On Human Nature and Its Implications for the Mind-Body Problem


Peter Hacker is an eminent philosopher and one of the world’s leading authorities on Wittgenstein. He has published a four volume analytical commentary on the Philosophical Investigations and a brilliant little book on Wittgenstein’s philosophy of mind, now sadly out of print.1 He is also well known for his debunking of neuroscientific reductionism in collaboration with various neuroscientists.2 3

In 2010 he published the first of a series of books on human nature. The series is the exposition of the wisdom Hacker has derived over his career from Wittgenstein and many other philosophers, including, importantly, Aristotle. Hacker generously looked over this review for me, so as well as consolidating my own knowledge, I hope I can also convey something of his revelatory understanding of the nature of life.

The first volume of Hacker’s magnum opus is the beginning of an intriguing exploration of what it means to be human.4 Hacker interrogates in detail both what it is to be alive in a general sense, and what it means to be the unique sort of living things that human beings are. The next two published volumes address ‘intellectual powers’ and emotions and passions, and a fourth volume, yet to be published, will cover the subjects of ‘morality, determinism and a worthwhile life.’

In his intention to understand human nature through an analysis of language, Hacker is undertaking the project implicit in Wittgenstein’s view of the role of philosophy — to elucidate the concepts we use and to reveal the origin of the philosophical confusions we become entangled in ‘when language goes on holiday’.5 (§ 38) It is a project of clarification, but in this rather mundane-sounding activity lie profound insights into the nature of being human, for, as Wittgenstein realised, our language expresses the sort of creatures that we are. Through disclosing the conceptual framework within which we think, act and come to know things, our deep and implicit understanding of ourselves and our world is revealed. ‘Essence is expressed by grammar’ as Wittgenstein put it. (§ 371)

In a way, Hacker is only showing us what we already know, but the brilliance and necessity of his analysis is twofold: first he examines concepts and ideas that most of us have never thought to examine, at least not in the way that Hacker does, and secondly he disentangles confusions that have arisen by our desire to explicate concepts in the wrong way. Scientific psychology and neuroscience lead us astray by suggesting that philosophical confusions, the ‘mind-body problem’ for example, are empirical issues to be solved by science.

For me, the revelation of Hacker’s work is the simplicity and common sense with which he describes the nature of living beings in general, and human beings in particular. He reminds us, for example, that human beings are ‘substances’, that is material things, or in Hacker’s words ‘sentient, space-occupying, spatio-temporal continuents of a certain animal kind’ (P 29). We are not minds or disembodied agents, nor are we brains, as much philosophy of mind seems to imply. We are whole material beings that, like other living organisms, have a finite existence. Like all other material things in the macroscopic world, each one of us traces a unique path through time and space. Hacker shows how concepts of material things or substances are among the most fundamental parts of our conceptual framework, our understanding, of the world. Our experience is first and foremost of the material — both of our own bodies and actions, and of the environment in which we are immersed.

Hacker’s most important point, however, is his emphasis on the unique features of living beings and how they differ from inanimate entities and substances. Hacker follows Aristotle in emphasising the teleological nature of life. Teleology is the explanation of things or events in terms of their goals or purposes. Unlike inorganic solids, liquids and gasses, living things grow, develop, reproduce and die. They can ‘thrive and flourish’ or they can ‘decline and decay’ (P 176). Hence it is possible to understand biology in terms of what is good for an organism and what is not good for it. Linked with this, living things behave in ways that are purposive. Their actions can be interpreted in terms of how they fulfill certain goals. The most basic of these are to survive, flourish and reproduce, but complex beings like ourselves can have purposes of our own, such as enjoyment, interest and caring, which may or may not be consistent with biological ‘goods’.

Living things have characteristic ‘powers’ or capacities that depend on the physical structure of their bodies and the development of their internal systems or organs. Oak trees can grow into huge, spreading trees that survive for centuries. A seagull characteristically learns to fly and fish to swim. Higher animals have capacities to nurture their young, to make choices and some of them to cooperate with each other to achieve a goal. Humans have particular physical capacities, including a high degree of dexterity, and they also have unique mental abilities.

Understanding human beings as organisms with certain powers is key to addressing the problem set up by philosophers such as Descartes and Locke about the relation between mind and body, or mind and world. For Aristotle, the psuche or ‘psyche’ was not a separate part of the organism with a relationship of some sort to its body; a creature’s psuche can be seen as the capabilities of the organism, the things it is characteristically able to do. Hacker suggests that, in a similar way, the concept of ‘mind’ can be understood as the set of mental capacities typically possessed by human beings. Most important among these uniquely human capacities is the use of language. Our intellectual ability and facility for language enables humans to be aware of general truths, to ‘reason and deliberate’ (P 239), to reflect on their own actions, thoughts and feelings, to be aware of the past and the future, to have a sense of right and wrong, to imagine things, to cooperate in a whole variety of demanding endeavours and to have complex emotions such as hope and regret.

Hacker also shows how the way that we use the term ‘mind’ in colloquial speech reflects various sorts of intellectual activities. To have a thought ‘cross one’s mind’, for example is ‘for something to have occurred to one’ (P 249). To call something to mind is to remember it. To ‘know one’s mind’ is to have formed an opinion. Thus Hacker concludes that in ordinary speech ‘talk of the mind . . . is merely a convenient façon de parler, an oblique way of speaking about human faculties and their exercise’ (P 250).

Therefore the ‘mind’ is not something inside us. Indeed, it is important to appreciate that it is not a ‘thing’ at all. It is the various capacities the human organism possesses to respond in a particularly sophisticated way to the world around it. These capacities are not separable from the human organism as a whole, including its physical body. The mind-body problem is, to use Hacker’s example, like trying to relate the colour of a five pound note to its value: ‘A £5 note is green and has a value of £5 but the colour green does not stand in any relationship to the value of £5’ (P 283).

In a brief history of teleology, Hacker describes how Aristotle’s views were adapted by Christianity, which introduced a divine Creator, a designer. Henceforth, the purpose of life became to manifest the intentions of the Creator rather than to fulfill the intrinsic nature of the organism in question. Purpose became entwined with design. This modified teleological view was then killed off by modern science, which expunged teleology from its view of the Universe, and attempted to apply the principles of physics to all understanding, including the study of human beings — both their biology and their activity. The modern scientific framework therefore analyses all aspects of the world as a mechanical system, in terms of cause and effect. Instead of looking at the underlying purposes of organisms and how their biological structure enables them to fulfil these, there is a search for the ‘causes’ of certain situations or outcomes. For Hacker this is a mistake. Although some aspects of biology can be understood in causal terms, a rich and complete understanding of life depends on understanding its purposive nature.

Hacker, like other thinkers,6 stresses the difference between nomothetic and idiographic forms of knowledge. The nomothetic is the typical scientific model which looks for generalities and universal laws, and analyses events in terms of cause and effect. The idiographic approach attempts to understand ‘something particular’ (P 162) by reference to its unique circumstances and antecedents. Hacker further distinguishes teleological, nomothetic explanations, which are those that are framed in terms of function, which he refers to as ‘teleonomic,’ for example the functions of bodily organs or instinctive or reflexive animal behaviour. Teleological explanations of human actions, on the other hand, are idiographic. They ‘render an act intelligible but not by relating it to a regularity or law’ (P 162). The idiographic approach does seek generalities, but not universals and it explains by reference to reasons not causes. As Hacker suggests in his third volume of the series on The Passions, we use art and literature to illustrate and explore various forms of emotion and feeling — both the familiar and the more unusual.7 We do not explain emotions by constructing a formula to predict what feeling will occur in a particular set of circumstances, we look to art to help us understand those aspects of our common human experience that are difficult to describe directly.

For Hacker, therefore, understanding human behaviour is not a science — it is something that everyone achieves to a greater or lesser degree through participation in the language-using community of human beings. A proper understanding of human behaviour, one that does justice to its nature, differs from the form of understanding that is proper to the natural world. Yet, unlike other critics of positivism, Hacker further distinguishes between the living and the non-living world, and suggests that the way we understand life, both the biology of the body and the behaviour of organisms, is fundamentally different from the way we understand the inanimate world, because the former is teleological, and the latter is not. Living things can be understood in terms of purpose, but inorganic matter cannot.

Hacker’s distinction between the teleonomic and the idiographic suggests, however, that aspects of the study of living things can be approached using the methods of natural science. Causal explanations are legitimate when studying biology, but they explain how an organism has the powers that it does and what mechanisms come into play when it does certain things. They do not explain or predict what exactly an animal will do, for which we need a sense of the animal’s purposes. Yet, Hacker further points out that many animate things do not have a purpose; disease, for example.

The teleological approach is, however, helpful to clarify what has become a tortuous discussion about the nature of disease. Leaving aside the contentious issue of whether mental disorders qualify as diseases for a moment, as far as physical conditions are concerned, health can be understood as a state of the body that enables the organism to undertake the activities typical of its kind. Disease is a state that interferes with this, including all the defects of organs and systems that prevent them from enabling the organism to function as a member of its species normally would. According to these definitions, which are simple, but also compelling, there is no great difficulty in characterising health and disease. There is no need to agonise about whether or not concepts of health and disease are socially constructed. Although there will always be debate at the margins, in general the concepts are implicit in a proper understanding of the nature of biology. Setting aside his attempts to incorporate mental disorder into a disease framework, they roughly coincide with the philosopher, Christopher Boorse’s naturalist definition of disease as the breakdown of a biological function.8

I agree with Hacker that Aristotle’s concept of a human being as an organism endowed with certain characteristic powers is correct and useful, and, following from this that the ‘mind’, or mental capacities, are necessarily inseparable from the material substance or body whose capacities they are. However, there is a way in which our mental attributes are more central to our identity than our physical or corporeal properties.

Our mental capacities, beliefs, preferences and choices can be thought of as our personality, and our personality is, I would suggest, what we think of as being most distinctive about us. I can imagine, for example, having a different sort of body, although this is, or course, a logical impossibility — a ‘nonsense’ to use Hacker’s term. Yet I cannot imagine having a different personality and still being me. My beliefs, attitudes, inclinations, emotional responses, and the activities all these are manifest in, are essential to my sense of myself in a way that my height and my hair are not. My beliefs and proclivities may change, of course, but in this case I am changing too.

This is relevant when thinking about the nature of ‘mental disorder’, which, as a variety of beliefs and actions has, I believe, a deeper and more direct relationship to our sense of ourselves than a disease of the body, except when that disease affects the brain. Diseases that affect the brain such as advanced dementia can change the personality profoundly, of course, but then we do not think of the person as being ‘themselves’ any more. Having a chronic disease of another part of the body can also affect an individual’s personality, but indirectly, through the way someone has to adapt to the presence of the condition, or the life lessons that can be learned through having it. The disease does not constitute a change in personality in itself, it leads to one. Yet a change in one’s beliefs and actions, as occurs with the onset of a mental disorder, like depression or schizophrenia, is a change in one’s personality, in itself. Although brain disease can cause personality change, I suggest that most situations we label as mental disorders are not the result of brain disease. Wittgenstein saw this when he suggested that that “Madness doesn’t have to be regarded as an illness. Why not a sudden — more or less — change of character?”9 (P 62)

In my view, our desperation to view mental disorder as a disease leads to unhelpful assumptions that it is somehow distinct from the ‘true’ self, as bodily conditions to some extent are, and this encourages the supposition that it can be treated or cured without changing the individual’s personality. This has led to a huge programme of medically-disguised social engineering, in which people are encouraged to change the way they think and behave, by being persuaded that they have a medical condition that needs to be eliminated. Antidepressants and anti-anxiety drugs are doled out with no attention as to how they alter normal intellectual and emotional capacities, on the unsupported grounds that they are rectifying an underlying neurochemical deficit. Even psychotherapy is presented, sometimes, as if it is a remedy for a medical disease. While it may, on occasion, be desirable that people should change their behaviour, either for their own sake, or for other people’s, this should not be something that is achieved through subterfuge, even if the majority of the population are signed up to that subterfuge.

Acknowledgements: I would like to thank Peter Hacker who very generously looked over this review and helped me to clarify my ideas; also Steven Tresker for helping me to understand Boorse’s view of disease.

Show 9 footnotes

  1. Hacker PMS. Wittgenstein. London: Phoenix; 1997.
  2. Bennett MR, Hacker PMS. Philosophical Foundations of Neuroscience. Oxford: Blackwell Publishing; 2003.
  3. Nachev P, Hacker P. The neural antecedents to voluntary action: a conceptual analysis. Cogn Neurosci. 2014;5(3-4):193-208.
  4. Hacker PMS. Human Nature: The Categorical Framework. Oxford: Wiley-Blackwell; 2010.
  5. Wittgenstein L. Philosophical Investigations. Oxford: Basil Blackwell; 1953.
  6. Lindlof TR. Nomothetic vs idiographic science. In: Donsbach W, editor. The Encyclopedia of Communication, First edition. 2008: John Wiley & Sons, Ltd; 2008. p. 1-5.
  7. Hacker PMS. The Passions: a study of human nature. Oxford: Wiley Blackwell; 2017.
  8.  Boorse C. A Second Rebuttal On Health. Place of publication not identified: Oxford University Press; 2014. 1 online resource p.
  9. Wittgenstein L. Culture and Value. Oxford: Basil Blackwell; 1970.


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  1. Joanna, I appreciate your attempts to grapple with the difficult philosophical problems that have led up to our post-modern confusion regarding what a human being is, what the mind is, and particularly whether or not there is any such thing as a “mental illness” or a “mental disorder.”

    Of course you, Hacker, and Wittgenstein are correct to debunk neuroscientific, or more accurately, neuroscientistic reductionism. You are also correct that if we are going to discuss human nature, or the nature of life, a good place to start is with Aristotle. It would be interesting to contrast Wittgenstein’s or Hacker’s conception of the connection between language and the kinds of beings we are with that of Aristotle, but as the internet sensation Sweet Brown wisely put it: “Ain’t nobody got time for that.” https://www.youtube.com/watch?v=waEC-8GFTP4

    You and Hacker are correct that psychology and neuroscience lead us astray. But Hacker’s attempt to describe human beings or the nature of life is also reductionist, albeit not to the same extent as the reductionism of psychology and neuroscience. In Aristotle’s teleology, human beings aren’t just unique in their physical or intellectual capabilities. You only allude to the deeper truth that was understood by the ancients, namely, that human purposes are connected to goods that are pursued because of three main motivations: the pleasant, the useful, and the noble.

    As you point out, many modern and post-modern philosophers rejected the wisdom of Aristotle, the ancients, and teleology. Beginning primarily with Machiavelli, they also rejected Christianity. This led to much of the confusion that was inherited and exacerbated by thinkers such as Hobbes, Descartes, Bacon, Locke, and others.

    Although Hacker posits a conception of mind that might resemble Aristotle’s “psuche” in some ways, the comparison breaks down as soon as he loses track of the ancient motivations grounded in the pleasant, the useful, and the noble, or the longing for a better world as articulated throughout the medieval Christian era. Hope and regret, for example, are not just complex emotions, and one’s sense of right and wrong cannot be severed from these ancient or Christian sources without falling prey to the same modern influences that produced the scientism and reductionism inherent in neuroscience, psychology, and especially psychiatry.

    But all of this philosophizing serves as your preface to the question of the nature of health and disease, ostensibly to support the conclusion that “health can be understood as a state of the body that enables the organism to undertake the activities typical of its kind,” and disease “is a state that interferes with this.” You also use this preface to bolster your conclusion that “our mental attributes are more central to our identity than our physical or corporeal properties.” But these things only beg the questions that Aristotle and Christianity answered more completely than any subsequent thinkers, namely, what is a human being, and what is human identity?

    The attempt to associate identity merely with personality is far from the definitions of a human being that were set forth by Aristotle or by Christianity, and hence much closer to the definitions set forth by Descartes and Locke. Furthermore, the attempt to connect enigmatic notions of a “mental disorder” with personality breaks down on many levels when we consider that fictitious “diseases” such as “schizophrenia” or “depression” have nothing to do with beliefs, actions, or sense of self, and everything to do with labels that are imposed from the outside by the very scientistic reductionists that you criticize.

    Not only is it madness to suppose that so-called “mental disorders” constitute disease, it is madness to suppose that there is any such thing as a “mental disorder” that corresponds with an underlying biological, psychological or personal phenomenon. Of course medically disguised social engineering is abhorrent, but so too is philosophically disguised social engineering. Psychiatry’s obsession isn’t just to view “mental disorder” as disease. Psychiatry’s obsession is to view everyone other than oneself as the problem. Instead of relentlessly seeking to change other people, whether through pseudo-medical or behavioral interventions, wouldn’t it be more pleasant, useful, and noble to engage our human faculties in the exercise of improving ourselves?

    I suppose it is only human nature to attempt to create or define a “mental disorder” where no such thing exists, instead of working toward those ends that the ancients and the medieval Christians saw more clearly than we do.

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    • Thank you Slaying the Dragon for your thoughtful comments. I look forward to them, because I know I will always learn something. So I especially appreciate your discussion of Aristotle and Christianity and the contrast between their understandings of human nature and the modern line of thought that has led to the sort of neuroscientific reductionism we see today. I agree with you that we are motivated by pursuing certain ‘goods,’ and that this motivation underpins our sense of right and wrong, and our sense of the meaning and purpose of life, but as Aristotle points out, these ‘goods’ are the product of society, at least to some extent, not something that is inherent in us. This is why, as individualism grows, and religion and social conservatism lose their hold, we struggle to find a universal basis for our beliefs and morals. Individualism has a bad name nowadays, and it is right that we are often tempted to neglect the social, but we should not forget that our sense of ourselves as indivisuals, with some power to influence events ourselves, is associated with the shaking up of centuries of unchallenged social heirarchy. I probably don’t need to point this out to an American! But I don”t think we can resolve modern existential problems simply by returning to ancient philosophy or medieval Christianity – and I apologise if I am over-simplifying your position, which as I said is definitely thought-provoking.

      On the question of mental illness/disorder, I think it is too simplictic to just blame psychiatry. I recognise that psychiatry does create many of the problems it is supposedly there to address, but there is a historical record of something that was widely recognised as ‘madness’ (lunacy, insanity etc) long before psychiatry came into existence, which caused problems for many different sorts of communities. I am not making a plea for psychiatry, but I am trying to work out how we, as a society, can respond to these problems without pretending they are medical conditions, with all the worrying implications that go along with that view.

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      • Religion lost their hold, because they entered into a faustian deal with the psychological and psychiatric industries long ago, not to mention the government. It’s called “the dirty little secret of the two original educated professions,” according to an ethical pastor.

        It’s all about the religious hospitals and doctors profiteering, now in the tune of billions, off of covering up the religions’ and their wealthy’s “zipper troubles.” And covering up child abuse and rape is the primary, historic and current, function of our “mental health” industries.

        And the DSM, to this day, is still set up such that NO “mental health” worker may EVER bill ANY insurance company for EVER helping ANY child abuse survivor EVER, unless they misdiagnose them.


        The DSM based “mental health” system is a child abuse and rape covering up system, by design. And make no mistake, if you report that medical evidence of the abuse of your child was handed over to a Chicago policeman. He’ll refuse to file a report, but tell you to go talk to a psychiatrist.

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      • “but as Aristotle points out, these ‘goods’ are the product of society, at least to some extent, not something that is inherent in us.”

        Citation please. Are you suggesting that Aristotle thought that the good, the true, and the beautiful were merely conventional? Perhaps I have misunderstood.

        “but we should not forget that our sense of ourselves as indivisuals, with some power to influence events ourselves, is associated with the shaking up of centuries of unchallenged social heirarchy.”

        Please elaborate.

        “But I don’t think we can resolve modern existential problems simply by returning to ancient philosophy or medieval Christianity”

        I didn’t mean to suggest that we can resolve modern existential problems simply by returning to ancient philosophy or to medieval Christianity, but I was suggesting that unless we have at least some grasp of both of those things, we will make very little progress in fully understanding modern existential problems in the first place.

        “On the question of mental illness/disorder, I think it is too simplictic to just blame psychiatry. I recognise that psychiatry does create many of the problems it is supposedly there to address, but there is a historical record of something that was widely recognised as ‘madness’ (lunacy, insanity etc) long before psychiatry came into existence, which caused problems for many different sorts of communities.”

        Your point is well taken, but there is something different about the modern manufacture of madness for which psychiatry is directly responsible. Although he is too libertarian for my taste, Szasz writes eloquently on this point. Oldhead has it right. It is a far cry from the “village idiot,” or ritual ostracism, or even a few so-called “lunatics,” to the mass production of “mental illness,” the mass persecution of the “mentally ill,” and the medicalization of everyday life. Szasz often referred to the problem as the “therapeutic state.” The therapeutic state is unique to our time, and psychiatry has played a major role in the growth of this therapeutic state.

        “I am not making a plea for psychiatry, but I am trying to work out how we, as a society, can respond to these problems without pretending they are medical conditions, with all the worrying implications that go along with that view.”

        The first and most obvious step is to understand what the “problem,” or really, the lack of a problem, is. By positing that there are “problems” (a euphemism for “mental illness”) to which society can respond, you are making a plea for psychiatry. Psychiatry, the so-called “mental health” industry, and the pharmaceutical industry, thrive by promoting and propagating the myth of “mental illness.”

        I do not wish to imply that all psychiatrists are inherently evil. Most are probably good, but egregiously misinformed people. One may recall that a certain man with an ugly mustache was very eager to take care of what he regarded as “the Jewish problem.” Many good people were drawn in by his propaganda.

        Listen to T.S. Eliot:

        “Half the harm that is done in this world is due to people who want to feel important. They don’t mean to do harm; but the harm does not interest them. Or they do not see it, or they justify it because they are absorbed in the endless struggle to think well of themselves.”

        Then listen to Henry Grady Weaver:

        “Most of the major ills of the world have been caused by well-meaning people who ignored the principle of individual freedom, except as applied to themselves, and who were obsessed with fanatical zeal to improve the lot of mankind-in-the-mass through some pet formula of their own. The harm done by ordinary criminals, murderers, gangsters, and thieves is negligible in comparison with the agony inflicted upon human beings by the professional do-gooders, who attempt to set themselves up as gods on earth and who would ruthlessly force their views on all others with the abiding assurance that the end justifies the means.”

        Finally (and this is the most perceptive comment), listen to C.S. Lewis:

        “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”

        This is a PERFECT description of psychiatry.

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  2. Thanks Dr. Moncrieff.

    It’s safe to say most shrinks are not Platonic philosophers. Yet mainstream psychiatry has subscribed to a dichotomous notion of the flawed versus the ideal real.

    The unaltered sufferer is the “flaw.” The mad scientist sees himself as a godlike creator of the ideal as he alternately fries, cuts up, or chemically damages the brain of his hapless test subject.

    It’s indeed odd how they think taking away people’s ability to work, have relationships, or live independently is an improvement. But acknowledging the damage would force them to accept responsibility. What’s a god to do? Blame the victim of course.

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  3. Making a service industry out of the treatment of disease, physical or imaginary, is not the same as seeking the cessation of the symptoms of “disease”. More and more “diseased” people, of course, keeps the service providers, the healers that can’t heal, in business, just as fewer and fewer “diseased” people would threaten their livelihood. I would suggest that all these convoluted methods of rationalizing your profession are unnecessary when it comes to dispensing with that profession.

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    • Exactly Frank. No amount of rationalization can turn evil into good or wrong into right. Even if you piled up every philosopher and brilliant rhetorician in the history of the world on the side of psychiatry, psychiatry would still remain a pseudo-scientific system of slavery.

      Abraham Lincoln’s wisdom applies here: “How many legs does a dog have if you call his tail a leg? Four. Saying that a tail is a leg doesn’t make it a leg.” Saying that psychiatry is medicine doesn’t make it so. Saying that there is such a thing as “mental illness” or “mental disorder” doesn’t make it so.

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  4. “Do you see the complete harmony between central dictatorship, fascism, political callousness, and the self-centeredness of the spiritual point of view?”

    “The word “normal” comes from the Greek norma, which was a carpenter’s square, that right-angled tool for establishing straightness.”

    “Psychoanalysis has to get out of the consulting room and analyze all kinds of things. You have to see that the buildings are anorexic, you have to see that the language is schizogenic, that “normalcy” is manic, and medicine and business are paranoid.”

    “My practice tells me I can no longer distinguish clearly between neurosis of self and neurosis of world, psychopathology of self and psychopathology of world. Moreover, it tells me that to place neurosis and psychopathology solely in personal reality is a delusional repression of what is actually, realistically, being experienced.”

    James Hillman

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  5. Thank you for years of community service in challenging the harm of psychiatry.

    Psychiatry has power in the community because it purports to be scientific; in contrast, the “mind-body problem” is a philosophical problem. This blog is an interesting philosophical commentary on human nature but our community considers science to be our best way to understand ourselves and our environment. The power of psychiatry to harm the community with the myth of “mental illness” rests substantially on a community belief that psychiatry is a legitimate biological (medical) science. Unfortunately, as a medical doctor discussing the “mind-body problem”, you create the implication that psychiatry has some legitimacy as a biological science.

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  6. “What’s a god to do? Blame the victim of course.” I do agree, there is a god complex problem with our “omnipotent moral busy body,” primarily child abuse and rape covering up, DSM deluded psychiatrists and psychologists. But this is because no one is arresting them for their child abuse covering up crimes, and the lawyers won’t take cases against them.


    I agree, Joanna, psychiatry today, as it’s always apparently been, is “subterfuge.” It’s primarily about gas lighting people to cover up child abuse and rape, systemically and on a massive societal scale. And this, of course, also functions to empower the pedophiles and child sex traffickers. So all of western civilization now has systemic pedophilia and child sex trafficking problems, even according to world leaders, and the few ethical within the “mental health” industry.


    Perhaps it’d be wiser if the psychologists and psychiatrists got out of the business of turning child abuse survivors, and their concerned family members, into the “mentally ill” with the psychiatric drugs.


    And our society started arresting the child abusers, rapists, and those who profiteer off of covering up child abuse instead. I’d like to see an end to psychiatry and psychology’s century long war against child abuse survivors, their families, and other vulnerable or trusting innocent people. I’d like to see an end to their modern day psychiatric holocaust of innocents.


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  7. I do not see disease as purposeless. If I get a cold, which I never do anymore, I might ask myself what the message is in it. Any kind of not feeling well, including something simple like fatigue, I look for what this is saying. I always learn something.

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  8. These are very apt existential questions which I was confronted by by my experience of neuroleptic drugs. What is it which makes us human, normal, meaningful; and what identifies us individually and collectively.

    I—although I hate the current psychiatric paradigms—believe that the treatment of mental conditions is, in principle, a medical matter.

    I also believe that the mind is physical, by analogue to renal filtration. The kidney is the anatomic entity; the filtration the physiologic. Brain: anatomic; mind: physiologic.

    I completely agree with you that nosologists of the mind need especial caution in unyieldingly making clinical that which is not clinical. I would say that that which is clinical is ‘that which does not best accord *our* purposes out of the available options of alternative bodily states’: i.e.: I broadly agree with Hacker. It is biologists’ modus operandi to find generalities (I suppose nomothetically) manifesting within nosology’s insistence on trying to find an absolute rulebook of what are diseases and what is health.

    In non-mental medicine, there is greater consensus upon what bodily states are not conducive to our purposes. However, as you so exactingly identify, the mind is part of our unique identity. Therefore, unforgivingly insisting on a list of ‘good’ and ‘bad’ mental states/traits is dangerous and duplicitous.

    I think the future of nosology should rather than rule upon what is a diseasing condition and what is an easing condition; it should list each condition with what the prognoses of each are; and what treatments can be deployed to cause a potential condition, maintain a condition, or reverse a condition. In non-mental nosology, this might seem pedantic because of broad consensus. But, potentially, someone might want, say, mild osteoporosis or osteopenia if being lighter would help with his/her occupation (maybe needing to be carried/lifted). As long as ability to consider this fully is demonstrated, this is his/her right, in my opinion.

    It is in mental nosology where this subtler difference in definition is manifest more clearly. If someone wishes to decrease his/her anxiousness, because the person himself/herself has identified it as not purposeful for his/her identified plans, then it is legitimate, I believe, to seek advice on how we know, as a species, to reduce anxiousness. Conversely, an, e.g., disinhibited person might seek to increase anxiousness as an inhibitory process.

    If someone cannot consider whether his/her mental state is problematic, then, I believe that it is legitimate to enforce treatment. But the Mental Health Act does not recourse to what is currently referred to as ‘mental capacity’. Just severity and ‘appropriacy of treatment’. A nonconsenting even-capacitous patient with a severe-enough condition loses his decision’s being honoured by doctors. Even if the person has capacitously opted against identifying the condition as diseasing or against treatment for another reason.

    The other legitimate justification is risk to others publicly, e.g. infectiousness or dangerous behaviour.

    You quite incisively identify the conundrum ‘is disease the person or separate from him/her?’ If the person has sought help in modifying his/her mentality, then, one can separate it from himself/herself as an ego-dystonic trait. If the person cannot consider this fully, then, once the incapacitating factor (e.g., drug, psychotic episode, delerium, unconciousness) abates, even the person might dissociate his/her identity with the beliefs (or in the case of unconsciousness: not consenting, because unconscious) which stopped the person consenting to treatment.

    Where a person able to fully consider whether his/her mental or otherwise state is how he/she wants his/her body (and I include the mind with the rest of the body) to be and is not directly affecting others adversely (i.e., without consent or unlawfully), then that bodily state is not diseasing him/her, so cannot be separated from him/her. This is the case, I opine; however extreme/severe it may indeed be

    So, in summary, I do include the mind as part of the body, and psychiatry as a legitimate branch of medicine; but only with the qualification that the medical model be adapted to put the person the lead purposive determiner of what he/she regards as a diseasing/easing state.

    As Hacker opines, disease undermines the beholders purposes, but I would say, as a person rather than of the person’s kind, from a moral perspective (of how things ought to be [normally])—although spotting nomothetic universalities in how people identify different conditions as easing or disrasing is legitimate as a describing scientist, not prescribing individually these labels onto individuals.

    Thank you for the thoughtful, thought inspiring article. I suspect I might still further think about, contemplate about, and consider its compelling topics over the next few days.

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