The Basic Question and the Search for Awareness

Curiosity is a fundamental part of human nature. We are motivation to understand, predict and impact the world around and within us. Our desire to understand is increased whenever we see behavior that is contrary to our concept of normal and logical human nature. A recurrent and basic question in psychiatry, philosophy, law, ethics and theology is:

How much of our mental functioning is impacted by conscious free will or other factors, such as instinct, prior learning, environment or pathological processes?

Our attempts to answer this question, creates a cascade of other related questions. As we strive towards a higher level of insight, we are restricted by the limits of creativity, technology and the organization of information. Based upon differences in our background, experiences, style and perspective; we all start our search for answers from different perspectives. This search for the “light at the end of the tunnel that illuminates the path from whence we came” is sometimes painfully slow as this search is sometimes diverted into tangents and blind alleys of investigation. Pulling together many different groups, individuals and sources of information in a unified direction is one of the greatest challenges in the field of health.

I feel the pursuit of insight is often hampered by five common problems—a tendency to maintain the status quo, even when there is evidence to the contrary; an grandiose view there is greater insight than actually exists at this point in history; a mistaken belief that consciousness is more powerful than emotions and controls all of our actions; an erroneous belief that we are the dominant species on this planet; and an excessive reliance upon a simple cause and effect paradigm rather than implementing a systems approach to problem solving.

Maintaining the status quo gives a comfortable sense of structure. People are creatures of habit, and it is difficult to change beliefs, social structure and institutions that are based upon prior views, even when found to be incorrect. As a result, progress is often associated with a significant price.

It is often difficult to replace excessive confidence in current knowledge with a healthy degree of humility. It is interesting to read historical documents on philosophy, science, medicine and the nature of man. Sometimes there is great insight, but it is also mixed with the bias that exists at any particular time and place. Current writings will be viewed is a similar manner in the future. There is a need to continue developing a scientific structure that will integrate the most solid knowledge of the past with the flexibility to incorporate the newest discoveries of the present and the future.

Man is not the dominant species of this planet. Plants, dinosaurs and other predators appeared to be dominant at different times throughout evolution. We mistakenly consider the very large to be the dominant over the very small. However, the small prey upon the large, just as the large prey upon the small. Maybe there is no dominant species, instead we all live with a complex interdependence. It may be difficult to adjust our thinking to the possibility that microbes may be an equally significant part of the ecosystem. If we open our minds to the possibility that we are the prey and chronically persistent stealth microbes are more dangerous than acute infections, it allows us to view health and diseases from an entirely different perspective.

Although the recognition of cause and effect relationships has been very useful in the advancement of science, it is only useful when there is a fairly simple cause and effect relationship. A different model is needed when we deal with situations in which an interaction of multiple causes can result in multiple outcomes. A systems approach is effective when more complex cause and effect relationships exist. With the use of this model from an evolutionary perspective, complex information is organized into two dimensions—time and space. In the time dimension, we recognize a sequence of events occurring at different points in time, beginning with remote contributors from evolution and progressing to the most proximate events. In the space dimension, we recognize these simultaneous interactive processes occurring in the hierarchy of the smallest and the largest interactive systems.