Zadok Paper S100 Winter 1999
The Nature of Humans-Mind and Brain; Body, Soul and Spirit
by Alan Gijspers

Appropriate models of mind function

At this stage in our understanding of the riddle of the mind-brain interface I believe it is unhelpful to take too dogmatic a position in the debate. Nevertheless, we can steer clear of extremes. Physical reductionism by itself cannot explain the complexities of human behaviour and even where neurological mechanisms are known we still use higher levels of explanation. On the other hand, there would be few who would not admit that the brain states influence the mind. They are somehow closely interrelated. The point at issue seems to be the degree of interrelatedness. It is helpful to distinguish between an ontological debate and modes (or even models) of description. The ontological debate seeks to find the mind in some non-material 'stuff' other than physical 'stuff'.
Even this debate is not settled and most Christians would still have some picture of the invisible world of the spirit, of God, spirits and angels. Further, and this is Cooper's main point, what happens to us when we die?74 Do we cease to exist until the resurrection of the body? He thinks not, although MacKay would argue that when a blackboard is wiped the ideas remain and can be re-expressed when they are rewritten the next day.75 Another approach would be to see that death is the transfer out of time into other dimensions completely. So we do not have to embrace an immortal soul, but we can take the concept of the resurrection of the body too glibly and literally. Paul seems to imply that the spiritual body will be a completely different dimension from a physical body. How will we see God and will God also have a spiritual body? Thus the resurrection of the body doctrine, although a greater recognition of the unity of human nature, is not so much a solution as a further statement of the problem.

The ontological problem is separate from asking what models are helpful. In current clinical practice a dualistic model is often useful for it helps patients to see where the problem might be. Patients with a somatisation disorder (such as a stress induced headache) present as psychological distress masquerading as a physical problem. It takes quite a bit of counselling for them to gain insight into their condition, but in this situation it is clearly unhelpful to take a mechanistic approach and deal only with the headache without dealing with the underlying stresses which led to the headache. Here at this moment of clinical practice I will be a functional dualist.

On other occasions a more monist approach is useful. Thus in people suffering from chronic pain, we can get into endless arguments about whether the pain is 'real' (physical) or emotionally related (and by implication, 'unreal'). Thus although we may have this dualistic dichotomy in our minds, we also need to recognise the degree to which mind and body interact as an organic whole. Psychic health can be a modulator of physical sensation. Thus by changing people's attitudes towards their organic pain we may enable them to live more comfortably with their disability. Here a unity model is more useful, and at this point I am a functional monist.

Some writers argue for and against a computer model of the brain. That is that there is an analogy in which the brain corresponds to the hardware and the mind to the software. Among computers, a software problem demands a software solution and a hardware problem a hardware solution. Such a model usefully illustrates that problems in different domains require solutions within those domains and also illustrates the separation of those domains. I personally have witnessed enormous pain in patients whose illness has been wrongly attributed either to their mind or their brain. This is the strength of the more dualist (or dual aspect) approach.

There are weaknesses with the computer analogy. Puddefoot argues against it because the model is too dualistic,76 but this seems to me to be begging the question. The uniqueness of the software is not adequately expressed by this model, but more tellingly in life the mind seems to control the body, like a pianist plays a piano. In that respect the brain more resembles the programmer than the program! Polkinghorne follows Penrose in suggesting that mental processes are not closed systems but evokes Godel's theorem that we can 'see' solutions which cannot be proved by a closed system. There are subtleties of mental function which cannot be reduced to algorithms.77
We are back to the intuition we discussed in the opening section. However, the most telling limit of the computer model is that the mind talks to itself, we are conscious in a way no computer software currently can. Although some computer buffs, like Puddefoot, would deny that.78 Even now they say certain networks can give the appearance of an inner world. It may even be, they go on to argue, that a computer at a certain point of complexity will develop its own consciousness. There is only one way to find out-ask it. It will have been programmed to give an appropriate answer, and there is no way of avoiding the dilemma that answer gives. In fact, we regularly accept that animals at a certain level of complexity seem to have an inner world (my dog loves me!) so why not complex computers, just as we ourselves, the most complex of computers recognised so far, have a conscious world.

In clinical practice, however, it is not just a case of developing appropriate models but of recognising more fundamentally the need to be diagnostically clear in distinguishing between mind problems and brain problems. This requires a practical dualism. Whether this is so because of our current lack of data or because of my lack of philosophical subtlety requires further scientific and epistemological research!

Some writers offer non-reductive physicalism as a way forward.79 They accept that the physical world is all there is but that there are emergent properties at higher levels which are destroyed by a reductive approach. Thus they witness to the complexity of the mind but deny that there is some non-physical 'stuff' from which the soul is made. This approach seems similar to the dual aspect monism that Jeeves, MacKay and Charlesworth80 embrace. My two major reservations with this viewpoint is that they do not adequately describe top-down causality and they do not adequately recognise how the unseen is expressed in the seen. However, my mind is not made up and I am looking for further enlightenment.

Can we, however, reduce the nature of humans to purely a mind/brain problem? Are there not other aspects of what it means to be human? Can there not be many layers of understanding which together make the total picture? I went to the bank the other day. I handed over about ten cheques and facetiously said to the teller, "Here are a few pieces of paper that I want to drop in!" The teller looked speechless. Those pieces of paper represented a lot of money. They also represented a lot of hard work. They also represented the gracious gift of a good God who had provided for his children. (Is going to the bank the nearest modern equivalent to a harvest thanksgiving?). A few pieces of paper, yet many layers of meaning. The exact correlation between each of the layers is unclear nor can they ever be reduced to a single understanding, yet together they form a complete picture of reality, science and symbolism, object and meaning.

To: Questions for discussion

Alan J. Gijsbers MBBS FRACP DTM&H PGDip Epi, is Specialist Physician at Turning Point Drug and Alcohol Centre and at the Department of Drug and Alcohol Studies St Vincent's Hospital. He is a Visiting Physician at the Epworth Hospital, a Senior Lecturer in Clinical Medicine at the Department of Psychological Medicine Monash University and Senior Fellow at St Vincent's Hospital Clinical School, University of Melbourne. He also contributes to a Dual Diagnosis Clinic at the St John of God and St Vincent's Collaborating Centre consulting on people with both Drug and Alcohol and Psychiatric Disorders. He is a fellow ISCAST and editor of their national bulletin. He also somehow manages to be a husband to his wife, Lois, and a father to three children.