Dorothy Rowe

5 February 2005:  Like a puppet on the couch

Psychologists and psychiatrists persist in treating us as if we were helpless victims of our biochemistry. This is a disastrous mistake, says Dorothy Rowe.

The Bible says you have free will and you can choose to do whatever you like, but if you make a choice God doesn't approve, He'll clobber you. Most scientists, on the other hand, argue that what you do is nothing but the end result of a long chain of causes over which you have no control worth talking about. Who is right? Are we agents capable of acting on the world anyway we choose or puppets dangling off biochemistry's strings?

Actually neither really fits our daily experience. In my work as a psychologist one of the big questions I ask people is: "How do you operate as a person?" I also listen to people talking to each other about how they operate. The vast majority describe themselves as engaged in making sense of a situation, deciding what to do and acting on those decisions. A few insist that they are being controlled by extraterrestrial powers or voices emanating from their television. Not surprisingly, these people don't manage their lives very well. Sometimes people who see themselves as agents will claim that some aspect of their behaviour is not under their control - "I inherited my bad temper from my father" - but these are merely agents ducking responsibility. The bottom line is that we all know we are agents making choices, but those choices are based on very limited knowledge.

Many psychiatrists and psychologists prefer not to see people as agents. They don't want to recognise that, while objects don't assess an experimenter, people do, and this assessment affects the outcome of the experiment. They prefer to think of themselves as experts who know more about the person as a puppet than the person can ever know about him or herself. So if, when you consult a psychiatrist about your intense sadness, you say: "I feel terribly guilty because I didn't look after my parents properly before they died," you are likely to be told: "That's your illness speaking." To the psychiatrist what you have said is not a statement about how you interpret your situation, but irrational guilt, a symptom of major depressive disorder.

Forty years ago there were only a handful of mental illnesses, and relatively few people were seen as being manipulated by a mental "illness" Now there are innumerable mental disorders, created by psychiatrists. In fact the most recent edition of the bible of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM), covers everyone. If every other diagnosis fails, you've always got "personality disorder not otherwise specified".

Psychologists use the DSM to label people, but they also like to pop people into boxes called traits - sociability, curiosity, extroversion and the like. Do you do what you do because you have x amount of sociability, y amount of curiosity and z amount of extroversion?
Unfortunately most popular magazines and national newspapers, New Scientist included, help perpetuate this puppet/agent mistake. So a story about technology presents humans as agents making decisions and acting on them, while one about mental health downgrades humans to puppets. People suffering from mental illness are described as manipulated by something acting in or on their bodies. And out in the world, depressed people are likely to be told by doctors that they have a chemical "imbalance" in the brain caused by a lack of serotonin, despite the fact that no abnormality in serotonin levels has ever been demonstrated to cause depression.

It is clearly all much more complex than they would have us believe. As the ancient Greek philosopher Epictetus said: "It is not things in themselves which trouble us, but our opinions of things". In other words what determines our behaviour is not what happens to us but how we interpret what happens to us. The human brain does not show us what is actually going on. What neuroscientists like V.S. Ramachandran and Richard Gregory have demonstrated is that our brain creates pictures of what is going on around us, and these pictures depend on what our body is equipped to learn and on what situations we find ourselves in. So if your eye lacks the receptors required to pick up certain wavelengths of light, you will live in a colourless world, and if you are a nomad child living in a yurt, you'll learn to see depth and distance differently from a child brought up in rectangular rooms.

Everything you learn goes into your mind/brain, this ever-changing, interconnected structure of meaning made up of ideas, images and memories. What you call I, me, myself is a complex system in which consciousness is a small, moving torchlight powered by the contents of your meaning structure. You interpret what goes on and make choices, usually without becoming fully conscious, just by putting your interpretation into action.

And the interpretations we choose are always aimed, at least in part, at holding ourselves/our meaning structure together. Of course, this complexity and the individuality of our choices make studying people very difficult. But surely from here on in, research (and treatment) not based on this understanding of ourselves as agent is a complete and utter waste of time.

Dorothy Rowe is a psychologist and writer
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Reproduced with the permission of New Scientist

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