[From Bill Powers (950825.0945 MDT)]
Martin Taylor (950825.11:00) --
Not having been privy to those conversations, I am unclear as to
why you think the use of drugs is inconsistent with PCT. I would
have thought there was a good case for presuming that some kinds of
drug would be useful for helping to correct pathologies that can
afflict a hierarchic control system.
My reason is quite simple; you mention it yourself at the end of your
post:
And I grant that, from a PCT viewpoint, the effects of no drug is
yet known.
The human system is a _system_, not a bag full of fragmentary cause-
effect relationships. There are and can be no simple direct connections
between putting a highly active biochemical into the bloodstream and a
change in the way the control systems of the nervous system, or those of
the biochemical system, are working. The medical approach, particularly
in the hands of practitioners rather than basic researchers, has always
been and is still oriented around a superficial treatment of superficial
symptoms, with essentially no grasp of why any given drug treatment has,
or fails to have, a given effect.
It's not just from the standpoint of PCT that the effects of drugs are
unknown. It's from any standpoint you care to mention. People use drugs
because, through some unexplained pathway, they sometimes make people
feel better. Some of them very often make people feel better: alcohol,
heroin, prozac, methamphetamines, valium, steriods, PCP, ritalin,
aspirin, cocaine, cannabis, and so on. However, as we know, "feeling
better" is a very deceptive state; it can arise from stimulating
internal receptors associated with a good state; it can arise from
masking pain and despair with overpoweringly pleasant sensations; it can
arise from numbing one's senses; it can arise from dulling
consciousness; it can arise from shutting down higher mental facilities.
The one thing we know about this kind of feeling better is that there is
a vanishingly low chance that the chemical effects of the drug have
actually fixed anything that has gone wrong. What such drugs do is to
stop the complaint.
All drugs also produce "side-effects." The side effects are major shifts
in the functioning of the system that are downplayed because they aren't
the effect that is wanted or advertised. When you buy a prescription
drug, you get a little slip of paper listing precautions, dosages, and a
few other things. But if your doctor gives you an unopened sample of
that same drug, you will find that this slip of paper is half of a
larger slip, the other hand normally being torn off before the customer
gets what's left (there are instructions to the pharmacist to that
effect). On this other half, there is a far more detailed description of
side-effects and contraindications, and more often than not a statement
saying that the other effects of this drug and its mode of operation are
"unknown." Some of the side-effects listed are rather alarming: the
description of Theophilin (I believe) is one that lists "sudden death"
as a side-effect that has been observed. Not, of course, on the
customer's half of the slip. That might cut into sales by unduly
alarming the public.
All that having been said, it is still possible to make a case for the
use of drugs and other treatments justified on a purely empirical basis.
The usual case is simple: we don't know what else to do, and the
situation is so bad that something clearly has to be done. The impulse
is to help, and the hope is that what we do to help doesn't cause more
harm than benefit. In the absence of science (that is, knowledge about
how the system works), this is how people have always acted. You try
something; if it makes matters worse you don't do it any more; if it
makes matters better, you remember it for the next time you run into
what looks like the same situation. This elementary approach can be
dressed up in all sort of impressive phraseology and made to look highly
scientific by the use of formalisms and technology, but it's still
basically not much more advanced than the method by which E. coli gets
around.
What we need, of course, is a systems approach, both to biochememistry
and to brain organization. The systems approach means understanding, not
guessing, how the system works. It means seeing the system as a whole,
not through a series of tiny peepholes. It means building up a model
that can be used to predict not only "main" effects but "side" effects
-- in other words, to predict what the actual effects will be on the
whole system.
PCT is a start toward a systems approach to human and animal
functioning. It entails building up a model of the whole system, bit by
bit, and testing it in all ways possible, including both behavioral
tests and examination of actual internal organization wherever possible.
The parts of the model that have survived the test are not stashed away
for a rainy day in case the same situation arises again; they become
part of the model that is used in ALL cases. We are not building one
model for this situation and another one for that situation. We are
building one coherent model of the entire human system, and we expect
the parts of the model that we accept as correct to be part of every
behavioral situation.
The existing methods of chemical and psychological therapy are not based
on any conception of a whole system. They are based on piecemeal
collections of unrelated observations, with no basic model to tie them
together. What is unfortunate from my point of view is that the
conventional approach has become so embedded and self-justifying that it
uses up all the resources that might otherwise go toward true systems
research. There is tremendous social and financial pressure not only to
continue the old scattered empirical approach, but to build it up to
appear as the only proper approach. In order to do this, the failures
have to be minimized and the successes exaggerated. The result is to
paint a picture of the current state of affairs as the best that can be
done, the top of the line, the state of the art. So what happens to the
motivation to find a better way?
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Best,
Bill P.