by Theodore Dalrymple (March 2007)
I attended a fascinating conference on neuropsychiatry recently. Neuroscience, it seems to me, is the current most hopeful candidate for the role of putative but delusory answer to all Mankind's deepest questions: what is Man's place in Nature, and how should he live. What is the good life, at least in the western world?
The fact that there is no definitive answer to these questions does not mean that we cease to ask them. Some philosophers have argued that a question that is in principle unanswerable is not really a question at all, but the philosophical equivalent of verbigeration, the symptom in which some lunatics make word-like sounds that do not actually correspond to any language. But this strikes me as evasive, a kind of high class magical thinking, in which a person believes that a state of affairs can be brought about merely by wishing it to be brought about.
An equal and opposite temptation is to believe that the questions have already been answered, at least in principle (that is to say, everything but the detail has been worked out). Freudians and Marxists, for example, once believed that they knew not only what had gone wrong with human existence, but how to put it right. They believed this because they thought they had a complete and sufficient explanation and description of Man. This, of course, put them at a great advantage, at least in their own estimation, to the great mass of Mankind that was neither Marxist nor Freudian. They had seen the light as clearly as any Evangelical; and there are few states of mind more delightful than an awareness of superior understanding to that of the great mass of one's fellows.
It will not have escaped the notice of the observant that Marxism and Freudianism have become a little frayed around the edges of late, and that their adherents are reduced to recalcitrant membership of increasingly beleaguered sects. But the attraction of all-embracing worldviews that explain not only who we are but prescribe how we ought to live remains as strong as ever. Some of the neuroscientists to whom I listened at the conference implied that we were on the verge of such a breakthrough in our self-understanding, thanks to neuroimaging, neurochemistry and neurogenetics and so forth, that Man, proud Man, will no longer be a mystery to himself. The heart of all our mysteries will be plucked out wholesale, as it were; and to understand all will then be not so much to forgive all as to control all, especially our bad habits.
Let me not be taken as denying that the neurosciences have advanced stupendously in the last few years. Progress, indeed, has been so rapid that leaders in various fields now talk of the late 1990s as if of an era of prehistoric antiquity and ignorance, just as those in the late 1990s used to talk of the late 1980s.
During the conference, I heard one of the best lectures I have ever heard by a professor at the Salpetriere in Paris. (This hospital, of course, has one of the most distinguished histories in neurology of any hospital in the world.) Not only did the professor speak brilliantly, with wit, learning and charm, but he showed astonishing before and after videos of patients treated surgically for a variety of conditions, from Parkinson's disease to Gilles de la Tourette's syndrome. It was difficult then not to succumb to a sort of euphoria, that consisted of the belief that at last we really did understand, at least in principle, what it was to be a human being. This was further reinforced by neuroimaging studies showing the areas of the brain that were active when a man in love perceives his beloved: the neurological basis of romantic love, as it were. Somewhat disappointingly for romantics, the parts of the brain that are activated during the encounter are primitive from the evolutionary point of view, and present in the pigeon and the lizard.
In fact, the professor from the Salpetriere, being a cultivated man, was comparatively circumspect in his estimation of the wider significance of his work. The operations he described were performed on people with gross and relatively discrete pathology, who were abnormal in a very obvious way. In fact, for all the wizardry of the means used, the extension of our knowledge upon the basis of which the operations were performed was not of an order of magnitude greater than previous advances, nor was that knowledge different in kind from that which we had already long possessed.
Nevertheless, several speakers strongly implied that with the exponential growth of neuroscientific research, we were about to understand ourselves to a degree unmatched by any previously living humans. I confess that, whenever I heard this, I thought of the old proverb about Brazil: that it is, and always will be, the country of the future.
At the very end of the conference, a well-known professor of philosophy was brought in to confirm that man's self-understanding would soon advance by leaps and bounds, thanks to the neurosciences. The professor was a man of great erudition, and spoke fluently without notes, with enormous and beguiling wit. Many times before, he said, Man had believed that he understood himself; this time, it was going to be true.
The speaker was so convincing and so fluent that I could not but help recall the way that Michael Oakeshotte, the former Professor of Political Philosophy at the London School of Economics, and the greatest conservative thinker of his time, introduced Isaiah Berlin at the LSE where he had come to give a lecture. Isaiah Berlin, he said, was the Paganini of the lecture platform: the best compliment-cum-insult I know, approximated only by Disraeli's remark when champagne was served after a truly terrible public banquet. Thank God, said Disraeli, for something warm at last.
Two main questions arose in my mind during the neuropsychiatric conference. The first was whether any scientific self-understanding was possible. The second was whether, if possible, it was desirable. My answer to both questions was, and is, no.
In the first place I find it difficult even to conceive of what a scientific self-understanding would actually be like. My patients often used to ask me, 'Doctor, why am I like this?' or 'Why do I do the things I do?' I would sometimes then ask them what they would consider an adequate and satisfactory explanation, and not a single one (including the highly intelligent and educated) was able to tell me.
For example, alcoholics would ask me why they drank. I would give the various, not necessarily mutually exclusive, explanations, including that related to the price of alcohol. If the price of alcohol falls, the consumption in a population as a whole rises, and the normal distribution curve of consumption shifts to the right, with a disproportionate number of people then falling into the category of problem drinkers. In other words, more than half of alcoholics drink too much because the price of alcohol is too low.
It will not perhaps surprise readers to learn that this explanation, while statistically sound, failed altogether to satisfy my patients; for, as they quite rightly asked, why then did some people drink and some not, whatever the price of alcohol? Even at high prices, some people become alcoholics; and even at low, most people never do.
Well, of course there is a genetic component. People with family histories of alcoholism are more inclined than others to drink to excess, and this is a genuine genetic effect, as twin studies have shown (identical twins are more likely to show similar patterns of drinking than are non-identical twins). But even identical twins show dissimilar drinking patterns more often than they show similar ones.
The fact is that, however many factors you examine, you cannot fully explain behaviour, not even relatively simple behaviour. And if you cannot explain relatively simple behaviour, how are we to explain the immense, indeed infinite, variety of human behaviour? How are we fully to account for the infinite variety and originality of human utterance, for example? (It is vanishingly unlikely that the last sentence, or for that matter this one, has ever been written before.) How does one develop a universal law that explains an infinite number of unique events that are infused with meaning and intentionality? It was on this question that the programme of behaviourism, that (as everyone now completely forgets, though it was not so very long ago) promised a complete and sufficient explanation of human behaviour, foundered.
A neuroscientist might reply that he is not trying to develop a theory that explains everything in detail, but only in general: that is to say, to explain the important and significant generalities of human thought, feeling and conduct. But on a purely scientific or naturalistic view, nothing is more important than anything else, in the sense in which the words are being used here. In a universe deprived of intentionality as a whole, a volcano is no more important than the death of a beetle, or the explosion of a star. Nothing is important or significant but conscious thinking makes it so: the type of thinking, moreover, that employs moral categories that are inherently non-natural.
What people consider important varies according to their interests. In imaginative literature, for example, some authors take the broad sweep of history as their subject, while others take the minor fluctuations of a single person's emotional state. (Only the very greatest, such as Shakespeare, successfully take both at the same time.) There is no way of deciding which approach is correct or better, though I have my preferences.
Those who say that we are on the verge of a huge increase in self-understanding are claiming that enlightenment will suddenly be reached under the scientific bo tree. The enlightenment will have to be sudden rather than gradual because, if it were gradual, we should already be able to point to an increase in human contentment and self-control brought about by our already increased knowledge. But even the most advanced societies are just as full of angst, or poor impulse control, of existential bewilderment, of adherence to clearly irrational doctrines, as ever they were. There is no sign that, Prozac and neurosurgery notwithstanding, any of this is about to change fundamentally.
In other words, I think that life will continue to bewilder us for as long as we are self-conscious, thinking, feeling beings.
Let me briefly turn to the question of whether complete self-understanding, if attainable, would be desirable.
It would entail an ability not only to explain but to monitor and predict all human thoughts whatsoever. It would be possible, in theory, indeed necessary, that we should have an implement capable of access to everyone's thoughts. For example, I would have a scanner that, directed at you, gave me access to your thoughts that you would not be able to hide from me. Of course, you too would have such a scanner, that gave you access to my thoughts.
You might say, of course, that while such a device would be possible, it would not be universally available; but it is a moot point whether such a device would be more horrible in its consequences if it were available only to some people than if it were available to all. What is certain is that, if our self-understanding reached the point that such a device were possible, life would be hell.
In my opinion, the great philosopher David Hume understood why human self-understanding was forever beyond our reach. It is not a coincidence that he always expressed himself with irony, for the deepest irony possible is that of the existence of a creature, Man, who forever seeks something that is beyond his understanding.
Hume was simultaneously a figure of the enlightenment and the anti-enlightenment. He saw that reason and consideration of the evidence are all that a rational man can rely upon, yet they are eternally insufficient for Man as he is situated. In short, there cannot be such a thing as the wholly rational man. Reason, he said, is the slave of the passions; and in addition, no statement of value follows logically from any statement of fact. But we cannot live without evaluations.
Ergo, self-understanding is not around the corner and never will be. We shall never be able seamlessly to join knowledge and action. To which I add, not in any religious sense: thank God.
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