Research in psychopathology: Epistemologic issues

VOL. 36, NO. 3

Comprehensive Psychiatry (Official Journal of the American Psychopathological Association)

MAY/JUNE 1995

Research in Psychopathology: Epistemologic Issues

Josef Parnas and Pierre Bovet

Etiologic research in psychiatry relies on an objectivist epistemology positing that human cognition is specified by the "reality" of the outer world, which consists of a totality of mind-independent objects. Truth is considered as some sort of correspondence relation between words and external objects, and mind as a mirror of nature. In our view, this epistemology consid- erably impedes etiologic research. Objectivist epistemology has been recently confronting a growing critique from diverse scientific fields. Alternative models in neurosciences (neuronal selection), artificial intelligence (connectionism), and developmental psychology (developmental biodynamics) converge in viewing living organisms as self-organizing systems. In this perspective, the organism is not specified by the outer

world, but enacts its environment by selecting relevant domains of significance that constitute its world. The distinction between mind and body or organism and environment is a matter of observational perspective. These models from empirical sciences are compatible with fundamental tenets of philosophical phenomenology and hermeneutics. They imply consequences for research in psychopathology: symptoms cannot be viewed as disconnected manifestations of discrete localized brain dysfunctions. Psychopathology should therefore focus on how the person's self-coherence is maintained and on the understanding and empirical investigation of the systemic laws that govern neurode- velopment and the organization of human cognition. Copyright © 1995 by W.B. Saunders Company

C URRENT ETIOLOGIC research programs in psychiatry are based on specific

theoretical conceptions of mental processes, brain structure and function, and their intercon- necting links, which posit that the external world impinges its true nature upon our cognitive apparatus, the latter being considered as a recipient and processor of this externally derived information. This framework is known as representationalism, or following Shanon, 1 as the Representational Computational View of Mind (RCVM).

Even though these assumptions permeate ubiquitously etiologic research, they are only rarely made explicit. Such tacit commitments create a scientific atmosphere in which results of empirical studies appear as "unquestionably objective," leaving only space for methodologic or procedural critique, but remain immune to more fundamental theoretical questioning simply because the theory is invisible. Nonetheless, theoretical commitments specify the range of relevant dependent and independent variables and inform the conceptualization of their con- nective links. Phenomenology as a dependent variable in psychiatric research happens to be

mutilated in different, interconnected ways. Some phenomena are eliminated as irrelevant because they cannot be grasped "objectively" or operationally (e.g., self-identity, self-consciousness, and intersubjectivity), whereas other phenomena, which are apparently more easily handled by such an approach (e.g., delusions), are in fact misconceived, thus hindering a meaningful empirical approach. 2,3 In general, the current psychometric approach to subjective experience is unable to grasp its qualitative, historical, and experiential nuances2 Corre- spondingly, the study of independent variables, e.g., brain structure and function, is dominated by a mechanistic conceptualization of biology and cognition (e.g., when Barta et al. s report an

From the Department of Psychiatry, Copenhagen University Hvidovre Hospital, Hvidovre; the Institute of Preventive Medi- cine, Kommunehospitalet, Copenhagen, Denmark; and the University Department of Aduh Psychiatry, Lausanne, Switzer- land.

Address reprint requests to Josef Parnas, M.D., Department of Psychiatry, Copenhagen University Hvidovre Hospital, BrCnd- byostervej 160, DK 2650 Hvidovre, Denmark.

Copyright © 1995 by W.B. Saunders Company 0010-440X/95/3603-0008503. O0 / 0

Comprehensive Psychiatry, Vol. 36, No. 3 (May/June), 1995: pp 167-161 167

168 PARNAS AND BOVET

inverse correlation between the severity of auditory hallucinations in schizophrenia and the volume of the left superior temporal gyrus).

We shall first articulate the hidden theoretical framework of current research programs and summarize a growing critique against RCVM stemming from various fields of scientific research. We will then introduce alternative concepts such as nonrepresentational views of mind and self-organization of complex systems, as well as recent scientific approaches in the neurosciences and developmental psychology that provide empirical support for these conceptions. These alternative approaches per- mit reintroduction of the crucial concepts of self-identity and intersubjectivity into psychopathology, without the risk for psychiatry of losing its scientific status. In our view, they offer a potentially more encompassing (and in some cases complementary) epistemologic framework for psychopathology than RCVM.

PREVAILING EPISTEMOLOGY

The term epistemology refers to a network of assumptions that underlie any theory of knowledge and of knowledge acquisition. An epistemologic point of view is usually linked to specific ontologic commitments, where the term ontology refers to a set of assumptions on the nature of reality and of being. Current psychiatric research is committed to the following view: there is "out there" a "true," observer-independent, pregiven external reality, which is in prin- ciple knowable by us. The "information" of the "information processing" resides originally en- coded in the external world as prespecified quantities, properties, and rules (the world's physicochemical constituents, their properties, and their interrelations). These constituents are seen as being separated by pregiven, observer- independent boundaries, and therefore constitute the so-called "natural kinds" (e.g., elms, hens, protons, etc.). Truth satisfaction consists of a correspondence between this outer reality and its rediscovery by us through a mental re-presentation of it in our brain, which therefore functions as a "mirror of nature." This objectivist view posits that the world is as it is independently of what any person happens to believe about it, and that there is one correct "God's-Eye-View" on what and how the world

really is. Development in science is usually seen as reflecting a progressive approximation to the God's-Eye-View position. Scientific achieve- ments are regarded as a corollary of evolution and natural selection, in which human cognitive abilities are considered as having evolved through a progressive modeling by the preexis- tent natural kinds. Although this view is incompatible with our knowledge of genetics, 6 it represents perhaps the most pervasive and un- questioned assumption of Western culture.

To conceptualize and communicate about this sort of objective reality, a language is needed that expresses concepts mapping onto the objects, properties, and relations in a literal, univocal, context-independent manner. Cogni- tion is therefore regarded as a formal ability to link and then deduce from these simple concepts according to the rules of logic. Correct reasoning mirrors the intrinsically rational structure of the world. Words are arbitrary symbols that, although meaningless in themselves, ob- tain meaning by virtue of their capacity to correspond directly to things in the world. Cognition is viewed as an algorithmic manipulation of such symbols.

From such conception of cognition as a rule- based manipulation of semantically transparent symbols, it was a short step for objectivism to take, when computer science emerged, to propose that the brain is working in a computer- like fashion and that both the computer and the brain perform computations by a rule-based operating of symbols. In the case of the computer there is, of course, no intrinsic meaning: the meaning of the symbols (semantics) is provided by the syntax of the computer program (i.e., the software and its programer). In the case of the brain, it is assumed that the symbolic value is somehow obtained by specific representations that derive from the originally true external reality. In a simplified view, one can consider the brain as a container of an appropriate list of representations (concepts), some of which stand for nouns such as table, chair, and pigeon and others that stand for operating verbs such as eating, sitting, and flying. Combinations of these with logical connectives (e.g., if-then, and, or, etc.) are all that is needed for thought and language. Some theoreticians of RCVM propose that there exists a universal grammar v

EPISTEMOLOGY IN PSYCHIATRY 169

or a universal "language of thought" (Mental- ese) that is common to all mankind independently of any actual and particular language. 8

The role of actual implementation of cognition (its "hardware" support) in the RCVM perspective falls into two broad categories: functionalism and physicalism. Functionalism assumes that mental states and processes can be adequately described in terms of "functional organization of the brain," much in the way that software determines the performance of the computer hardware. Functionalism is indiffer- ent to the actual instantiation of the system; what ultimately counts as important are the algorithms, not the hardware on which they are executed. In other words, cognition can be instantiated in any material, e.g., silicone micro- circuits, trained pigeons, or the CNS, given the right input-output relations and the right pattern of inner cause-effect relations. Physicalism, on the other hand, posits that each mental representation, taken in isolation, must be somehow caused by a specific neurochemical brain process. If you are imagining a red devil, you are in a different neurochemical state in a specific brain area than if you are imagining a black devil. Conversely, two people imagining a red devil are in the same (or very similar) neurochemical state in the same brain area. Both functionalist and physicalist RCVM require that mental representations are unambiguously semantically transparent through their correspondence to the pregiven categories in the outer world. Successful communication depends on the sameness of mental representations and on a fitness of these representations to the objects of external reality.

To illustrate how current psychiatric thinking is permeated by these specific but covert epistemologic and ontologic commitments, let us quote the DSM-III-R 9 definition of delusion, which is noncontroversial for the majority of psychiatrists: "[Delusion is] a false personal belief based upon incorrect inference about external reality and firmly sustained in spite of what almost everyone else believes and in spite of what constitutes incontrovertible and obvious proof or evidence to the contrary."

By using the adjective "false" in this particular context, the definition commits itself to a correspondence theory of truth. This is also

reflected in the notion of "external reality," which is here presumed to exist in a "true" and observer-independent manner. The notion of "incorrect inference" presupposes that human comprehension of the world relies on information processing that applies logical manipulation to "objective" sensory data. The "information" resides primarily in the outer world.

Because the current status of the neurosciences does not allow us to grasp morbid experi- ences at their physiologic level, such experi- ences cannot be exhaustively described in the objectivist vocabulary. In a naturalistic observa- tion setting (e.g., clinical setting), we have to rely on the way people convey their cognitive processes, which implies notions such as belief, desire, hope and fear. For this reason, the DSM-III-R definition operates with the notion of belief, which in an objectivist perspective is a notion belonging to folk psychology. But folk psychology, according to the objectivist view, has no referent in nature, and should be ideally eliminated from the study of cognition. 1° There- fore, perhaps due to the fact that the DSM- III-R is not fully aware of its own theoretical foundations, the definition is also internally incoherent by mixing objectivist and nonobjectivist assumptions. The delusional quality of a statement is defined as deriving from a mis- match between this statement and both outer reality as an independent validator of truth and beliefs of the human community as an intersubjective guarantee of what is true or false (following this definition, it would be difficult to decide whether Galileo was deluded).

DIFFICULTIES IN OBJECTIVIST EPISTEMOLOGY

RCVM is subject to a growing critique from various standpoints: philosophy and philosophy of science, 1H6 psychology, 1,17 linguistics, 18-2° neu- robiology, 21-23 and artificial intelligence itself. 24,z5 We shall list some of these critiques.

1. The problem of homunculus: "If representations and computations must be postulated to account for the production of meaningful language and its interpretation, then representations and computations (of a second order) should also be postulated for the processing and interpretation of the semantic representations in mind. This argument can be invoked recur-


sively, thus leading to a paradoxical infinite regress" (p. 99). 1

2. RCVM is unable to grasp adequately a number of essential aspects of psychologic phenomenology: consciousness, beliefs, desires, hopes, etc.; the relationship between mind and body; and the knowledge of the existence of mental phenomena in other beings.

3. RCVM is confronted with difficulties in accounting for the actual use of language, with its dependence on contextual variations, and the use of metaphorical and other figurative expressions and of polysemy. It is also confronted with difficulties in handling the infinite adaptive ability of cognition to an ever-changing and partly unpredictable world.

4. The present knowledge of the brain's anatomy and physiology is hardly compatible with an actual instantiation of RCVM. Notably, RCVM would be confronted with the problem of capacity and reliability of information processing. Moreover, the Mentalese hypothesis would necessitate a far larger amount of coding genes than the relatively few genes that are known to be expressed in the brain.

We shall address in more detail the issue of the fitness of conceptual categories with the natural kinds of the outer world, both because it is the central assumption of RCVM and because our main line of argument will be directed against the idea of an "external" specification of cognition (for a detailed naturalistic defense of natural kinds, see Kornblith26).

When a 4-year-old child points to a sparrow and says that it is a bird, he makes evident that he is able to classify that seen object as a bird. His classification seems to match the adult concept of birds. However, this apparent matching is based on different structures of concept formation. 27 The child's concept formation relies on actual, visible features of the object, permeated with feelings, which are "aggre- gated" into a single concept. In the case of a bird, every object possessing two legs, having wings, being able to fly, and arousing a mixture of slight fright and amazement might be classi- fied as a bird; consequently, a bat may be misclassified as a bird. The adult concept of a bird originates in the experiential history and retains concrete features, but becomes partially decontextualized or more abstract through addi-

tionally learned criteria, both morphologic and functional (a bird is a vertebrate, warm-blooded animal with lungs, and has feathers covering its body; consequently, a penguin is a bird, although it cannot fly). Through the ontogenetic development, concept formation changes from concrete operations of aggregating features im- pregnated with feelings, which are therefore highly labile, contextual, and anchored in activity, to more stable, logically organized, hierar- chic structures less dependent on concrete features.27,28

The question posed by this developmental example is the following: Is the adult mental representation of a bird the same as that of a child? The answer depends on the criteria of sameness. If it is defined by a successful communication, we may say that in most but not all instances it is the same representation. If sameness is dependent on the mental organization of the representation or its underlying brain mechanisms, we are dealing with different mental representations. Even if such a conclusion is distressing to the objectivist cognitive model, it is still reassuring that mental representations in both cases generally correspond to their proper object-determinants in the "outer reality" (co- referentiality).

To illustrate the notion of representation and its reference, we can look at historical shifts in the meaning of scientific concepts. It is acknowl- edged among scientists that Bohr's theory of the electron developed in 1913 referred to the same particles (i.e., the same external referent) that were called electrons in 1900, even though the theories and descriptions of the electron proposed at these two occasions were completely different from each other. The 1900 theory says that electrons move around the atomic nucleus just as planets move around the sun, i.e., electrons have trajectories, whereas the 1913 theory says that an electron has no actual trajectory. Currently, an electron is viewed as a "hidden variable," which can be mathematically formulated for use in experimental settings framed by a given physical theory. But the electron does not represent an ontologic entity of a natural kind.

This example illustrates the fact that even scientific categories cannot be assumed to represent strictly natural kinds. A concept is not


solely determined by a referent residing in the outer reality. Rather, the meaning of a concept depends on interactions between experiential aspects, referential aspects, functional aspects, and interpersonal agreement.

The notion of clear-cut boundaries of categories, whose membership depends on shared features that are jointly sufficient and singly necessary to define the category in question, is the cornerstone of the objectivist perspective on meaning and cognition. This view of categories and concepts has deep roots in the Western history of thinking and underlies the entire objectivist program. However, there is increasing evidence that this view cannot be maintained. Wittgenstein 29 provided an influential critique of this position. He insisted that category boundaries are often fluid, and that membership does not depend on shared criteria, but rather on "family resemblances," which is a network of criss-crossing analogies.

Consider for example the proceedings which we call "games." I mean boardgames, cardgames, ballgames, Olympic games, and so on. What is common to them all? Don't say: "There must be something common, or they would not be called 'games' " but look and see whether there is anything common to all. For if you look at them you will not see something that is common to all, but similarities, relationships, and a whole series of them at that. To repeat: don't think, but look! Look for example at boardgames, with their multifarious relationships. Now pass to cardgames; here you find many correspondences with the first group, but many common features drop out, and others appear . . . . In ball games there is winning and losing; but when a child throws his ball at the wall and catches it again, this feature has disappeared . . . . Think now of games like ring-a-ring-a-roses; here is the element of amusement, but how many other characteristic features have disappeared! And we can go through the many, many other groups of games in the same way, can see how similarities crop up and disappear. And the result of this examination is: we see a complicated network of similarities overlapping and criss-crossing: sometimes overall similarities, sometimes similarities of detail. ! can think of no better expression to characterize these similarities than "family resemblances"... (§ 66). 29

It is important to note in Wittgenstein's account that prototypicality or "family resemblances" rely on the relations between features contained in the category rather than on the features themselves. Objectivist requirements for category definition apply only to a limited universe (e.g., the concept of a triangle in

Euclidean geometry). In most cases, category membership is a matter of degree, of prototypicality, and categories have fuzzy boundaries. Robins are more prototypical of birds than penguins and ostriches. The category of "red- ness" contains central elements but has overlapping limits with neighboring colors, and exhibits large intraindividual and interindividual variations that are partly culturally determined. 3° There is growing empirical evidence from the domains of psychology, anthropology, linguistics, and other sciences that human categorization does not respect objectivist requirements for a category definition (see Lakoff 19 for an exhaustive review).

ALTERNATIVE APPROACHES

Nonrepresentat ional views of cognition do not constitute a coherent system, and many of their claims are provisional, in need of addi- tional empirical validation. However, these views may prove especially fruitful in cognitive research. In the following subsections, we shall introduce aspects of nonobjectivist theoretical approaches that may begin to form an epistemologic matrix for empirical research in psychiatry. Due to space limitations, this exposition will be brief and therefore will not avoid a flavor of simplification.

The Embodiment of Cognition and Its Epistemologic Consequences

The relationship between the notion of natural kinds and their phenomenal counterpart has been a long-lasting endeavor of Western philosophy. Philosophic phenomenology, especially in the work of Edmund Husserl, Martin Heideg- ger, and Maurice Merleau-Ponty, represents the first important Western at tempt to over- come subject-object dualism.

According to Merleau-Ponty, a real (phenomenal) object is always perceived in the process of unfolding and becoming, and for this reason its very reality is linked to "partiali ty" or incom- pleteness, which stems from the "finitude" or limit of human experiencing; phenomena are circumscribed by such basic aspects of finitude as spatiality, temporality, sexual/cultural sedi- mentation, etc. (i.e., everything that prevents humans from divine omniscience). Partiality is a natural consequence of inclusion within the


framework of a lived world, which functions as a contextual background providing meaning to perceptual themes emerging from it. Essence (thing-in-itself, i.e., natural kind) must be considered as an ever-receding and unreachable goal of human experience. Essence does not have any pregiven status in itself, but depends on our experiencing the world, with this experiencing being constantly motivated by essence. 31 Essence and experience are in a dialectical relationship to each other. Merleau-Ponty's concept of "presence" conveys this dialectic: "Sub- ject and object are two abstract 'moments' of a unique structure which is presence ''32 (Engl. transl., p. 430). Merleau-Ponty rejects the dual- istic notion that the percept is our inner representation, ontologicaUy disjunct from the outer object it purports to represent. Scientific statements about the "true nature" of the phenomenal world are derivative from the latter and are useful in specific contexts, as measured by the success of their pragmatic reference back to the phenomenal world, but they do not testify to a pregiven existence of natural kinds. In other words, scientific statements are constructs that are idealized and abstract. Categories, or boundaries separating object classes, are best viewed as reflecting socially coordinated vehicles of epistemic access between a linguistic community and features of the world. Such categories become enactively constituted through our experiential search for the essence. What we per- ceive as natural kinds in the phenomenal world are attributable to the rules of autofigurative (autochtonous) organization of a Gestalt (phenomenon). The ontologic primacy of phenom- enality means that the phenomenal world is the real world.

The epistemologic primacy of perception is linked to the ontologic primacy of the phenomenal world, and human perception derives its specific character from our embodiment. The human body has a double character as a subject and an object, being intrinsically perceiving and perceived. The living body [Leib] with its peculiar, unique simultaneity of the subject-pole and object character represents a new, emergent unity:

. . . the connecting link between the parts of our body and that between our visual and tactile experience are not forged gradually and cumulatively. I do not trans-

late the 'data of touch' into the 'language of seeing' or vice versa--I do not bring together one by one the parts of my body; this translation and this unification are performed once and for all within me; they are my body itself . . . . We do not merely behold as spectators the relations between the parts of our body, and the correlations between the visual and tactile body: we are ourselves the unifier of these arms and legs, the person who both sees and touches them. The body is . . . the 'effective law' of its changes (Engl. transl., pp. 149- 150) .32

Our experience of our body has various features, e.g., bodily expressivity, sensitivity, spatiality, and motility. In each of these experiential aspects, a peculiar synthesis is achieved between the intentional pole of the "I" and its physical correlate. Our embodiment (especially our motility) structures our experience of space and our organization of perception and expression. For example, the notion of the three- dimensional Euclidean space as a container of objects is derived from a more primary, lived spatiality, constituted and framed by our perceptual abilities as mobile centers of perspectival orientation.

Phenomenology emphasizes the role of the living body in the constitution of intersubjectivity, i.e., the apprehension of others' inner mental states. 33,34 We experience similitude between, on the one hand, our own bodily expressivity as being associated with certain cognitive-emotional states, and, on the other hand, bodily expressivity of others, as signifying their inner mental states. This is a noninferen- tial process that Merleau-Ponty calls "transfer of corporeal schema". 35 The corporeal schema is an intertwining of motility (action, doing, and intention), experience, expression, and perception, which emerges very early in the infant's development.

Since the corporeal schema is intrinsically visible, it is not hidden within a private sphere of ownness. There is an overlapping of the infant's experience of his body and his experience of other bodies: he sees others doing what he sees himself doing, and vice-versa. The notion of corporeal schema renders mimetic behavior conceiv- able and provides a theoretical foundation for the phenomena of transitivity [i.e., empathy] . . . . It is the phenomenal g r o u n d . . , of intersubjectivity (p. 122). 36

Two aspects of human development are em- phasized by Merleau-Ponty: (1) There is a necessary co-constitution of Self and the Other


(neither one has genetic primacy); and (2) Motility is the fundamental vehicle of cognitive development.

Lakoff 19,2° proposes a cognitive grammar based on embodied schemas, e.g., a "center-periph- ery" schema (as in body center v extremities) and a "source-path-goal" schema, which emerge from our motor activity. These embodied schemas underlie our use of metaphor (transfer of structural relations from one domain of dis- course into a different one) and metonymy (designing something through something else, which is in a necessary relationship with the former, e.g., an aspect standing for the whole), which pervades all human reasoning and experience. 18 Adult abstract or decontextualized cognitive abilities remain anchored in embodied conceptualization, which occurs through bodily activities prior to language. This embodiment is used in categorizations and allows for the hetero- geneity and complexity of real human categorization.

The notion of embodiment emphasizes the fact that human cognition resides in the biologic substrate, and no convincing account of cognition can neglect this biologic instantiation. Bio- logic laws differ from the laws of physics. Living organisms are subject to evolution and natural selection, which do not operate in the domain of physics. The complexity of living organisms is the product of evolutive mechanisms and not of programed and programing instructions, although the "genetic envelope ''21 constrains this complexity.

The Biologic Nature of Cognition

Natural selection has long been viewed as an environmental pressure leading to optimization and increasing fitness over generations, the so-called adaptationist or "prescriptive" view. According to the prescriptive view, "what is not allowed is forbidden." Selective pressure acts on the entire range of organismic characteristics, producing changes over time according to an optimization or improvement of the fitness potential. In that perspective, all characteristics of an organism at any given stage of its phylog- eny are the product of successful stages of shaping by environment, and are therefore specified by the environment. This specification in-

cludes cognitive abilities (e.g., genetically inher- ited syntax of Mentalese).

More recently, it has been proposed that natural selection acts in a proscriptive way ("what is not forbidden is allowed"), where selection only discards what is incompatible with survival and reproduction, letting the vari- ety of evolutive "tinkering" work as long as it satisfies these two basic constraints. 37 Environ- ment in that perspective is no longer specifying the organisms' organization; instead, organisms are self-organized, and their variability allows for differentiated responses to the changing environment while maintaining their self-organization. Self-organization is a fundamental tenet of biology. In fact, it defines what is a living organism. We shall illustrate that view with an example from the immune system, which can be considered analogous to a cognitive system. 23,37

Until the late 1950s, the prevailing immuno- logic theory was a theory of instruction, which assumed that a foreign molecule transferred information about its structure to the combining site of the antibody molecule (the antigen served as a template). The current theory of clonal selection 38 proposes that prior to any contact with a foreign molecule, the organism is equipped with a vast diversity of antibody mol- ecules. The antigen simply selects and binds to the lymphocyte producing the antibody that best fits to the antigen, with a subsequent proliferation of that lymphocyte. In this process, the antigen does not prescribe the nature of the antibody, but triggers a proliferation of the preexisting lymphocyte cell that happened to match the antigen. The antigen provides a signal for the "best-fitting" lymphocyte to prolif- erate, but does not specify the lymphocyte's or the antibody's characteristics. The organism is not injected with a bit of "information template" from the outer world that it would subsequently recover in itself as a "re-presentation."

In the example of the immune system, specifications of its structural changes are intrinsic to the system. The immune system maintains its organization while exposed to perturbations that happen to be relevant for its possible structural vicissitudes. In other words, on the basis of its autonomy, the immune system selects or enacts from its environment a domain of


significance that acts as antigens. The antigenic property is not located in the molecule, but emerges from its encounter with the immune system. The immune system can be exposed to macromolecules to which it does not react and which are therefore "outside of its cognitive field." What counts for the immune system as its world is the domain of distinctions that are relevant to it.

The distinction between a cognitive agent and his environment is not prespecified, but instead dependent on the observational perspective. For the brain, elements of its environment trigger but do not specify its operations. Instead of representing an independent world, the mind enacts its world as a domain of distinctions that are inseparable from the structure embodied by a cognitive agent.

Action realizes (a) noteworthy type of closure, in that it is in doing something that an agent learns to 'isolate' a . . . system from its environment and to discover the possibilities of development inherent to this system. The agent learns this by setting the system in motion, [which] constitutes interference, at the intersection between one of the agent's abilities and the resources of the system (Engl. transl., p. 135). 39

Self-organizing models of the brain have been proposed by neuroscientists. 21,23,4° These models are indebted to Hebb, 41 who suggested that synapses between two neurons are strengthened when both neurons are active simulta- neously; more sophisticated rules of synaptic modifications have been subsequently formulated, and some of these mechanisms have been empirically demonstrated. 42 In these models, cognitive categorization is conceived as an internal process of the CNS responding to stimuli according to its own dynamics, but not as recapturing the outer world in the form of a representation. The organization and morpho- genesis of the human brain cannot be solely accounted for by a genetic program. The ap- proximately 100,000 genes expressed in the CNS (almost the same number as for rodents) represent a "genetic envelope" that frames but does not specify the complexity of the neuronal organization. Early during ontogenesis, there is an abundance of redundant and fragile connections within the neural networks. This fuzziness makes a final tuning of the connectivity necessary, but also offers the opportunity for an

adaptive shaping, which happens through synaptic selection, where some connections become eliminated and others strengthened. The electri- cal and chemical activity in the CNS develops spontaneously in an endogenous manner. Its enormous potential for interaction and combination contributes to the epigenesis of the synaptic networks at a low cost in terms of structural genes. The process of synaptic stabilization is sometimes called "mental Darwinism": the spon- taneous activity of the CNS results in the so-called "pre-representations," which are tran- sient, coherent, but fleeting activity states, ana- logs of the Darwinian variations. Some of these pre-representations become stabilized through a mechanism of "resonance," which is a matching event between a pre-representation and an external or internal somatic stimulus. 4°

Connectionist models developed in artificial intelligence show how concepts can emerge from a network of interconnected neuron-like elements without assuming any physicalistic point-to-point reduction between the concept and the network. The phenomenon of emergence denotes a situation where a new qualitative domain arises from the organization of essentially unchanged, interconnected components. Emergent properties cannot be exhaustively reduced to the underlying components, i.e., to the system's structure.

The Connectionist Model

The connectionist model proposes that cognitive capacities reflect certain global activation patterns of interconnections in large ensembles of "neurons" (i.e., neuron-like elements), where each neuron, considered separately, is an unin- telligent component acting in multiple, changing, context-dependent responses. The system is considered as a whole and operates with continuous values derived from the level of activation of the neurons and from the strength of connections between neurons. Functional nonlinearity emerges from the systemic structure composed of dichotomously firing/nonfiring neurons. Rule- dependent synaptic modification is a fundamental premise for the connectionist paradigm.

The elementary connectionist model goes like this: Take N simple neuron-like elements, connect them reciprocally, and provide a learning feedback rule for the system. Then present


this system with a succession of patterns of 16 different dogs, by treating some of its nodes as sensory ends. After each presentation, let the system reorganize itself and rearrange its connections by modifying the links between those neurons that happen to be active together for the item presented. Each exposure will thus lay down a memory trace in the form of a pattern of altered connectivity, modifying the previous exposure, according to the Hebbian rule. After the learning phase, the system is able to classify an unseen dog in the category of dogs, is able to generate a picture of a "prototypical" dog, and is able to perform a pattern completion by recognizing an aspect of a dog. The system has acquired a concept of "doghood" that reflects a global state of its internal activity configuration. The representational level has no direct physical support in any single part of the system. Connectionism is an engineered approximation of biology; its current applications still depend on learning phases specified by external information, and the standard approach still involves a classic notion of representation. Attempts are being made to develop connectionist models that function without instruction or supervised learning:

In unsupervised learning a network just looks at the world, and, without further instructions, it constructs an internal representation . . . . [Unsupervised] learning is trying to achieve significant agreement between the outputs of different modules that look at different parts of the input. We show that by reaching agreement the modules can internally reconstruct the external causes of the input (p. 5, our italics). 43

Development in Self-Organization

In the study of infant development, the focus of interest is the emergence and maintenance of self-coherence in an appropriate interactive context. It has been proposed 44 that in his ongoing involvement in the world, the infant organizes his experience by delineating "moments" that can be considered as a "sense- giving activity" to the flux of his experiencing of the world. A moment is an emergent mental property, and organizes into a whole the diverse simultaneous happenings registered during an event. These "proto-concepts" possess three characteristics, namely temporal organization, quasi-narrative structure, and a nascent proto-

typicality by establishing a certain relational invariance between properties. These chunks of experience derive their coherence from cross- modal integration of various perceptions. It has been proposed that cross-modal matching may be achieved through two distinct processes: (1) "matching by analysis," which involves some sort of internal comparing of objects' features perceived through different modalities, and (b) "matching by recognition," which is based on rapid and holistic memory linkagesY Spatial constraints, stimulus intensity, rhythm, and temporal contour are especially important for the latter process.

Recent advances in developmental biodynamics have demonstrated the impossibility of separating perception and action, and have empha- sized the role of proprioceptive exploration in the development of motor coordination. The relation between perception and action is a reciprocal, complementary one: action and perception co-occur and mutually guide one another. 46 As an example, the human motor system is mechanically infinitely complex, and can use infinite degrees of freedom. The development of economically coordinated movements cannot be solved by applying computational models derived from RCVM. 47 Rather, effective reduction in degrees of freedom is developmentally achieved through a selection of neuronal groups in maps for the progressive transformation of a primary movement repertoire into a set of motor synergies and adaptive action patterns. Similarly, Bushnell and Boudreau, 48 in their studies of relationships between motor activity and perceptual development, demonstrated that infants must be able to execute specific motor abilities in order for the corresponding perceptual abilities to emerge. In their study of haptic perception and depth perception, they showed that motor abilities make available certain information required for the acquisition or operation of the related perceptual abilities. Thelen et al . 49,5° demonstrated that the development of walking abilities cannot be accounted for by the unfolding of "programed" instructions, but pro- ceeds on account of adjustments and reorganiza- tions of components intrinsic to the whole functional motor system itself (such as the relative weight and strength of different parts of


the infant's body). In summary, Bushnell and Boudreau 48 state:

Traditionally, developmental changes in motor abilities were attributed to maturational processes (e.g. myelinization, dendritization) in the central nervous system . . . . Modifications of standard learning theory, reference to perceptual and social incentives, and information-processing concepts have also been em- ployed in explanations for motor development . . . . In any of these prior accounts, motor development is viewed as a derivative of processes and events occur- ring at some higher or more central level. Changes in the 'mind' (or brain) of infants effect changes in their abilities to deploy the 'body.' An approach formulated in physics and biology holds, however, that changes may emerge from or 'fall out of' the self-organizing tendencies and constraints among the interacting components in the system itself (p. 1006). 48

Developmental views are couched in systems formulation. Systems combine many elements or subsystems in a large potential number of ways, and have an enormous number of "degrees of freedom." Under certain conditions, complex systems may produce emergent order without preexisting prescriptions: the participat- ing elements or subsystems interact, and the original degrees of freedom are compressed to produce spatial and temporal order. The reorganization of elements can generate patterns that have much fewer dimensions, but order is a product of self-generating process, not of instruction. Contemporary studies in mathematics, chemistry, and physics show how order may emerge from chaos. 51 Such models can provide a coherent guide to investigations in developmental psychology, although it has to be stressed that their applicability to living systems is only emerging in empirical research: °,52 The dynamics of such systems can be summarized as follows: From a number of initial stages, the system settles into (temporary) dynamic stabil- ity within an "attractor" state, and will tend to return to its attractor as long as "normal" fluctuations or perturbations stay below a certain level. In biology, an attractor state is defined as a constrained region of structural relations and states "preferred" by a particular biologic organization within a particular context. Under certain conditions, amplification of fluctuations may shift the system into a far-from- equilibrium state. The system reaches "bifurcation points," where it can switch through phase

transitions to one of several different new discrete stable modes (new "attractor" states).

The 'historical' path along which the system evolves . . . is characterized by a succession of stable regions, where deterministic laws dominate, and of instable ones, near the bifurcation points, where the system can 'choose' between or among more than one possible future. Both the deterministic character . . . and the random fluctuations . . . are inextricably connected. This mixture of necessity and chance constitutes the history of the system (pp. 169-170). 51

In our view, two propositions can be inspired by this theory: First, neither the organism nor the environment has a privileged status in effect- ing change--they are "inextricably connected." Second, the history of a complex system cannot be predicted from its initial conditions (nor the initial conditions "retrodicted" from a given point of its history); due to the unpredictability imposed b y points of bifurcation, an arrow of temporality is imposed, and the coherence of the system's history is left within the system itself.

Self-Identity and Hermeneutics

RCVM considers cognitive structures as specified by the outer world in the sense that there is an innate encoding program of cognitive development fitting the nature's requirements and that itself is a product of natural selection imposed by the external world. The unfolding of this program is prompted by the environment, resulting in some sort of standard end state, which is shared by all members of a species. In the case of human cognition, this end state is marked by similarity of the mental syntax, ensur- ing communication between individual members of the society. This model presupposes a unidirectional homology between the external world and the organism. What is important from a RCVM teleologic perspective is therefore an adaptation, which is maintaining the cognitive system's homology to the current state of the external world. The conceptual locus of the organismic coherence therefore resides in the external world. This model underlies argu- ments of both environmentalists and geneticists because their internal quarrel is confined to the respective weight of innate or environmental specification of development but does not question the very fact that the organismic coherence is provided by the external world.


By contrast, the teleology underlying the self-organizing perspective is the maintenance of the internal coherence of the organism already dwelling in his world. In fact, this epistemologic perspective, known as "internal real- ism," is increasingly influential in Anglo-Saxon philosophy.

Internalism does not deny that there are experiential inputs to knowledge; knowledge is not a story with no constraints except internal coherence; but it does deny that there are any inputs which are not themselves to some extent shaped by our concepts . . . . Even our description of our sensations, so dear as a starting point for knowledge to generations of epistemologists, is heavily affected (as are the sensations themselves for that matter) by a host of conceptual choices (p. 54).53

This self-coherence is neither a pregiven entity nor a faculty of the mind, but the very (self-)definition of a living organism, which our language describes and to some degree reifies as self-identity. The ontogenetic development therefore is not seen as an adaptation to the demands of a pregiven outer world, but rather as vicissitudes of maintaining self-identity or self-coherence through the enactment of relevant interactions. The substrate of cognition is inseparable from its history, and self-coherence throughout the history encompasses the organism and its world. 54

The locus of self-coherence is not confined to the brain, but to the whole living organism enacting its domains of significance. It is at this point that a hermeneutic approach reveals its epistemologic relevance. A hermeneutic epistemic standpoint does not pretend to be located outside and independent of the subject of inquiry. It has the underlying more modest claim that the investigator and his subject matter are interdependently linked. In the process of hermeneutic inquiry, through constant mov- ing from a part to the whole, a mediation is achieved between description and explanation, or to use hermeneutic terms, analysis and reflection. A better description becomes already a beginning of explanation, and a better explanation guides the direction of further description. This way of studying human existence achieves a coherent approximation of causes and goals. From a hermeneutic point of view, the temporally anchored vehicle of self-coherence is the subject's narrative activity. The theory of narra-

tive occupies a central position between the history of an agent who has the capacity to act and the anticipation of this agent's projects. "At the broadest and most abstract level (the subject's) identity is constituted out of the part- whole relation between the 'now' and the at least implicit horizon of (his) life as a whole" (p. 45). 55

The concept of narrative indicates that human existence, with all its connotations such as development, acting, thinking, and planning, has a character of emplotment that allows this self-coherence to be manifested. Emplotment has by necessity a temporal character with beginning, middle, and end, and it unifies teleologic segments of life amenable to practical reasoning with systematic segments of life amenable to causal explanations. In the narrative of action:

What matters here and what poses a problem are precisely the points of suture between the two. Indeed, every result of a practical syllogism is a real action which introduces a new fact into the world order, and this in turn sets off a causal series. Among the effects of this series are new facts which are then assumed as circumstances by the same agent or by other agents. Now what makes this linking of needs and ends fundamentally possible? Essentially, it is the agent's capacity to make one of the things he or she knows how to do (knows he or she is able to do) coincide with an initial system-state, thereby determining the system's conditions of closure (Engl. transl., p. 110). 56

Thus, narrative structure not only relates to the question of time, but also to the constitution of the Self, because it is in the form of a narrative that the whole of a subject's life is meaningfully "gathered together" (Dilthey's 57 "Zusammenhang des Lebens"). Narrative structure anchors and constitutes personal identity, which comprises the dialectic of Self and An- other and the twofold valence of permanence in time: the sameness of a person (the "what" of a subject, i.e., the temporally evolving but immu- table aspects allowing indexical reference to him) and the selfhood of a person in his historical vicissitudes (the self-constancy of the "who" of self-consciousness).56

The role of narrative is not only confined to language, but is inchoate in every human experience. As we mentioned earlier, it is in the infant's protonarrative structures that a clear link appears between the shaping of our cogni-


tive development and the development of senso- rimotor abilities.

CONCLUSION

Operationalism is often viewed as the most promising revolution in psychopathology. The notion of an operational criterion stems from physics 58 and specifies an operation that, if applied, ensures the concept's link with reality. A substance X is "harder" than a substance Y if X makes a scratch on Y and Y does not make a scratch on X. Since "operations" are rarely feasible in psychopathology, attempts are made to define concepts by a set of necessary and sufficient conditions. Operationalism appeared in psychiatry at the moment when the crisis in clinical skill became alarming and impeded scientific communication. 59 Poor interclinician agreement is still considered as a golden argument to justify any simplification of psychopathology for the sake of reliability. A recent review on research methods in diagnosing personality disorders, 6° devoid of any deliberation on the theoretic foundations of operationalism, contains the following statements:

The reason for developing standardized PD (personality disorder) interviews was to improve on the poor interrater diagnostic reliability of unstructured clinical evaluations. If clinicians cannot reliably diagnose PD, their diagnoses cannot serve as a standard of compari- son . . . . If an interview (instrument) is chosen, it is probably prudent for the raters to be trained in the interview's administration (pp. 238 and 241, our italics). 6°

The review 6° alludes to the advantage of using nonclinicians in data collection because of their lack of "clinical prejudices." However, poor interclinician agreement cannot be a proper rationale for disregarding clinical skill and its importance for research. Poor interclinician reliability does not only reflect the complexity of phenomenology in psychopathology, but is also related to a dramatic decrease of interest in psychopathology due to a combination of various historic, sociologic, and economic factors. In our view, this crisis will never be resolved without a critical reflection on the theoretic foundations of psychopathology.

Psychopathologic concepts are historically and culturally determined, but our linguistic prac- tices reify them into seemingly "preexisting

natural kinds." In fact, such concepts have by necessity a certain fuzziness and openended- ness, and they can be validly thematized (i.e., made epistemically useful) only through a pains- taking accumulation of clinical expertise involv- ing theoretic inquiry and intersubjective sharing both with other experts and with patients. In a phenomenologic clinical process aiming at diagnosis, we arrive at a typification of a particular patient's experience through an oscillation between empathy and distance. Successful typification is never achieved solely through logical inferences from observed signs and reported symptoms, but also involves preconceptual em- pathic elements that are linked to interbodily communication and attunement. 6~ Recognition of this fact should be consequential for the training of psychiatrists and for data collection in empirical studies.

The operationalist-objectivist view of psychiatric symptomatology as a series of disconnected categoric entities that are definable in a context-independent manner is incompatible with the current knowledge of human mental processes.

Phenomenologic-hermeneutic inquiry focuses on the vicissitudes of self-identity and self- coherence. What the patient presents are not disconnected symptoms, but rather his quest for being-in-the-world, which is always a dialectic between a current self-coherence and its place in the historically unfolding self-identity. A hermeneutic perspective is compatible with current knowledge of the self-organization of biologic systems.

Phenomenologic investigation discerns a certain structure in the patient's self-coherence that already encompasses his world and where component symptoms unite in and derive from such a self-coherence. As an example, seemingly disparate schizophrenic symptoms have been viewed as reflecting an underlying "lack of common sense," i.e., a defective preconceptual attunement to the w o r l d . 3,62,63 Such an essential structure of the patient's symptomatology can be translated into variables suitable for empirical research. 64,65 The neglect and oversimplifica- tion of psychopathology as a dependent variable most likely impedes biologic research. 66 But even the discovery of, e.g., a specific genetic marker for the schizophrenia spectrum disor-


ders would not be sufficient for unveiling the biologic pathways from such liability to the overt symptomatology of an individual patient because, in the case of presumably most psychiatric disorders, overt symptomatology is an end product of nonlinear self-organizing processes 67 that attempt to maintain the self-coherence of the patient. A phenomenologic-hermeneutic approach will therefore remain important both in studying the evolution of symptomatology and in therapeutic efforts.

RCVM is a straightforward model for studying simple causal links such as point-to-point relations between mental phenomena and their putative biologic substrate. However, the net result of countless studies using such an approach does not match the invested effort. The application of RCVM epistemology in psychiatry was largely motivated by successes in the cerebral localization of neurologic diseases. However, psychiatric disorders are unlikely related to circumscribed brain dysfunctions or to a single neurotransmitter system dysfunction, but rather to malfunctioning interconnections between neuronal modules. 23 From a connectionist neural network perspective, there is no possibility of any simple point-to-point reduction of a mental function to a circumscribed brain area. Etiologic research programs should therefore take into account neurodevelopmen- tal pathways leading to fragile self-organization of the brain and focus attention on the nature of vulnerability to a disease.

We need in psychiatric research a proper and detailed understanding of the dynamics of complex systems in living organisms, with specification of hypotheses that are empirically translat- able and testable. As it is today, systemic terms are usually added in the discussion section of research articles and exemplified by the so-

called "feedback loops," but the underlying view remains that of steps and paths of a purely deterministic, externally driven causality.

For example, we proposed elsewhere 3 that the emergence of a delusional state in paranoid schizophrenia may be considered as a phase transition; however, our exposition remained at a "metaphoric" level and should be reformu- lated in proper systemic terms. In such terms, vulnerability to schizophrenia can be seen as instability of attractor states, leading to various phenotypic outcome manifestations of self- reorganization; the underlying instability could be related to a developmental "weakness" of proto-conceptual organization due to a fragile cross-modal integration. 65 Part of such an hypothesis could be empirically tested by comparing the development of cross-modal abilities in high-risk and control children. Hypotheses derived from the theory of self-organization should be tested in contextually relevant paradigms. In other words, if we abandon the computational view of human cognition in favor of enactment, the specifications of empirical test procedures become of crucial importance. Such test procedures should develop after a careful reflection on a priori important features and, to the extent possible, approximate test situation to naturalistic circumstances.

Our argument emphasizes two general propositions: (1) The mind undergoes a self-organizing epigenesis in which deterministic steps and random fluctuations alternate (a balance between "structure" and "noise"), which implies inseparability of genetic constraints and individual historicity; and (2) The relation between the organism and its environment is of an enactive nature, and the distinction between what is intrinsic and extrinsic to a system is a function of observational perspective.

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Research in psychopathology: Epistemologic issues

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