The medico-centric mentality

The medico-centric mentality is a term I use for the commonly held belief that the central pillar of good health is to be found in the pharmacological medical tradition - in other words; doctors.

I am sure it has another name, but I prefer medico-centric mentality because it best sums it up. In this view medicine stands as the pinnacle of health-giving practices. Surrounding it in various orbits are the "complimentary" practices, starting from the most like medicine (Psychiatry) to the far reaches of crazy like crystal healing and sun-worshiping. Everything else falls somewhere on a continuum in-between.

Good health is reduced to biological perfection. Within the confines of the body this is quite effective. Something goes wrong and we correct it. As the science of medicine progresses we get better and better at fixing the things that go wrong. As it goes this is wonderful, but here's the problem; we aren't JUST bodies.

Passed off as one of the orbital "compliments" to good health is psychology. Begrudgingly doctors refer patients to psychologists because medical science hasn't figured out a way to drug away depression or unhappiness. Psychiatry is not exactly an example of successful integration; the mystical psychoanalysis was replaced merely with pharmaco-reductionism stating that all psychological problems are merely problems of neuro-chemistry (for a great discussion of this problem see Doctoring the Mind by Prof. Richard Bentall).

Non-medical psychology such as Cognitive-Behavioural Therapy and Behaviour Analytic interventions are seen as useful to a limited population but only until such a time as medical science becomes the cure-all.

Why is this a problem? Well as I mentioned earlier we are not just bodies. I am not here making the case for a "mind" as a separate, non-physical entity, rather as a distinct, natural thing that is real and physical but none-the-less irreducible to merely biology. A major problem in modern philosophy is that of the mind/body dichotomy. We are told there are two alternatives; either we have a mind which is none-physical, non-natural and that is, for all intents and purposes non-real. The converse is the idea that the mind is reducible to a stimulus-response function of electrical activity in nerves that gives us the illusion of awareness.

Personally I reject this dichotomy; I view consciousness as the aggregate summation of sensory experience condensed into conceptual knowledge and concretised through verbal behaviour. In other words it's a fully integrated faculty, both natural and yet distinct from the body as such. A proper treatise on this subject is beyond a blog post and frankly beyond my skills to articulate, however I'd refer to the works of Ayn Rand, particularly her book Introduction to Objectivist Epistemology and the fantastic new book How We Know by the philosopher Dr. Harry Binswanger who's book I will be reviewing in the next month or so (time depending).

Why the segue into philosophy? Because the idea that the mind is actually merely electrical impulses is the dominant view in medicine and in our broader culture. Here's the rub; we are an unhappy society. We all complain of psychological problems. We are stressed, unhappy, tired, bitter and angry. We treat our mind as a passive thing, something we are just "born with" that remains immutable and intractable. A mysterious force whose ways are shrouded in darkness to be controlled only by the proper application of the newest, shiniest drug.

The benefits of proper psychological health are clear to see. Pioneering work in mindfulness-based stress reduction, for example, show the positive impact of training our cognitive faculty. The benefits of a superior education, a frequent reading habit, even the practice of gratitude and awareness all result in positive, real benefits. I am not talking here of mystical, other-worldly experiences. I am talking about real, practical benefits like more adaptive stress management. A positive approach to work and relationships. Better sleeping patterns. Greater economic earning power. And so on and so on.

The novel Dune by Frank Herbert offers an insight into this idea; in a far-future world thinking machines (computers) are outlawed, and instead humans, highly training to compute at astronomical rates (called Mentats) are used as human computers to work things out. Now that's an unrealistic example, but it perfectly characterises the issue at hand. Our consciousness is trainable. We know this from experimental evidence, our faculty of learning, for example, shows that we can affect change in our minds through deliberate action.

Unfortunately the science of cognitive training is in it's infancy. We know very little about how to consistently improve human cognition. Behaviour Analysis provides a clue to this area; Verbal Behaviour is a little understood branch of behaviour analysis that deals with cognition and language. It shows us that our language (and by extension our cognition) is malleable and capable of improvement. How? Well that's something we haven't fully figured it out.

A good starting point, however, is the much ballyhooed 3rd and 4th wave of therapies such as Acceptance and Commitment Therapy (ACT, or Training, in a workplace setting) and Dialectical Behaviour Therapy (DBT) both of which seek to effect behaviour change through managing language and private-events (thoughts).

I propose, therefore, a new model. For want of a better term I will call it the Objective Health Model (OHM) that, at it's core, rejects the reductionist model of S-R neuropsychology and at the same time rejects the mystical, Platonic notion of a "mind without reality". Instead it maintains that consciousness is both distinct (and irreducible) and yet also naturalistic and understandable. In this model physical health is put alongside (not above) psychological health with a bi-directional arrow between the two (signifying the idea that one entails, and is linked to, the other.