I recently posted about unawareness versus denial of mental illness. The formal term is anosognosia, brought over from neurology, where it has long been observed that patients are sometimes unable to perceive even straightforward and obvious phenomenon, such as the absence of a limb. Until recently. Psychology has tended toward the less-biological explanations of lack of insight, attributing the lack to denial or other defense mechanisms, with the implication that the patient “could” be able to see their symptoms but were prevented by psychological factors. This is changing.
It was driven home to me because of several recent patients of mine, contrasted to others with similar diagnosis. Kevin is able to understand that we think his worry that his throat is closing is a delusion. Christopher cannot even repeat our point-of-view back to us, but launches every time into his proofs of the enormous, intricate conspiracy in the entertainment industry to torment him specifically. Amber sometimes thinks that the voices she hears are from her own head, based on past event, and sometimes thinks they actually are her dead father speaking to her. Ruth is convinced she is under chemical attack and must wear bronzing paste and a helmet. As with Christopher, she is somehow unable to even touch the idea that others disagree with this. She cannot even theoretically consider, just as an exercise, that some other possibility exists.
Those of us who work in mental health are familiar with people denying reality and being unreasonable. Yet there is something about these schizophrenics that is an even harder wall. Not a thread can permeate this barrier. In a world of lack of insight, this is the extreme. It is worth noting that these two, and many like them, are among the most intelligent patients, and in most areas, their functioning is unimpaired. Everything not touched by the delusions is fine, or more than fine.
The very existence of human minds that can be this physically shut off from reality raises questions about all of us. It is not merely that there is no insight, but that the brain does not seem to have an alternate route. There is not a work-around. There is not enough redundancy in the system to compensate. Our thinking is vulnerable in this way, like a child’s tower of blocks built too high. Even with the plainest data and extremest need, the brain cannot find a way to at least jury-rig a solution. We know that it is possible to believe things for bad reasons, or even no reason. We now find that things are even a bit worse: there is not enough fence to keep the sheep in inside our brains, and we might wander anywhere. We consider reality to be the final teacher. Rather chilling if that is true only in an eliminationist sense.
Because there seems to be no final something that will compel us to change our minds, even when we are horribly wrong, the whole question of how much control we have over our opinions and choices becomes very uncomfortable. There is a long tradition of doubt and skepticism in philosophy, so wondering how reliable our thoughts are is hardly new. In the 1970’s at least, it was one of the primary topics of freshman bull sessions. Perhaps we have imagined it all, and all that. Yet I think we take it a bit harder to have even our thinking, our tool for working around whatever puzzling, ambiguous, and contradictory data we encounter, called into question – and not just theoretically, but with some evidence actually on the table.
So, how much control over our opinions and decisions do we have? There are a thousand people who could answer that better than I, but I think I can bring something different to the discussion anyway. In Part II I’ll have a go at that. For the moment, two things.
1. If our thoughts are thus unreliable, then at the bitter end of all brutal self-examination, before one should despair of having to give up some cherished belief, such as a faith or set of values, remember that all offered replacements are in the same boat. If your being an Adventist is some entirely irrational accident and byproduct of your genetics and where you happened to be born, then that is also true of the agnostic arguing against you. His beliefs must also be accidental. If yours are no better, then neither are they worse, and you might just as well keep them. If all the beliefs of mankind are that unsupportable, then so is that last belief. It is self-defeating and self contradictory. If everything were that pointless, we would be unable to know that. So there is an escape hatch even if the worst possible theories about our brains turn out to be true. Not an especially noble one – we’ll work on that – but no fear.
2. Christians should remember that our faith has always raised a questioning eyebrow at the idea of free will. We forget this in the west, especially in America, and especially among evangelicals, because we stress the personal choice, come-to-Jesus moments in our theology. We therefore think that our faith must require that we must have some considerable percentage of our will that is free, or all bets are off. Not so. Not a bit of it. The scriptures and the teachings of the church for 20 centuries have an arms-length relationship with the idea of free will.