In my more lucid moments, I try to justify my membership of the multi-disciplinary mental health team by saying that I put the “psycho” into biopsychosocial. Sometimes this gets a laugh, more often an embarrassed silence. In my more grandiose moments, I liken the role of the psychologist in the team to that of the grit in an oyster shell, the irritant, without which there would be no pearl. My pearls of wisdom fall to the floor like a broken necklace, and in the end turn out to be just paste. More often than not, I put the “nit” into cognitive.
However, notwithstanding the above, I have been grappling of late with the challenges of reductionism. A bit like grappling with a crocodile. Biological psychiatry is the crocodile in the river – highly respected, a bit scary, and you wouldn’t want to get too close.
Without the physical reality of our brains we would of course not exist as conscious beings. But are we more than our brains? Am I more than the areas of my brain that light up in response to external stimuli? For my latest analogy, I have turned to the cinema. Think of some of your favourite movies, of some the great classics of the big screen. Think also of some of the not so great films you have seen. The films, in a reductionist sense, are reels of celluloid in metal tins. A great movie will look exactly like a poor movie. It is only through the wonders of technology that we experience the films and can make judgments about their artistic merits. The distinction is between the physical reality of the film and what it actually is at an experiential level. The film is what is on the screen, not what is in the tin. I think I know what I mean. Cut!