Consciousness
People suffer distress of consciousness and we want to help them. A good place to start is to understand a little bit about consciousness. This section talks about why the idea of consciousness is important in the context of consciousness care and provides some links to resources. (2014)

What is consciousness? Is it, in fact, only the brain? The so-called "hard problem," a term coined by Australian David Chalmers in 1994, is essentially this: "How does subjective experience arise from the physical processes of the brain?" and the best primer on this question from a Western perspective (there are alternatives) for the layman is the book Conversations on Consciousness by Susan Blackmore (2006), (amazon.com link), who asks a number of leaders in the field of Consciousness Studies what they think.


uploaded July 14, 2014

In which the brilliant David Chalmers reviews the leading ideas surrounding consciousness. In this talk he mentions "neuroscience" and "psychology" but not MPAPT. Transcript and very useful footnotes.

Why is this important? Because "mainstream psychiatry as practiced today" (MPAPT) is based on the assumption that consciousness (which, presumably, governs behavior) is simply, somehow, part of the brain and that giving powerful brain-altering drugs or passing electricity through the brain will change the brain and thus consciousness and thus behavior in precise ways. 

In the light of the complexity of consciousness, this doesn't seem realistic. How complex is consciousness? To give you one example, read this story of how a man saw time slow down (June 2014) or listen to this 18-min segment of a Radiolab broadcast (June 2013). See also the cross-link to "Consciousness Organizations" for a list of people hard at work on this challenge.

The fact is that no-one knows for sure how consciousness arises from or is connected to the body. No-one. "Arises from" suggests they are kind of the same thing, "connected to" suggests they are two.

For example, here's something that Michael Gazzaniga, one of America's leading neuroscientists, wrote while he was still at Dartmouth College (he left in 2002). He is well-known for his work with people who had the "bridge" between the right hemisphere and the left hemisphere of their brains cut, "split-brain" patients.

"After many years of fascinating research on the split brain, it appears that the inventive and interpreting left hemisphere has a conscious experience very different from that of the truthful, literal right brain. Although both hemispheres can be viewed as conscious, the left brain’s consciousness far surpasses that of the right. Which raises another set of questions that should keep us busy for the next 30 years or so."

And then this is from his book Who's in Charge? (2011), Chapter Four, "Hard determinists: The Causal Chain Gang"):

 "I do not think that brain-state theorists, those neural reductionists who hold that every mental state is identical to some as-yet-undiscovered neural state, will ever be able to demonstrate it. I think conscious thought is an emergent property. That doesn't explain it: it simply recognizes its reality or level of abstraction, like what happens when software and hardware interact, that mind is a somewhat independent property of brain while simultaneously being wholly dependent upon it." (emphasis added).

And this is what his biography says now (2014)--he now heads the SAGE Center for the Study of the Mind: 

“He oversees an extensive and broad research program investigating how the brain enables the mind.”

So it doesn’t seem to be at all clear-cut what the answer is. 

There was a conference "Toward a Science of Consciousness" (@brainyday) in April 2014 that was the 20th anniversary of a conference struggling with these kinds of issues of consciousness. One Harvard psychiatrist even suggests we have two consciousnesses working independently. 

In fact, to take the second point first; What, incidentally, would that mean for psychiatry? What happens if there were two consciousnesses in every person and the powerful, brain-altering drugs altered the two consciousnesses differently? Or, to put it more simply and to use an older model, without having to take into account the Harvard psychiatrist's idea: what happens if brain-altering drugs affect the conscious mind in a different manner than they do the subconscious?

If one chooses to entertain the possibility that we perhaps don’t have all the answers all kinds of interesting ideas begin to surface. Here's one reference (Legion Theory) to Dr. Gazzaniga’s work picked almost at random. Just search for "Michael Gazzaniga split-brain" to find others. 

In fact it gets worse! Here is a quote from Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being article (2010) in Scientific American:

"As Olympians go for the gold in Vancouver, even the steeliest are likely to experience that familiar feeling of "butterflies" in the stomach. Underlying this sensation is an often-overlooked network of neurons lining our guts that is so extensive some scientists have nicknamed it our "second brain.”

"A deeper understanding of this mass of neural tissue, filled with important neurotransmitters, is revealing that it does much more than merely handle digestion or inflict the occasional nervous pang. The little brain in our innards, in connection with the big one in our skulls, partly determines our mental state and plays key roles in certain diseases throughout the body."

Now we are talking about potentially three consciousnesses! And on and on. (For a particular reference to psychiatry--note that this is *not* MPAPT, but more like Integrative Psychiatry--see this August 2014 article, Gut feelings: the future of psychiatry may be inside your stomach.)

The Council of Evidence-based Psychiatry points out:

"There are no known biological causes for any of the psychiatric disorders apart from dementia and some rare chromosomal disorders. Consequently, there are no biological tests such as blood tests or brain scans that can be used to provide independent objective data in support of any psychiatric diagnosis."
  
and
  
"Psychiatric diagnostic manuals such as the DSM and ICD (chapter 5) are not works of objective science, but rather works of culture since they have largely been developed through clinical consensus and voting."
  
Both quotes are from the Council for Evidence-based Psychiatry (UK) website, retrieved June 2014.
 
In moving forward, then, the idea of Consciousness should play a more important role in attempts to formulate programs to address distress.

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