Saturday, May 09, 2009

How medicine lost—and then slowly regained—its mind

Keith Loftin of Areopagus Journal advises me that my article "How medicine lost—and then slowly regained—its mind" is now in print. I don't seem to find it on line, so I am providing an excerpt below. By the way, if anyone cares, Areopagus (or Mar's Hill) was the place that ancient Greek philosophers used to congregate. Here's the excerpt:
The mind as a demonstrated non-material cause

Also, once neuroscientists got a chance to study the brain at work, they were able to look at the way the mind acts on the brain as a non-material cause. A useful outcome was new treatments for mental disorders such as obsessive compulsions.

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disease marked by distressing, intrusive, and unwanted thoughts (obsessions) that trigger an urge to perform ritual behaviors (compulsions) like constant, abrasive handwashing. UCLA psychiatrist Jeffrey Schwartz, a practitioner of Buddhist mindfulness, saw OCD as a good candidate for a non- pharmaceutical—essentially non-materialist—approach to treatment. That is because OCD sufferers are not delusional. They actually know that their beliefs are mistaken and their compulsive activities are useless. But they do not know how to stop them either. Yet giving in makes the sufferers worse over time. The more they give in, the more persistent the beliefs and behaviors become. It is as if their brains have been hijacked. During most of the twentieth century, OCD was little understood and considered very difficult to treat.

Schwartz used neuroscience techniques to identify the cause of the disorder. Specifically, the cause is most likely a defect in the neural circuitry connecting the orbitofrontal cortex, cingulate gyrus, and basal ganglia, from which panic and compulsion are generated. When this “worry circuit” is working properly, we worry about genuine risks and feel the urge to reduce them. But, Schwartz found, when that modulation is faulty, as it is when OCD acts up, the error detector can be overactivated. It becomes locked into a pattern of repetitive firing. The firing triggers an overpowering feeling that something is wrong, accompanied by compulsive attempts to somehow make it right.

He then developed a four-step program (Relabel, Reattribute, Reassign, and Revalue) to help patients identify and reassign OCD thoughts, until they felt that they were diminishing in severity. Schwartz was not simply getting patients to change their opinions, but to change their brains. Subsequent brain imaging showed that the change in focus of attention substituted a useful neural circuit for a useless one. For example, it substituted “go work in the garden” for “wash hands seven more times.” By the time the neuronal traffic from the many different activities associated with gardening began to exceed the traffic from washing the hands, the patient could control the disorder without drugs. The mind was changing the brain.
If the whole article goes on line, I will link to it.

Freedom of religion: One benefit is more piety

My friend Mustafa Akyol discusses religion in Malaysia here in "Islam, apostasy, and 'Erdoganists' in Malaysia."

... what happens if a Malay wants to change his religion, and become, say, a Christian?

What happens is a big problem. The ex-Muslim is required to take "permission" from the Islamic Sharia courts to convert. But since he or she is not a Muslim anymore, that is absurd. Moreover, the courts are generally not willing to give permission. The consequential limbo can last for a long time. Moreover, the same courts do not allow a Muslim Malay (which is a redundant term, actually) to marry a non-Muslim.

Since I learned a little bit about this problem, I decided to address the issue of apostasy at the speech I gave last Tuesday at a public panel on "the role of religion in a plural society." First, I argued that a secular (not secularist!) Political system is the best option for Muslims, because it allows them to practice their faith freely, without any compulsion from state. In return, I noted, Muslims should not exert compulsion on others, too. The latter idea included granting people freedom from Islam, even if they decide to leave it. And what would we achieve after all, keeping people in the faith by force other than hypocrisy?

Yes, exactly.

Look, I am a Roman Catholic. I could probably get 90 percent of people in the world to agree to become Roman Catholics by grabbing a pistol and offering to shoot them through the head if they didn't. So what would that mean?

It would mean that the definition of Roman Catholic becomes: "I don't want to get shot through the head."

Hmmm. We Catholics used to have a more intellectually detailed faith than that. We are the heirs not only of Aquinas, but of Aristotle and Plato, and of the Hebrew Prophets, as well as the New Testament and the tradition that followed. A traditional of rational thought and spiritual inspiration, and of the many witnesses to the power of God to change lives.

Anyway, I wrote a note to Mustafa, saying,
“And what would we achieve, after all, keeping people in the faith by force other than hypocrisy?”

Beautifully put, Mustafa!

The key reason for promoting religious freedom is to benefit religion.

We have long understood this in North America.

Europeans often criticize us here for being “too religious.”

Yet consider! We do NOT have state churches, as they do. We have strict separation of church and state – but primarily to protect the church, not the state.

When the church and the state are too closely involved, the church is expected to “bless” all kinds of essentially political projects that may be good or bad - but are not part of the church’s mission.

Fact: Left to ourselves, we turn to God. And no, we are not hypocrites. We really do believe it - as the Europeans constantly complain.

That’s what they most dislike about us. We really do believe it.

Anybody is allowed to bang on doors here in Toronto and evangelize on behalf of any religion, including weird ones, and believe me, they do.

When I point out politely that I am a Roman Catholic and am busy, they just go bang on the next door.

The level of religiously inspired violence is very low here, because no religion would be allowed an enforcement squad.
So, based on historical experience in North America, I entirely agree with my friend Mustafa that freedom of religion in a secular (but not "secularist"*) environment actually leads to more genuine piety in the long run.

*secularist - I abhor the French government's notion that Muslim girls cannot wear scarves if they want. I do not see why a girl should not be permitted to dress in any non-provocative way she wants, and of course she must not dress in a way that conceals her identity. (Of course, if she is a student or employee, she must wear the required uniform, but usually that means more clothes, not fewer - and it can be made consistent with a religious tradition, in a tasteful way.)

Naturally, I was interested, because The Spiritual Brain is being translated into Bahasa Meliyu (the Malaysian language).