Public Theology & Christian Living

by Denyse O’Leary –

A key—and little heralded—story in medicine over the last century has been the gradual loss, and then the gradual recovery, of the role of the mind in healing the body. The causes of the loss are much better understood than the causes of the recovery. Université de Montréal neuroscientist Mario Beauregard and I wrote in some detail about both phases in The Spiritual Brain (Harper One, 2007), and this discussion touches on some of the subjects we addressed.

There were two principal reasons for the loss: First, mechanist and materialist theories of the mind became fashionable. Second, medicine that ignored the role of the mind appeared successful. The recovery reversed these two conditions: Mechanist and materialist theories of mind proved neither intellectually persuasive nor fruitful for further research. More important, new discoveries established the mind’s role in the healing of complex illnesses. A side effect of the new approach was clear recognition and extensive documentation of the role of spirituality in maintaining and improving health.

How Did We Loose Our Minds?

The strongest current in twentieth century thinking about the mind was eliminative materialism, the view that the mind is an illusion, a byproduct of brain-body processes.

By “strongest current,” I do not argue that it was necessarily embraced by the largest number of thinkers but that it was the most powerfully in tune with the assumptions and research directions in mind-brain issues. Its basic thrust was summed up by philosopher Daniel Dennett,

We now understand that the mind is not, as Descartes confusedly supposed, in communication with the brain in some miraculous way; it is the brain, or more specifically, a system or organization within the brain that has evolved in much the same way our immune system . . . evolved.¹

Eliminative materialism also drove (and continues to drive) the descriptions of research conveyed to the public in mainstream media. For example, Michael D. Lemonick offered a typical pronouncement in Time Magazine:

Utterly contrary to common sense . . . and to the evidence gathered from our own introspection, consciousness may be nothing more than an evanescent by-product of more mundane, wholly physical processes.²

The fact that most humans do not experience our minds in this way has frequently been put down to an illusion created by Darwinian evolution. As cognitive scientist Steven Pinker writes, “Our brains were shaped for fitness, not for truth. Sometimes the truth is adaptive, but sometimes it is not.”³ This was the state of the question during the famed Decade of the Brain (1990–2000).

How did we get to this point? For much of the twentieth century, the problem of the mind-brain-body relationship was often simply avoided. This was not for lack of theories; quite the opposite. In a recent book on consciousness, Gerald Edelman and Giulio Tononi provide a list— which they emphasize is not exhaustive—of theories that have tried to account for the relationship between mind and brain, including Spinoza’s dual-aspect theory, Malebranche’s occasionalism, Leibniz’s parallelism and doctrine of preestablished harmony, identity theory, central state theory, neutral monism, logical behaviorism, token physicalism, type physicalism, token epiphenomenalism, type epiphenomenalism, anomalous monism, emergent materialism, eliminative materialism, and functionalism (various types).⁴

No consensus had emerged, and popular behaviorist psychology ruled out the discussion of mental events as such. Behavior was to be studied in terms of stimulus and response, avoiding the question of mind. B. F. Skinner, the best-known mid-century behaviorist, argued in Beyond Freedom and Dignity, “It is in the nature of an experimental analysis of human behavior that it should strip away the functions previously assigned to autonomous man and transfer them one by one to the controlling environment.”⁵

Later, with the development of cognitive psychology in the 1950s, the computer became the favored model for human thinking. Strangely, in many quarters, there was only limited discussion of the serious conceptual problems of this “machine” model. Artificial intelligence enthusiast Ray Kurzweil spoke for many when he predicted in The Age of Spiritual Machines,

The machines will convince us that they are conscious, that they have their own agenda worthy of our respect. We will come to believe that they are conscious much as we believe that of each other. More so than with our animal friends, we will empathize with their professed feelings and struggles because their minds will be based on the design of human thinking. They will embody human qualities and will claim to be human. And we’ll believe them.⁶

Another model gained popularity in the 1970s— the “Machiavellian primate” or “98% chimpanzee” approach—which sees the human mind as a souped-up version of primate minds, and assumes that the illusion of consciousness or self arose as a survival mechanism during the course of evolution.⁷

Why were eliminative materialism and allied models taken seriously? They appeared to be a welcome relief from unproductive earlier conflicts, such as the one between counterfactual behaviorism and unfalsifiable psychoanalysis. Many thinkers also associated these models with the dramatic, inspiring history of recent success in medicine. For example, vaccinations prevent diseases and antiseptics kill microbes irrespective of patient beliefs. No wonder that ignoring the patient’s mind seemed “scientific.”

By the 1930s, the Index Medicus contained no reference to the effect of mental states on physiology.⁸ While “psychosomatic medicine” was introduced in the 1940s to foster better understanding and management of the relationship between body and mind in health, the tendency to treat the body as a machine and the mind as an irrelevance prevented much advance. In the 1960s, physician Herbert Benson even had a hard time persuading colleagues that mental stress could contribute to high blood pressure. When he encouraged patients to meditate, mentors warned him that he was risking his career.⁹

In reality, however, all eliminative models have serious conflicts with evidence. The view that they are the only “scientific” way of viewing the mind was due for a challenge, and the most significant challenge came from medicine.

So How Did We Recover Our Minds?

We recovered them bit by bit. A central dogma of neuroscience during the twentieth century had been that neurons do not change. As neuroscientist Jean-Pierre Changeux put it, “Of all the organs of the body, the nervous system is unusual in that its total number of cells is fixed at birth. Any neurons that are destroyed are never replaced. . . . The possibility of restoring function is quite high in the young but gradually declines with age.”¹⁰ A key neuroscience discovery during the 1990s was that Changeux’s statement is incorrect. The brain, semi-liquid, is more like an ocean than a machine. It is enormously plastic throughout life, constantly reshaped by many factors—including our choices of what we pay attention to.

Not surprisingly, the computer metaphor has dramatically waned in perceived usefulness. Consciousness is precisely what humans have and computer programs do not. A program encodes the thoughts of the programmer, freezing them in time. It can be interactive, but only up to a point—the point beyond which the programmer’s imagination never went.

The Mind as a Demonstrated Non-Material Cause
Also, once neuroscientists got a chance to study the brain at work, they were able to look at the way the mind acts on the brain as a non-material cause. A useful outcome was new treatments for mental disorders such as obsessive compulsions. Obsessive-compulsive disorder (OCD) is a neuropsychiatric disease marked by distressing, intrusive, and unwanted thoughts (obsessions) that trigger an urge to perform ritual behaviors (compulsions) like constant, abrasive handwashing. UCLA psychiatrist Jeffrey Schwartz, a practitioner of Buddhist mindfulness, saw OCD as a good candidate for a non- pharmaceutical—essentially nonmaterialist—approach to treatment. That is because OCD sufferers are not delusional. They actually know that their beliefs are mistaken and their compulsive activities are useless. But they do not know how to stop them either. Yet giving in makes the sufferers worse over time. The more they give in, the more persistent the beliefs and behaviors become. It is as if their brains have been hijacked. During most of the twentieth century, OCD was little understood and considered very difficult to treat.

Schwartz used neuroscience techniques to identify the cause of the disorder. Specifically, the cause is most likely a defect in the neural circuitry connecting the orbitofrontal cortex, cingulate gyrus, and basal ganglia, from which panic and compulsion are generated. When this “worry circuit” is working properly, we worry about genuine risks and feel the urge to reduce them. But Schwartz found that when that modulation is faulty, as it is when OCD acts up, the error detector can be overactivated. It becomes locked into a pattern of repetitive firing. The firing triggers an overpowering feeling that something is wrong, accompanied by compulsive attempts to somehow make it right.

He then developed a four-step program (Relabel, Reattribute, Reassign, and Revalue) to help patients identify and reassign OCD thoughts, until they felt that they were diminishing in severity. Schwartz was not simply getting patients to change their opinions, but to change their brains. Subsequent brain imagine showed that the change in focus of attention substituted a useful neural circuit for a useless one. For example, it substituted “go work in the garden” for “wash hands seven more times.” By the time the neuronal traffic from the many different activities associated with gardening began to exceed the traffic from washing the hands, the patient could control the disorder without drugs.¹¹ The mind was changing the brain.

Placebo Effect: Number One Thing That “Doesn’t Make Sense”?

But in truth, most of us have experienced the impact of the mind changing the brain in a more commonplace situation: what doctors call the “placebo effect.” That is the effect we often note when sitting in a doctor’s office: A person sits there to get a note demonstrating to her employer that she is sick—and she begins, embarrassingly, to feel better. Is she shamming—or delusional? No. The placebo effect—the significant healing effect created by a sick person’s belief and expectation that a powerful remedy has been

applied when the improvement cannot have been the physical result of the remedy—is simply the mind starting the healing process before the medication is given, but after the conviction is established that it will be given.

For millennia, doctors have given placebos, knowing that they often help when all else fails. Since the 1970s, a proposed new drug’s effectiveness is routinely tested in controlled studies against placebos, not because placebos are useless but precisely because they are so useful. Placebos usually help a percentage of patients enrolled in the control group of a study, perhaps 35 to 45 percent.¹² Thus, in recent decades, if a drug’s effect is statistically significant, which means that it is at least 5 percent better than a placebo, it can be licensed for use.

In 2005, New Scientist, hardly known for its support of nonmaterialist neural theory, listed “13 Things That Don’t Make Sense,” and the placebo effect was number one on the list. For example, in one study, the tremors of Parkinson’s disease¹³ were eased by a placebo (saline solution). Neural activity associated with tremors declined as the symptoms decreased, so the patients were not simply confabulating that they felt better. Believing that they had received a powerful medication had triggered the release of dopamine in their ailing brains.

Other studies of Parkinson’s show similar results. Raül de la Fuente-Fernández and colleagues reported in 2001 that “our results suggest that in some patients, most of the benefit that is assumed to be obtained from an active drug might derive from a placebo effect.” The researchers observed from PET scans that the placebo effect in Parkinson’s patients was mediated through activation of the damaged nigrostriatal dopamine system.¹⁴

In short, not only does the mind change the brain (and body) through the placebo effect, but the changes can actually be observed by neuroscientists. And of course, the placebo effect only “doesn’t make sense” if we assume that the mind either does not exist or is powerless — an assumption that appears increasingly unlikely. So we have begun to recover our minds, at least in medicine.

Besides Which, Spirituality Turns Out to be Good For You
British theologian Alister McGrath asks, countering Richard Dawkins, “So just what is the experimental evidence that God is bad for you? . . . Recent empirical research points to a generally positive interaction of religion and health.”¹⁵ Yes indeed. But why have so many doubted this widely attested fact? It was partly because many twentieth century pundits assumed that science exists in order to confirm materialism, but there were other factors as well.

One confounding factor was the way in which research into spiritual influences on patients was conducted. For example, patient histories that ask merely for a religious affiliation cannot distinguish “intrinsic” from “extrinsic” faith. Pioneer sociologist of religion Gordon Allport defined intrinsic faith as internalized experience; extrinsic faith expresses group membership. This distinction is critical where health is concerned

because identified health benefits come mainly from intrinsic faith.¹⁶ In addition, sophisticated instruments for measuring attitudes were rarely used in the research on faith. Study samples were often unrepresentative of the general population.¹⁷

Dr. David B. Larson (1947–2002), an epidemiologist, psychiatrist, and also a devout Christian found considerable bias as well in diagnostic criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM-III), for example, used many case examples that characterized religious patients as “psychotic, delusional, incoherent, illogical, and hallucinating,” suggesting a general psychopathology that misrepresented clinical experience. When that edition of the manual was in use, only 3 of 125 medical schools in the United States provided any instruction on the relationship between health and spirituality—in a nation where roughly one third of the population claims to have had a religious experience. Despite his sudden, untimely death in 2002, Larson played a key role in helping to revise the DSM-III. And, thanks in part to his work with the Templeton Foundation, nearly twothirds of medical schools now offer course work relevant to spirituality.¹⁸

In the 1980s, together with Jeff Levin and Harold Koenig, Larson pioneered an evidence-based approach to the relationship between health and RSMEs. Whereas many research reviews provide an overview of those articles a reviewer wishes to highlight, he developed a “systematic review” method that avoids selection bias by looking at every quantitative article published during a given number of years in a single journal. This method provides a comprehensive survey of findings that is both objective and replicable. In The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects, Larson, Dale Matthews, and Constance Barry conducted a detailed review of 158 medical studies on the effects of religion on health, 77 percent of which demonstrated a positive clinical effect.¹⁹

Of course, qualifications abound. One study shows that people who believe that God wants to punish them with illness do worse than people who think that God wants them to get better.²⁰ Most clergy would not be surprised to hear it.

Have we found our mind again? Yes, but only if we want to hang on to it. If we really prefer to be the “third chimpanzee,” in Jared Diamond’s phrase, we could easily lose it again.

Denyse O’Leary is a Toronto-based journalist and co-author of the book The Spiritual Brain: A Neuroscientist’s Case for the Existence of the Soul (HarperOne, 2007).

Notes

¹ Daniel C. Dennett, Breaking the Spell: Religion as a Natural Phenomenon (New York:Viking, 2006), p.107.
² Michael D. Lemonick, “Glimpses of the Mind,” Time, July 17, 1995
³ Steven Pinker, How the Mind Works (New York: Norton, 1997), p. 305.

⁴ Gerald M. Edelman and Giulio Tononi, A Universe of Consciousness: How Matter Becomes Imagination (New York: Basic Books, 2000), p. 6
⁵ B. F. Skinner, Beyond Freedom and Dignity (New York: Knopf, 1971), p. 198.
⁶ Ray Kurzweil, The Age of Spiritual Machines (New York: Penguin, 1999), p. 63.
⁷ See, for example, V. S. Ramachandran, Reith Lectures, Lecture 5, 2003; http://www.bbc.co.uk/ radio4/reith2003/ and David Livingstone Smith, “Natural-Born Liars,” Scientific American Mind 16, no. 2 (2005):16–23.
⁸ Herbert Benson and Marg Stark, Timeless Medicine: The Power and Biology of Belief (New York: Scribner, 1996), pp. 116–17.
⁹ Benson and Stark, Timeless Medicine, pp. 99–
100. The question of the relationship between high blood pressure and mental stress is still debated, but the prejudice against considering the possibility has largely evaporated.
¹⁰ Jean-Pierre Changeux, Neuronal Man: The Biology of Mind, trans. Laurence Garey (New York: Oxford University Press, 1985), p. 282.
¹¹Jeffrey M. Schwartz and Sharon Begley, The Mind and the Brain: Neuroplasticity and the Power of Mental Force (New York: HarperCollins, Regan Books, 2003), pp. 54–90.
¹² G12 Gary Greenberg, in “Is It Prozac or Placebo?” Mother Jones, November/December 2003 gives this figure in “Is It Prozac or Placebo?” Similar figures are found elsewhere.
¹³F. Benedetti, L. Colloca, E. Torre, et al. “Placebo Responsive Parkinson Patients Show Decreased Activity in Single Neurons of Subthalamic Nucleus,” Nature Neuroscience 7 (2004): 587–88.
¹⁴R. de la Fuente-Fernández et al., “Expectation and Dopamine Release: Mechanism of the Placebo Effect in Parkinson’s Disease,” Science 293 (August 10, 2001): 1164–66. They write: “Our observations indicate that the placebo effect in PD is mediated by an increase in the synaptic levels of dopamine in the striatum. Expectation-related dopamine release might be a common phenomenon in any medical condition susceptible to the placebo effect. PD patients receiving an active drug in the context of a placebo-controlled study benefit from the active drug being tested as well as from the placebo effect.”
¹⁵Alister McGrath, Dawkins’s God: Genes, Memes, and the Meaning of Life (Oxford: Blackwell, 2005), p. 136.
¹⁶Michael Sabom, Light and Death: One Doctor’s Fascinating Account of Near-Death Experiences (Grand Rapids, MI: Zondervan, 1998), p. 82.

¹⁷ Jeff Levin and Harold G. Koenig, eds., Faith, Medicine, and Science: A Festschrift in Honor of Dr. David B. Larson (New York: Haworth, 2005), pp. 16, 140.
¹⁸Jeff Levin and Harold G. Koenig, eds., Faith, Medicine, and Science: A Festschrift in Honor of Dr. David B. Larson (New York: Haworth, 2005), pp. 15–16, 140-43.
¹⁹ Michael Sabom, Light and Death: One Doctor’s Fascinating Account of Near-Death Experiences (Grand Rapids, MI: Zondervan, 1998), pp. 81–82.

²⁰K. I. Pargament et al., “Religious Struggle as a Predictor of Mortality Among Medically Ill Elderly Patients,” Archives of Internal Medicine 161 (August 13/27, 2001): 1881–85.