[From Bruce Buchanan 950314.20:30 (EST)]
This is a self-explanatory open question, inviting comments. The basic
question addressed is that of the role of higher levels (what is usually
understood by volition or Will or intention) in relation to primary level
neurological control systems.
Some 25 years ago Warren McCulloch visited Toronto and I heard him describe
some studies of causalgia which he presented as instructive. Causalgia is a
disease of peripheral nerves, associated with autonomic sympathetic
activity, with acute hyperaesthesia and sometimes progression to vasomotor
spasm with circulatory impairment, muscle atrophy and marked disability,
all with anxiety and fear of pain. Treatments have included sympathectomy
to break the vicious cycle. (I am not a neurologist and I do not know the
latest thinking on the pathophysiology and management of this condition -
hence my question below).
As I understood him, McCulloch was advancing the view that, while the basic
primary disorder involved excessive stimulation to peripheral sensory
inflow, which seemed to derive somehow (e.g. nerve injury) from sympathetic
outflow, the fate or clinical progression of what might be in origins a
functional disorder could be influenced in the early stages. Patients who
decided to carry on, as if normal, and in effect override their own
discomfort, would find the problem diminish and disappear. Those who
continued to shrink from the pain in fear and trepidation, with heightened
sympathetic activity, became progressively more anxious, in more pain and
disability, with the consequence that organic changes became for all
practical purposes irreversible, i.e. established as chronic disease.
Assuming this description still has some validity, are there more recent
theories as to the pathophysiology of causalgia? Are there indeed
implications for conscious or deliberate purpose as an agency with some
capacity for control over biological processes, and not merely an
epiphenomenon (i.e. an illusion)? Was McCulloch mistaken in suggesting
that the clinical course of causalgia might have implications for the
relation of the mind (decision and intention at least) and the physical
nervous system? Or did I perhaps misinterpret him?
Probably few physicians other than neurologists encounter many cases of
causalgia, and I have not thought of this for years, until the recent
discussion of levels of perception and control brought it to mind.
Sometimes nature provides empirical data in the form of clinical disorders
which may be as informative as laboratory tests. I know a lot of work has
been done on emotions and their role in the pathophysiology of so-called
psychosomatic disorders, but the relation to deliberate intention to
perceptual mechanisms may not often be very clear. On the other hand it
does seem to be the experience of many people that minor dysfunctions of
many kinds many well be sorted out by natural processes over time (whatever
these are 
e.g. multiple homeostatic mechanisms), of which causalgia may
be one striking example - _provided that higher level capacities for
organization and control are operative_, whether or not expressed in
language or as values.
If the facts are correct, may they be explained in terms of PCT principles?
Have I missed something relevant in B:CP or Living Systems I and II? Do
neuroscientists have better explanations now?
I have nothing much to add to the above , but would be interested in more
informed comments - or perhaps a reference or two, especially if this is
all too familiar to neurologists.
Cheers and best wishes.
Bruce B.