Scope and challenges of mind-brain relationships in the context of the dialogue between neuroscience and Philosophy
Author: José Manuel Giménez Amaya and José Angel Lombo
Published in: Annals of the Royal National Academy of Medicine 2024; 141(01): 58-63.
Date of publication: 2024
summary
The so-called "mind-brain relations" are shown as a privileged place to understand the human being in a unitary way in its biological and psychic aspects. From here we discover the need for an interdisciplinary approach to understand it in an integral way. This approach can be carried out in at least two directions, taking as model the dialogue between neuroscience and Philosophy. The first of these follows a path from neuroscience to Philosophy and covers, above all, the topic of knowledge, mainly in the so-called internal senses. The second extends from Philosophy to neuroscience through the deepening of topics such as attention, report and habits. From this vision, an understanding of mind-brain relations emerges in which the interdisciplinary approach is extremely important. From this, we propose a possible application of these relationships to the ethical field, inspired by the philosopher Alasdair MacIntyre in his analysis of human vulnerability in a context of social co-dependence.
1. Introduction
2. programs of study neuroscientific that demand a philosophical reflection
3. programs of study philosophical that require a neuroscientific analysis
4. Corporeality and rationality: ethical dimension of human biology
5. Notes
Mind-brain relations are today a privileged field of meeting of an ancient discussion that crosses the history of human thought: the interaction between the immaterial and the corporeal. It is a topic that has always been present, in different contexts, throughout the history of the Philosophy, and that has recently attracted the attention of experimental science. Therefore, in this topic there is a peculiar convergence of these fields of knowledge, which has led to progressively more interdisciplinary approaches. 1.
Three main phases can be distinguished in this interdisciplinary relationship. On the one hand, in ancient thought, there is continuity between empirical knowledge and sapiential reflection. In a second moment, however, with the development of modern science (especially from the 15th century onwards), a process of divorce between Philosophy and experimental science began. In a more recent phase (since the end of the 19th century and throughout the 20th century), this separation has result become increasingly unsatisfactory, status which has opened the way to dialogue and cooperation 1, 2.
Thus, at the present time, both Philosophy and experimental science, when dealing with mind-brain relationships, are seeking answers that go beyond the approaches of isolated knowledge. Thus, the programs of study on the human brain throughout the 20th century has led to the demand for a partnership between different biological disciplines, giving rise to what is known today as neuroscience. By this knowledge we mean the interdisciplinary analysis of the nervous system as a whole and its implications in human behavior, both normal and pathological.
The interdisciplinary nature of neuroscience has led to an increasing interaction with humanistic knowledge. In this context, mind-brain relations have received new light, giving rise to increasingly extensive developments, which involve, in a concrete way, a fruitful dialogue between the physical-biological sciences and Philosophy.
This interdisciplinarity can be considered in at least two directions. On the one hand, in recent decades, programs of study has been published in which the neuroscientific approach demands a closer relationship with Philosophy. Among these, it is worth mentioning those aimed at clarifying what classical thought called "internal senses": perceptual synthesis, imagination, estimation of value, and report 3. On the other hand, there are philosophical topics of special relevance for the understanding of the human being that are being carefully analyzed from a neuroscientific perspective. Such is the case of attention, report, and the skills, routines and habits 4, 5,6.
From agreement with this double direction of the multidisciplinarity, to which we have pointed out, we will make next, in the first place, a exhibition of the mentioned internal senses as a point of meeting of the reflections of neuroscience and the Philosophy. Secondly, we will take this analysis to the field of human action in those topics that require a precise neuroscientific study, such as the aforementioned attention, report, skills, routines and habits.
As we shall see, from the preceding considerations, a peculiar understanding of mind-brain relations emerges. From this understanding, we will propose an application of these relations to the ethical sphere. For this purpose, we draw inspiration from the well-known British moral philosopher Alasdair MacIntyre in his analysis of corporeality and rationality in a context of social co-dependence 7,8. These conclusions, however, are drawn on a purely hypothetical level.
2. programs of study neuroscientists that call for philosophical reflection
It is beyond doubt that the knowledge is one of the neuroscientific topics that require a special deepening by the Philosophy. Indeed, neuroscience explains, to a large extent, the set of phenomena involved in the activity of knowing, mainly at the molecular, cellular, synaptic, neurophysiological or systems neurobiology levels. However, it seems quite clear that these elements are not sufficient to fully explain this activity. In this sense, some authors have pointed out the need to take into account dimensions that we could call "immaterial", i.e., those processes that do not involve a physical subject transformation in the captured reality. At the same time, these dimensions are in deep connection with the above-mentioned dimensions of subject more directly physical-biological, which are measurable. Consequently, a continuity is observed between both planes involved in the very activity of knowing.
The aforementioned connection is already present in the most primary stages of knowledge, which correspond to sensory reception and its transmission within the peripheral and central nervous system. However, the articulation between the biologically measurable aspects and those of an immaterial nature becomes clearer at the hierarchically higher, associative levels of the central nervous system.
Already in antiquity, Aristotle had proposed a study of the senses that connected the physiological dimensions with other immaterial ones (related to what he will call "forms"). 9. From this perspective, programs of study will be developed, especially in the Middle Ages, which will seek to describe the sensitive knowledge in an integrative way of the mentioned dimensions. In this field, authors such as the Persian physician and philosopher Avicenna, the biologist and philosopher Albert the Great, and the theologian and philosopher Thomas Aquinas stand out. 10.
In our opinion, all these authors address at least two neuroscientific problems of particular relevance. The first would consist in the distinction between the apprehension of more or less discrete dimensions of objects (light, sound, smells, etc.) and other clearly associative ones (the different sensitive aspects in a unitary apprehension). The second refers to the apprehension of valuational aspects linked to representations of objects, which can be articulated and preserved in experience over time.
With this historical perspective, the fruitful possibility opens up to consider the neurobiological analysis in the framework of a more holistic and sapiential approach . In this field, it may be useful to discern two lines of consideration of human sensitivity: firstly, the distinction between an external level of differentiated sensations and another internal level of associative knowledge ; and, secondly, within this associative knowledge , the discrimination of the representative dimensions with respect to others of subject valuative.
The authors of the Aristotelian tradition, to which we have referred to reference letter, will refer to these two lines by distinguishing, on the one hand, between external sensitivity (the five senses described classically) and internal sensitivity; and, within the latter, between the internal representative senses (sensory unification and imagination) and the evaluative senses (estimation and report). 3.
Thus, to better understand the human knowledge , the neurobiological research can benefit significantly from a conceptual framework that distinguishes between external and internal senses and, within these, between representational and valuational senses. From here, it can try to understand how the internal senses are unitarily articulated in the neural networks of the associative cortexes.
3. programs of study philosophical that require a neuroscientific analysis
In a field more proper to philosophical anthropology, the topics that in our opinion call for an interdisciplinary articulation with neuroscience are, at least, the following three: attention, report (also mentioned in the previous section ) and habits.
Indeed, in the whole of a person's activity, several distinct processes can be observed, which nevertheless form a unity, namely, human action 3,11. The continuity between them is possible, in our opinion, by virtue of a circularity between knowledge and action, which occurs through the selective concentration of information (attention) and the conservation of both the evaluative data (report) and the behavioral schemes (habits). Research suggests that, in these areas, the interaction between philosophical reflection and neuroscientific analysis is highly valuable 12,13,14. Let us now briefly describe them from an anthropological point of view.
As far as the attentional process is concerned, it should be emphasized, first of all, that it is a complex activity, which always involves different Degrees of knowledge (e.g., alert systems, value selection and goal orientation), more or less voluntary intentionality and a preparation for action 4,12.
On the one hand, our knowledge is open to the reception, in principle unlimited, of very diverse stimuli subject. This openness constitutes a basic disposition, necessary for survival, and can be understood, in some way, as a state of alertness. However, the very unlimited character of sensory reception requires a selection of the data that allows to act in the concrete reality, on which the subject's experience is based. This selection is based on different aspects of value and, therefore, requires an estimation of what is known, both internally and externally. Moreover, the result of this estimation motivates the affectivity of the individual, and through it, allows the subsequent application of the knowledge to action. This application can be more or less voluntary or instinctive from agreement with the level of motivation and with the affectivity.
Thus, the attentional capacity is at the basis of the voluntary direction of actions, and, in turn, this direction is what gives a unitary sense to all human action. Together with attention, this unifying process also requires the conservation of experience in the elaboration of its value and in the stabilization of the actions already performed. All this requires the harmonious articulation of attention with report and habits, which we will describe below.
On the one hand, the report is essential for the integration of the sensitive knowledge . As we have stated above, this has two fundamental dimensions, namely, a representational and a valuational one, of which the second presupposes the first. The report consists, precisely, in the conservation of the sensible experience in its valuational dimension, and establishes, therefore, an integrative continuity of the knowledge with the affectivity. Thanks to the report, the individual recognizes his own continuity in the process of his actions, unifying and integrating his external and internal experience. 3,13.
In addition to the above, the report is also important in the attentional dynamics, since it preserves and elaborates the previously selected information. Thanks to this elaboration, report provides content to affectivity and predisposes to action with respect to known and desired objects. Moreover, the activity on these objects provides a new source of information and evaluation on reality, which, in turn, progressively enriches our experience. The report, therefore, not only unifies the external data , but, in fact, gives global continuity to the whole sensible experience and contributes, in this way, to the configuration of self-consciousness.
On the other hand, habits also constitute an important philosophical topic that demands an interaction with neuroscientific analyses 6,14,15. To understand it, it is important to take into account the role they play in human behavior as a whole. Indeed, the human being pursues, with his action, some objectives through some means, and these means can be either natural subject or acquired or behavioral.
On the natural level, the means may consist of external instruments (physical, technological, sociocultural, etc.), or internal (psychosomatic constitution, temperament, etc.), and it is in this domain that we find what is often indicated by the neurobiological term "skills", which are more or less open to plastic developments. On the acquired level, on the other hand, these means are incorporated into the subject progressively with his experience, and here neurobiological plasticity plays a very important role. These means, in turn, can be connected more directly with psychobiological dimensions (routines), or they can be of subject properly rational (habits). The former are also found in animals, while the latter are properly human and concern scientific as well as technical and ethical spheres.
The idea of habit has been extensively treated by experimental psychology 15,16. From this perspective, habits are not clearly distinguished from routines, or else they do so in a purely social and conventional sphere. According to agreement with this view, habits appear as stereotyped behaviors that can contribute to human coexistence. For this reason, they tend to be considered as more or less fixed and invariable modes of behavior, similar to automatisms.
However, from the point of view of philosophical anthropology, habits are shown to be internal qualities that enhance our activities. Thus, from this point of view, they escape both a deterministic and a mechanistic conception, that is, one that recognizes them either as perfected automatisms or as mere behavioral mechanisms. Thus, habits, thus considered, do not simply imply a stereotyped behavior determined from outside the subject, but the stabilization of a behavior controlled by the individual himself. From here, the link between habits and decision-making can be understood, insofar as they allow a progressive mastery of the subject's own actions, in the context of his free behavior.
It should be emphasized that the perspectives of experimental psychology and philosophical anthropology are not mutually exclusive but rather convergent. The former analyzes a dimension of our behavior (routines) involving stereotyped behaviors with a neurobiological basis. The second, on the other hand, studies the stability of our behavior in terms of available to the subject himself. In both cases, there is stability in behavior, but, in routines, this appears as rigid and determined in such a way that it tends to be inflexible. Habits, on the other hand, are available to the subject himself and provide a unity to his behavior. However, the very fixity of routines not only does not exclude habits, but serves as a basis and instrument for their stability.
Thus, to the extent that habits stabilize and unify human behavior and are available to the individual, they allow him to direct his own actions in a way that can be described as "enhanced" or "increased" with respect to his own natural capacity. However, this empowerment is not necessarily positive, but can also be negative, and, in this case, we speak of an acquired defect that tends to impede the subject's ends. Positive potentiation, on the other hand, constitutes an instrument coherent with the individual's own objectives.
In this sense, habits constitute a fundamental anthropological dimension as the basis of moral action, since they allow moving from the stabilization to the direction of behavior in a way that configures affectivity and facilitates voluntary decision making. Moreover, in this connection, the continuity between the neurobiological sphere (corresponding to routines) and that of morality is also manifested, that is, habits understood as the internal improvement of the subject that leads to full human fulfillment.
From agreement with what has been said in this section, we can distinguish a sequence between the acquisition of information through attention, the conservation of this information in the report and its application and development -from this conservation- in habits. From here, we can access the understanding of human identity in time. And neuroscience financial aid us to a better understanding of this identity, investigating in depth the neurobiological mechanisms that are at the base of attention, of the storage and disposition of the sensitive report and of the organization of routines and skills.
4. Corporality and rationality: ethical dimension of human biology.
What has been said in the previous sections highlights the need to understand the human being in an integral manner. This approach, by attempting to encompass both the biological-corporeal dimensions and the psychic or immaterial ones, points to the relevance of mind-brain relations. In this sense, philosophical anthropology offers medicine, in our opinion, a privileged perspective, by illuminating the understanding of the unitary reality of the human being not only in its structural composition, but also in its development and in its possible deficiencies.
Indeed, since its beginnings, medicine has sought to understand and solve the problems related to health and disease, and, to this end, has developed its own anthropology 17,18,19. Thus, the unitary understanding of the human being, which is a nuclear aspect of this anthropology, has progressively led to a deepening of the mind-brain relationship. Thus, the very idea of health implies not only complete physical, but also mental and social well-being.
The concept of health, thus understood, implicitly refers reference letter to a state that is considered optimal, towards which medical science and internship are oriented. This state appears - at least in this field - as an integral part of the telos or end of the human being, and therefore has a certain normative character 20,21. In this sense, health care appears as a right and a duty, distinct, in any case, from a presumed right to be healthy.
Consequently, we can make at least two statements about health. On the one hand, health is an integral element of the human end, necessary to achieve it: it is necessary to enjoy a minimum of health in order to live in a manner appropriate to the human being. On the other hand, health is only a part of our telos, since it also includes other possible dimensions that transcend the medical perspective. Indeed, health, as we have described it, is ultimately an instrumental good, since no one desires health for its own sake. Instead, human beings aspire to an end that is good for its own sake - not for something else - to which the other goods contribute as means 22. Health, therefore, cooperates in favor of human well-being together with other dimensions, such as knowledge, affectivity or moral aspirations, all of which exist in the context of relationships with other rational beings.
The question thus arises of understanding how health articulates with these other dimensions in a social environment, since the experience sample that a certain Degree of fullness is compatible with our own vulnerability 7, 8,23,24. To the extent that the human telos includes factors that transcend health, health care has a necessary but instrumental character. At the same time, its connection with the integral end of the human being shows that it is not merely a productive means, but rather the global condition that makes it possible to achieve this end.
However, this global condition does not depend entirely on human action (no one gives himself health in a perfect way), but also on external and contingent factors. Among these, there is, in the first place, the relationship with other rational beings 25,26 whose action undoubtedly influences our own; but, in addition, we are influenced by other accidental and variable elements of subject physical, social, cultural, etc., which the classics encompassed in the concepts of chance and fortune. In effect, we are thus capable of giving meaning to and welcoming the unforeseeable in our own end. 27.
Therefore, human beings are capable of integrating into their own telos the deficiencies of health and other variable components that do not depend entirely on their actions, among which the relationship with other human beings stands out. Thus, to achieve human fulfillment requires an awareness of one's own vulnerability and co-dependence on others 7, 8,22,23.
As is evident, the lack of health has something mysterious and unfathomable 16,17,23. However, it seems to us that the concepts of vulnerability and dependence allow us to penetrate the reality of human illness insofar as they lead to a realistic understanding of our own condition. But, in addition, these concepts open us to a dimension that is, in a way, beyond medical anthropology, but in continuity with it: namely, the moral dimension of the human being 28,29. Indeed, by recognizing our vulnerability and our dependence on others, we become position aware of the profound need to care and to be cared for, which ultimately places us before the radicality of giving and receiving.
In this sense, the anthropological and ethical relevance of care relationships towards patients appears in full force. In deepening these relationships, the need to understand them in the complexity of mind-brain interactions also becomes apparent. In these relationships, giving and receiving are reciprocal, so that the caregiver can receive and perfect his or her humanity through the exercise of caring for the patient. For his part, the patient himself can be a giver of humanity to others. This is also the case when the patient is not fully aware of his or her own status, as occurs, for example, in mental and neurodegenerative disorders, from the subject of senile dementias or Alzheimer's disease.
Finally, and by way of conclusion, we think that this approach allows the development of the research in several lines, covering both the field of anthropology and medical ethics. On the one hand, from the anthropological perspective, the central themes of the interdisciplinary dialogue between neuroscience and Philosophy would be, among others, the internal senses, attention, report and habits and routines. On the other hand, on a more ethical level, the above themes are connected to a level of values in which the condition of vulnerability and dependence of the human being appears as a backbone of the internship of medical ethics 7, 8,11,22,30,31.
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