Re: R: Can pcp and neuroscience jointly help schizophrenics?

Tony Downing (
Thu, 3 Dec 1998 11:36:03 +0000

Massimo Gilberto asks a question, which he says "is relevant to the e
epistemology fondaments of PCP:

> What does "the possibility of an interface with
>neuroscience" mean (Tony Downing)? Does it mean that it is possible, for
>example, to explain my smile with neuronal activation? But this 'level'
>don't explain my smile for my daughter. I believe with Maturana e Varela
>that there are two separate level of knowledge, two distinct domain of
>knowledge. It's not a question of being hostile to the medical model, but
>rather of making a choice. An important consequence of this choice is that
>I'm concerned with a person or with a presumed object that is called
>'schizophrenia', 'depression' or 'brain damage'. They are two knowledge
>domains which do not interconnect in an explicative sense.

Although the contents of cognitions, and the mechanisms in which they are
embodied, do normally belong to two different domains of discourse, they
can interconnect in several ways, and sometimes it is viital that we bring
them together. I think my point about the Capgras syndrome shows one way
in which these different levels of discoursse do need to interact.

If the neurolological model of the Capgras syndrome proposed by Prof. Andy
Young is right (Young et al., 1993), British J. Pychiatry, 162, 695-8),
then the normal neural mechanisms of face recognition, voice recognition,
etc. let the Capgras sufferer get almost all the way in recognising some
significant other person, but specific damage within their brain prevents
this being linked to relevant social information about the person who is
being recognised. This presents the sufferer with a paradox: they
recognise who the person seems to be, but they don't get that click of
recognition that goes along with linking this recognition to the knowledge
that this really is their wife, their mother, or whoever it really is. As
Stone & Young (1997) proposed, (Mind & Language 12: 327-364), there are
several ways that the sufferer might construe this. One way is to jump to
the conclusion that they are an imposter - and this usually requires
subsidiary suppositions which amount to paranoia. Another way is to
conclude that one has oneself died, and that that is why everything feels
so strange. Another way - among others - would be to bring in knowledge of
the proposed neurological explanation and recognise that one's brain damage
does lead to apparently paradoxical experiences.

Now even if the particular explanation proposed by Young et al. is not
quite correct, we do know that, in at least those Capgras cases where the
symptoms directly follow the occurrence of brain injury, some kind of brain
damage is producing the cognitive dilemma that the sufferer finds
themselves in. The sufferer then needs to construe it. That is one very
obvious way in which the output of one domain of knowledge (neurology, a
hardware fault in the brain) produces faulty cognitions which belong in
another domain of knowledge (cognitive psychology). The faulty cognitions
do not make sense in the usual way - but of course the sufferer has to make
what sense they can of it. I don't see how PCP can decline to encompass
that construing. I don't see how PCP can hope to do so helpfully if it
declines to accept that, sometimes, brains do malfunction and thereby
produce mental states that do not make the usual kind of sense.

All this is obvious to anyone who is willing to integrate the science of
personal constructs with the rest of psychology. The issue is indeed, as
Massimo Gilberto says, illuminating for the fundamental philosophy of PCP.
It raises again the issue of whether this science should be conceived of as
PCP (an entire psychology, sufficient on its own, disdaining all other
psychology as error) or PCT, a body of theory which fits within and around
various parts of a wider science.

Abnormal and/or paradoxical cognitions that arise because of abnormal
neurological functioning are not rare. If we drink too much wine, we know,
in general terms, that our confidence in our driving ability is impaired
and yet our sense of confidence in our driving ability tends to be
enhanced. Let's hope we construe the situation at the time in a way that is
dominated by our well-learned knowledge that after plentiful wine
consumption, judgement is unreliable. If we gaze at a waterfall for a long
time, and look away at the surrounding trees, they seem, paradoxically, to
be drifting upwards, yet staying in the same place. Elementary psychology
textbooks give a good explanation in terms of adaptation of certain
motion-detecting cells relatively early in the visual pathways. How many
people have spent time in a green tent and emerged to think, at first, that
the world has gone pink? Again, a simple "hardware" explanation in terms
of visual adaptation leads us to a correct construing of the situation.
With a little neuroscientific knowledge, we can experience these illusions
with pleasant interest, rather than with alarm or paranoia.

Our success in our everyday contruing of the effects of fatigue, drugs,
dizziness and, for some people, suicidal depression, surely depends on a
willingness to allow to neuroscience part of the explanation of what's
going on. This doesn't demean the importance of PCP, the science of

This has been an interesting discussion thread, I think, but trying to make
PCP explain everything has led some contributors to dismiss some people's
coping with their depression through knowledge of the brain mechanisms of
mood as _merely_ avoiding their personal responsibility, and has,
mistakenly, had to cast many honest and humane psychiatrists as

Tony Downing, M.A., Ph.D.
Lecturer, Dept. of Psychology,
University of Newcastle upon Tyne, NE1 7RU,

Phone +44 (0)191 222 6184 Mobile: +44 (0) 468 427 481
Fax: +44 (0)191 222 5622