Biological and chemical diff erences

It might be the case that we cannot simulate some minds because biological or chemical diff erences result in them working diff erently from our own. Such thoughts have inspired a minor tradition of psychiatrists taking mind-altering drugs in the hope that this will enable them to better understand their psychotic patients. Most such work was conducted in the 1950s and 1960s and involved

psychiatrists taking

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or mescaline in the hope of gaining insight into schizo-phrenic thought processes.

Fairly typical in this tradition is a 1956 study by John Macdonald and James Galvin called “Experimental Psychotic States” published in the American Journal of Psychiatry. A pharmaceutical company had given Macdonald and Galvin a large quantity of

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. Th ey gave much of it to their patients, but took some themselves. Th ey considered that while on

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“the psychiatrist may experience hallucinations, illusions, depersonalization, and other symptoms that he sees in his patients” (1956: 973).

Th ere are a number of problems that one might note with such studies. Most obviously, one might doubt the extent to which

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-induced mental processes can be expected to resemble schizophrenic mental processes. Plausibly diff erent types of hallucinogenic drugs produce diff erent types of experience, and the hal-lucinations produced in schizophrenia might be expected to diff er yet again.

Let us place such concerns to one side, however, and ask whether if a drug did alter the mental processes of the psychiatrist such that they became similar to those of a psychotic patient, this would enable the psychiatrist to simulate the patient more easily. We can only simulate another to the extent that our mental processes are similar. Th us, to the extent that the drugs make the psychiatrist’s mind like that of a psychotic patient the psychiatrist can expect to be able to simu-late the psychotic. Here a problem emerges, however. While on the drugs many experimenters found that they lost interest in their research project. While in the state they need to be in if they are to simulate (i.e. on the drugs), they simply did not feel motivated to think about schizophrenic thought processes, or to describe their own experiences. In the MacDonald and Galvin study: “one of the writers found the phantasy world so entertaining that he became impatient when asked to describe it. Th e experience was too satisfying and the time too precious to be spent in describing this state of ecstasy” (1956: 972).

Psychiatrists on drugs are not interested in understanding psychotic thought patterns, but what about aft er the drug experiences? Could the psychiatrist who has experienced

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-induced hallucinations simulate a psychotic patient when he is no longer on the drugs? Some psychiatrists have claimed that their drug induced experiences have enhanced their post-drug understanding of patients.

John Kafk a and Kenneth Gaarder (1964) gave psychiatrists

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the day before they practised psychotherapy. Some of the psychiatrists felt that their drug expe-riences gave them a better understanding of behaviour that they had previously found peculiar. In particular, one patient would repeatedly ask her psychiatrist to come into her room so she could “explain things”, but would then fall silent.

Her psychiatrist reported that: “His

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experience of the richness of the physi-ognomy of objects made this behaviour seem less bizarre since he could assume that she was silently asking him to share this richness” (1964: 240). However, although the psychiatrist considered his understanding to have been enhanced,

psychiatry and philosophy of science

there are reasons to be doubtful. Th ere might be many diff erent reasons why the patient acted as she did, and the therapist’s claim that she was awestruck by the richness of her visual experiences is just a guess. Overall, I am sceptical of the idea that those who have taken drugs will be able to aft erwards simulate what it is like to be on drugs. When someone has taken drugs their mind works in particular ways because of the chemical changes brought about by the drugs.

Th ese chemical changes are not available to consciousness, and so it would not be possible to reproduce them consciously when one wants to run a simulation at a later time (I guess this would be why it is not possible to get drunk-feelings by just thinking about drinking alcohol). Th is being said, although I do not think that

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experiences will enable psychiatrists to better simulate psychotic patients, drug experiences may enable one to learn some things that will help one to be more sympathetic to psychotic patients. For example, an

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experi-ence might enable one to learn that hallucinations can be very frightening, and learning this might change how a psychiatrist interacts with patients.

5.3.4 Trauma

Th ere may be some mental states that we have problems simulating because the situation of the subject is too horrifi c. Consider this vignette, which opens John Wilson and Rhiannon Th omas’s Empathy in the Treatment of Trauma and PTSD:

I was given another choice: I rape my daughter or the guard does. I tried to reason with them, telling them that she was an innocent child

… Th ey laughed and repeated the two choices. I looked at my daughter hoping that she would tell me what to do – our eyes met and I knew that I could not save her from those wretched men. I lowered my eyes in shame to keep from seeing my daughter abused. One guard held my face up, forcing me to watch this horrible scene. I watched, motion-less, as she was raped before me and her little brother. When they were through, they forced me to do what they had done to her. My own daughter, my son forced to watch it all. How could anyone do that?

What kind of men are they? What kind of father am I?

(Wilson & Th omas 2004: 3, citing Ortiz 2001: 18) Some therapists claim that they can empathize with people who have under-gone such events. I do not think I can. Th e problems are twofold. On the one hand the events described are far beyond the realms of my experience. I have never seen anyone raped, and I do not have any children. Th e other problem is that seeking to simulate terrible thoughts is disturbing. As such, it is very hard to force oneself to do it. Th e problem is that one tends to fi nd oneself avoiding

attempting the simulation. Th us, Wilson and Th omas found that many of the therapists they spoke to encountered diffi culty in empathizing with trauma patients: therapists would fi nd themselves thinking of other things, or falling asleep, to avoid having to pay attention. Somewhat similarly, Regehr et al. (2002) found that ambulance paramedics developed a whole range of techniques that enabled them to avoid empathizing with the victims of tragedy. Th e paramedics picked up bodies but avoided talking to the relatives of the dead, or they avoided empathizing with victims by concentrating on the technical details of what they needed to do next. When those who work with trauma victims do empathize with them, they frequently fi nd this extremely upsetting. Th ose who empathize with trauma victims can fi nd that they themselves experience intrusive imagery, nightmares and so on (ibid.). Th e problems that are faced by those who empa-thize with the victims of trauma also mean that it is hard for an individual to gain much experience in such work; rather than getting better at simulating the thoughts of the traumatized, the risk is that the person who works too long with trauma victims instead just becomes hardened or traumatized themselves.

It is worth noting that those who have experienced traumatic events them-selves can also be expected to have problems simulating the thoughts of those going through similar events. Commonly, those who have undergone traumatic events have problems when they encounter stimuli that remind them of their trauma. Th ose who have been traumatized by war can end up panicking when they hear fi reworks, for example. When a person who has been traumatized seeks to simulate the thoughts of someone in a similar situation it is likely that the aff ect generated will knock their thoughts off kilter. Th ey will stop simulat-ing and get caught up with their own unpleasant emotions.³

In document Psychiatry and Philosophy of Science - Rachel Cooper (Page 83-86)