Mind over matter? I: philosophical aspects of the mind-brain problem

Towards an evidence-based 'Medicine of the Person': the contribution of psychiatry to health care provision

The purpose of this essay is to outline how the conceptual and clinical approaches of psychiatry contribute to increased understanding about the nature of evidence, and the art and science of medicine. It is based on the author's search for a more integrative medicine, the influence of Paul Tournier's 'Medicine de la Personne' and the Institutional Programme on Psychiatry for the Person led by the World Psychiatric Association. Evidence to support this approach from palliative care and general practice is cited, but new educational and research initiatives from other international organizations, such as the World Medical Association, the World Federation for Medical Education and the World Association of Family Practice and the medical Royal Colleges, are proposed.

Mind over matter? II: implications for psychiatry

OBJECTIVE

To explore concepts of causality within the mind and aetiology of psychiatric disorders in the light of the proposed formulation of the mind-brain problem.

METHOD

Taking the two propositions of this formulation as 'first principles' a logical analysis is attempted.

RESULTS AND CONCLUSIONS

Neural activity cannot in principle be regarded as causing mental activity, or vice versa. Causal processes are most coherently conceptualised in terms of the 'mind-brain' system. Determination of causal and aetiological effects will always necessitate consideration of contextual evidence. Because of the 'explanatory gap' between explanation in neurophysiological terms and 'mentalistic' terms, whenever formulation in mentalistic terms is possible this will carry greater explanatory power; that is, it will carry meaning in the way a neural formulation cannot.