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Psychiatry
Real Psychiatry and Darwinian Evolution are One and the Same
Molecular psychiatry has missed the forest for the trees.
Posted April 26, 2015
The basic principle for the development of human personality is the very same as Darwinian evolution. The issue at hand is not the origin of the species, but the creation of individual personality. We humans are purely biological creatures, like all other creatures. There is only a 4 percent difference in the DNA of a human and a chimpanzee, which accounts for our species uniqueness. We even have a 60 percent overlap of our DNA with that of a fruit fly. A cheetah has its exquisite muscular physicality. An eagle has its feathered predatory arrogance. The unique and distinguishing feature of our biological adaptation is the human theater of consciousness. Our entire consciousness evolved to serve the functioning of the organism. Human consciousness is our medium through which we engage and live the human life. We survive, live, and propagate through the characterological world, integrated with the rest of the brain-body.
In our quest to understand human biology, we have lost our way. We are looking in all the wrong places. The human organism from the beginning adapts to its salient environment. We can trace our adaptations from a zygote, to an embryo, to a fetus, to a newborn, a baby, a toddler, a child, an adolescent, all the way to adulthood. This also tells us how psychiatric problems arise, and informs us of the appropriate and effective treatment. All of the issues of psychiatry operate on this level of adaptation.
You and I began with our parents. Out of the sixty million sperm that entered and swam through Mother’s vagina, cervix, uterus and fallopian tube, your particular sperm won the great race. It penetrated the membrane of your-egg and injected its DNA. And so the DNA of those two meiotic cells hooked up, and we got you - a one-celled living organism—a zygote. At implantation, we turn into an embryo. As such we began morphing furiously. At one point, the embryo is without a heart, and then one appeared and it was beating. In conjunction with a heart, we morphed some of our cells into a circulatory system and blood cells. And so on and so forth. Even though an embryo doesn’t really go through every stage of evolutionary history, in a rough sense we do recapitulate phylogeny. After beginning as an ameba, we morph into an invertebrate. Then we grow a spine and become a fish. Our gill arches will later morph into facial and throat muscles that would be used for talking in a few years. Then we turn into an amphibian. Once we had a tail, and then it was gone. But we did get arms and legs. Primitive organ systems came and went and changed and migrated and got supplanted and re-used. Brain tissues and nerves appeared and developed.
The most active locus of fetal morphogenesis is the brain. Throughout the entire seven-month fetal period, we produce, on average, three million brain cells per minute. At peak times, neural cell replication takes just an hour and a half. By adulthood, our brain is composed of a trillion cells, a hundred billion of which would be neurons. Not surprisingly, half of our DNA is devoted to the development of the brain. Our brain is body. Our brain morphogenesis is body. Our salient environment in utero is our mother’s womb. Once we attain consciousness at about six weeks old, our germane environment is responsiveness, emotional deprivation, and abuse. Each of us fields and digests our experience through the unique constellation of our temperament. The four elements of temperament are Internalization/Externalization, Introversion/Extroversion, Active/Passive, and Participant/Observer. (See “The Nature-Nurture question – Nature. The role of nature comes from our genetic temperament.”) Each one of us is absolutely unique. I may process by being an Internalizer, Extrovert, Active, and Participant. You may be an Externalizer, Introvert, Passive, and Observer. We are all somewhere on an axis of those dynamics. With each dynamic we can range from 90-10, 60-40, or be balanced. And one temperamental element may be stronger or weaker in its influence. Each of us then fields the unique actualities of responsiveness, deprivation, or abuse in our emotional environment through our temperament. By six weeks old we begin to write a play in consciousness. Initially consciousness is too immature to create representational form. At that point we only have the ‘feeling of our being’. By age three we mature into representational consciousness where we create a three dimensional drama with personas, feeling relationships between them, scenarios, plots, set designs, and landscapes. Once our play consolidates, the rest of our experience is always filtered through the existent play in consciousness, which influences our ongoing experience. As the twig is bent, so grows the tree. When we reach adulthood, we consolidate our character. Our characters are as unique as our fingerprints. No two snowflakes are alike, but we are all snowflakes.
Contemporary psychiatry has focused on the molecular level of the brain, on hormones, or neurotransmitters, on genetic abnormalities, nucleic acids, on epigenetics, on false theories of brain diseases, etc. We have missed the forest for the trees. Psychiatric researchers don’t even see the trees anymore, nor the wood, but our search is on the level of its fiber properties – the chemical composition of cellulose, lignin, and other chemicals. And then they conclude that drugs are the appropriate treatment, as if pharmaceuticals can treat what ails us. This is an insult to the complexity of the human condition.
All the issues of psychiatry operate purely on the human and social level, not the molecular level. And it’s appropriate treatments do as well. Don’t get me wrong. I love neuroscience and the study of the brain. They teach us the mechanics as to how the whole thing operates. I am in awe of Sebastian Seung’s Connectome project. And Matt Faw’s brilliant paper –which illuminates the centrality of the hippocampus in consciousness. See – “Full Subjective Experience is a Hippocampal Simulation”. These teach us the mechanics as to how the unbelievably complicated brain operates. However, biological psychiatry, neurology, and neuroscience in general, have pre-empted a claim on what is biological. They have defined biology as the domain of physical brain structure; brain organization, brain anatomy, and functional brain centers; neurotransmitters; hormones; information learned from studying brain lesions; and activated patterns of neurons that can be seen in brain scans associated with certain localized functions. There is a great deal of knowledge to be appreciated from these approaches. Unfortunately, their orientation has mistaken the parts for the whole. They have ignored the brain’s most important biological manifestation of all - the culmination of our adaptations results in the organization of our personality as the ‘play of consciousness’.
We should not confuse the operational mechanics of the brain with how people actually function in the living of a life. The component parts of brain functioning all work together in concert in the service of the central biological creation of the human genome - the play of consciousness. This specific production of the human brain is the unique adaptational feature of our Darwinian evolution—the defining characteristic of what it is to be human. It is the central organizing function of our biological lives and the fulfilled manifestation of our biology.
When we consider the evolution of the human species, what makes us human is not defined by the unique human functions, such as opposable thumbs, abstract thinking, reasoning, or computational abilities—those are good. The defining feature of our species is the synthetic ‘play’ of human consciousness. The evolution of the structure and function of the limbic-cortical brain is at one with the creation of the play. The morphology, organized structures, and pathways of complex neuronal webs throughout its architecture create the patterns of patterns of patterns that enable the characterological drama. This is the cortical processing that allows for the meaning and coherence of our moment-to-moment functioning in life. The creation of images of personas, their emotional relatedness, and life plots—the full range of tragedy and comedy—is the drama. It constitutes the top-down processing of our individual selves and our emotional and relationship life. The coherence of human consciousness is the highest level of order of the human genome. We walk around all day long, each of us, in this brain-body synthetic bubble of consciousness, our genetic endowment.
The characterological drama of human consciousness is our adaptation to and is consonant with living the human life—the life of the individual and relatedness to others. It encompasses our surviving, our child rearing, our imagination, and our culture. It allows us to function as the individual and social animals we are. It creates the meaning landscape of human experience. This landscape encompasses the symbolic representations of human experience—self, others, relationship, and drama—in myths, narratives, literature, art, nursery rhymes, songs, movies, hieroglyphics, plays, belief systems, dance, journalism, cave paintings, fashion, religious incantations, and theologies.
All psychiatric issues reflect problems in our play of consciousness. They have nothing to do with neurotransmitters or molecular psychiatry. They are to be addressed on the human level with good psychotherapy. In the context of therapy we can mourn the pain of our problematic ‘plays’ which allows us to write new ones. This alleviates psychiatric symptoms and fosters our capacity for authenticity and love. See – “Psychotherapy is the real deal. It is the effective treatment.”
Robert A. Berezin, MD is the author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain.”
robertberezin.com
