Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Philosophy is here to stay
- Gareth S Owen (14 March 2003)
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Mind and Body - split - is it a zoologic problem?
- Andreas M. Worel (16 March 2003)
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Detrimental Body-Mind Philosophy, Essential: Ethical-Spiritual Philosophy
- Erich K Ledermann (17 March 2003)
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"There is no such thing as society".
- Richard G Fiddian-Green (18 March 2003)
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Medicine's conceptual framework should be post-positivist
- D B Double (18 March 2003)
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seeing the 'hole.
- stephen r. kettle (18 March 2003)
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Gareth S Owen, Senior House Officer Maudsley Hospital, Denmark Hill, London SE5 8AZ
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Editor - Sugarman enters into a well rehearsed paradox when he contends that the study of philosophy and politics is detrimental to doctors (1): he invokes the help of a philosopher (Ryle)! Sugarman clearly thinks that postmodernist thinking about the mind is bunk whereas naturalistic thinking about the human organism is helpful. Why he thinks the later way of thinking is not philosphical is opaque and probably confused. Philosophy concerns itself with conceptual foundations. Not surprisingly, there are differences in opinion. If you have an opinion on foundations, or even if you don't, you assume a philosophical position regardless of whether you intend to or not. Sugarman rejects the notion that medicine would benefit if more doctors studied philosphy as neither appealing nor evidence based. It may not be appealing: hundreds of medical students misusing the word 'ontological' would vex any patient but to reject philosophy as contrary to the the spirit of critical appraisal is quaintly self-defeating. Evidence-based medicine is a philosphical movement par excellence. Would it have been possible without dozens of ponderous doctors reading the works of Karl Popper? If the BMJ ran a campaign against 'postpsychiatry' (2) as Sugarman urges then it would need some arguments. Rather awkwardly for Sugarman these would end up coming from the study of philosophy and politics. Sounds like an interesting and probably useful thing to do to me! (1) Sugarman P.S. Philosophy can be detrimental to doctors. BMJ 2003;326:601 (letter) (2) Bracken P, Thomas P. Postpsychiatry: a new direction for mental health. BMJ 2001;322:724-727 Competing interests: None declared |
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Andreas M. Worel, pediatric surgeon CH-2501 Biel, Switzerland
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EDITOR - I hope Mr. Philip A Sugarman will remain sane for his actual and future life. If not, and consistent with his opinion of man to be an animal, he would have to consult a veterinarean rather than a human science professional. But seriously: Although I don´t know much about of the debate regarding „post-psychiatry" in GB, it is a matter of fact that one of three essential and existential differences between man and animal is philosophy, the mother of all sciences. The second one is: Art. Philosophy, since more than 2000 years, is the art of questioning, exploring the creative tension between thruth and reality, between experience and conception. Dogmatism in Philosophy always resulted as a dead-end street, far more than in other sciences. In the same time, the evolution of medicine can be observed as the history of dogmatic conflicts, leading to the very radical and obviously erroneus, but fundamentalistic dogma of the mind-body split and its consequence: to esteem man as a higher mammalian. This seems to be a defamation of the animal world, if You consider the activities of Adolf Stalin, Josef Hitler (and their medical collaborators) or actually George W. Hussein, Saddam Bush or other radical mankind-„leaders“. Here we have the third difference, the dark side of mankind: the capability for evil - something You hardly will find in animals. But there is no shadow without light: man is also capable to do the good (and not only to think it). And, at heart, isn´t that capability the mainspring of medical work done by human beings to each other? Of course, the mind-body split is a matter of fact - I wonder whether Wittgenstein or Heidegger, nor one of the Ulitiarian guild, is able to override this split really, by means of their particular philosophy. Nevertheless, man is able to overcome this abyss: recognizing himself and all other men as singular individuals with one common attribute: their spiritual activity. It begins with questioning, and there ha to be mentioned a third Philosophist from Central Europe, who really succeeded in transforming the dualism of the body-mind split into a monistic concept: Rudolf Steiner and his „Ethical Individualism“, as developed in his main opus: „Philosophy of spiritual activity“(1) . Philosophy, as the art of questioning and source of scientific evolution as well as of individual ethical responsability, and doing the good, are both essential in medicine: science and the art of healing are the two sides of the coin. Conclusion: Banning Pilosophy will result not only detrimental for doctors, but far more for patients. Philosophy, Art and individual ethical responsability are the best active immunisation against inhuman medicine. As a foreign but frequent reader of BMJ.com, I do appreciate the critical but common sensed line of this Journal very much, and I suggest You to give more, not less room to the mentioned aspects of medical activity: To Philosophy as an essential ground of medical scientific claims to the manifold aspects of healing as an art and issues of ethical practice. (1) Steiner, R: „Die Philosophie der Freiheit - Seelische Beobachtungsresultate nach naturwissenschaftlicher Methode“ 1894, in English published as: „The Philosophy of Freedom - The Basis for a Modern World Conception“ or: „Intuitive Thinking as a Spiritual Path - A Philosophy of Freedom“, London 1999 Competing interests: None declared |
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Erich K Ledermann, Private practice 13 Ardwick Rd, NW2 2BX
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Editor-My reply to Philip A Sugarman’s letter (Journal 15. March) consists in insisting that patients must be granted the possession of the dimension which distinguishes man from the animals: the freedom of his conscience, his sense of responsibility which guides his bodily and mental health and illness. The functions of body and mind are conceived deterministically by medical science which has achieved undoubted success in the treatment and prevention of bodily illness and of mental illness when applied to the body’s cerebral part. But a scientific deterministic psychotherapy has been harmful: Freud’s libidinal science has equated love with sexual satisfaction and has elevated the pleasure principle of sexual satisfaction to a hedonistic psychology and hedonistic ethic: a disastrous Weltanschauung that leads to endless suffering from disillusion and pain. Jung’s deterministic archetypal science has denied the person responsibility, which is found in the archetypes and warns people not to resist the shadow archetype which causes people to behave in a way of which they are ashamed. The author has developed a “true-self “ psychotherapy, which helps patients to accept the voice of their conscience in realising the aims of their lives. These entail Philip A Sugarman’s “ considerations of what people actually do and say, think and feel “ E.K.Ledermann, Member of Critical Psychiatric Network Ledermann E K .Medicine for the whole Person , Vega section, Chrysalis Book Competing interests: None declared |
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Richard G Fiddian-Green, None Nne
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These two published replies to Braken and Thomas' article on mind- body split have overlooked Sergio Stagnaro exhortation published in the rapid electronic responses to look beyond linear physics (1,2,3). He wrote in his unpublished rapid electronic response that these perspectives might "not be able to help us in solving our essential medical problems, e.g., preventive medicine essential questions: in my opinion, based on 45-year- long “clinical” experience, medicine will require, rather, an urgent and deeper relation with non- linear physics” . I agree. We have to define the physical and metabolic realities of the mind-body split before we can have any hope of establishing or rejecting psychiatic diagnoses with any accuracy and of managing them rationally. The Alice hypothesis proposed that the physical body might alternate with an invisible form at a frequency in the order of one attosecond or even less, implying that the mind-body split might be intermittently complete (4). Futher evidence in support of this hypothesis was published in the special edition of Scientific American that reached the bookstores this month. In this issue it was reported that "an ultrahigh-power laser that delivers a mere joule in a pulse lasting 100 femtoseconds achieves 10 trillion watts, or more than the output of all the world's power plants combined", power being the rate of energy delivery (5). Remarkably this power can be harnessed with a benchtop instrument that may even be portable. The squeezed vacuum states, fields in which destructive quantum interference suppresses the vacuum fluctuations, that have been created with quantum optics "are associated with regions of alternating positive and negative energy"(6). (Negative energy should not be confused with anti-matter which is positive energy. Neither should it be confused with the energy associated with Einstein's cosmological constant postulated in inflationary models of the universe). Negative energy or mass--also called exotic matter--is said to bend Einstein's spacetime. It is required for the consistency of the unification of black hole physics with thermodynamics. "Because energy must be conserved positive energy, which distant observers see as Hawking radiation, is accompanied by the flow of negative energy into the hole". It is the combination of this negative energy and Hawking's radiation that it was proposed, in terms of the Alice hypothesis, forms the invisible pseuoscopic hologram that precedes the formation of the next visible orthoscopic hologram in Julian Barbour's jumping cat Lucy (7). In effect, therefore, the conceptual basis of the Alice hypothesis has been established at the quantum level by the application of laser pulses to squeezed vacuum states. Negative energy may also be created by the Casimir effect, the narrower the gap between two uncharged parallel metal plates the greater the negative energy. The negative energy pulls the two plates together. As these two plates are analogous to the alternating visible orthoscopic and invisible pseudoscopic phases of existence the Casimir effect could account for successive othoscopic holograms being continguous or bonded and giving the visual appearance of a single jumping Lucy. If this were not the case successive orthoscopic holograms might occur randomly anywhere in the universe and the continuity of Lucy's movement be completely lost. Negative energy makes a number of science fiction phenomena theoretically possible. These include travel at warp speed, traversing wormholes, time machines, perpetual-motion machines and the destruction of black holes. For teleportation to be achieved with a negative energy, or anti-gravity as it may also be called, machine the hypothetical bonding of successive orthoscopic and pseudoscopic holograms would have to be broken. Negative energy is also gravitationally repulsive. In other words it is capable of inducing the levitation of objects reported by Nick Cook, aeronautical consultant and section editor for Jane's Defense Weekly, in his book "Hunt for the zero point". "Legend has it that Archimedes focused the sun's rays with a gigantic mirror to set the Roman fleet afire at Syracuse in 212 B.C."(5). It is said that another Greek, Diocles, had in fact invented the first ideal focusing optic, a parabolic mirror, two years earlier (200 B.C). One look at the Inca ruins, the pyramids and even Stonehenge is enough to make one realise that the ancients must have had access to some form of technology that is not in the public domain today. Given the sophistication of their knowledge of the planets, astronomy, geometry and mathematics might the ancients have developed a practical method of harnessing the sunlight to generate negative energy and apply it to levitating large objects during the construction of their buildings? In 391 A.D. the Roman bishop Theophilius is said to have overseen the destruction of the great library in Alexandria in which was housed a large part of the written information about scientific phenomena (8). The library is said to have housed the book of Thoth which might have held information especially relevant to the practical application of levitation and teleportation. Centuries later the Catholic Church revealed again its obsession with concealing scientific information that threatened its doctrines in its suppression of Galilleo's works for three hundred years. One might view Henry VIII's destruction of the monastaries and Napoleon's raping of the Vatican library in the same context. The question is might practical knowledge of the harnessing of the enormous powers of negative energy have been suppressed for millenia for political reasons. Braken and Thomas also argue that the "mind is not inside but out there in the middle of a social world" and emphasise the importance of the social context (1). I find this statement very disturbing given the proposal to "change the mental health laws to allow the indefinite detention of people who pose a risk to the public" even if they have never committed a crime (9). Any move to extend the legal power of psychiatrists beyond their patients would give them unprecedented power in society. As indicated in my earlier but unpublished rapid response the power they have at present has already been grossly abused. The same applies to any other state-regulated or religious bodies. Margaret Thatcher was correct when she said there is no such thing as society, there are only individuals and families. What is more a man's home is his castle and should be protected from intrusion by the state, psychiatrists and religious bodies. Psychiatrists need to define the physical and biochemical determinants of normality before they are given any extra legal powers. Furthermore there are good grounds for removing those legal powers that have already been vested in them. 1. Time to move beyond the mind-body split Patrick Bracken and Philip Thomas BMJ 2002; 325: 1433-1434 2. P. A Sugarman and S. Jayasinghe Mind and body split BMJ, March 15, 2003; 326(7389): 601 - 601 3. Time to move beyond linear physics Sergio Stagnaro (20 December 2002) Rapid resp[onse to: Time to move beyond the mind-body split Patrick Bracken and Philip Thomas BMJ 2002; 325: 1433-1434 4. Mind-body split: the Alice hypothesis Richard G Fiddian-Green bmj.com/cgi/eletters/325/7378/1433#28056, 21 Dec 2002 Rapid responses to : Time to move beyond the mind-body split Patrick Bracken and Philip Thomas BMJ 2002; 325: 1433-1434 5. Mourou GA, Umstadter D. Extreme light. In: The edge of physics. Special edition of Scientific American "updated from May 2002 issue", pp77-83. 6. Ford HF, Roman TA. Negative enrgy, wormholes and warp drive. In The edge of physics. Special edition of Scietific American, "updated from January 2000 issue", pp85-91 7. Re: time to move beyond linear physics Richard G Fiddian-Green bmj.com/cgi/eletters/325/7378/1433#29680, 15 Feb 2003. Rapid response to: Rapid response to : Time to move beyond the mind-body split Patrick Bracken and Philip Thomas BMJ 2002; 325: 1433-1434 8. Laurence Gardner. Lost secrets of the sacred ark. Element, Harper- Collins Publishers, Hammersmith, 2003 9. Presumed dangerous Geoff Watts BMJ 1999; 319: 326. Competing interests: None declared |
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D B Double, Consultant Psychiatrist Carrobreck, Hellesdon Hospital, Norwich NR6 5BE
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Is Sugarman really saying he has solved the mind-body problem?1 Wow! Quoting Gilbert Ryle to support his argument highlights that the issue is about the paradigm we should adopt in medicine and psychiatry. Ryle's linguistic philosophy is a branch of analytic philosophy and was influenced by logical positivism. His Concept of Mind goes beyond the argument that it is misleading to view the mind as the "ghost in the machine" to suggesting that the only reality is physical.2 This is an ontological statement, suggesting that there is nothing of significance beyond observed behaviour, and minimises the role of culture in human agency. Should medicine's conceptual framework be positivist, as favoured by Sugarman, who sees progress in physical science and sociobiology alone? Or should it be interpretative, recognising the importance of context, as suggested by post-psychiatry?3 As this issue cannot be decided a priori, we do need philosophy to help us. It may make more sense to view post-psychiatry as a form of post-positivism rather than post-modernism as such.4 Nonetheless post-psychiatry opens up a debate about the nature of medical practice that should not be foreclosed by a positivist consensus, however much Sugarman may want to escape from what he sees as post-psychiatry's radical, critical agenda.
Competing interests: Founding memeber of Critical Psychiatry Network (www.criticalpsychiatry.co.uk) |
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stephen r. kettle, solo gp [ self-employed ]. c'mundi q 4551 oz
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surely a truly holistic approach would allow all the different approaches / facets of this problem / these problems to be appreciated.
one could say that we are all looking at the same stone and seeing 1 or more of the following: 1. a diamond 2. a piece of charcoal 3. a rough piece of stone 4. a smooth bevelled stone 5. an amoeboid life form 6. an pre-amoeboid life form 7. any fossilised remnant of life up to & including modern day man but not as yet his / her successor. 8. any permutation / combination of the above. so why do we persist in arguing the ' toss ' over what to some are minutiae? some might call it 'original sin' others merely the very human aspects of yin / yang. remember despite 'evidence based medicine' clinical medicine remains both an art as well as a science and both of these aspects have to be taken into account in order to successfully individualise the treatment of each and every patient seen by each & every 1 in the caring / treating role. things are not so mutually exclusive as some would have us believe. Competing interests: solo gp |
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