Saturday, April 29, 2006

My Interest In Psychiatry

My in terest in psychiatry backs to when I was in secondary school. I was enjoying reading whatever book I find. In those years, the 90s, Iraq was under embargo and poverty and ignorance was living with us, so it was very difficult to find a book that you want, instead you must find your way with the available books in the market. AL MUTANABBIE streat, named after the famous poet, was offering used old books. It was there where I found about many novels and books about diferrent sciences accedently. Many times I buy one book or two then found my self got no enough money to go back home, so I walk.....I was very thin!

Words like CRAZINESS, MADNESS, LUNACY, faced me recurently throught these books which I was reading, and I was very interrested to explore and elaborate on them... and it was when I was 16 years old when I first bought a mini book in arabic discussing psychiatry and I read it in just few hours , may be minutes!

I had interred the colledge of medecine in 1996 where I studied, among many sciences, the science that I like, PSYCHIATRY. When graduated worked for 2 years as a resident doctor in general medicine, then started my residency in psychiatry in 2004 and I hope to get my Ph.D. degree in psychiatry in a couple of years .


Ali-Al- Omari said...

My dear Sami
The door which make psychiatry acceassible to you is phenomenology.
there is shift in psychology towards it.
i hope i can be of benefit in future if you wish to enter through this avery important site for you:

Ali-Al- Omari said...

What is Consciousness?

Dr. C. George Boeree

It is very difficult to describe one's consciousness. Observation and analysis are psychological processes; To observe and analyze one's own psychological processes is rather unnatural, and may be impossible to do with any assurance of accuracy. And so we may need to resort to a variety of metaphors and other roundabout devices to do the task justice. This said, it is nevertheless worth the effort.

One of the first things I notice is the outwardly directed feel of my experiencing. The most vivid experiencings are those that are associated with the senses -- the parade of images and sounds most of all. There are also bodily sensations, such as the pains in my legs, the strain of my hands and fingers as I type, and so on. Smells and tastes are not a factor at the moment, but I do feel my breathing.

These experiences seem to be there at all times, but do come into and go out of focus as I change my attention. The attention can be fairly random, a sort of experiential wandering; It can be strongly directed as when I focus on the computer screen before me; It can be changed from without, as when my wife calls me. A sudden change in the quality of leg pains also draws my attention as though it were external to me.

Very prominent is the outpouring of words onto the page. When I am busy typing, there is little in the way of thought. The words just flow from my fingers and appear on the page. A slight shift of my attention, and I notice that I am speaking "in my head." When I am searching for words, the voice is more obvious. Most of what I normally think of as thinking seems to be a form of silent speaking. Nevertheless, I hear my voice, although it is rather quiet.

Occasionally, I pause my internal monologue to imagine a situation other than the one before me now. These imaginings, when I am not too focused on them, feel very complete. But when I try to see an image more clearly, the feeling of completeness disappears. In fact, there seems to be little if anything there. My images are very pale, incomplete representations of sensory experiences. In fact, it seems that only the images' meanings are there, without the sensory information. The experience is more "as if" the image were there. This is the same sense I get with my internal voice.1

Whether I am observing reality or pondering mental images, there always seems to be a perspective from which I am experiencing. James referred to this as the "I." It is not actually a very powerful presence: Most of my experiencing is still outward, a parade of images and sounds, external and internal.

The "I" of seeing has a very particular physical sense: It is as if I were looking out through my eyes. I notice the bony structures around my eyes, especially my nose. My view is always framed with the fuzzy outline of my glasses. I notice my body flowing out from underneath my cheekbones. The "I" of hearing is less obvious and seems located in the center of my head. It is only more closely associated with my ears when I am actively involved in listening but that association remains rather rather weak. The "I" of my leg pain is the oddest. The pain is localized in my leg, and yet it is mine somehow. It is as if the leg were both foreign to me and part of me. The pain is definitely not experienced as located in my head or brain.

The experiencing also has a temporal coherence to it. There is a sense that each moment leads to a future moment, which is in part actually present in each moment. The past, especially the immediate past of seconds or minutes before, is also somewhat present. It feels to me that the now has a certain thickness to it, that it is never truly only the present moment, but rather a minute or two thick.

Part of this seems to be something that I have added to the picture: There are even occasions when more distant past events arise and make the present meaningful, and when imagined futures do the same. My experiencing is infused, in other words, with "me." My physical presence, my past experiences, my plans for the immediate and distant future, and more are present to one degree or another.

It is as if I were looking at the world through myself, through all the sediment that has collected around my idea of who I am over the years. The metaphor that strikes me is the way our rods and cones receive light that must actually pass through the interneurons to which they will send their messages and the capillaries from which they get their sustenance.

The experiencing is also colored by mood and emotion. I find myself, for example, annoyed at a distracting noise and irritated at the difficulty of finding words. It seems that there is always an emotional color to my experiences, even when things are rather peaceful. The moods are clearly an expression of myself: They reflect how events are meaningful to me, how they are valued or disvalued.

The perceptual experiences are experienced as exterior to me, even when they are physically interior (as is the pain). The more cognitive events have the quality of faint perceptions, or even meanings that merely imply the perceptions. Emotions are more within me, not physically but mentally, and indicate a state of being.

The experiences are tied together by my physical presence, by my emotional presence, and by their connectedness through time. The sense of perspective (the "I") seems to be there more after the fact than before. Building on my body, emotion, and temporal continuity, the "I" seems to be built upon the sedimentation of my life's experiences which constitutes the "me."

Logic leads me to think that the perspective or "I" should be there from the start, in order to provide a form for the experiences of life to circle around and settle into. But honest observation tells me that the "me" actually comes first, and that the sense of perspective comes from the "me." The question, then, is: If it is not the "I"-perspective that provides the "gravity well" into which a sense of self settles, what is?

There is another aspect of experiencing that isn't always fully available, but seems to me to be lurking in the background at most, if not all, times, and that is neediness. There is always a sense of being drawn or pushed in one way or another. My experiencing is always "going somewhere," apparently dissatisfied with where it is now. It is most obvious when I feel pain and need to move my legs, and when I am irritated or distracted by something. But it is also there in my desire to continue writing, in my efforts to remain focussed, and when I follow some train of thought.

There are times, when staring out the window, or meditating, or settling into sleep, when that neediness seems to be absent (or nearly so). It is curious that my sense of consciousness also begins to slip away from me at these times. The experiencing entity and the experienced reality blur. Emotion and mood settle into a certain peacefulness. And, often enough, I fall asleep.

Unfortunately for my purposes, I have more than 50 years of "me"-sediment through which I experience each moment. It is certainly difficult for me to imagine the mental state of a newborn child. A little "creative empathy," perhaps, might help: I would expect that there is a fairly constant perceptual "buzz," within which certain events develop a degree of meaningfulness for the child by becoming associated with the onset of delight and distress, including, of course, pain and pleasure. These experiences, plus the physical perspective of body, become a cluster around which a sense of identity develops. The child begins to anticipate the complex sequences of events around him or her, and may even have simple recollections of earlier experiences, the first, perhaps, in the form of dreams.

I may be stretching things a bit, but I imagine that there may be a series of "aha" experiences along the way: Finding that one's hands and feet allow for the odd experience of touching the toucher; Recognizing that one can hold an image in one's mind when the object disappears for a while; Seeing another child in the mirror, only to find that it is you; Pretending something is other than it is and fooling someone.

Perhaps these experiences continue throughout childhood, even into maturity. I vaguely recall, somewhere in elementary school, a sudden awareness of myself from the perspective of others, for example.


If we make the assumption that the world outside our minds is pretty much as we experience it (I have never come across any good reasons to doubt this),2 then the qualities that set consciousness above simple sensitivity to stimuli include the following:

1. We have within us a certain neediness or set of needs, a capacity for distress and delight, which provides us with the foundation for the distinction between what is meaningful to us and what is not.

2. Over time, we collect self-relevant experiences, based on this neediness, which grow into an identity such as the one James refers to as "me."

3. This "me" provides us with moods, emotions, anticipations, memories, etc., which become a part of the ongoing parade of outer and inner events that constitute our experiencing.

4. Seen "through" these manifestations of self, we experience life as if from a perspective (James' "I"), binding our experiences to each other and to ourselves.

If you grant my assumption and agree with my observations and speculations, I believe you will notice that consciousness is no longer a mystery within an otherwise sensible reality. Instead, consciousness is a natural result of being a life-form that has needs, is sensitive to a variety of stimuli, and is capable of storing and using information. That we are conscious remains astounding none-the-less.


1 My phenomenological investigations have convinced me that images are more a matter of unrealized looking than internalized seeing. When we imagine the unicorn, we "draw" the horse's head and single horn with our anticipations. In the same way, we listen for the song, rather than hear it "in our heads", and explore with restrained movement an imaginary surface rather than experience faint sensations of touch. However, people also experience some rather striking mental images as well as imageless ideas that do not involve this kind of bodily anticipation. Please see Images and Ideas for more.

2 This is, of course, Reid's direct realism. My version of direct realism is called quality realism, which includes the idea that the qualities we perceive are prior to the measured structures science usually assumes to be fundamental. For more detail, see my article Quality Realism.

Ali-Al- Omari said...

Ali-Al- Omari said...