Academic journal article American Journal of Psychotherapy

Mind, Medicine, and Metaphysics: Reflections on the Reclamation of the Human Spirit

Academic journal article American Journal of Psychotherapy

Mind, Medicine, and Metaphysics: Reflections on the Reclamation of the Human Spirit

Article excerpt

Reflections on the Reclamation of the Human Spirit*

Following the publication of such works as Auguste Comte's Cour de Philosophie Positive (1830-1842), in which he argued the inherent immaturity of metaphysical discourse, metaphysics, for Western intellectuals-and especially for Western intellectuals committed to science-has largely been abandoned. In recent years, however, we have seen renewed interest in metaphysics among some researchers and clinicians, due, in part, to increasing attempts to integrate diverse fields of study into some unified and coherent understanding of human life. For many psychologists and psychiatrists, this renewed interest is accompanied by an implicit, and sometimes explicit, re-embrace of the notion of the "human spirit." In this paper we explore some of the processes animating this movement and some of the clinical implications that flow from it.


By metaphysics is meant that branch of philosophical inquiry that concerns itself with the unobservable dimensions of objective reality, and with fundamental ontological questions-such as the nature of the human person. Of all empirical researchers and clinicians, psychologists and psychiatrists may be particularly interested in metaphysics because much of the work that we do is concerned with "hypothetical constructs." Hypothetical constructs are entities or processes that are not available for direct sense inspection, but are invoked in order to explain phenomena that are observable. Intelligence, memory, attitudes, and love are all hypothetical constructs because they refer to entities or processes that cannot be perceived directly, but are known by the visible effects that they produce in the world. In this paper, we limit our concern to the conceptual construction of "mind" and to the implications of our way of understanding mind for the development of the discipline. Furthermore, as psychopathologists our discussion of mind will be focused on the unique way that this construct has developed among psychiatrists and clinicians.

In view of the foundational nature of metaphysics, it is fitting that we begin our exploration by revisiting the conditions out of which modern psychoanalytic psychiatry was born, and by reflecting upon the origins of current notions of what it means to be a person in need of psychotherapeutic assistance. These issues, we will suggest, hinge upon our concept of mind. Following this brief overview, we will suggest that a concept of mind that reembraces the notion of the "human spirit" appears to be on the horizon for those psychologists and psychiatrists that are interested in the application of the discipline to the resolution of human problems.


In the 19th century, medicine-as a professional discipline-was just beginning to be consolidated. There were only three firmly established branches of medicine: internal medicine-which traces its roots back to Hippocrates; surgery-which had been practiced primarily by barbers; and neurology-which can be traced to the pioneering work of one of the founders of scientific method, Rene Descartes. Notwithstanding the work of Phillip Pinel, the 19th-century Parisian physician who is often credited with being the founder of modern psychiatry, psychiatry, as distinguished from neurology, could not have been born without a new, working-theory of mind; and it was, whatever our present attitude towards him might be, the Austrian physician, Sigmund Freud, who largely developed the conceptual basis for the theory of mind that has dominated psychiatry (and clinical psychology) for more than a century. Let us examine, then, how Freud's theory of mind was born.

The Concept of Functional Delta

One of the notions that was to appear early in medicine, and which was to pave the way for a scientific construction of the psyche, was the concept of Functional Delta. Functional Delta can be explained by noting the difference between a symptom in medicine, which is some kind of verbal or behavioral report of physical dysfunction or distress, and a medical sign, which is some pathophysiological evidence that stands in causal relation to the reported symptom and accounts for it. …

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