Anxiety and Elephants, Part Two

I’ve worked with many, many people with psychological problems in the extreme, and it’s impossible not to think that some of these folks are primarily the victims of some kind of brain disorder. I don’t deny that genetics can be a factor, and that some people can inherit a dysfunctional brain or a tendency to have certain problems. Anyone who’s ever worked with developmentally disabled people or people whose brains have been affected by injury or disease can attest to the reality and effects of brain dysfunction. There are also some very interesting twin studies on schizophrenia that must be taken into account in any integral approach to understanding these issues. In my experience, however, these kinds of conditions are exceedingly rare, and certainly do not account for the “one of every four” phenomenon that we see in our society today. So, to be clear, I do think problems in functioning can be due primarily to structural problems in the brain, inherited or not.

My main point is that it is dangerous and flat-out wrong to think of “psychological” problems or subjective experience in general as being “caused by” objective or upper right quadrant realities. My examples of the tiger and elephant were a little over the top, I admit, but in general I do see people being seduced (by The Man as well as by their own understandable desire for relief) into making the upper right primary when, in fact, an emphasis on other quadrants is in order. In some cases, such as grief over the death of a loved one, or the psychological abuse of a child, we can see how simplistic and reductionistic it is to think in terms of “causes.” Someone in a prolonged state of grief or a child exposed to the stress of continued confusion and terror will change on a physiological level in ways that can be measured. But to say their subjective feelings are caused by the physiological changes is no more or less true than saying their feelings are caused by the death of the loved one or by the abuse. The way we respond to death is partly a matter of how death is viewed in our culture, and the child abuse might partly be influenced by cultural and economic factors. Human health has to looked at integrally, in my opinion, to effectively deal with problems. Even the language here makes things difficult. Calling something a psychological problem sounds like a denial of the upper right quadrant, while calling it a medical problem denies the other quadrants. “Problems of living” are always a four quadrant affair, although when it comes down to helping a real person having a problem, the main concern is “what works.” Even if the problems of a schizophrenic man stem from some sort of child abuse or whatever, still the most helpful thing to do for him may be to prescribe him some risperdal. A health care professional cannot fix all the problems in society, culture, and in the mind of the patient in three days. But they can prescribe risperdal, and that does help ease the suffering of many, many patients.