Writing by Kuba Olszak. Artwork by Yury Aleksanyan.
‘I am really distinct from my body and can exist without it’, posited Renee Descartes in his Sixth Meditation (1). Intuitively, it is a viable claim. Not only does the mind feel extracorporeal and inexplicable by the means of natural sciences, but it oftentimes also seems to be at odds with its physical vessel. Furthermore, this distinction between the mind and the body can manifest in tangible symptoms, such as panic attacks or gender dysphoria. For this reason, Cartesian dualism has been a framework for the development of science for over three hundred years, leaving an imprint on how both the mind and the body are understood by psychology and medicine (2).
The nature of the corporeal and ethereal has been considered since Greek antiquity. Plato, basing on the works of Pythagoras, introduced the idea of physical objects being imperfect copies of intangible Forms (3). Aristotle thought of forms as properties immanent in objects, with the soul being the form of the body. Following the period of Christian medieval philosophy, where the soul was thought to be the subsistent form of the human being, Descartes introduced the concept of the mind and body dualism (4). While the Cartesian mind is an immaterial and thinking substance, the body is extended and unthinking. The subsequent scientific revolution, which prioritised the body and the empirical realm, has brought about a tectonic change in how the nature of the mind is interpreted. During the 20th century, the ongoing developments in neuroscience seem to continuously favour physicalism, attributing the essence of the mind to physical processes embedded in the brain (3).
The three emergent branches of dualism propose different ways, in which the body differs from the mind. Predicate dualism argues that psychological predicates are irreducible to physical predicates; while what we know as water can always be reduced to H2O, no similar reduction can be performed to describe what we know as ‘feeling’ or ‘believing’. The inability to describe these concepts in the language of physics signifies their extracorporeal nature. The concept proposed by Descartes has been coined as substance dualism. It describes that there are two ontologically different types of substance in the universe; one that is ethereal and mental and one that is corporeal and physical. In contrast, property dualism makes no ontological difference between the substances. It attributes the universe to be composed purely of physical matter with two distinct kinds of properties embedded in it – the physical and the unmeasurable mental (5).
However, the physical and mental are often intertwined; for example, the pain perceived by the mind is caused by a physical stimulus that injures the body. This raises a question of how mind-body dualism handles causation. According to interactionist dualism, the physical and mental properties influence each other all the time. On the other hand, epiphenomenalism states that only physical events can impact the mind. According to Hume, the mind is nothing but a collection of different perceptions; the self is unable to catch itself without any perception, be it of the visual, emotional or physical kind. There is a gap between perception and action – our brain responds to distal stimuli and the mental states required to generate them are not perceived by us (6).
The fact that the mind is not reducible to empirical sciences appeals to one’s intuition. In the end, how could one measure and describe an emotion specific to each mind in terms of neurones and neurotransmitters? Another strong argument for dualism states that even after acquiring all the knowledge of how the cognitive apparatus of a bat works, one could never know what it is like to be a bat (7). Similarly, one could imagine a philosophical zombie whose internal architecture is identical to a human, with the difference of not having a conscious mind (8). Despite having a textbook congregation of a beating heart, working muscles and firing neurones, the zombie would be devoid of the thinking mind. Or would it? Numerous counterarguments have been put forward in the mind-body dualism debate; all in all, how could one prove a zombie, whose brain could mimic human emotions, would not experience them? Furthermore, how could the intangible mind influence the physical brain, when changing the trajectory of a physical entity requires energy expenditure? How could an ethereal mind create physical energy triggering neurones to fire and emotions to be felt? And if the mind is separate from the body, why does damage to the brain produce predictable patterns of impairment of the self?
Despite a well-established critique against it, Cartesian dualism has largely shaped the societal understanding of body and mind for over three hundred years. The medical field, to which the body is a central concept, has been particularly shaped by the dualistic tradition. Descartes advocated for prioritising empirical research, which has resulted in a ‘Scientific Revolution’. Although positivism accelerated the speed of biomedical discovery, it gave precedence to describing illness as a deviation from the normal functioning of the body (2). The psychological aspect, which is often intertwined with various medical conditions, has been attributed to the mind and removed from the scope of medical intervention. Consequently, dualism has established a hierarchy of substances, placing priority on the physical, which is explicable in terms of the natural sciences. The resulting disregard for the unmeasurable mental has resulted in the neglect of the mind as a function of the organism (9).
In the dualistic tradition, emotions and the social context of illness were ignored. In contrast, the mind-body dichotomy was used to enforce gender roles, where rationalism was superior and masculine, and emotions were irrational and feminine (10). The ensuing carnal focus of medicine attributed mental disorders to aberrant anatomy or physiology of the brain (11). The focus of treatment was aimed at the physical property of the body rather than the patient as a person. As a result, lobotomy and other invasive procedures disproportionately performed on women were introduced in the history of psychiatry (12). However, the increasing burden of mental health disorders and the insufficiency of their proposed medical treatments has exposed the inadequacy of mind-body dualism in addressing illness. Only in the last decades of scientific development has an increasing focus been placed on providing treatment that is holistic and biopsychosocial; addressing physical disturbances as well as the mental and social aspects intertwined in the condition. In the end, it is impossible to distinguish between the body and the mind in numerous disorders. For example, people suffering from post-traumatic stress disorder often experience dissociation and disembodiment as a result of their mental distress. The pain of patients suffering from neurological functional disorders is seldom physicalised, yet it can be felt no less than symptoms of an organic nature (13).
Now, health has come to be defined as a state of holistic well-being rather than a lack of illness, and medical perception of the human has shifted to a concept of a ‘lived body’ rather than an embodied mind (14). The social and interpersonal contexts of illness are being increasingly stressed, posing a challenge to the individualistic model our society is built around (2). Do these changes signify the incoming end of mind-body dualism?
Numerous neuroscientists have claimed the Cartesian framework to be archaic and inconsistent with the current understanding of the brain. Advancements in brain imaging have allowed us to map numerous mental processes, such as emotions or memory, and reduce them to specific physical states of the brain. Furthermore, the discovery of neuroplasticity has allowed us to account for the brain tissue adapting to the outside world. Given the progress in neuroscience, it is commonly accepted that further discoveries will provide definite arguments for physicalism (15). On the other hand, advances in medicine continue to provide more questions than answers when it comes to the mind-body relationship. All in all, can we fully draw parallels between mental processes that lead to pain and our mind’s perception of pain, knowing that patients subject to psychological therapy report better symptom control (16)? Perhaps it is a mistake to treat scientific discovery as a decisive factor in answering questions of philosophical nature – and perhaps our nature is as corporeal, as it is ethereal.
References:
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Terrier, LM., Levêque, M. & Amelot, A. Most lobotomies were done on women. Nature 548, 523 (2017). https://doi.org/10.1038/548523e
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