Understanding Human Behavior

A couple of months ago I wrote an article concerning ECT which generated some controversy.  One of the issues that came up was the relationship between biological explanations of human activity and more global explanations, which, for want of a better term, I’ll call person-centered explanations.

Any human activity can be viewed from different levels of abstraction.  Suppose, for instance, that I am sitting in my living room reading a book.  Then I put the book down, stand up, and go outside.  If the question were to be asked:  why did he put the book down and go outside? A wide range of perspectives and answers are possible.  One could, for instance, focus on the fact that I am a biological organism, and one could develop a detailed and comprehensive flow sheet of every muscle movement, every heartbeat, every sensory input, neural impulse etc., that had occurred from the moment that I put the book down until I was standing outside.  Such an account might be more or less detailed.  There would, of course, be physical limitations on the amount of information of this sort that is attainable, but from a theoretical point of view, one could compile a detailed, complete, and accurate biological account of the actions in question.  And such an account would be a valid response to the question:  why did he put the book down and go outside.

But there are other perspectives.  One could, for instance, ask me why I had behaved in this way.  This would be a person-centered approach.  And suppose I reply:  I had been sitting inside for too long; I wanted some fresh air.  Assuming that I’m truthfully describing my motives and feelings, this is also a valid and accurate explanation.

Of particular note is that although the two explanations appear very different, they are entirely compatible.  In fact, if the biological account is thorough and complete, one would be able to identify the neural activities that corresponded to my feelings of restlessness, my decision to move, my muscular movements, and my relief on getting outdoors.  Again, I stress that I doubt if that level of precision is, or ever will be, possible in practice, but the concept is valid.  Every element of the person-centered explanation will have a corresponding element in the biological flow-sheets.

For this reason it makes no sense to argue about which explanation is correct.  They are both correct.  I – the subject of the person-centered perspective – am also the subject of the biological perspective.

The act of stepping outside for fresh air is trivial and unremarkable, but the same plurality of perspectives can be applied to all our actions, including dysfunctional or counterproductive behavior.  The activity can be viewed as biological and can be probed and catalogued by neurologists, physiologists, etc…  Or it can be seen from a person-centered perspective and explored and formulated from that point of view.  There are also other perspectives, e.g. economic, political, social, familial, occupational, etc…  From the economic perspective, for instance, I would be considered a consumer, and my restlessness and my desire for fresh air might identify me as a marketing target for outdoor wear, wilderness vacations, bird-watching magazines, etc…  From a familial perspective, I am a husband, father, father-in-law, and brother within a fairly extended network of supportive relationships.  From a political perspective, I am a voter.  And so on.  I can be observed and studied from all of these perspectives, and although the observations will look very different, they are entirely compatible provided they are accurate.

For every thought, feeling, and behavior there is a corresponding neural event.  Some people contend that the thought/feeling causes the neural event; others say that the neural event causes the thought/feeling.  Still others contend that the cognitive/emotional activity and the neural activity are the same thing, but viewed form different perspectives.  The relative merits of these contentions have been debated by philosophers for hundreds of years, but for our present purposes, it doesn’t matter which is correct.  The point here is that there are neural events and there are thoughts/feelings/actions, and there is a correspondence between the two.  A super-neurologist with super-equipment could probe my brain and identify and catalog various patterns and clusters of neural and chemical activity.  But I experience these neural activities as thoughts and feelings.  Each perspective is valid, and each has its proper place.

A neurosurgeon, for instance, would be primarily concerned with the biological perspective, while most of our day-to-day interactions with other people are approached from a person-centered perspective.  A person asking me, for instance, why I had stepped outside is not enquiring about neural activity, inside my skull.  He’s asking about my thoughts/feelings/actions.

It is often tacitly assumed in psychiatric circles that because every thought, feeling, and/or behavior has a corresponding neural underpinning, therefore counterproductive thoughts, feelings, and/or behaviors must be the result of faulty or malfunctioning neural equipment.  But this is an unwarranted assumption.

Let’s take the example of childhood temper tantrums – and let’s look at these from a person-centered perspective.

If a child throws a tantrum in a grocery store, demanding candy or a toy or whatever, and if the parent gives in to his demands, then other things being equal, the probability of a tantrum in future store visits is increased.  This is one of the ways that we learn:  if an action brings about a favorable result, we try it again.  This is an adaptive mechanism.  It is not an instance of something going wrong in the child’s brain.  Rather it is an instance of something going right.  The child’s learning “machinery” has worked perfectly.  And from a person-centered perspective, it is an instance of the child learning to navigate his way in social relationships.

In the example above, I’ve described the scenario and outcome in very simplistic terms and have included the qualifier “other things being equal.”  But in practice other things are never equal, and the precise outcome on any given occasion is impossible to predict.  But whenever we interact with our children, we are teaching them something, and they are teaching us something.  In the above example, the child has learned:  if I want candy, I throw a tantrum.  The parent has learned:  if I want to stop his tantrum, I give him candy.  Unless something significant changes, it is likely that two things will happen.  The child will start to throw tantrums in other situations besides grocery stores, and any attempt on the part of the parent to regain control of the situation will be met initially with escalation of the tantrums.  This is not an instance of something going wrong within the child.  Instead, and apparently paradoxically, it is something going right.  The child is expanding his behavioral repertoire in accordance with the normal principles of behavior acquisition.  What has gone wrong is that the parent is teaching a response that ultimately will be problematic and counterproductive.

From a person-centered perspective, even frequent and severe temper tantrums can be understood as normal responses to suboptimal situations.  Obviously, in this context, I do not mean statistically normal.  Severe and frequent temper tantrums are not normal in the statistical sense of the term, but in the circumstances outlined above, they are normal in that they can be understood if viewed from a person-centered perspective.  There is no a priori need to invoke explanations based on neural malfunctions or pathology in the absence of compelling indications that such factors are present and causally significant.

Obviously each tantrum has a specific neural underpinning, but it is fallacious to assume neural  pathology based purely on the presence of negative or counterproductive behaviors.  Neuronal circuits and neurotransmitters that are functioning perfectly can underpin and drive destructive behavior as readily as constructive behavior.

The distinction between a person-centered perspective and a bio-neurological perspective applies to almost every facet of human existence.  We are biological organisms, but we are also thinking, feeling and self-directed persons.  For instance, I carry within me memories of the home in which I grew up and of my family of origin.  These memories are complex and intertwined, but I can bring them to the forefront of consciousness more or less at will.  Now let’s say that my super-neurologist with his super-equipment can probe around inside my skull and locate the neurons in which all these memoires are stored.  And let’s make him (or her) even more super, and imagine that he can “read” these various neuronal engrams.  There is still a fundamental qualitative difference between his readings and my memories of my childhood.  A good analogy would be that he can read the book, but I’m living the part.  Another analogy:  a person could, in theory at least, analyze a movie on a DVD and identify every pixel and sound unit.  But this is not the same as watching the movie.  A chemist can analyze every molecule of paint and canvas in the Mona Lisa, and still know absolutely nothing about the picture as a work of art or the motivation of the artist.

Our super-neurologist could analyze and catalog perfectly every sensory input and neuronal impulse in the actions of a tennis player making a spectacular backhand return.  But this is not the same kind of experience as that of the tennis player or even of the exulting fans.  And so on.

It’s tempting in this context to say that psychiatry has lost sight of the forest for the trees.  But it’s worse than that.  They’ve lost sight of the tree for the minute fibers and biological processes that sustain the tree’s growth.

There’s a quality to human experience that transcends neurons.  One can know everything that there is to be known about neurons and neurochemicals and know nothing of human life.  People are living, sentient, motivated beings, and we each have our own perspective and point of view.  We can be studied at various levels of abstraction:  atomic, molecular, bio-molecular, physiological, neuromuscular, skeletal, psychological, social, economic, political, occupational, etc… But we can also be approached and understood simply as individual people, with our individual histories, contexts, hang-ups, and aspirations.  No one perspective has any legitimate claim to being the preferred point of view.  One’s perspective has to be chosen in the light of the context.  If a person is sick (with a real sickness), then a biological perspective is probably preferable.  If he is sad or anxious, then a person-centered perspective seems the most apt.  If he is lonely and isolated, a social perspective might be most fruitful.  And so on.

In my experience virtually all the problems listed in the various editions of the DSM can be best approached, understood, and ameliorated from a person-centered perspective.  If you want to know why someone is depressed, take the time to get to know him, and then ask him.  Most people can tell you why they’re depressed or worried or nervous or scared or whatever.  But if it’s clear that your only interest is a 15-minute med check, they will tell you nothing.

If there is neural pathology then this, of course, should be addressed and alleviated to the extent possible.  But tampering crudely with the brain in the absence of confirmed pathology is dangerous and destructive.  Drugs do create altered states of consciousness, but the notion that we can provide effective help to people with problems of thinking, feeling, and/or behaving by tweaking their neurons betrays a fundamentally flawed and condescending view of humanity.

 

 

 

  • Guest

    Excellent post, as always!

    Let me offer you another analogy from the world of computers and that I have used at several places to attack psychiatry: hardware and software.

    I don’t know what operating system you use for your personal computer, but it is likely to be Windows or MacOS. In either case, one thing is the “software”, ie, the “instructions” that tell the computer what to do, which, with current computers, are executed at the rate of several billions per second, quite another the computer that runs those instructions. By “instructions” I do not mean just the instructions of the CPU but the general concept of a set of deterministic rules that tell the computer what to do in every interaction with users but also with peripherals (your printer, scanner, camera, etc). These “instructions” are a pure abstract concept that are usually expressed in some kind of computing language, but they remain an “idea”. But the instructions themselves and their expression in a given language are different things, just as the idea “I love chocolate” can be expressed in many different languages.

    If I give you a computer and it were possible for you to monitor the billions of switches that run “software” you are not going to “see” any of those abstractions. You will see a computer running the abstractions.

    Now, going back to your post. In computer science, and science in general, the distinction hardware vs software is perfectly understood. Nobody would call a software engineer to fix your broken hard disk, just as nobody would call a hardware engineer to fix a genuine software problem such as https://en.wikipedia.org/wiki/Memory_leak . Surely, adding memory to the computer can provide temporary relief, but the right way to fix it is to reprogram the computer.

    In this analogy, psychiatrists are hardware engineers trying to fix software problems.

    When I say this, I am usually told that the analogy is too simplistic, which I concede but, the ways the analogy breaks make the case against psychiatry stronger, not weaker:

    – Computers do not have “free will”, we do. Whether this “free will” is real or an illusion is irrelevant. “Free will” is embedded in our laws and is a basic prerequisite for the establishment of civil society. So, while in theory it is perfectly possible to predict what a given computer will do in every case (the same inputs, no matter how large those inputs are, always result in the same result), in humans, the same inputs not only result in different results for different humans but also the same human at different times. This aspect of human nature is what makes endeavors like economics so unable to make good predictions.

    – In computers what a good “hardware” is can be perfectly defined. It’s equivalent in humans, “a good brain” can also be defined to a certain degree using only biological parameters. To a certain degree, what “good software” is can also be defined with metrics such as “how fast does the operating system boots” or “how many scientific computations does this computer do per second”. I say to a certain degree because there is no possible way to say whether the user interface of Windows is “better looking” than that of MacOS; it’s a matter of taste. In humans, because of our subjectivity, there is no real definition of “good software” (ie, “good mind”) or “normal software” (ie “normal mind”). The right way to deal with “abnormal minds” is the criminal justice system. And even then, at least in constitutional democracies that protect individual rights, there are issues the criminal system cannot criminalize, such as political speech. Again, psychiatry sells the lie that there is such a thing as a “normal mind” that can be “fixed” through biological interventions.

  • Phil_Hickey

    guest,

    The computer analogy is very apt. It’s as if psychiatrists are tinkering around
    inside chips and discs picking out specific ones and zeros with needles,
    toothpicks, etc. Except it’s more like jackhammers!

  • Francesca Allan

    You’ve nailed it perfectly, Guest. I’m dealing with this very issue in a 2nd year psych course — mind vs. brain. Prof actually put in his notes “The mind is physical as proven by the fact that it can get drunk.” Yeah, really, that’s his position.

  • cannotsay

    Francesca,

    You can give a pass to a psychology professor since few psychologists have done hard science in their lives. Psychiatrists defending the same is more troublesome. And actual computer scientists buying the lie without questioning it is even worse.

    Once I had a debate online with a guy who was defending psychiatry’s position. He claimed to be a software engineer so I provided basically the same argument I provided above. He never returned back to the debate. I interpret this as some people having compartmentalized their critical thinking skills when it comes to defending psychiatry dogmatically.

    As I mentioned somewhere else, people forget that that the field of psychiatry, and the DSM in particular, fulfill the same role that clerics and the bible played in our society when we were more religious. Some see “defining behavioral normality by way of exclusion of the DSM” as a very powerful argument to defend the “normality” of whatever behavior they engage in. One would expect, for instance, that the gay lobby would be one of our natural allies. WRONG. Ever since they managed to get homosexuality of the DSM, they didn’t use that achievement as most reasonable people would, ie, to show that the DSM is a fraudulent endeavor. They use it as “see, I am normal because I am not in the DSM and therefore you cannot deny me same sex marriage”.

    If psychiatry is successful is not only because of the shrinks themselves, but because they have a market for people who see it useful. That is unlikely to change any time because the human condition is like that. There are people who believe in astrology, in homeopathy and in “chemical imbalances”. That is why I see the fight against coercive psychiatry as the holy grail. I respect people believing in chemical imbalances. I do not respect they imposing that view on me under ANY circumstances.

  • Francesca Allan

    Hi, cannotsay.

    That’s an interesting point you make about how removing homosexuality from the DSM changed minds just by expanding what we call normal. Let me think about it some more. Did gay people have a responsibility to question other DSM categories? I don’t know.

    Re: the mind/brain debate, I see that as more philosophical than scientific. Should point out that only some profs seem confused on the issue, especially the one who teaches biological psychology (big surprise).