Is It Me or My Brain? Depression and Neuroscientific Facts
by Joseph Dumit
[Dumit, Joseph. 2003. “Is It Me or My Brain? Depression and Neuroscientific Facts.” Journal of Medical Humanities 24 (1–2): 35–47.]
Points
- Wittgenstein says that there are certain points about which we no longer ask for an explanation or a test of its truth, and explanations come to an end:
- “Giving grounds, however justifying the evidence, comes to an end; —but the end is not certain propositions’ striking us immediately as true, i.e. it is not a kind of seeing on our part; it is our acting” (On Certainty, p. 204) (39).
- We might call the set of acts that concerns our brains and our bodies deriving from received-facts of science and medicine the objective-self”
- The objective- self consists of our taken-for-granted notions, theories, and tendencies regarding human bodies, brains, and kinds considered as objective, referential, extrinsic, and objects of science and medicine. That we “know”we have a brain and that the brain is necessary for our self is one aspect of our objective-self” (39).
- “Furthermore, objective-selves are not finished but incomplete and in process. With received-facts we fashion and refashion our objective-selves.
- Thus it is we come to know our bodies as endangered by poisons like saccharine, our brains as having a “reading circuit,” and humans as being either mentally ill or sane or borderline.
- I call this “objective-self fashioning” to highlight our own activity in encountering “received-facts.”
- I emphasize “received-facts” rather than just “facts”to highlight the activity of translation that has taken place in order for the results of a scientific or medical project to reach us.
- Each of these movements of facts from one media to another is also necessarily a transformation of the fact. Science studies scholars Bruno Latour and Michel Callon call this process “translation,” a term connoting both movement and change in meaning. We all know that a fact established in a lab is not known immediately by everyone, everywhere. It must travel through specific channels” (39).
- “Each of the aspects of our objective-selves has this personal history (of coming-to-know via received-facts) and also a social history. (39-40)
- “Some human kinds that we are starting to take for granted, e.g., depressives, require attending to broader social and institutional forces in order to understand how it is that we look to the brain for an answer” (40).
- “These social histories enable and constrain science at every level of fact conception, experimentation, publication, and dissemination and reception, but this does not imply that science is culture. Science produces facts in spite of and because of these constraints—laboriously, continuously, and creatively” (40).
- “And we fashion our objective-selves with the fruit of this labor in the form of received-facts in our own continuous and often creative manner, no matter how skeptical we are. This way of living with and through scientific facts is our form of life” (40).
- Examining sufferers of mental illness pints Dumit to a type of selfhood he wants to “a pharmaceutical self whose scale is one of days and weeks.
- Contrary to a Heideggerian phenomenology in which one is passively thrown into moods, here one’s abnormal neurochemistry actively throws one into depression or mania. Sometimes one can respond to this by taking drugs that, days or weeks later, throw you into yet a third state—not normal, but better.”
- This pharmaceutical Self brings forth “three critical aspects of objective-self fashioning for our purposes.”
- First, there is a tremendous flexibility and openness of explanation of the objective-self”
- Even in the face of specific received-facts about ourselves such as brain images, there is room for negotiation and redefinition. Sociologists and anthropologists of psychology have called this the “pandemonium” of folk psychology. But they also note that even as we can play with mind and brain, motivation and behavior, we also ultimately must satisfy local common sense” (44).
- “The second aspect … is the need for a nuanced, complex cultural, historical and institutional as well as scientific or biomedical understanding of context.
- Objective-self fashioning is an ongoing process of social accounting to oneself and others in particular situations in which received-facts function as particularly powerful resources because they bear the objective authority of science” (44).
- “The third critical aspect of objective-self fashioning is the fundamental connection between the brain as objective-self and one’s own personal identity.
- When genes are invoked as the cause of one’s objective-self and aspects of one’s personality they can become synecdoche for one’s identity. If one has a gene for depression, one can fear becoming depressed.”
- “We can note here that brain images further confuse the part with the whole—even though brain images only show a slice of the brain, they show the slice as representing the whole brain, which in turn is the person” (44).
- First, there is a tremendous flexibility and openness of explanation of the objective-self”
- “Individual sufferers are trying to both understand their illness and live with it. These are activities that are not necessarily compatible. Using the notion of the pharmaceutical self, I would suggest that they have entered into a relationship with their brain that is negotiated and social” (46).
Terms
objective-self—our taken-for-granted notions, theories, and tendencies regarding human bodies, brains, and kinds considered as objective, referential, extrinsic, and objects of science and medicine (39)
objective-self fashioning—”an ongoing process of social accounting to oneself and others in particular situations in which received-facts function as particularly powerful resources because they bear the objective authority of science” (44)
identification— borrowed from psychology and semiotics, “we can characterize our relationship to culture as identification.In Kenneth Burke’s definition, identification includes the “ways in which we spontaneously, intuitively, even unconsciously persuade ourselves” (Burke, 1966, p. 301)” (36)
Abstract
This article considers the roles played by brain images (e.g., from PET scans) in mass media as experienced by people suffering from mental illness, and as used by scientists and activist groups in demonstrating a biological basis for mental illness. Examining the rhetorical presentation of images in magazines and books, the article describes the persuasive power that brain images have in altering the understanding people have of their own body—their “objective self.” Analyzing first-person accounts of encounters with brain images, it argues that people come to understand themselves as having neurotransmitter imbalances that are the cause of their illnesses via received facts and images of the brain, but that this understand- ing is incomplete and in tension with the sense that they are their brain. The article concludes by querying the emergence of a “pharmaceutical self,” in which one experiences one’s brain as if on drugs, as a new form of objective self-fashioning.”