Lewis B
Psychiatric Day Treatment Center, George Washington University Medical Center, Washington, D.C. 20037.
Am J Psychother. 1994 Winter;48(1):85-93. doi: 10.1176/appi.psychotherapy.1994.48.1.85.
Neuroscience is conceptually founded on a philosophy of mind known as identity theory. This theory claims that mental phenomena are reducible to the physical organ of the brain. But identity theory, and consequentially neuroscience, is unable to address essential human features of intentionality, consciousness, and autonomy, i.e., free will. Intentionally is the quality of having content or "aboutness," consciousness is quality of self-awareness, and autonomy is the ability to make undetermined choices. These essential human features make up our common sense and our psychodynamic understanding of ourselves. Without these features we would have to change our entire way of seeing ourselves and our dynamic psychotherapy would be impossible. We need intentionality in psychotherapy because it is only through the content of our patients' thoughts and feelings that we can help them derive meaning; we need consciousness because it is primarily through introspection that we get access to our patients' inner world; and we need autonomy because unless our patients have the option of doing things differently there is no point to the therapeutic endeavor. Consequently, psychiatry cannot rely solely on neuroscience as its basic science without creating a conception of people devoid of essential human features and without eviscerating its psychotherapeutic capacity.
神经科学在概念上建立在一种名为同一性理论的心灵哲学之上。该理论声称，心理现象可还原为大脑这一物理器官。但同一性理论以及由此而来的神经科学，无法解决意向性、意识和自主性这些人类的本质特征，即自由意志。意向性是具有内容或“关于性”的特质，意识是自我意识的特质，自主性是做出未被决定的选择的能力。这些人类的本质特征构成了我们的常识以及我们对自身的心理动力学理解。没有这些特征，我们将不得不改变看待自己的整个方式，而我们的动力心理治疗也将变得不可能。我们在心理治疗中需要意向性，因为只有通过患者思想和情感的内容，我们才能帮助他们获得意义；我们需要意识，因为主要通过内省我们才能进入患者的内心世界；我们需要自主性，因为除非患者有选择以不同方式行事的机会，否则治疗努力就毫无意义。因此，精神病学不能仅仅依赖神经科学作为其基础科学，否则就会创造出一种没有人类本质特征的人的概念，并且会削弱其心理治疗能力。
