemicals and their quantities, but we still cannot produce life. Life is the spirit or the mind that matter cannot explain. Ernst spoke of a spirit that causes the body to animate and that spirit or mind is what controls the body.

A new direction for this debate suggests that humans are like computers. The hardware is the brain and the software is the mind. The difference in the software accounts for the difference in response to the same stimulus. This is similar to the type of Dualism that Descartes believed in. It is widely known as Interactionism, which means that the mind and body affect each other at different times. Neither one is dominant over the other, rather it goes both ways.[10]

Table 1 shows the different patients I observed in the hospital for my Internship experience. The most common complaints have been of depression; not just any form of depression but somatoform disorders as a result of prolonged depression were very dominant. My observation of the hospital records for Psychiatry also suggested that depression is the most common mental health illness.  Amongst patients with depression, somatoform disorders were very dominant.

Somatoform disorders are mental disorders that show physical signs of illness and injury. When a mental factor induces a physical symptom it is categorized as a somatoform disorder. They are common in patients with depression.  The most prevalent type is gastrointestinal problems of indigestion. Headaches, weakness, hypertension and many other physical symptoms are common.

No.

Gender

Age

Mental/ Physical Illness

Mental/ Physical Symptoms

1

Male

20

Anxiety

Shivering, Muscle Weakening, Dehydration

2

Male

50

Diabetes

Depression, Weakness, Weight loss

3

Male

12

Mental Retardation

Speech disorder, Epilepsy

4

Female

40

Schizophrenia

Sleep disorders, Auditory hallucinations

5

Female

35

Depression

Acute depression, Indigestion, Vomiting,

6

Female

40

Suicidal History

Depression, Anger, Weakness,

7

Female

80

Ionic imbalance

Jaw twitching

8

Male

55

Depression

Weight loss, Indigestion, Weakness

9

Female

60

Depression

Muscle weakness, Low Stamina, Anger

10

Female

65

Acute Depression

Weakness, Dehydration, Hypertension

11

Male

40

Depression

Hypertension, Weakness, Gastric pains

Table 1: Patient Records

Some very important details can be established from this observation. The 2nd patient who had diabetes was depressed because of his diet plan. Now diabetes is a physical illness caused because the cells of pancreas, islets of Langerhans fail to produce the proper amount of insulin to maintain your blood glucose level. This physical illness can bring about depression. Hence, something physical is causing the non-physical.

Also, the other aspect is to look at the patients who complained about the weakness of muscles, hypertension, dehydration, indigestion, etc. frequently. Some knew they were basically depressed but for patient No. 10 her symptoms were because of old age. Considering she was active, drank enough water and had a healthy intake of food, the reason for her symptoms was depression. She had lost 4 of her children at different times in life. Point of consideration is that the non-physical mind, in these cases, is affecting the physical body in some way. Depression is a resultant of the thoughts that the mind thinks over and over again. It can affect the body negatively and the common forms of somatoform disorders that we see in these patients are hypertension, indigestion, vomiting, muscle weakening, etc.

A dualist would take my observation and call this interactionism, like Descartes, because we can see the mind affecting the body (Patient No. 5, 8, 9, 10 and 11) and the body affecting the mind ( Patient No. 2). However, a Somatosist like Wilhelm Griesinger would hold depression as a physical illness and not mental. He would say it is possible to explain that a chemical imbalance in the brain causes depression and that leads to the physical symptoms, according to which all of this is physical. And the conclusion would be that the mind does not exist at all. He can always be brought down by pointing out that patient No. 5, 8, 9, 10 and 11 did not go through the same experiences in life. Their depression has been caused by different events in their lifetime. The thought process that works on these events in life has not yet been explained in terms of neurons, signal transmission and chemicals. Hence, it is not rational to say brain does the thinking. The non-physical mind can therefore be the thinker that affects the body in some way.

 

 

Bibliography

Burns, Charles L.C., A Forgotten Psychiatrist—Baron Ernst von Feuchtersleben, Proceedings of the Royal Society of Medicine, 1953.

Chappell, V. C.. The philosophy of mind. Englewood Cliffs, N.J.: Prentice-Hall, 1962.

Damasio, Antonio R.. Descartes’ Error: Emotion, Reason, and the Human Brain. New York: Putnam, 1994.

Feuchtersleben, Ernst. The principles of medical psychology. New York: Arno Press, 1976. Print.

Gregory, R. L., and O. L. Zangwill. The Oxford companion to the mind. Oxford [Oxfordshire: Oxford University Press, 1987.

Griesinger, Wilhelm. Mental pathology and therapeutics. New York: Hafner Pub. Co., 1965.

Maudsley, Henry. Body and mind an inquiry into their connection and mutual influence, specially in reference to mental disorders. Enl. and rev. ed. New York: Macmillan, 1873.

Maudsley, Henry. Responsibility in mental disease. 3rd ed. London: H.S. King, 1876.

Minter, Catherine J.. The mind-body problem in German literature 1770-1830: Wezel, Moritz, and Jean Paul. Oxford: Clarendon Press, 2002.

Myers, David G.. Psychology. 9th ed. New York: Worth Publishers, 2010.

Putnam, Hilary. The threefold cord: mind, body, and world. New York: Columbia University Press, 1999.

Shaffer, Jerome A.. Philosophy of mind. Englewood Cliffs, N.J.: Prentice-Hall, 1968.

Tye, Michael. Consciousness revisited materialism without phenomenal concepts. Cambridge, Mass.: MIT Press, 2009.

 


[1] V. C. Chappel, The philosophy of mind. Englewood Cliffs, (N.J.: Prentice-Hall, 1962), p. 76.

 

[2] Jerome A. Shaffer, Philosophy of mind. Englewood Cliffs, (N.J.: Prentice-Hall, 1968), p.120.

 

[3] Ibid., p.123

[4] Wilhelm Griesinger, Concerning Mental Reflex Action. With a Glance at the Nature of Mental Illnesses, (1843), p. 76.

[5] Henry Maudsley, Body and mind an inquiry into their connection and mutual influence, specially in reference to mental disorders. (New York: Macmillan, 1873), p. 67.

[6] Ibid., p. 69.

[7] Henry Maudsley, Body and mind an inquiry into their connection and mutual influence, specially in reference to mental disorders. (New York: Macmillan, 1873), p. 68.

[8] Charles L.C. Burns (1953), A Forgotten Psychiatrist—Baron Ernst von Feuchtersleben, Proceedings of the Royal Society of Medicine. p. 190.

[9] Ibid., p.191

[10] Hilary Putnam, The threefold cord: mind, body, and world, (New York: Columbia University Press, 1999), p. 177.

 

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This entry was posted on July 8, 2012 by in Philosophy.
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