Philosophy matters in brain matters.

A first-person critique argues that the terms 'functional,' 'organic,' and 'psychogenic' in neurological diagnosis perpetuate a Cartesian mind-body dualism that most clinicians claim to reject. The author, drawing on personal experience with medically unexplained seizures, contends that a close reading of a textbook chapter on psychogenic seizures reveals the author's unreflective separation of psyche and soma, implicit bias against illnesses labeled psychogenic, and sexist assumptions. The author proposes that even when symptoms persist, heightened self-consciousness and narrative framing can strengthen a patient's sense of agency and offer therapeutic benefits, concluding that ethical treatment demands respect for patients' stories.

Study at a glance

Abstract

Although most neuroscientists and physicians would argue against Cartesian dualism, Descartes's version of the psyche/soma divide, which has been controversial since he proposed it in the seventeenth century, continues to haunt contemporary neurological diagnoses through terms such as functional, organic, and psychogenic. Drawing on my own experiences as a person with medically unexplained seizures, I ask what this language actually means if all human experience has an organic basis. Close reading of a textbook chapter on psychogenic seizures. I expose the author's unreflective embrace of psyche and soma as distinct entities, his inherent bias against illnesses labeled psychogenic, and the implicit sexism of his position. I further argue that even when a patient's symptoms are not alleviated, heightened self-consciousness and narrative framing can strengthen his or her sense of agency and have therapeutic benefits. The ethical treatment of patients requires a respect for their stories.