Winding Up
Is it me?
The concept of the self' is one of those ideas that is quite capable of making your brain ache if you think about it a lot. Unless one is in an especially philosophical state of mind, it may be better to direct one's thoughts elsewhere. Just say no' as the drug educators (used to) say. However, sometimes such matters do intrude into the realm of the practical and the every day. In clinical practice, this arises occasionally when certain disorders make the sufferer's experience of themselves especially problematic or especially interesting ยฑ split brains, schizophrenia, some kinds of seizures and so on. But there is also the issue of the ways in which disease and disorder are discussed.
So, for instance, when someone ยฎnds herself in a state of anorexia nervosa is it better for her to think of it' as an aspect of herself or as something alien and other. And what is the better way for clinicians to talk about her problem? Should we be talking about anorexia nervosa as being a part of or apart from the person who has' it?
Even as I write this I am becoming aware of the potentially loaded nature of all of the ways of talking about such matters.
As clinicians we not uncommonly exhort out patients to ยฎght their illness. Some therapeutic techniques emphasize the otherness' of the anorexia or whatever so as to promote such ยฎghting spirit. For instance, we may ask if anorexia is a friend or a foe? Then our discourse can move perilously close to sounding like talk of spirit possession. Have we simply traded in our devils' and substituted reiยฎed diseases'? And if we start pointing out the pictures arising from neuro-imaging and the like as evidence for the it' which makes life difยฎcult for the person, are we promoting a new dualism? And is that bad? On the other hand, if we avoid such language through some sort of principled scruple, do we make the problem more difยฎcult for the patient to think about? Or indeed for us to think about? Is this, in the end, an empirical issue or a theoretical issue or even perhaps a moral issue?
Oh dear, I don't know. My brain hurts. Are these real problems? Do these things matter? What do you think? Perhaps it's just me.