Human Experience

"(We) occupy landscapes of values--worlds made up not of quantum lattice structures, but of opportunities and obstacles, affordances and hindrances."

Alva Noe

The full 13.7 post is here and worth reading.

I think that this, the sensation of swimming in a sea of significance(s), whether noxious or gratifying, is a major reason I wound up a psychiatrist. It is no wonder that our species yields paranoids and creates deities to worship. We do not generally perceive the universe as what it would be without us--that is, a constellation of infinite facts--but rather as a shifting drama of desire and revulsion, of affirmation and repudiation.

Postscript

One more thing. I ended a bit abruptly a month ago, yet I recently came across two links that encapsulate the blog's preoccupations so fittingly that I cannot resist tying this last speculative bow.

The Wittgenstein scholar Peter Hacker explains that philosophy, unlike science, does not add to our knowledge of reality; rather, it examines the conceptual schemas through which we consider reality. Formal science is extremely successful in the relatively narrow task of documenting external reality, and it brooks no competitors; but arguably everything we most care about exists outside of science's purview. I particularly liked his comment that science yields an aggregate of facts that can be transmitted from generation to generation as a kind of epistemological bolus, whereas philosophy--like the arts--must be perpetually recreated.

Hacker also assails the prevailing scientistic fetish for neuroscience, arguing that from the point of view of real human priorities, it is the unified human agent that counts, not his or her brain and its myriad parts. "My amygdala made me do it" is not so different from "My soul made me do it." The moral self must take ownership of its concepts and its actions, not hide from them by ascribing them to the brain. Neuroscience may increasingly give us the capability to tinker more viscerally with our own experience, but this is nothing but the means to an ever debatable end. Science is nothing but a method, and one which can never identify the life most worth living. The latter can only be arrived at biographically and culturally, through lived experience, dialogue, and contingency. Everything that is not a fact exists in the vast penumbra of narrative.

Andy Martin looks at the overlap of autism and philosophy, arguing that both phenomena (endeavors? conditions?) involve a basic inability, or perhaps unwillingness, to fathom seemingly transparent communications. He suggests a tension between a philosophy that seeks to eradicate or solve conceptual confusions and one that accepts their inevitability. The latter is what always drew me to philosophy and to literature, which to me constitute the infinite project of outlining and marveling at the fundamental riddles of (inter)subjective experience. Consciousness is interesting not despite, but precisely because, imperfect understanding cannot be avoided. A philosophy or a science that proposes to eliminate conundrums is oppressive and must be resisted; a refusal to fully understand or be understood is a kind of assertion of freedom.

However, philosophy should not be sheer mystification. Language is the most powerful tool ever devised, and as such it can never be totally under our control; to some degree it always has a life of its own. Its spontaneous complexity is luxuriant and life-giving, as I have said, but it is well-known that metaphors can become stifling vines threatening to choke off light and space. Philosophy is fundamentally a linguistic pruning operation, lopping off conceptual excresences that threaten our narrative well-being.

Philosophical, that is, moral and aesthetic truths can never be as unambiguous as scientific ones, but they achieve a certain pragmatic objectivity because, well, human beings are so constituted that we need certain standards that are not lightly or trivially modifiable. Where does psychology fit? Like medicine, psychology derives from science a sense of realistic empirical boundaries of what may be technically achieved, but its aims must arise through personal and cultural narrative philosophy.

And that really is all I have to say for now.

Finis

"Now my charms are all o'erthrown,
And what strength I have is mine own,
Which is most faint."

Prospero

In the Times Judith Lichtenberg examines altruism, in particular the fact that it seems impossible to isolate pure unselfishness, uncontaminated by all self-interested motives (even if only the often unconscious satisfaction of having done good). But she argues that altruism is no less desirable, individually and socially, for all its imperfections; indeed, a flawed, all-too-human altruism is the best we can hope for in this world, that is, at all.

It seems to me that the wish for unsullied altruism is parallel to the fantasy of an absolute free will, untrammeled by ambivalence, weakness, or material considerations. The totally free and altruistic act would, of course, be the act of God, not of human beings.

That seems like a fine note upon which to end this blog, which has now run for more than two years and 400 posts. A blog has no natural ending apart from the demise or sheer exhaustion of its author. I find that I have said all that I have to say in this format, and nothing would remain here but the recycling of old themes and, of course, gawking at the baubles of the Web as they flash by. I have arrived at that definite point marked not by ambivalence or by frustrated block, but by dispassion--it is time to move on.

If Emerson was right that life consists of what a man (sic) thinks about all day, then this blog has been a reasonable record of the past two years of my life. Many posts have been tossed off, but many have been thoughtful, carefully wrought and even alarmingly personal, especially to any perceptive readers out there. It has been a transitional time, befitting a blog I suppose.

Other projects await. I will need to prepare for a Grand Rounds presentation a few months hence (a late echo of the academic life), and I am getting closer, finally, to starting a private practice, which will take considerable doing. Any additional post here in the future would be a link to a possible different kind of blog, a more professionally discreet and decorous one that might support a practice.

Thanks to readers--be well.

Murray Bail's The Pages

In Murray Bail's The Pages (NYT review here), two women, one a philosopher and the other a psychoanalyst, drive into the Australian hinterland so that the former may appraise the unknown work of a reclusive self-styled philosopher who has died, leaving his work in disarray in the austere corrugated steel shed where he labored for years.

So far the story itself sounds austere, but Bail's short novel is told briefly and impressionistically. Within the framework of the mystery of Wesley Antill, of his life and his life's work, philosophy and psychology as competing ways of being and knowing are set in relief.

That Bail, previously unknown to me but clearly an assured and sophisticated writer, trots out certain well-worn stereotypes makes me wonder if he didn't do so knowingly, as if defying the stigma of stereotyping or implying that there is more truth in such than we would care to admit. For we meet the flaky psychoanalyst, who has affairs with married men (and at least once in the past, with a client) and who manages to come across as both curious and self-absorbed. Her ambivalent friend is the detached, vaguely awkward, Aspergers-ish philosopher. Both of these are juxtaposed with the tough, taciturn ways of the sheep farmers (Antill's brother and sister) whom they meet on their errand.

Of course, philosophy and psychology do not exist in simple contrast or parallel. Philosophy is seen to have crucial emotional and biographical functions, whereas psychology makes truth claims, all too often unexamined. But Bail is obviously not interested here in academic arguments, but in philosophy and psychology as differing ways of being in the world, which Bail strikingly links to the physical environment:

Hot barren countries--alive with natural hazards--discourage the formation of long sentences, and encourage instead the laconic manner. The heat and the distances between objects seem to drain the will to add words to what is already there. What exactly can be added? "Seeds falling on barren ground"--where do you think that well-polished saying came from?

It is the green smaller countries in the northern parts of the world, cold, dark complex places, local places, with settled populations, where thoughts and sentences (where the printing press was invented!) hae the hidden urge to continue, to make an addition, a correction, to take an active part in the layering. And not only producing a fertile ground for philosophical thought; it was of course an hysterical landlocked country, of just that description, where psychoanalysis itself was born and spread.

It would appear that a cold climate assists in the process. The cold sharp air and the path alongside the rushing river.

In Bail's telling, here and elsewhere, philosophy (even if it is thoroughly naturalistic) has an otherworldly aspect; that is, it can only deal with deeply human problems, yet it seeks to distance itself from its human roots, becoming suspicious of language itself and attempting to break into some situation of truth above or beyond. It thrives in barren (mental and physical) landscapes, whether everything extraneous is put aside. It is unclear whether the enterprise is heroic or pathological. Elsewhere he writes:

"Too much light is fatal for philosophical thought." But some light is necessary.

That is, philosophy is about clarity, but total illumination lays bare the questionable motives of philosophy itself. Philosophy can only seek its own justification as a cat chases its tail. Yet one comes away from the book with the impression that psychoanalysis, while stemming from an honorable impulse to know oneself, is forever losing its way in acts of self-indulgent navel-gazing in cluttered, verbose interactions. Like I said, stereotypes--there it is, that idea again.

This is an intriguing fly-by view of philosophy--see its towering peaks and desert expanses--and psychology--see the buildings crowded into the hillsides, with people busily moving to and fro. Overarching it all is a book like this, the work of the imagination.

Science Run Amok

Every art and every inquiry, and similarly every action and pursuit, is thought to aim at some good; and for this reason the good has rightly been declared to be that at which all things aim.

Aristotle (trans. W. D. Ross)

Over at Edge, Sam Harris writes on science as it may apply to morality. He raises many compelling issues, but his piece exemplifies the grievous attempt to extend the relentless rigor of science beyond its rightful purview. If nothing else, the article is worth reading for its sheer effrontery (leave aside the moral debates of three thousand years, it's really rather simple!).

Harris argues that the force of science may be brought to bear on the problem of morality in three respects, not only anthropologically (documentation of actual ethical practices), but also as regards the ends of morality (which he stipulates as the well-being of conscious creatures), and surprisingly the art of persuasion, that is, bringing the benighted into the orbit of the empirically right-thinking.

His method is to claim that since the methods of science (i.e. evidence, consistency, parsimony) depend on consensus, and morality depends on consensus, then they are parallel endeavors; that is, normative moral phenomena--the ways one should live--are objectively true or false in the fashion that physical states of affairs are true or false. In other words, one may dissent from scientific methods (appealing, presumably, to revelation or intuition) just as one may opt out of moral claims, but to do so, Harris implies, is to place oneself beyond the pale. He also draws an analogy with economics, suggesting that just as goods and services may (theoretically) be generated and distributed in an objectively optimal manner, so is there a neutral calculus of human well-being.

The problem is that one may recognize many modes of human well-being without falling into the mire of moral relativism. To be sure, we are not entirely adrift in ambiguity. It is uncontroversial, for instance, to suggest that the citizens of Switzerland are better off in absolute terms than those of North Korea, just as it is safe to say that Bach is superior to Kate Perry. However, these are extremes, and most moral distinctions are more subtle. Are Americans better or worse off on average than Germans? Is Bach superior to Schubert?

The real problem for Harris appears to be what to do with the outliers, that is, those unreconstructed folks who fall in with creationism, or those societies that do things like execute adulterers. But the problem is that those with whom we disagree do not generally object to human well-being; they merely assess it differently. Those who oppose abortion or even stem-cell research believe that a society in which post-conception Homo sapiens are not disposed of is, on the whole, a desirable one. Muslim societies that discriminate against women or execute adulterers believe that they do so for the average benefit of all. Even Hitler believed that he was adding to the sum total of moral goodness (of the human beings who mattered to him). Can the methods of science, as opposed to moral consensus, really prove otherwise?

If so, there would presumably be some foolproof method, as yet undiscovered, of ascertaining comparative well-being. Are Californians better off than New Yorkers? How about men and women? Doctors and lawyers? The very notion is absurd.

Unsurprisingly, given the ambit of this blog, the matter may be best approached through the lens of psychopathology. In the various realms of fact, of morality, and of aesthetics, there are those with whom we merely disagree and those who are indeed beyond the pale. For instance, the evidence supporting the human contributions to global warming is strong, such that those to disbelieve are suspect and perhaps perverse, but nothing more. However, those who hold that the moon landing was faked or that Barack Obama was born in Kenya are, properly speaking, delusional in the sense of the cultural fringe.

Similarly, Auschwitz and North Korea are examples of psychopathy and megalomania, respectively, both of which may be held to be forms of moral delusion. In contrast, those who object to abortion or secularism are those with alternative moral views. Except in jest, there is no such thing as aesthetic delusion, although it seems to be ubiquitous.

The problem with applying the authority of science to moral and aesthetic realms is twofold. First, the external world exists independently of us, and is has certain characteristics and laws that we come to understand more or less accurately. Science is supreme here--no other technique for fathoming external reality comes close. However, ethics and art are not external to us--they are generated by us, and are found after the fact to be more or less admired or salutary. In science consensus as to method is the means to an end, but in matters of morality and art it is consensus through and through.

The second problem is that science leads inexorably to technology; understanding here implies the power to control and manipulate. And unfortunately the history of trying to engineer consensus in morality and art where it does not naturally exist is not propitious. For when we apply technological methods not to external reality but to human reality (ourselves), strange things start to happen. Yes, human beings and societies have a material reality that is subject to science, but that reality also supersedes and frames the very undertaking of science. Ethics and art are not technical problems to be solved but perennially unfolding realities to be experienced. The moralist and the artist are gardeners, not machinists.

Truth and Popularity

The last comment provoked some thoughts which probably warrant a new post. What is the relation of truth/value and popularity? The impulsive answer is none at all; indeed, the very test of moral integrity resides in its indifference to polls, in political terms. However, I don't know that it's that simple.

It's obvious that physical/scientific truth bears no relation to popularity; if global warming is primarily the result of human activities, this will be the case even if only 5% of the population believes it to be so. In contrast, I would suggest that advocates of both moral and aesthetic truth do aspire to majority confirmation, but crucially over the (very) long term.

I think it was the ancient Greek Solon who reputedly said, "Call no man happy until he is dead," by which he meant not that death brings happiness (although that is certainly one interpretation), but that a life can only be judged in its totality, when all the results are in. An otherwise blessed or virtuous life can go seriously sour in its final years, just as an otherwise benighted life can see redemption toward the end. Similarly, moral and aesthetic values may be measurable only over the lifespan of the human species.

At any given point in time, Homer or Shakespeare enjoy fewer readers than, say, John Grisham or Dean Koontz, but in addition to the fact that the former enjoy much more sophisticated literary apologists than the latter, their readership is multiplied over the generations. In terms of sheer cultural influence, readership over time matters more than mass readership within a short period; I can't imagine what the "value multiplier" might be--perhaps 1 million readers spaced out over a century matter far more than 100 million readers concentrated in a year. So while at any given time a taste for Homer would have to be considered a minority or niche interest, in the grand scheme of literary influence it is very much a mainstream taste. Aesthetics is a popularity contest, but those amassing "hits" or publishing figures today are likely the hares who will lose out by far to the turtles in the end.

Similarly, while an avid support for human rights may have been a minority position in Hitler's Germany, in the prevailing context of moral thought, it is now the majority position. There are certain moral convictions--equality for women, gay rights, vegetarianism--that, considered from the point of view of world history, remain very much minority views, but the hope is that over the very long term of centuries of millenia, these will become dominant opinions. When George W. Bush stood by his decision to invade Iraq, he may have been thumbing his nose at contemporary popularity, but he was wagering that in the much larger court of future historical and public opinion, he would be vindicated (we'll see).

As the cliche goes, from the standpoint of science, a tree falling in the forest does make a noise even if no one is there to perceive it. The interesting question is: does a moral conviction hold true even if it doesn't attain its majority? Take the equality of women for example. Many of us adhere to this position even though it has been violated throughout much of history as well as in the world today; but as I said, we hope and intend that in the future of humanity it will become a default moral value. But what if human life had been abruptly ended in, say, the year 1800 by a massive asteroid? Could it be said that the equality of women was somehow a "true" moral value for Homo sapiens even if it had scarcely been observed by the species up until that time?

I think this is true primarily from the point of view of logic. Inasmuch as we are rational creatures, we admire consistency in moral views. So if a premise of one's moral system is that human beings should be treated equally in terms of basic rights, then the equality of women and minorities is logically implied whether or not human beings are around to recognize this. So even if civilization were ended by an asteroid tomorrow (or if Republicans took over the country in perpetuity), gay rights may still be logically valid as an implication of the values reflected by the Constitution. However, this is arguably a formal and somewhat empty triumph. When we press our moral views, we aim not only to persuade our current peers, but also to set precedents that may contribute to crucial influence over time.

So when we argue values, whether moral or aesthetic, the stakes are large--we lobby for the kind of human world we hope to see instantiated in the future. If only a few will join us now, we hold out hope that we may campaign for coming generations. A scientist who feels certain that he has arrived at the empirical truth on a certain matter may be blissful in the knowledge even if it is not much appreciated. But an artist or moralist, while he may tolerate contemporary disdain, must--if he is not solipsistic--be disappointed to know that his vision would be relatively rejected not only now, but also in perpetuity. But I see this, in the best cases, not as an issue of narcissistic admiration, but as one of shared respect for a human ideal. Even those artists closest to schizoid pathology make a bid for connection to future readers. Emily Dickinson did not publish for the most part...but left her poems to be found. Franz Kafka bid his works be burned...but did not burn them himself.

The Soul, Explained

"Why, look you now, how unworthy a thing you make of me! You would play upon me, you would seem to know my stops, you would pluck out the heart of my mystery, you would sound me from my lowest note to the top of my compass; and there is much music, excellent voice, in this little organ, yet cannot you make it speak. 'Sblood, do you think I am easier to be played on than a pipe? Call me what instrument you will, though you can fret me, you cannot play upon me."

Hamlet

In the latest entry in the Times's philosophy blog, Galen Strawson trenchantly outlines both the inevitable logic gainsaying free will and the practical necessity supporting it. Rationally and scientifically, free choice can only be a mirage: a decision of what to do must stem from what one is. But what one is must in turn result from an interaction of genetic composition and environmental context; there is no room in the causal chain for some kind of ex nihilo self-creation. How can one be responsible for one's biologically and culturally contingent dispositions?

Interestingly, Strawson answers this by appeal to a novelist (Ian McEwan), who suggests another way of looking at free will, as that for which one is obliged to accept ownership. This reflects the central sociability of free will; ownership is an inherently social concept, and the conviction of free will that attends consciousness is an evolutionary means of modulating individual behavior. Free will involves that for which we must answer before our peers; human groups cannot function insofar as individuals disown their own conduct. Free will is therefore a matter of reason and language; a choice is always accompanied by at least an implicit self-justification before a virtual tribunal (this is internalized with varying degrees of integrity as conscience). From the vantage point of science, free will is a fiction, but practically speaking only the fatalistically depressed and the psychopathic disavow personal choice. Free will is located not in neurobiology, but in sociology--no emotions are more fundamentally interpersonal than guilt and shame. The mythical human being raised by wolves, without human contact or language, is by definition unfree.

So free will is located not in the brain, but "in" the group or human culture. What does this imply for the soul? I would argue that just as free will is not some kind of metaphysically magical legerdemain, the soul is not some kind of ethereal "stuff" existing separate from the brain. But the soul is not merely another name for the brain. Rather, the soul is massively distributed, consisting of vast networks of social and experiential contacts (another name for it would be "identity" or "the self").

My soul, like anyone's soul, does contain my irreducibly subjective experiences, but beyond that it entails every kind of relationship I have ever had, the work I have done, the influences I have taken in or given out. And crucially the soul has a history and a rationally supported system of values, both of which depend upon language. This is why animals, who presumably have moment-to-moment conscious subjectivity, do not have souls (that doesn't mean we should eat them though). Infants do not begin to develop a soul until language acquisition begins, and arguably the severely demented have largely lost their souls (both groups are still deserving of care and respect not only because they can still feel pain, but because regard for them is part of our souls). Having a soul is not like being pregnant--it is a matter of degree and diversity (although from the point of view of human rights and dignity, we consider all Homo sapiens to be fundamentally ensouled).

So the soul is not some kind of mysterious stuff, it is a network of ideas and relations. Most people's souls die when their bodies die or within a generation or two, but some souls live on in perpetuity, like Plato's or Muhammad's or Shakespeare's. Hitler's soul, regrettably, will have a very long life. Similarly, if we inquire about the identity of some country, the United States for example, it is obviously true that the U.S. consists of a certain part of the land mass of North America plus the bodies of some 300 million inhabitants as well as their various artifacts and structures. However, the U.S. is not merely these material conditions; for better or worse, its identity comprises a history and a system of ideals--all of this goes to make up its collective soul.

People almost universally have an intuition, whether right or wrong, that they are something beyond their bodies and brains, and in the sense in which I am speaking they are right. For the soul depends crucially upon actually lived history and relations with widely dispersed persons and phenomena. My soul contains not only my body/brain, but also my family, my profession, the Big Bang theory, the Andromeda Galaxy, the Louvre, and countless other entities. And my understanding of my soul requires that these things really exist, that they are not merely phantom firings of a deluded nervous system. The soul is very much a developmental beast: what I did yesterday defines my current soul much more than what I did twenty years ago.

Even though, from a scientific standpoint, I could not have ended up (in this universe anyway) with any other soul than the one I have, I conduct myself in explicit or implicit view of others with whom I share a mutually negotiated system of values, such that I feel obliged to keep my soul in what I consider to be the best possible condition. As with anyone, results may vary. And at times one maintains the soul with an eye not so much toward the currently available group as toward a stipulated or ideal community.

The Analog Life

"The formula for my happiness: a Yes, a No, a straight line, a goal."

Friedrich Nietzsche


Not long ago I wrote a post contrasting ambiguity and clarity; this came to mind today in response to a video by Dan Ariely that was on Arts and Letters Daily. His point was that online dating is less helpful than it could be because it sorts people by digital, searchable characteristics (think height, religious affiliation, etc.) when our actual experience of others is far more subtly graded: analog.

Indeed, personal sensibilities can be (digitally!) grouped into the analog and the digital. The former sees nothing but continua and shades of gray, while the latter craves contrasts. Think yes and no, good and evil, male and female, liberal and conservative, young and old, rich and poor, sick and well. The mind variably demands and abhors such simplifying, absolute goalposts as frames for experience.

Literature is analog; psychology is digital. Psychoanalysis is analog; medical-model DSM-IV psychiatry is digital. History is analog; politics is digital. The tension between humility and conviction: both seem to be necessary.

Ghost in the Machine

Or: the metaphysics of childhood. (Paraphrased) actual conversation:

Seven-year-old: Daddy, how could Sandman [a Spider-Man adversary] survive since he's just made out of sand? I mean, wouldn't he need internal organs (sic)?

Me: Yes he would, that's why he's just make-believe. That's why ghosts aren't real either [seven-year-old clings fervently to a belief in the supernatural].

Seven-year-old: But ghosts are invisible.

Me: So, they would still need internal organs, wouldn't they?

Seven-year-old: No, Daddy, ghosts are made out of the afterlife (sic).

It never ceases to amaze me that matter has evolved to the point of deeming its own role in consciousness to be dispensable in this way. Sort of like ascending a tower and kicking the ladder away--the view is excellent, until one gets hungry or restless...

Simplify, Simplify

I will ponder color and design over the weekend, but here I must recommend a recent David Brooks column stoutly defending the liberal arts in education. Eschewing grand but airy pronouncements (of the kind frequently found on this blog), Brooks argued that the study of history, literature, and other domains creakily termed "the humanities" gives unique insight into "The Big Shaggy," his term for the deeply complex and wayward aspects of human nature that escape systematizing theories, whether biological, political, or otherwise ideological ("The Big Shaggy" isn't the term I would have chosen, but Brooks is writing for the New York Times, while I'm writing here).

His column nicely encapsulated what I've stood for in life and fought for in my years of clinical work, that is, resistance to the dumbing-down of human experience that is often found in diagnostic systems and, well, simple-minded approaches to minds that, rightly considered, are infinitely complicated. And yet I found myself contrasting that truth with a recent Jon Stewart routine in which he showed multiple clips of Barack Obama, with respect to situations like the gulf oil spill, health care, and the economy, pronouncing again and again to reporters, "It's complicated." Stewart followed this up with appalled exasperation: "Well simplify it!"

This usefully reminds me that human beings, while capable of appreciating complexity (to varying degrees) are alike in needing, especially in times of crisis, forceful and dramatic metaphors that are, yes, simple. So when I am tempted to disdain such words as "depression" or, even worse, "chemical imbalance," that seem to obscure a wealth of nuance with a kind of advertising slogan, I need to remember that such terms help to orient people. While a minority of folks--those who seek out psychoanalysts and English doctorates--may revel in boundless complication, most people are not wired that way. That is not to say that they're stupid or simple-minded; they merely crave contrast and direction. Leadership, whether political or clinical, is about providing these things; by breaking things down into basics, it risks dumbing-down, but the alternative risk is endless equivocation.

It seems to me that the art of medicine, like the art of life, is steering a path between over-simplification and over-complication, making use of metaphors without becoming trapped by them. Indeed, isn't language itself a kind of over-simplification inasmuch as it reduces, to paraphrase William James, the blooming, buzzing confusion of experience to a finite number of limited words? We can only grasp reality by making a narrative out of it, a narrative that necessarily distorts the stuff of experience. Just as we charge Barack Obama with constructing a narrative of the gulf oil spill that usefully but modestly apportions responsibility and possible avenues of action, we would charge a psychiatrist with drawing up a diagnostic and therapeutic narrative that is respectful of its own limitations. Whenever one tells oneself, "It's complicated," one should inwardly reply, "Simplify, simplify," and vice versa.

Muddling Through

A few posts ago a commenter questioned why the perpetual furor over psychiatric diagnosis is so strident and acrimonious. I think the matter, dealing as it does with questions of human nature, identity, and responsibility, hits close to home, and often in a visceral way. Psychiatry presumes to comment upon the selves that we are and the selves we ought to be--as such it is as ambitious and as rightly contentious as politics or religion.

This came to mind yesterday when I read Stanley Fish's typically fine primer on pragmatism as a philosophy of life. Pragmatism is the difficult third option once despotic absolutism and cynical nihilism have been spurned. His piece demands to be read in full, but I particularly liked this:

It is a story, says Margolis (following Kuhn) driven from behind and not by a teleological end awaiting us in the form either of a union with a deity or an ascent to the realm of pure Reason. It is, Margolis tells us, "an extraordinary form of bootstrapping."

Pragmatism, when done well, achieves rigor and clarity without oversimplification and preserves freedom and ambiguity without slack complacency. It is the inherently messy, political, and incremental process by which humanity--comparing and trying out alternatives--somehow muddles through, although often not without appalling errors. I particularly like the idea of the universe as propelled by contingency and not drawn forward by the will-o'-the-wisp of a static perfection.

Psychiatry will never be perfected any more than politics will be perfected. However, we readily recognize some politics as preferable to others--it is not a matter of "anything goes"--and so with psychiatry. There is, in theory, no end to the possible number of DSM editions any more than there could be an absolute end to interpreting the constitution. After all, human nature and culture are moving targets.