May 29, 2012
Explanation and Understanding
As stated earlier, in psychiatry, the all too obvious philosophical dilemma is the so-called mind-body problem. It is often asked, "Is my experience (or problem, if you like) mental or physical? Am I having psychological problems or a brain chemical problem/imbalance?" The answer to this question is not as easy as it may appear to some. Psychiatric sufferers are often quite consciously confused about this. Others are confused in that they are certain they know the clear answer (which in current times is more often the brain chemical ideology). We will try to address the form of what a truer answer might look like for an individual person. And the particular answer does very from one particular experience to another.
When this question comes up in the office, I often ask patients to reflect on the fact that every time we have a thought or a feeling something is going on in the brain. Even as we are communicating at the moment, something chemical or physical is also going on in our brains; the chemical changes are probably quite small ones and not susceptible to micro-modification. At least not yet, thankfully! But larger changes, more brain-global "chemical or neurological changes" such as significant and disabling moods, can possibly be modified. For the moment, let us put aside the important question and individual judgement of whether such problems should be addressed with medication.
Some philosophers make a distinction between explanation and understanding, which I think is useful. Some mental experiences are better explained chemically or biologically, while other experiences are better understood psychologically through their meaningful connections to other psychological or social experiences. Most difficult of all (and my true "sub-specialty" in psychiatry) is that some mental and emotional experiences can definitely benefit from being looked at from both perspectives.
Now, everything I've just said begs for endless elaboration and conversation. Feel free!