Tress Wolfgang
Universität Düsseldorf, Klinisches Institut und Klinik für Psychosomatische Medizin und Psychotherapie, Düsseldorf.
Z Psychosom Med Psychother. 2011;57(3):261-74. doi: 10.13109/zptm.2011.57.3.261.
Even psychosomatic researchers seem to want to avoid the so-called body-mind problem, which is actually a mind-brain problem. In line with Beckermann (2008), the first the four possible positions on the mind-brain problem are presented. The debate over the past 100 years has revolved around the question of whether mental events are ontologically independent of brain physiology or whether they are in fact entirely determined by it. Such a physicalism approach based on properties (i.e., mental characteristics or phenomena are physical or can be completely reduced to physical characteristics), however, is diametrically opposed to some of our strongest intuitions, e.g., that computers will never be able to develop qualities of human experience (qualia) and thus become subjects in the first person singular. Yet we are equally unable to prove the fundamental impossibility of such a development.
In this stalemate situation, a differentiation was undertaken by Gottlob Frege (1892) which could be of help: Expressed in today's language, a distinction is made between the sense of an expression, its contextual presentation (e.g., where there is a difference between "the evening star" and "the morning star"), on the one hand, and its so-called reference (the object to which it refers, here the planet Venus in both cases) on the other. The school of Gestalt psychology that developed in Berlin at the start of the last century similarly posited a "psychophysical level of the CNS," a continuum in a pattern of electrical field forces which manifests itself first in cerebral physiological-neuronal processes as well as in other perspectives such as consciousness and experience. A subsequent speculative concept then extends this model to assume also an (as yet) unknown Alpha configuration as being a common reference of two sense contents: (1) the results of the neurophysiological third-person perspective and (2) of the emotional-cognitive first-person perspectives. Only through the latter will Alpha be able to become self-conscious and an instance acting in his world.
Only through the latter will Alpha be able to become self-conscious and an instance acting in his world. The postulate of an Alpha configuration thus retains the possibility of a biology not (yet) accessible to our knowledge, such that our fundamental conviction regarding the holism of soma and psyche can be maintained for us as medical practitioners and scientific physicians. Our patients need both, our medical-scientific competence (3rd-person perspective) as well as our empathic sensibility in exploring their phenomenal experience (1st-person perspective). They need us as medical artists.
甚至身心问题研究者似乎也想回避所谓的身心问题，而这实际上是心脑问题。按照贝克尔曼（2008年）的观点，这里首先呈现心脑问题的四种可能立场。在过去的100年里，这场争论一直围绕着这样一个问题：心理事件在本体论上是否独立于大脑生理机能，或者它们实际上是否完全由大脑生理机能所决定。然而，这种基于属性的物理主义方法（即心理特征或现象是物理的，或者可以完全还原为物理特征）与我们一些最强烈的直觉截然相反，例如，计算机永远无法发展出人类体验的特质（感受质），从而成为第一人称单数的主体。然而，我们同样无法证明这种发展根本不可能。
在这种僵持局面下，戈特洛布·弗雷格（1892年）所做的一种区分可能会有所帮助：用当今的语言表述，一方面要区分一个表达式的意义、其上下文呈现（例如，“昏星”和“晨星”之间存在差异），另一方面要区分其所谓的指称（它所指的对象，这里在两种情况下都是金星）。上世纪初在柏林发展起来的格式塔心理学派同样假定了一个“中枢神经系统的心理物理层面”，这是电场力模式中的一个连续统，它首先在大脑生理 - 神经元过程以及意识和体验等其他层面表现出来。随后一个推测性的概念将这个模型扩展，还假定了一个（尚未）知晓的阿尔法构型，作为两种意义内容的共同指称：（1）神经生理第三人称视角的结果，以及（2）情感 - 认知第一人称视角的结果。只有通过后者，阿尔法才能变得自我意识，并成为在其世界中行动的个体。
只有通过后者，阿尔法才能变得自我意识，并成为在其世界中行动的个体。因此，阿尔法构型的假设保留了一种我们尚未知晓的生物学可能性，这样对于我们作为医学从业者和科学医生来说，关于身体与心灵整体性的基本信念就能得以维持。我们的患者既需要我们的医学 - 科学能力（第三人称视角），也需要我们在探索他们的现象体验时的共情敏感性（第一人称视角）。他们需要我们成为医学艺术家。
