Rethinking Mental Health, Part 1: From Positivism to a Holistic/Organismic Paradigm

Paris Williams, Ph.D

June 29, 2013

(Editor’s note: we are breaking up Paris William’s essay into two sections. The second part, which addresses the need for an alternative system of diagnosis and other implications of his proposed paradigm, will be published next week. We expect that the essay will attract a lively discussion, so the hope is to afford an opportunity to address the essay  fully and cogently in parts.)

We find ourselves in very interesting times with regard to our understanding of mental health. We find ever more heated, passionate and polarized discussions taking place with regard to the so-called mental disorders — how or even whether to try to classify them, which factors are generally helpful in recovery vs. which factors are generally harmful, what does “mental disorder” or “mental illness” even mean, and what does “recovery” even mean. I consider myself something of a constructivist (believing that we all develop individually constructed “lenses”), an existentialist (believing in the importance of understanding the core dilemmas inherent within our existence), and a pragmatist (emphasizing the importance of identifying and meeting relevant needs). So given the way my own mind works I find it helpful, when such conundrums appear, to try to take the issues all the way down to the most fundamental assumptions and experiences that give rise to them, and then try to reconstruct an understanding that is more conducive to meeting our needs.

This discussion, then, is an attempt to do just that. I’ll begin by looking at the basic assumptions underlying the most prevalent scientific paradigm in the West, and why I believe this paradigm is so problematic. Then I’ll present an alternative paradigm—a synthesis of both Western and Eastern understandings of human nature, human experience and of living systems in general—and discuss why I believe this alternative paradigm has the potential to be far more helpful (and far less harmful) in our attempts to understand the complex issues of so-called psychosis and other mental disorders, and in working towards ways to offer real support to people who are struggling with these conditions.


Part One:
The Current Dominant Paradigm—
When will Positivism Finally Rest in Peace?

While there are a number of different scientific paradigms (also known as epistemologies) that have emerged in the West over the past centuriesthe paradigm that has greatly dominated for several hundred years and continues to dominate today is positivism. The roots of positivism extend all the way back to the dawn of Western philosophy, with Aristotle’s emphasis on substance (matter) over pattern, and the belief that patterns or processes could be ultimately reduced to substance. The main cornerstones of positivism are “materialism,” “objectivity” and “reductionism”—these include the assumptions that all that exists can be reduced to matter or matter/energy; that we can understand the whole by isolating its parts and studying them individually; that by isolating these parts, we gain a greater understanding of the whole; that there is some absolute truth that we can observe as completely detached observers; and that it’s possible to observe this so-called objective world without influencing or biasing what we observe in any significant way.

In my opinion (and in the opinion of many others who’ve grappled with these epistemological questions), the core tenets of positivism have been soundly debunked, and done so ironically by many of the same scientific fields that have emerged directly from positivism — especially modern physics, the life sciences (especially with ecology, microbiology and evolution theory) and systems theories such as chaos theory and complexity theory. The new picture that continues to emerge is that the whole is greater than the mere sum of its parts, that process itself appears to be more fundamental than matter, and that it really isn’t possible to observe the world in any kind of unbiased and entirely non-influential manner. Yet, generally speaking, we in the West continue to hold positivistic thinking and positivistic methodology as the most sacred of all methods of inquiry with regard to living systems and organisms, still generally buying into its outdated tenets. And not only do these tenets remain strong in the West, they are clearly spreading throughout an increasingly globalized society.

The entrenchment of these positivistic tenets is especially evident when we look at our attempts to better understand subjective experiences (such as the so called mental disorders) by placing the vast majority of our attention on the brain and body rather than what is actually occurring within people’s minds, and by relying predominantly on randomized controlled trials, or RCTs, rather than on research that emphasizes people’s actual experiences in situations that are as natural as possible. I don’t mean to completely discredit the value of controlled trials and quantitative analysis in general — I do believe that there’s a place for them as long as we don’t forget the very strict limitations of this kind of approach, especially when we’re dealing with (a) very complex systems such as living systems and organisms, which are guided by circular- and network-causality as opposed to linear causality (which is generally assumed within positivistic thinking), and (b) when we’re exploring experiences that are by their very definition subjective, which of course include those experiences that we label “mental disorder,” “mental illness” and “recovery.”

The problem is that we’re not acknowledging these limitations, and all we have to do is take a look around to see the serious trouble this is causing. We have continued in full force for over a century trying to locate the so called mental disorders within the brain, but to absolutely no avail. Just think of what we could have accomplished in these many decades and with these many billions of dollars if we had instead been putting our emphasis on trying to understand people’s actual experiences and trying to address their actual needs. Imagine how different the world would be today if rather than seeking for those “magic bullets,” we instead focused on the cultivation and implementation of support systems that we already know work very well—addressing poverty and discrimination, cultivating relationships and negotiations between individuals and groups, ensuring that everyone has access to meaningful education and activity, providing individual- and family-based interventions and empathy-based sanctuaries to those in crisis, etc.  But no — tragically, we continue trying to utilize a framework founded on a belief in materialism and reductionism to understand human experience, human suffering and life in general, when these are more appropriately recognized as arising from a dynamic, holistic and profoundly interdependent “web.”  In other words, we almost completely ignore the most recent findings of our own science, which are in general highly congruent with this more holistic, interdependent vision, and so we continue in futility trying to fit a round peg into a square hole.

Unfortunately, the harm caused by the positivistic paradigm doesn’t end with the mental health field. If we take a moment to contemplate the world that we live in, the signs of the devastation caused by this paradigm are everywhere. One thing that becomes immediately evident upon looking around is the incredible technology that we’ve developed, a technology that’s clearly born directly from our emphasis on materialism and reductionism. And some may use this observation to argue for how well positivism has served us. On one hand, this is true. We clearly have made tremendous progress with regard to material technology. We’ve developed the truly astonishing ability to manipulate matter into incredible shapes and functions that have dramatically changed our world and allowed us to achieve amazing feats—mass transportation, skyscrapers, landing on the moon, computers with enormous storage and processing capabilities, and the list goes on and on. When it comes to manipulating the “objective” material world, there is no doubt about it. We have really got it down, and perhaps we really can thank the positivistic emphases on materialism and reductionism for this.

It doesn’t take a whole lot of contemplation to recognize, however, that many serious problems have emerged from the positivistic worldview,  in spite of the many conveniences that have arisen from it (at least for the more privileged members of our society, and at least in the short term). We find that the positivistic emphases on materialism, individualism and reductionism have leaked into virtually every area of our lives, including our general understanding of the world, living beings, ourselves and even our own value systems. And it’s evident that this leakage has clearly caused enormous harm. While this is a fairly complex topic, I’ll take a moment to go over some of the main bullet points here.

  • Positivism subscribes to the idea that there is only one “true” understanding of the world, and that our society, and especially particular members of our society (the “educated,” the “well adjusted,” etc.) have come the closest to grasping this true reality. It doesn’t require particularly deep contemplation to see exactly where this kind of attitude has taken us:
    • Ethnocentrism and other forms of discrimination—the greater propensity to carry out and justify oppressive and aggressive actions towards other societies and even members within one’s own society whose perspectives or behaviors differ significantly from those of the dominant group.
    • Psychiatric oppression—attempts to make a distinction between those who are “sane” and those who are “crazy” or “ignorant,” which takes us down the path to psychiatric discrimination, labeling, coercive and forced “treatment,” and even eugenics in its more extreme forms.
    • Intellect worship—failing to recognize that the human intellect, while certainly awesome, is nonetheless merely the tip of a vast “iceberg” of organismic wisdom that is so much deeper and wiser than the conscious intellect could ever be alone. This leads to a particularly harmful kind of arrogance, which when combined with a lack of appreciation for fundamental interdependence, leads to the general disrespect of other species (speciesism) and the natural environment in general. This in turn leads to rampant environmental destruction, the widespread disrespect for and even eradication of entire species, and eventually what may well become a form of species-wide suicide as we continue to wreak so much havoc upon our very home and the web of life that sustains us.
  • But what about our values? Surely the positivistic emphasis on materialism and reductionism (which naturally includes an emphasis on individualism and competition) has not invaded this sacred terrain. Well, actually it clearly has. Recognizing that the “wealth” of virtually all industrialized societies is measured in material production rather than in wellbeing pretty much says it all. Even using terms such as “industrialized” and “developed” societies in the typically elitist way of contrasting these societies with those that are “undeveloped” or “indigenous” reveals very clearly exactly which values we generally hold in highest regard.

So if we come to terms with the fact that positivism has been debunked (and thankfully so), then where does this leave us? Well, the bad news is that history tells us that once a particular paradigm has become established within a society, it can become very entrenched and quite difficult to uproot. But the good news is that history also tells us that dramatic paradigm shifts are possible. And further good news is that a new and in my opinion much more beneficial and sustainable paradigm is already emerging, which ironically appears to be supported by the leading edge of positivistic science itself. The findings of many of the scientific fields originating from the positivistic paradigm have been converging on a new set of fundamental principles including interconnectedness, holism, self-organization and even a kind of primordial intelligence in the form of a fundamental propensity for awareness, response and becoming. In yet one more irony, this emerging “new” paradigm is actually very similar to some very “old” paradigms—such as that developed thousands of years ago by the nondual traditions of the East (especially within Buddhism, Taoism and Advaita Vedanta), and that which was probably more or less ubiquitous among the earliest human, or indigenous, societies.

Part Two:
Towards a Holistic Organismic Paradigm

To better understand this emerging paradigm, it will help if we come at it from two different angles—a deep exploration into direct subjective experience, and an exploration of the most essential qualities of living organisms and living systems.

Exploring the Fundamental Building Blocks of Subjective Experience

Positivistically-oriented thinkers generally discredit research methodologies that have been established from within other epistemologies, and especially those such as mindfulness meditation, a form of subjective inquiry that was established thousands of years ago in an entirely different culture to that which exists in industrialized society today. In spite of this, the limits of positivistic inquiry are becoming increasingly recognized, especially with regard to studying subjective experience. One particular branch of research methodology known generally as qualitiative research, has emerged as a response to these recognized limitations. As the name suggests, qualitative research emphasizes quality rather than quantity, and process rather than matter, emphases which are essentially opposite to those of positivistic inquiry. One kind of qualitative research is known as phenomenological research, which essentially refers to the exploration of direct present experience. And it turns out that mindfulness meditation (known as vipassana in its original Pali language) is an extraordinarily well structured form of phenomenological inquiry dating back over 2,500 years (being discovered by Sidhattha Gotama, who became known as the Buddha as a result of this discovery and the dramatic impact that it apparently had on him). Mindfulness meditation is becoming increasingly appreciated and well respected in the West, not only for its therapeutic effects but also for its means as a very powerful method of phenomenological inquiry.

For those unfamiliar with mindfulness meditation, it’s extremely simple but far from easy—you develop the capacity to maintain your attention on direct present experience (raw sensory experience taken in through the five somatic senses and what is often referred to as the sixth sense, the contents of the mind—images, memories, thoughts, etc.). This is all you do—remain with direct present experience in as consistent a manner as you can, while also trying to cultivate a general acceptance, or equanimity, with regard to this experience. And since there are different aspects of present experience (the six senses mentioned above), you can choose to focus on one or all of these sensory modalities. Then, you simply witness the passing show and ride the process of organic unfolding into ever deeper layers of subjective experience.

What’s particularly interesting about this form of inquiry is the incredible robustness of the findings that have emerged from it. Millions of people over thousands of years have arrived at the conclusion that there are essentially only three primordial qualities lying at the very core of our experience: nonduality or fundamental interconnectedness (anatta in Pali), impermanence (annicca), and suffering/discontentment (dukkha). And overlying these most primordial of experiences are one’s set of cognitive constructs—the interpretations and evaluations we make of a particular raw sensory experience—and the feelings and impulses that in turn arise in response to these interpretations and evaluations (the word cognitive comes from the Latin word cognoscere, meaning “to know” or “to recognize”). I find it very interesting that the most recent findings within the so called Western fields of inquiry are in direct accord with this understanding of these fundamental qualities, which was established literally thousands of years ago in the East. I’ll go ahead and say a little more about these three core qualities of experience, the constructs which develop on top of them, and how all of these contribute to the most fundamental forces that drive us.

Nonduality and Impermanence

We can say that at the most fundamental level of our experience, there is no subject/object dichotomy at all. However, as conscious living beings, it appears that is somewhat natural to perceive the world in a dichotomous (or dualistic) manner—distinguishing a relatively secure and permanent “self” set apart distinctly from relatively secure and permanent “others,” and distinguishing one type of “other” from another. In fact, perceiving the world in such a manner likely plays a very important role in maintaining the self’s existence and in meeting its various needs. Nonetheless, this way of perceiving is essentially an illusion. The only thing that we can say is even somewhat semi-permanent within a particular “self” is a process — the process of maintaining a particular organization or pattern of relationships, both between the various components of which the organism is composed, as well as between the organism as a whole and other organisms and features of the “external world.”

This is similar to the illusion of perceiving a wave as separate from the sea, or perceiving a vortex in a draining bathtub as somehow separate from the water flowing down the drain. Matter and energy are continuously flowing through all organisms—a continuous flow of intake and output—and it is only a particular pattern of relationships that remains somewhat steady, and even this pattern is more or less in a constant flux and flow. We can say that the positivistic worldview, generally speaking, is this illusion taken to extremes—an attempt to reify this illusion of a world comprised of relatively isolated, permanent and distinct parts into a fundamental truth; and in spite of the fact that the particular types of Western science that we hold with such high regard have concluded that this worldview actually has no solid foundation, most of us have a very difficult time perceiving the world in any other way. Again, the very existence of the “self” depends upon maintaining this self/other dichotomy.

We find that we struggle with this same illusory dichotomy in various ways, such as trying to make distinctions between the brain and the mind, or between the organ within our head (calling this brain) and the rest of our body (in spite of significant evidence that this brain/body split is yet another false dichotomy—see Candace Pert’s work). We also tend to dichotomize different orders of “self.” For example, it’s well established that all multicellular organisms (including humans, of course) are essentially a complex organization of individual single-celled organisms (i.e., many small “selves”) living symbiotically with each other, resulting in a higher-order experience of “self.” In other words, the larger, higher-order organism experiences itself as a single “self” in spite of the fact that it’s actually comprised of a community of many smaller organisms living in symbiotic relationship with each other. And these multicellular organisms in turn live symbiotically with other organisms (both unicellular and multicellular), resulting yet again in an even higher-order experience of “self” (e.g., a family, a society, an ecosystem, and even the entire biosphere).

Joy and Suffering

The third fundamental quality of experience is the more or less universal dance between joy and suffering that goes hand in hand with the inevitable vicissitudes of life. In some ways, this is the simplest of these three fundamental qualities to grasp. If a living organism were to maintain a sense of complete contentment, it would never feel inspired to do anything including meeting its own basic needs, and therefore would likely not continue to exist. On the other hand, if an organism experienced only suffering, then life would become intolerable, and again we find a situation in which the organism would likely not continue to exist. So we can say that this movement between joy and suffering is an essential quality of all living organisms—that which drives one towards continued existence and health. The more we experience our needs as being met, the more we generally experience joy or contentment, and the more we experience our needs as not being met, the more we generally experience suffering or discontentment.

Cognitive Constructs

Most people who seriously contemplate the three fundamental qualities of experience mentioned above will most likely find it difficult to disagree with them. However, as already discussed, living organisms apparently need to distinguish “self” from “other”, and one “other” from another, in order to meet their needs and to maintain their existence. This capacity for discrimination is done using one’s cognitive constructs — a basic framework for assessing one’s environment and making sense of oneself and the world. Each person’s (and indeed each living organism’s) cognitive constructs are unique, being based upon a blend of their innate structure or temperament (what we generally think of as the hereditary component) and environmental conditioning (which, for humans at least, will likely have significant overlap with other members of one’s society, and even more overlap with other members of one’s family, but will still be unique in many ways to each individual).

We can think of our set of cognitive constructs like a tall building composed of a hierarchy of levels, with each level being built directly upon the level(s) beneath it. And the very first levels are based upon the most core assessments we make of our experience, especially with regard to our existence. At these levels, because these are based directly upon the most fundamental qualities described above that we all share, it’s likely that the assessments we make here are very similar for all of us, and therefore they result in a couple of profound existential dilemmas and corresponding drives that we also all share.

The Unity/Duality and the Self/Other Dialectics — Our Primordial Drives

On what we could say is the first level of assessment of our situation is the recognition that the very existence of our “self” is resting on a very precarious foundation—a dynamic and interconnected flow in which there really is no real solid and secure “self” at all. At this deepest level, then, exists what we could call a profound dilemma that represents the origin of all of our suffering and discontentment. “We” arise from a unified field in which there are ultimately no separate “selves,” the subjective experience of which naturally consists of unitive feelings such as unconditional love, compassion, sympathetic joy and deep peace and equanimity. However, the experience of this unified field comprising the very fabric of the “self” also consists of the profound terror of self annihilation—no “self” can really exist within these no-self conditions. So our existence at this most fundamental level entails a profound and painful dilemma. On one hand, we experience a powerful longing for our continued existence and the general experience of aliveness on one hand, but this also carries with it a profound sense of insecurity and vulnerability. So we find ourselves also longing for a deep peace and security that are ultimately never entirely possible as long as we exist. So in order to maintain a tolerable and hopefully enjoyable existence, we have to find some dialectical balance between the experience of existence and the experience of transcending one’s existence, between duality and unity (see Figure 1). I suspect that it is this most fundamental of our dialectical dances that lies at the source of our most deeply held liberating or spiritual experiences and aspirations, as well as our most deeply held fears and insecurities.

Going up to the second level of our cognitive constructs “skyscraper,” we are now more fully immersed in the experience of duality (illusory as it is). We experience a “self” as relatively distinct from “other.” Explorations within the fields of object relations, attachment theory, and existential psychology (and my own personal exploration in my doctoral dissertation and in my book, Rethinking Madness) have discussed in different way the dilemma that occurs at this level. In essence, we find ourselves torn on this level between a powerful longing for autonomy and agency of the “self” on one hand, and a powerful longing for love, belonging and acceptance from “other” (see Figure 1). As we strive for autonomy, we find that we encounter increasing isolation anxiety, which compels us to strive in the opposite direction, towards connection with “other.” But as we move in this direction, we find that we encounter increasing engulfment anxiety, which compels us to once again strive for autonomy.  So here again on this second level, we find yet another dialectic struggle—one that is in many ways similar to the dialectic taking place on the unity/duality level, but this dialectic has resulted from the emergence of a higher order level of complexity, and so the dialectic also becomes more complex and nuanced. Ultimately, more layers develop on top of these, which consist of increasingly complex and nuanced interpretations of the world and their associated dialectics, fears, longings, feelings, and needs. The further we work our way up this towering skyscraper of cognitive constructs, the more each level becomes susceptible to the influence of the particular organism’s innate structure (temperament), and the more each level becomes shaped by idiosyncratic experience. The result is that while different organisms experience overlap within their general experience and understanding of the world to differing degrees, every organism will develop a set of cognitive constructs that is unique. This is similar to the way that we can say that no two snowflakes are exactly the same in spite of their sharing many of the same basic patterns with other snowflakes.

Needs_Diagram

Figure 1. The unity/duality and self/other dialectics along with some of their most closely related needs. While I    believe it’s generally helpful to categorize these particular needs in this way, our actual experience of these needs is often far more jumbled and blended than this (you can find a more comprehensive list of human needs and emotions here).

 

What are the Most Fundamental Properties of Living Organisms?

So, now that we’ve explored what it feels like to be alive from the “inside,” let’s explore the process of life by taking a somewhat more objective approach. What exactly is a living organism, and are there properties or qualities that we can say are common to all living organisms?

Most of us are aware that there has been a general trend to try to reduce organisms to their smallest material parts—the genes in particular—as would be expected given the dominance of the positivistic paradigm and its emphasis on reductionism and materialism. There has also been the tendency to emphasize selfishness and competition as the most fundamental drives of living organisms, again as would be expected given positivism’s emphasis on isolation and its general view of the world as consisting of fundamentally separate entities. The natural extension of this worldview to living beings is that they are entirely separate entities having to fight tooth and nail with other entities in order to maintain their own existence, although reluctant cooperation may occur at times but for entirely selfish reasons. This vision has given fruit to expressions such as “nature—red in tooth and claw” and “the selfish gene.”

However, as already alluded to, recent findings within the life sciences and new understandings emerging from complexity and systems theories have been forcing us to consider a very different understanding of living organisms and living systems and a very different set of properties belonging to them. Contrary to the general positivistic paradigm, we find that living beings simply are not machines nor are they anything like them, existing under an entirely different set of principles. Following is a list of what I believe are some of the most fundamental principles of living organisms.

Living beings and living systems are comprised of patterns of relationships, not matter:  All living beings and living systems (what I will collectively refer to as simply living organisms) consist of self-organizing and self-maintaining patterns of relationships and matter/energy flow—both between its own internal components and also between itself and other organisms and the environment in general. They all have semi-permeable boundaries, which conduct the constant exchange of matter and energy with the environment while maintaining its particular pattern. Even this pattern itself is in constant flux and flow, though it is far more consistent than the matter and energy that flow through it. Recall that the concept of a wave moving over a sea or a vortex standing above the drain in a draining bathtub helps us to conceptualize this idea that an organism is essentially made up of a particular pattern of relationships and matter/energy flow rather than the matter and energy itself.

Living organisms are holistic:  When it comes to living organisms, the whole is much greater than the sum of its parts. Studying the parts, no matter how much detail we gather, will never capture the qualities that emerge on the level of the whole—entirely new properties emerge on the level of the whole that are literally nonexistent within the simple sum of its parts.

Organisms exist within a hierarchy of symbiotic holistic organization:  One interesting feature of the property of holism is that we find the organism itself to be its own most fundamental unit. To understand this better, we can look at some of the most recent findings in the life sciences. The general consensus is that the nucleus-free (prokaryotic) bacterium is the simplest living organism that we have discovered. Any attempt to isolate its parts or reduce it any further will result in a lifeless mass—the matter still exists, but the qualities that give it “life” (discussed in more detail shortly) completely disappear. Going up the ladder of complexity, the evidence suggests that several different kinds of bacteria came together symbiotically to manifest as a nucleated (eukaryotic) unicellular organism. Continuing up the ladder still further, multiple unicellular organisms come together symbiotically to manifest as a single multicellular organism; going up the ladder further, we find ever more complex multicellular organisms—some kinds of protists, fungus, plants, animals and of course humans. Continuing up the ladder even further, we have ecosystems, which are composed of many different multicellular and unicellular organisms living together symbiotically, and which act very much like an organism in their own right. Finally, at the top of the ladder, at least on Earth, we have the entire biosphere consisting of all ecosystems and organisms on earth living together in a surprisingly cooperative and symbiotic manner. Again, the evidence suggests that the biosphere itself acts very much like an organism in its own right—the basis for the Gaia theory. So we find that life on Earth is composed of holistic symbiotic organisms, arranged hierarchically in terms of complexity, where symbiosis and cooperation are at least as important as competition and selfishness.

Order and Chaos — the two faces of organic development:  One particularly interesting feature of this hierarchy of organization is that the progression towards new levels of organization appears to occur in steps rather than along a continuum, from one order of organization to a state of relative chaos and disorder before finally emerging at entirely new order of organization with entirely different qualities than that which existed previously. This new understanding of the development of living systems has intriguing implications with regard to our understanding of virtually every area of living systems, from intra-organismic development to evolutionary progression to social behavior to the so called mental disorders and psychosis to the process of regeneration and healing of all kinds.

A universal organismic process:  The continuous unfolding of an organism through time as it strives to meet its needs is guided by a knowing/responding/becoming process that is common to all organisms, no matter how simple or complex it may be, what I’ll refer to simply as theorganismic process (See Figure 2):

(1) Perception:  Receiving input via sensory stimulation from the internal and external environment.

(2) Interpretation/Evaluation:  Interpreting what is perceived and making an evaluation with regard to its potential to either meet or interfere with one’s needs (i.e., is it potentially nourishing, harmful, or neutral?). One’s cognitive constructs are used to make this interpretation and evaluation.

(3) Desire:   The generation of an emotional and somatic response based the assessment that occurred within the previous phase. While this likely manifests as relatively simple craving and aversion in simpler organisms, these evolve into a far more complex array of emotions, impulses and interoceptive sensations in more complex organisms (the word emotion comes the French word émouvoir, which means “to stir up”). Generally speaking, unpleasant emotions/feelings arise (with the general qualities of craving and/or aversion) when needs are not being met, and pleasant emotions/feelings arise when needs are being met.

(4) Response:  Taking action/responding in an attempt to meet one’s needs (i.e., attempting to take in nourishment and avoid or repel threats). This phase has essentially two steps—an assessment of how best to respond (utilizing one’s cognitive constructs), followed by the actual response itself.

(5) Learning/Adaptation:  The main goal in this phase is to increase one’s future efficacy with regard to steps (1) through (4). This phase has essentially two steps—an assessment of the effectiveness of the response with regard to one’s needs, followed by the modification of one’s cognitive constructs and one’s physical structure in accordance with this assessment.

. . . and around and around this process goes, on each different organismic level—the more complex the organism, the more the levels. This process generally takes place so quickly and automatically that it is primarily unconscious. Humans and perhaps some of the other highly complex organisms clearly do have the capacity to slow down certain phases of this process, especially the assessment and response phases, which is likely one of the major benefits of self-consciousness and the associated physical structure (especially the highly developed prefrontal cortex). Whether the organism actually chooses to do this is another story.

What is particularly important to recognize about the organismic process is that this process is the process of life—as long as life exists within a particular organism, this process of knowing, responding, becoming, knowing, responding, becoming . . .  continues. It’s an all or nothing kind of a thing. Consider that even a single cell carries out the continuous repetition of this sequence of steps. Of course, its capacities with regard to each of the phases within this process are vastly simpler than those of an organism as complex as a human being. Generally speaking, as an organism becomes more complex and more resourced, the capacity for each phase of this process and the process as a whole becomes ever greater. What is particularly intriguing is that the evidence suggests we can even ascribe this same process to an entire social group (such as an ant colony, a flock of birds, a human family or society, an ecosystem, and even the entire biosphere—often referred to as Gaia within this context). It appears that there is something about this fundamental process of life that is simply invulnerable, so long as the particular organism remains alive. Another important implication of this idea is that all organisms conduct “real science” all the time—utilizing information that they take in from the world to shape their understanding and work towards ever more efficient strategies for meeting their needs.

 Organismic_Process_Diagram

Figure 2.  The Organismic Process

The emergence of cognitive constructs from the organismic process:  Concurrent with the unfolding of the organismic process is the development of an organism’s cognitive constructs, the particular patterns of knowledge or understanding unique to each organism that are both directly shaped by the organismic process and also directly guide it. They are shaped most directly within the “Learning/Adaptation” phase of the process, and they provide guidance especially during the “Interpretation/Evaluation” and “Response” phases (more on the details of this later). Whereas the organismic process is, as the name suggests, a dynamic process, the cognitive constructs are more appropriately considered a kind of structure—they allow for particular patterns of understanding and responding to remain relatively resilient in the midst of this very dynamic process. Recall that the word cognition essentially means the act of acquiring knowledge or understanding. So cognitive constructs allow for exactly that—the maintenance of particular patterns of knowledge or understanding (which ultimately guide responding) via the formation of structure.

Although there is essentially just one structure being formed in this process, we can say that it has two very different aspects:  one aspect is that which is experienced subjectively by the organism, as occurring within what we often think of as the “mind”—a qualitative (non quantifiable) knowing; and the other aspect of this structure is that which takes place within what we often think of as the “body”—that aspect of the organism that can be quantified and perceived objectively. Even though these are both associated with the process of cognition, for the sake of simplicity, I will refer only to the mental (subjective) experience of these as cognitive constructs , while acknowledging that these always contain a corresponding counterpart manifesting in bodily form.

To put this idea into context, let’s take the case of an amoeba who has recently arrived at the understanding that a particular element within its environment is toxic to it. This new understanding will manifest within this amoeba’s being as one structure with two different aspects—as the quality of subjective knowing itself (as occurring within mind), and as a bodily change corresponds with this (i.e., changes in the permeability of the cell’s wall or membrane, changes within the various components involved in its metabolism, etc.). This same kind of interdependent mind/body change occurs on many different organismic levels within more complex organisms. Consider, for example, the much more complex changes that occur within a human being upon recognizing the existence of an influenza virus in her or his environment. Subjectively, there would be the qualitative knowing that occurs on the mental level as the person integrates this new information; and objectively, there would be the physical changes that occur within the person’s body such as modified neural networks that go along with this new understanding or modifications taking place within the immune system upon coming into contact with the virus.

Mind and body are simply two different perspectives of the same thing:  So following from the discussion of cognitive constructs above, we can say that mind and body are actually not discrete entities at all, but rather are simply two different perspectives of the very same organismic process. Recall that the organismic process consists of the basic process itself as well as the structure (both mental and physical) that both emerge from this process and also continue to guide it in various ways. Mind, then, simply refers to the subjective experience of this entire process and its associated structure—in other words, what it all feels like from the “inside.” And body refers to that aspect of this process that can be observed objectively (as in “as an object”) and quantified. Recall that according to the positivistic worldview, with its emphasis on what can be objectively observed, the assumption has generally been that all human experience and indeed all life can be reduced to the body, with mind being nothing more than an often inconvenient epiphenomenon of the body. Notice how different the positivistic understanding is from the one being presented here, where mind and body are merely two different perspectives of the very same thing.

While on the topic of mind and body, it’s important to take a moment to discuss the use of the term brain. In mainstream discourse, the term brain is often used to mean both the primary organ of the central nervous system (in those organisms that have one) and that which generates the mind (i.e., subjective experience). However, as we’ve been discussing, the reductionistic and materialistic assumptions inherent in this way of thinking have been shown to be highly incongruent with the developing research. Sure, there’s no problem with using the term brain to refer to the primary organ of the CNS, but it’s not appropriate to consider that the brain generates the mind or even that the brain is synonymous with the mind. The brain represents only one part of what is experienced within the mind. Recall that the mind refers to one’s subjective experience of the entire organismic process, including the entire physical structure (the entire body, not just the brain) and the intersubjective interaction between the organism and its environment.

One final point here is that we can build off of this idea and recognize that all organisms (whether it be a bacterium, a human being, a flock of birds, or the entire biosphere) have both body and mind—again, body is simply that aspect of the organism that can be observed and quantified, and mind is that aspect that is experienced subjectively.

Responsiveness as opposed to reactivity:  It’s clear that the behavior of living organisms is very different from the behavior of nonliving matter. You only have to consider the difference between the knocking together of two billiard balls and the interaction between two unacquainted dogs to understand this important property of living beings. The billiard balls behave in a very predictable manner. But with the dogs, there will always be some degree of unpredictability with regard to how they will respond (and drawing from the chaos/order principle, in the case of the dogs, we will usually find that they interact in a more or less “chaotic” manner first before (hopefully) settling down to a more ordered pattern of behavior with each other).

Network- and circular-causality as opposed to linear causality:  Living organisms and living systems do not operate in a strictly linear cause and effect manner, but function within a complex web of network- and circular-causality. Very complex feedback loops and networks of mutual causality operate both within organisms and between organisms and the external environment, leading to conditions of vast complexity and fundamental uncertainty and unpredictability. These are conditions that positivistic inquiry is simply not equipped to adequately handle.

Putting it all Together—Towards a Holistic Organismic Paradigm

So we find a natural movement away from the strict materialism and reductionism of positivism to a much more holistic paradigm that finds merit in both the exploration of subjective experience as well as more objective observation, while holding the recognition that there really are no entirely distinct subjects and objects at all but rather a profoundly interconnected network of different patterns of relationships. The discoveries of both primarily objective and primarily subjective methods of inquiry are converging on a common paradigm:

From the methods of inquiry that have focused on direct subjective experience, we have arrived at an understanding of ourselves as arising from a profoundly interconnected and dynamic sea composed of the dance between unity and duality, which in turn gives rise to both unitive experience — what is often referred to as spiritual experience — and dualistic experience — our experience of a “self” as distinct from “other.” And this in turn gives rise to our most fundamental drive to maintain an enjoyable, healthy existence and the means with which to achieve this.

…and from the fields that have emphasized objective observation, we find a very similar kind of understanding emerging. We see the growing recognition of much more holistic principles within the fabric of our universe:  “Consciousness cannot be separated from matter, . . . the observer cannot be removed from what is observed, . . . [and quantum-actions are] information events that involve the interaction of parts of one interconnected, conscious universe” (Battista, 1996, pp. 203-4). And closely related to this is the emergence of a very similar kind of understanding with regard to the living organisms that have naturally unfolded from this fundamental fabric of the universe—understanding organisms as patterns of knowing/responding/becoming that unfold in a series of altogether new orders of organization with ever increasing complexity and symbiosis.

So bringing these relatively objective and subjective perspectives together into one overarching paradigm, we arrive at a holistic organismic paradigm that is very similar to the one that has long been recognized by the nondual traditions of the East and most (if not all) indigenous societies:  Life consists of an often mysterious blend of order and chaos, autonomy and symbiosis, mind and body taking place within a profoundly interdependent, interconnected relational field.

Rethinking Mental Health, Part Two:  From a Disease-Based Model of Support to One Emphasizing Organismic Wisdom

Paris Williams, Ph.D

Rethinking Madness:  With the rare perspective of someone who’s experienced extreme states from both sides — as a psychologist/researcher and as someone with lived experience — Paris draws from multiple perspectives to explore what it means to be “mad” in a “mad” society.

Rethinking Mental Health, Part 1: From Positivism to a Holistic/Organismic Paradigm Comments RSS

24 thoughts on “Rethinking Mental Health, Part 1: From Positivism to a Holistic/Organismic Paradigm

  1. I think you do a good job of capturing why I want to vomit or worse, when I see what positivism is doing to our lives. Only a world where the majority feel disgust at the way mainstream research objectifies us and our fellow humans and our lives and our worth and our inherent dignity, can be safe from atrocities. In the current situation where people are just fine with viewing ‘problem people’ as objects, it is not a matter of will the next holocaust happen, but when. It may well be a neuro-holocaust.

    I think of all of it, the biggest canary in the coalmine, is the access parents give psychiatry to their own children’s bloodstreams, without a second thought. That might even be a more significant coalmine canary than even forced psychiatry.

    A modern home is filled with iPads and kids. Each of these objects is just awaiting a technological innovation and can be better than ever…. the mindset goes.

    • “I think of all of it, the biggest canary in the coalmine, is the access parents give psychiatry to their own children’s bloodstreams, without a second thought. That might even be a more significant coalmine canary than even forced psychiatry.”

      _Anonymous,

      This is, to my mind (right now, at this moment), a rather frightening and devastatingly *true* statement you’ve offered.

      For, suddenly, I can well recall, that, in the past twenty-five years, there were a number of times (just brief periods of a few months) that I momentarily convinced myself that psychiatry is really *not* all that dangerous.

      I would do that self-convincing by telling myself that it’s ‘just my own *memories* of long-past trauma’ of ‘psychiatric abuse’ that make psychiatry *seem* quite dangerous.

      And, nonetheless, I’ve always come back to realizing the actual reality (i.e., to knowing that psychiatry is *plenty* dangerous); inevitably, that’s happened whenever I’ve heard that yet another child acquaintance has been “diagnosed” as “bipolar” or “ADHD,” by a psychiatrist, and, hence, has been placed on a daily regimen of psych-drugs.

      At the risk of now being somewhat minimally repetitive, here’s my most favorite brief quote from any psychiatrist (an unusually bright psychiatrist); it’s a line, a sentence, from a comment he offered, on his Youtube channel. Surely, some MIA readers have recently seen me post this in a comment, under another blogger’s blog; I lend it again because it is so perfectly apropos of this blogger’s blog, on positivism…

      “Criteria in DSM-IV are so sloppy that I often tell people I could diagnose a ham sandwich with bipolar disorder.” Niall McLaren M.D.

      Here’s to the prospect of broadly educating parents, on the dangers of Child Psychiatry.

      Respectfully,

      ~Jonah

      P.S. — a couple of related links…

      “ADHD Rises: 11% of U.S. Children”:

      http://www.madinamerica.com/2013/04/a-d-h-d-diagnoses-rise-to-11-of-u-s-children/

      “How Can a 4000% Increase in Bipolar Disorder Be Possible?”:

      http://articles.mercola.com/sites/articles/archive/2011/07/30/why-did-bipolar-disorder-increase-40x-over-last-ten-years.aspx?np=true

  2. Good piece, deserving of a second read to properly digest the whole. In the mean time, I’d like to offer two quick thoughts.

    First, mental health research has always had a bit of an inferiority complex, precisely because it is difficult if not impossible to conduct positivistically. Positivism dominates the conversation precisely because the conversation is so easily dissected by those coming from disciplines that yield more results by positivistic inquiry.

    Secondly, there is good money to be made by selling technological fixes to isolated, decontextualized problems. (Yes, I say “problems” without irony here. Many who seek mental health treatment do so because they are suffering and want help; hence they have a problem they would like solved.)

    In case of interest, here is a short link to some articles that relate to the malleability of the ADHD construct (Note and disclosure: some of these papers are my own): http://bit.ly/13WSLg5

    • I don’t think anyone would have a problem with you saying problems. Problems are problems are problems. We need the freedom to choose a solution to our problems from a range of choices. Government has thrown its weight behind the ‘one true’ creed. We live in a psychiatric theocracy.

    • Thanks for sharing these articles. I think ADHD is an excellent example of positivistic thinking applied to subjective experience (and undesired behavior) gone so wrong. Kids are kids–healthy children are very active, naturally wanting to run around, climb trees, explore,bounce their attention around to the many elements in their environment, etc., etc. Just look at kittens and puppies. Yet, if children have difficulty sitting in a chair and staring at a blackboard for 6-8 hours a day, then we think they must be diseased in some way, and we better give ‘em some drugs (essentially speed, no less). Sigh… I’m not discounting that there are numerous factors that can lead to certain kinds of distressing experiences or behaviors that sometimes get labeled “ADHD” (including poor nutrition, lack of time in nature, lack of enjoyable exercise, lack of supported curiosity, a little too much time in front of the tellie, etc.), but we really need to stop and reconsider (1) what kinds of experiences/behaviors are actually distressing/limiting, as opposed to which do we simply find annoying or are not congruent with our rapidly increasing desire for a society of conformists, and (2) is the “find the disease and throw drugs at it” approach really going to lead to sustainable solutions to our various life problems?

      Thanks for bringing these issues up,
      Paris

      I address these issues much more in Part 2 (next week).

      Paris

    • To cpmorley, _Anonymous, Paris Williams, Ph.D and whoever else may be interested,

      For a fairly brief and stunning example of postivist thinking, in action…

      http://www.psychiatrycpd.co.uk/default.aspx?page=15604

      That’s a link to a fifteen minute audio interview from a bit over a year ago; it’s presented by Britain’s Royal College of Psychiatrists.

      On that Royal College of Psychiatrists Web page, you’ll read:

      “Treatment of ADHD in prison inmates”

      “Dr Ylva Ginsberg and colleagues recently conducted a study to test the effectiveness of methylphenidate as a treatment for ADHD in prison inmates. Here, Dr Ginsberg discusses her findings with Dr Ovais Badat, and reviews how the research can influence future treatment in prison populations.”

      [Really, I highly recommend this bit of audio -- to anyone who may have a desire to experience, in the depths of their being, a conversation of the most outrageous positivist nonsense; and, if you're interested in issues of psychiatry and 'criminal justice' (e.g., _Anonymous, I know this interests you), and you have some sense of both the imminent and future danger, of society's further merging, of Psychiatry with the Prison System, then, by all means, do click on the above link -- then go to the "DOWNLOAD" button, to access the free audio podcast...]

      Respectfully,

      ~Jonah

  3. A great start on the complexity of all this. I’ve written a much shorter piece about chaos and mental health here: http://redesigningmentalillness.blogspot.com/2012/08/chaos-of-needle-man.html

    But I’m not ready to toss out positivism, science, psychiatry, life in America, the notion of health vs illness, safety vs. risk, an ideal relating to worldly success, family life, social controls, government intervention and so forth. These work for me (to a certain extent). I don’t favor Eastern civilization or methods over Western civilization or methods. We all have our druthers.

    But thank you nonetheless for this beginning. I am looking forward to reading the second half of this post.

    • Thanks for sharing your other own piece on chaos and complexity. We’re definitely on to some similar ways of thinking.

      I’m not sure, however, how you interpreted that I favor Eastern civilization over Western. I do believe that some of the philosophies that have come out of the East (especially the nondual traditions) have a whole lot to offer us in our attempts to understand the nature of our own subjective experience at a very deep level (as discussed in this article), though I think that generally speaking, civilizations in both the East and the West have been moving away from a more sustainable symbiotic relationship with our natural environment beginning thousands of years ago. If anything, I believe it’s the indigenous societies (so the collective ancestors of both the Eastern and Western civilizations) that have the most to teach us with regard to living sustainably–after all, they managed to live sustainably for hundreds of thousands of years, whereas this broader shift in our evolutionary path that has led us increasingly seeing ourselves (humans) as somehow separate and “better than” the rest of the natural world has begun arguably as long as 10,000 years ago, kicked up a good notch a few thousand years ago, and went to full steam ahead in the last few centuries.

      Look around. Do you really think we can sustain our current track indefinitely? While I recognize that my own views are controversial, I personally see signs everywhere that we are racing ever more quickly towards a very serious precipice. I believe that we can try to change course the best we can now and hope to avert the worst of the carnage, or we can just keep the blinders on and hope we can somehow fly…

      As for looking to indigenous society and their more ecological values, I’m not suggesting that we can go “back” to living as indigenous tribes (though who knows, we may not have a choice at a certain point), but that perhaps we can learn from this much more holistic/ecological/organismic paradigm that is actually very similar to our original paradigm, and consider how we can bring these ideas and values back into our societies now. I don’t have any groundbreaking answers on how to do this, other than hope to inspire others to contemplate these issues and consider ways that we can move collectively in this direction.

      Paris

  4. It is easy for me to understand why you found an alternative to the current “science” of psychology; it is fundamentally wrong. Neuroscientists wrongly assume that the brain is malfunctioning when it expresses distress; they also wrongly assume that they can describe what’s malfunctioning with a mental process unknown to them. My criticism of your philosophy is expressed in the reply by “cpmorely” (above); it seems to discount the problems and painfulness of mental distress. I am a scientist who is convinced that real science proves that mental distress is the natural, normal biology of distressful experiences.

    Best regards, Steve

    • Hi Steve,

      I actually agree completely with your assessment that “real science proves that mental distress is the natural, normal biology of distressful experiences.” I thought this would have been clear in this post, but if not, it will certainly be made more clear in Part 2 next week.

      All the best,
      Pais

    • I don’t believe that his philosophy discounts the problems and painfulness of mental distress. I’ve not found that Buddhism or certain expressions of Hinduism or the Tao do this at all. They certainly do offer a different way of looking at what is happening. I believe that they also give us a different way of dealing with this distress rather than drugging people to the gills with toxic drugs and making them frozen to their true feelings and emotions.

      • Well said, Stephen.

        In the second part of this article (being posted next week), I address these issues explicitly and discuss the implications for why drugs are so problematic, especially in the long term–primarily because of “making [people] frozen to their true feelings and emotions” as you say so well. I’ll also discuss why I believe the practice of mindfulness meditation and other practices that allow one to develop the ability to be with one’s experience (even the painful and distressing aspects) in a more open and allowing way can be so beneficial.

        Paris

  5. “Stripping Living Organisms Down to Their Essence”

    This makes me want to scream RAPE. I scream rape everyday but then, I’m supposedly severely mentally ill (probably because of the rape).

    “Putting it all Together—Towards a Holistic Organismic Paradigm”

    It was about one to two weeks ago when I heard “put it all together” inside of my mind. My body moves, automatically. I call it “spirit dancing”. I don’t always know what the movements and signals mean. My hands have been holding something, for a while. Few years. I’m not exactly sure what I’m holding. But I’ve been holding my two hands SEPARATELY now, when I had been holding them together. I’m sure that I actually DO have to “put things together”, but I was in conflict. WHAT two things? What model do I want to use? Male / Female? Good / Evil? Health / Sickness? I couldn’t identify or specify WHAT I was holding in each of my hands. I moved on to something else. But seeing those words is a “trigger” for me, gets the subsequent flood and dump. And as always, I NEVER stop looking for the right connections and outlets for what it is that *I DO* (which is mental, and communications, at a DIFFERENT level than others). Always out of place. Hmph!

    Holistic. Organ. Ism.

    Myself, I cannot be “put back together”. I’m shattered.

    • Hi mkj,

      Now that you’ve drawn my attention to this section title, I can see how it is a little intense. I regret that you found it so triggering–I’ve gone ahead and changed it to a less provocative title.

      I’m sorry to hear that you feel so “shattered,” though I admire your ability and desire to move and dance through it all. Thanks for sharing a little bit of your own being’s organismic wisdom.

      Sending my best wishes,
      Paris

  6. What you say makes complete sense – not only as you criticize the prevailing conventional wisdom and also as you attempt something very different. It becomes so complicated though doesn’t it? To engage with the everyday world in which most of us live and to confront mental problems and societies which encourage them, something simpler and deeper is needed.

    Well I am raising the question to answer it. Based in UK, a full psycho social model and paradigm has been developed. Its called Human Givens. Have you come across it?

    If not you should investigate it urgently. And if you are open (and the readers of this website), it will blow your mind. Feel free to ask for more on this from me for this forum, including the basic ideas and references.

  7. Thanks for letting me know about the “human givens” approach. I just perused it’s basic principles on Wikipedia, and it is clearly very much on the same page as what I’m bringing up here and what the human potential movement and humanistic psychology in general have been promoting.

    I also agree with you about the need for simplicity, which I try to bring in in Part 2 of this article–if you haven’t read that yet, I recommend it. The first half of it is a little complex, because I’m attempting to reframe the mental health diagnostic system that’s currently in place, but in the final part of it, I hone it all down to a few simple dilemmas and core needs that are most essential, and a few methods of support that I believe are the most effective in supporting someone in meeting these. Again, it seems to be very much in alignment with the “human givens” perspective, with a few different twists.

    Paris

Leave a Reply