Philosophy of mind has been one of the most interesting disciplines within philosophy. There have been many debates over the nature of the mind, and we can confidently say that the discipline has come a long way from the times of Cartesian dualism. In recent decades, as the philosophy of psychiatry has established itself as a legitimate subject within both psychiatry and philosophy, it has thoughtfully depended on philosophy of mind. It would seem obvious that, when speaking of disorders of the mind, we need to have an idea what the mind is. Unfortunately, this is the area about which, in my opinion, we need to have more discussions. I have seen different models of mind, from Cartesian dualism to physicalism, applied in different occasions. How we answer the question of the nature of mind has further reach than just defining disorder. If, for instance, we submit to a materialistic view of mind, how can we reconcile it with the concept of free will? In recent decades, there has been an increase in the dominance of a materialistic/reductionist model of the mind. Our brains and our emotions, our will and reasoning are all seen as a product of the interactions of neurons and neurotransmitters. Subjective experience, which is hard to measure, is becoming less important and is seen to be subsumed under the rubric of neuroscience. In response, some lament that ‘we are not our brains!’. To which the materialist/reductionist proponents reply, then what are we? What are we indeed? I think it is at this point that this book can make a significant contribution. Thomas Fuchs has previously written about phenomenology, intersubjectivity and embodiment. Here, he provides an account of an embodied brain in the world.
He starts with the criticism of a brain-centred model that aims to reduce human experience to neurobiology, which includes assertions such as ‘we are our brains’. The downside of this approach in psychiatry is that mental illness is seen as a neurobiological process, something at the neuronal/neurotransmitter level, at the expense of relationships with the physical/sociocultural environment, affecting our agency, will and decision-making. This reductionism separates humans from the world they inhabit, and this is what Fuchs opposes.
In place of reductionism, Fuchs gives an account of the brain as the mediating organism. He replaces the mind–body dichotomy with existing as an embodied being. I particularly liked his thesis that all higher brain functions presuppose the human being's enactment in life in a shared social world. This reminded me of the evolution of the human brain, whereby the brain became more complex as the environment, including the sociocultural one, became more complex. We evolved in the world and cannot be cut off from it. Fuchs applies these ideas to the field of psychiatry, which makes it clinically relevant too.
The book is an interesting read, although some background knowledge in philosophy and phenomenology is recommended. However, the reader does not need to be an expert in phenomenology to understand the main thrust of the book.
Fuchs is not dismissive of neurobiology, and books such as Ecology of the Brain can be a valuable resource in showing that there is more to psychiatry than neuroscience, as important as it is, and how much philosophy can contribute to the practice of a truly holistic psychiatry.
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