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IBS is not "all in the mind"

Discussion in 'Latest ME/CFS Research' started by cigana, Jan 13, 2011.

  1. Angela Kennedy

    Angela Kennedy *****

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    Hey Esther, no problem. These discussions are useful. None of us can always fully source our discussions lol! We'd be here all day.
     
  2. Mark

    Mark Acting CEO

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    Thanks Angela - this is actually the heart of the problem, for me.

    I was excited too by Dennett's "Consciousness Explained", when I read it all those years ago - I still think it's one of the most memorable and fascinating books I've read and I'm tending to assume that it's this largely this work (and the science it's based on) that lies behind the neuropsychologists' easy confidence that all the fundamental mysteries of mind and body are now explained, in mechanistic, materialist terms.

    The problem for me is that, brilliant and fascinating though the book is, it doesn't explain what I understand as consciousness. It explains something very well, but not consciousness. However much the consciousness can be supposedly explained as the sum of the activities of 'millions of tiny robots', it still can't get to that 'metaphysical' stuff that Angela refers to - it still doesn't answer what that is. This point seems so obvious to me that I've always struggled to understand when people fail to see that distinction: however much the experiences I feel may correlate with physical processes in the brain in an understandable way, I still don't see how that explains the consciousness itself - the actual "feeling of being" itself. I remember thinking when I read it that it might be more accurately titled "Consciousness Explained Away" (unsuccessfully).

    The other thing I find odd about that sort of deterministic and mechanistic perspective is its strange implications. I don't quite understand what room this philosophy leaves for what we call "free will". Perhaps I misunderstand the philosophy, but it seems to imply that we don't actually, really, have free will at all. Does the materialist psychologist ultimately feel that whatever their patient is doing and saying is fully determined by physical processes and their responses are thus inevitable and in theory completely predictable? Is the psychologist himself, who acts to correct the patient as if they were some kind of machine obeying inevitable physical laws, is that psychologist also obeying those deterministic laws whilst counselling them? And does that perhaps absolve the psychologist of any kind of moral responsibility for their behaviour, since they too are walking an inevitable, pre-determined path?

    Another peculiar implication seems to me to be that if the thing that we call consciousness - and 'soul', 'spirit', 'mind' - all of that 'metaphysical' stuff - is simply inherent in any sufficiently complex system, then all of physical reality also participates in the same 'stuff'...and then, surely, things that we wouldn't normally think of as conscious - like computers, rock formations (over a vastly different timescale), the sun, the earth - also have a claim to participate in that same 'consciousness-stuff'...not as the same nature of experience as human consciousness, sure, but surely both the sun and the earth are more complex systems than my own brain, so what then might their equivalent of 'consciousness' be like?! I rather doubt that these materialists who have evolved beyone the old 'naive' dualism would be as comfortable contemplating these sort of ideas as I am...but I'm not sure how they evade them as implications of their theory.

    Admittedly I don't understand their philosophy in depth, and they may have had some intelligent thoughts on those subjects in the last 15 years - sadly I've been somewhat indisposed and unable to keep up with their arguments - but unless I missed it I somehow, I still haven't been referred to the book, or research, that answers these fundamental age-old philosophical mysteries in the definitive way they claim when they talk about the 'naive dualism of the past'. The philosophy seems to boil down to saying: There was this age-old dualism of the mind and the body, which we have now solved when we learned a few things about how the brain works, and were thus able to conclude that 'the mind' doesn't really exist at all: mystery dissolved, game over: there is no mind. I can't help but take offence: that's me they're talking about, and despite what they claim, I still feel reasonably confident that I do, in fact, exist...and I'm still waiting to see the proof that I don't.
     
  3. Angela Kennedy

    Angela Kennedy *****

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    Hi Mark,

    Yep. These are fair and important questions. I'm one of those people who think that no, the 'mind-body' problem hasn't been 'solved' yet, and may never. We (humans) have a highly 'bounded rationality' often, and therefore the complexity of metaphysical phenomena may prevent us from effectively unravelling these issues. It also means the 'great and the good' frequently send us all off on wild goose chases, intellectually/philosophically/even scientifically speaking.

    Claims to be able to transcend 'mind-body dualism' are ridiculous. Every time I've seen someone claim that, they've gone on to privilege the 'mind' over the body! They claim illnesses like CFS are psychogenic because of the status of 'medically unexplained' etc. so they are, in effect, claiming a metaphysical aetiology (beliefs, lies, delusions), sometimes to the point of 'mind over matter' (i.e. that beliefs causing ever increasing types of somatic (bodily) dysfunction) in the face of the unknown.

    And they also forget the brain IS part of a body! It's not separate, and it's not some servant of the 'mind' (Igor to Victor Frankenstein) , which it is often portrayed as.
     
  4. Esther12

    Esther12 Senior Member

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    Ah well... this I should be able to reply to from memory, without any of the gruelling 'learning' or 'research'.

    I think Dennett’s reply would be that he’s quite aware how unsatisfactory his explanation will be to many who believe in a certain type of consciousness.

    I’ve seen him compare it to a magic trick. When it’s explained, most people will be rather disappointed “You’ve not explained it at all, you’ve just explained a series of little tricks!” But what if consciousness is just a series of unsatisfying tricks, gradually evolved according to the same Darwinian processes which shaped our bodies? That's such a process may leave us feeling unfulfilled would not mean it did not occur.

    Dennet tells an anecdote of a friend who was writing a ‘History of Magic’ book. People would always ask him “Do you mean REAL magic?” and he’d have to reply “No, not real magic, just conjuring tricks and stuff like that.” In this context REAL magic is the sort of magic which doesn’t exist, where as the sort of magic that is actually being performed does not count as being REAL.


    I think that Dennet’s Freedom Evolved is the best of his books – but it was also the first of his I read, and he does tend to get repetitive. It could well be that, as with consciousness, the sort of freedom defended is not really the sort you really want though.

    I think in this books he also talk about the potential for computers to evolve real consciousness and free will (I thought he did so in CE too, but can’t really remember).

    I don’t think it’s right to talk about these arguments having been ‘proven’. But to me, the sort of approach that people like Dennett are taking seems the most likely explanation for consciousness that we currently have. But then I’ve grown up assuming that our minds are the result of our brains, and find that alternative explanations posited difficult to take seriously… I’m not sure to what extent that’s due to my own unchallenged presumptions. Or it could be that you need some prior belief in a non-materialistic conception of mind in order to find such a theory plausible.


    I quite agree that this sort of materialism, especially when combined with the belief (which I think is false) that it over-throws prior moral and personal commitments, is part of the explanation for the very casual and careless approach that has been taken to CFS patients by the psycho-socialists. Just because our minds are the results of only the chemical operations of our brains does not mean that they are not of particular importance and should be pragmatically tinkered with in the way one would set a broken bone – especially when we still have such a weak understanding as to exactly how our minds work, and what the full affects of a particular intervention may be. (My concerns here could be expanded for pages… some many different problems could and have arise by subsuming psychosocial factors into a pragmatic and medical approach).
     
  5. Marco

    Marco Old blackguard

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    If you haven't already, check out the Santiago Theory of Cognition. Consiousness/cognition is an emergent property. Not a thing but emerging from the process of living. All living things exhibit 'consiousness' through the process of living and interacting with their environment.

    There's more to it than that obviously.
     
  6. Mark

    Mark Acting CEO

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    I continue my struggle to express what seems to me an obvious distinction in words...but here's another try, by analogy. I don't have any problem, per se, with this concept of something 'emergent' from the process of living, but I think there is just something else that this model can never touch. The best way I can think of to describe how I see it, right now, is by analogy to a mathematical series approaching a limit. As our understanding of the physiological processes in the brain inexorably increases, as we learn more and more about that, we get closer and closer to 'understanding' 'consciousness', but we can never reach the limit; the explanations always fall short of an 'explanation' of 'consciousness'.

    It may be something of a semantic point - but a crucial one IMO - but all of Dennett's explanations, fascinating though they are, for me fall short of an 'explanation' of 'consciousness' - an explanation of what it means to 'be inside' and to experience that consciousness. It feels like something, to be conscious, and that feeling itself is of a different nature to the physical stuff and the processes they undergo. A sense of experiencing something remains, and that 'inside experience' is what I mean when I use the word consciousness. So I can accept that the consciousness may arise from the physical processes (unprovable though that is), but it still doesn't explain what the consciousness itself is.

    Thanks for reminding me Esther of the line that Dennett takes on these questions. I'd love to read the explanation of free will. I would interpret your post as confirming that in essence what he does is to 'explain away' consciousness and also to 'explain away' free will. He tries to show that they are, in some sense, illusions. That's all very well, but then, if one tries to accept that one isn't really "conscious", that one doesn't really have free will, it just isn't possible to do that, because consciousness and free will are the starting point of the definition of what it is to feel as though one exists. I don't think it's really possible to fully believe and accept that this is just an illusion, because if it's an illusion, it's an illusion that defines who and what we are. I can intellectually understand the argument as to how this illusion is created, how it works, but I can't suspend my belief in my own consciousness. Maybe to do so is 'enlightenment', or 'ecstasy' - that's the closest I've come to achieving that suspension of belief in 'myself'...but those experiences are more like a dissolving of the subjective experience of oneself into a wider experience of the 'consciousness of the universe'...they still aren't a complete annihilation of consciousness itself.

    So I still feel that this whole theory doesn't really 'explain' what I call 'consciousness' - it still doesn't answer the fundamental question, for me.

    Also, as Angela highlighted, there's a further bizarre aspect to the way that so many of the believers in this purported post-dualist model also talk about 'psychogenic' explanations. It's as if, having proved that 'the mind' doesn't exist, and there is only 'the body', they then go on to allege that 'the mind' is acting over the body and causing effects in the body. Having supposedly unified the mind and the body in their theory, it's bizarre that they then resume that dualism in a reformulated set of 'psychogenic' or 'mind over matter' theories - they seem to be giving primacy to something which they claim to have just proved does not really exist!
     
  7. Esther12

    Esther12 Senior Member

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    Dennett tries to show how the aspects of free will which he thinks are important (moral responsibility, our ability to make decisions, etc) but accepts that to some there is an innate conflict between materialism and the sort of free will that they want to have. There are conceptions of free will which require REAL magic, but Dennett doesn't think their rejection is that significant to the way in which most people live their lives (maybe I should stop speaking for Dennett... my memory's not that good).

    Also, there are undoubtedly experiences of consciousness which are not accurately described or explained in Dennett's work. But that will be the case for all theories of consciousness because the internal workings of our minds are so varied, complex and difficult to communicate. The title 'Consciousness Explained' may have led to unobtainable expectations of his work (and greater sales!) but I don't think it's fair to complain to much about his ideas not achieving the impossible.

    I think it's entirely possible for the mind to create all sorts of bodily sensations and interpretations of reality... but I don't think it's at all safe to therefore presume that currently medically unexplained symptoms are psychogenic in nature. It's entirely possible for someone's mind to create false memories of child-hood abuse... but we certainly shouldn't assume that all cases of reported child abuse are imagined. I think that some CFS researchers are so very excited by the possibilities raised by all this mind/body stuff that they've adopted a rather carefree approach to treating their patients as if they're mentally disturbed... imagining that any moral concerns about such an approach to medicine could only be founded upon a naive dualism, or out-dated views of mental health. And I think a lot of people are rather impressed by their gentle hand-waving and mutterings about the chemical nature of our minds, choosing to give these experts the benefit of the doubt, rather that wade into a controversial topic which all sounds uncomfortably complicated.
     
  8. biophile

    biophile Places I'd rather be.

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    Stressing stress

    I haven't accessed the full text either so I don't know exactly what statistical method they used. I'm not good at statistics anyway but I'm guessing their "effect size correlation coefficient" would have a range of 0 to 1, with 0 being no correlation and 1 being perfect correlation, while 0.2 = small, 0.5 = medium, 0.8 = large. AFAIK an effect size of 0.21 is considered small no matter what method they used. Falagas et al 2010 say "significant overall main effect of psychological stress" and I don't know how this was measured or if they lumped all types together, but the abstract does say "effect sizes for the association did not vary according to type of stress". We don't really know what other factors are involved.

    You both were correct in your interpretations. Let me elaborate on my position.

    It is often claimed that CFS involves increased comorbidity with other functional syndromes, high rates of and association with psychiatric comorbidity, "stress-related", psychopathology can influence reporting of symptoms, etc. These are often implied as or alluded to by the psychobabble as somehow unique to psychosomatic and psychiatric diagnoses, or evidence for psycho>somatic mechanisms in the supposed absence of recognised pathophysiology.

    However, there is a mountain of reported evidence for such phenomenon in many medical diseases as well (often the evidence is conflicted and/or there are systematic reviews which sober up all the hyperbole), so all these claims are probably a form of special pleading when applied to CFS. One caveat here is that when compared to other medical diseases there does seem to be a trend for somewhat stronger associations for some aspects of so-called medically unexplained and functional symptoms in some scenarios but again there are major methodological issues here as well that need resolution.

    The correlations found in research on psychological factors in illness/disease often do survive after adjusting for obvious confounding factors, sometimes they do not or are reduced. But the effect sizes, relative risks, odds ratios, hazard ratios etc in these studies aren't all that impressive either, usually nothing like smoking and lung cancer, and rarely of clinical value (unless severe or the disease already exists).

    Issues with defining and measuring "stress" or other psychological and social variables is another problem, Angela has looked into this much more than me, I have only begun to investigate that (slowly like a turtle!). Until then, I will continue to tentatively accept there are probably some genuine associations between comorbid and premorbid psychological dimensions and medical disease, but I believe the exaggeration and overgeneralisation we often see in the common psychobabble simply isn't justified by the evidence, while the reported links from research can't be routinely taken at face value either. This of course doesn't mean that stress isn't relevant to one's health.

    I also consider possible alternative explanations for such associations, like shared risk factors, overlapping pathophysiology, early psychological manifestations/vulnerabilities of disease pathology that are misinterpreted as causal when physical symptoms follow later, disturbed homeostasis and neuroendocrinimmunological overlap with disease pathology giving the illusion of a "mind over body" mechanism (which wouldn't exist without the primary disease), etc.

    Then, as Angela said, "not to mention psychologist's fallacies in deeming negative appraisals of predicaments 'maladaptive' or 'irrational'". I think even the role of psychosocial factors in the onset of psychiatric diagnoses may be overstated as well. Also, I noticed that some people view "chronic whiplash" and "chronic lower back pain" as obvious psychosocial problems, but again, systematic reviews into psychosocial factors don't really support this psychosocialisation either. This isn't to say such factors don't exist, but to note the theme of blanket hyperbole.

    I heard an anecdote about someone who goaded suspected "somatisers" into getting angry as a demonstration in order to help them realise that their worsening symptoms were evidence their "illness" was primarily rooted in emotions. Some illnesses/diseases may not respond abnormally to anger but that certainly isn't universal and is a rather stupid litmus test. What do they think would happen if they angered someone who just a heart attack, or a stroke, or are suffering the consequences of chemotherapy, or are in emergency care, or have a significant infection, or are experiencing migraine or sleep deprivation, or have one of many other conditions which leaves the patient as impaired as what is often experienced in ME/CFS?

    Yep, particularly the parts about overstatement, difficulties unraveling the numerous forms of different kinds of stress (negative, positive, "physical", "psychosocial"), conflating mind with brain, black boxing and lack of demonstrated mechanisms, lack of critique towards dubious claims regarding stress in somatic illness, inappropriately blaming patients for any associations, us not affording the luxury of reams of faulty psychobabble just in case a small portion may one day be correct. There is a systematic review (Guiraud et al 2010) which finds both "negative or positive emotions" are significant risk factors for triggering ischemic stroke, do we all now need CBT to correct faulty positive thinking? :)

    Indeed.
     

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