The New York Times buried the bad news on its science section’s back page, but it really ought to have been bannered across the newspaper’s front page.
The headline, as it appeared in the print version earlier this month, reads: “While People Languish, Science Plays the Long Game.” A more appropriate headline would have proclaimed: “People Languish while Science Fiddles in Dead-End Research.”
The article, written by science writer Benedict Carey, speaks to his personal disappointment that the nation’s understanding of mental health made so little progress during his two decades on what was known in the newsroom as “the behavior beat.” He writes: “I had wanted to report on something big,” to be there to chronicle the scientific breakthroughs “that would shake up our understanding of mental health problems.”
The field attracted enormous scientific talent, he notes, and significant discoveries were made in brain-injury cases and the origins of schizophrenia. Yet “the science did little to improve the lives of the millions of people living with persistent mental distress.” If anything, he writes, almost “every measure of our collective mental health—rates of suicide, anxiety, depression, addiction deaths, psychiatric prescription use—went in the wrong direction, even as access to services expanded greatly.”
The article appears to be Carey’s sad swan song. He assesses the mental-health landscape “as I say goodbye to my job, covering psychiatry, psychology, brain biology, and big-data social science …” His departure seems to have inspired his retrospective, as he notes that the mental-health system, “for all its caring professionals, is chaotic and extremely difficult to navigate.” There are few systemwide standards, he adds, and vast and hidden differences in quality of care. “Good luck finding an authoritative guide to navigating the full range of appropriate options.”
Carey’s observations are supported in Harvard Professor Anne Harrington’s book, Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness (W.W. Norton, 2019). She observes how psychiatry’s dependence on neuroscience, brain-imaging, genetics, and psychopharmacology failed over past decades to improve mental health. A new approach is needed, she writes, a broader interpretative approach through which psychiatry would “aim to overcome its persistent reductionist habits and commit to an ongoing dialogue with the … social sciences and even the humanities.”
As I see it, medical and hard-science approaches to understanding human nature operate at a disadvantage. I’m a psychotherapist who has encountered, at deep levels, the consciousness of thousands of people. I believe that mental-health progress depends more on insight into our consciousness than on knowledge of the brain or genetics. Human consciousness is burdened with significant degrees of fear, chaos, and conflict. Each of us is responsible for addressing these dynamics within ourselves. To do well in life, we each have to bring our consciousness into some degree of harmony. Psychiatric medications have had some success doing this, yet the declining mental health of Americans indicates much more is needed.
Thinkers have speculated for millennia on the nature of consciousness, and scholars today are exploring the thesis that mental health is primarily a factor of consciousness. Psychiatrists and neuroscientists have been getting away with overlooking the central role of consciousness because they haven’t seen clearly enough what it is or appreciated how it evolves. For one thing, science can’t observe or explain consciousness in terms of substance or matter.
Consciousness constitutes mysterious, ethereal realms of delicacy, refinement, and intangibility that baffle hard science. Our best understanding of these realms derives from what a social-science approach can describe or qualify of our mental content and emotional experiences, as it observes the magnitudes of pleasure versus displeasure—as well as the desires, impulses, wishes, and behaviors—that arise from this inner content.
Consciousness is the sense we have of ourselves and our surroundings. We all experience it. We recognize it in ourselves and can imagine how others experience it. We feel our consciousness changing or shifting when experiencing joy or sorrow, or when consuming alcohol or drugs or going for a run. Yet people can be quite unconscious in matters of the utmost importance to their wellbeing, particularly concerning the nature of inner conflict and its toxic effects. Through evolving consciousness, we can understand how inner conflict produces malevolence, hatred, and self-defeat. We acquire the strength and wisdom to disengage—mentally, emotionally, and behaviorally—from the negative impulses and biases generated by inner conflict.
Consciousness is an intangible quality that exists on a spectrum, with lucidity and refinement at the upper range. It’s a capacity for reflection and self-reflection that manifests uniquely in each individual. Our consciousness decides, at both conscious and unconscious levels, what content is given prominence and what is denied or repressed. An individual who identifies with ego, body, intellect, profession, family role, gender, nationality, race, social class, or possessions, rather than with the authentic self that evolving consciousness discovers, will likely have less access to mental and emotional self-regulation.
While consciousness manifests uniquely in each of us, it’s also governed by psychological principles, dynamics, or laws that are common to all humanity. At a largely unconscious level, psychological dynamics—involving resistance, repression, transference, projection, passivity, aggression, and masochism—are experienced and processed through inner conflict’s common operating procedures, in ways that often produce more displeasure than pleasure. Evolving consciousness becomes attuned to these inner dynamics and understands how, through them, we create and maintain negative thoughts and feelings.
The degree to which an individual is compulsive, reactionary, or hateful is a measure of consciousness, as is the capacity to act in one’s best interests. Evolving consciousness is reflected in the degree to which an individual has some inkling of, or can acknowledge without self-recrimination and with humility, the scope of his ignorance. Some people, like animals, go through life without being conscious of being conscious. They have higher intelligence than animals, but not a consciousness more in harmony with nature.
Our cleverness is not the same thing as consciousness, just as general knowledge is not the same as wisdom. The mind itself incorporates functions such as verbalization, cognition, sensory discernment, and access to working memory, while evolving or healthy consciousness determines the degree to which these mental processes are pleasurable, rational, discerning, and ethical. The wisdom or foolishness of individual and collective behaviors are all factors of consciousness. Yet fields of study such as political science, economics, sociology, and history have not sufficiently acknowledged or explained how human events, beliefs, policies, and decisions—and especially wars—are shaped less by the commanding power of the few and more by the passivity inherent in the consciousness of the many. Reductionistic perceptions are themselves symptoms of a deficient consciousness.
Consciousness is influenced by trauma, genes, society, culture, and environment. It’s also influenced by the degree to which—mentally, emotionally, and unconsciously—we give undue significance to how these factors might be oppressing or disfavoring us. A lower consciousness is ready and willing to experience itself as passive and at the mercy of these influences. It’s easy to feel victimized by external factors, especially as we give emotionally biased significance to them. Of course, mentalities such as racism and misogyny do produce genuine victims, and these mentalities and their effects are best addressed and mitigated by evolving consciousness.
Consciousness is lacking when we’re emotionally or psychologically disconnected from our best self. The Pulitzer-Prize winning critic, Hilton Als, in his review of a new film about Earnest Hemingway, speaks obliquely to this disconnect from self in reference to the famous author, who committed suicide in 1961: “Part of the sadness at the core of the film ‘Hemingway’ is how much life we see happening to the writer that he doesn’t seem to feel, or doesn’t want to feel, protecting a self he didn’t know, or could not face.”
Hemingway was plagued by clinical depression. Medicine has been especially interested in curing clinical depression, yet medical scientists and doctors have not recognized inner conflict as a primary source of the problem. Through inner conflict, our inner critic (superego) harasses us with accusations, sarcasm, mockery, and ridicule. On an inner level, we fight back, usually rather weakly, through the thoughts, feelings, and instinctive defensiveness of inner passivity. We can’t resolve this inner conflict when we’re identified with inner passivity, the weak unconscious ego that simply can’t represent us effectively. Hence, we absorb the inner critic’s aggression (self-aggression). The cumulative effect of this self-debasement undermines our vitality and spirit, disconnects us from our better self, and leads to depression.
A medical approach to our mental and emotional wellbeing is appropriate in cases involving brain damage, toxins, or drugs, as well as in cases of coma, epilepsy, severe trauma, and psychiatric disorders. Inner conflict, though, is a problem that produces some measure of suffering in most human beings. Inner conflict accounts for the widespread extent of neurosis, which collectively produces social and political dysfunction. The problem is essentially psychological, and even everyday “normal” people can benefit greatly from psychological insight. Acquiring this insight, whether from the best-informed literature or therapy, involves the assimilation of self-knowledge that identifies and untangles inner conflict, thereby elevating consciousness.
Developing consciousness does alleviate, to a significant extent, the symptoms of childhood trauma and unfavorable genetics. Still, having an evolved consciousness doesn’t mean, of course, that all is perfect. For one thing, symptoms such as passivity and fear can persist, clinging stubbornly to the mind and body. Yet evolving consciousness enables us to respect and love ourselves, rather than to berate ourselves for our frailties and fears or linger in guilt and shame for limited abilities, past misdeeds, or unfulfilled ambitions.
People usually benefit by making a conscious connection between what happened in the past in the way of trauma with what’s happening now, says Dr. Bessel van der Kolk, author of the best-seller, The Body Keeps Score: Brain, Mind, and Body in the Healing of Trauma (Penguin Books, 2014). “Sensing, naming, and identifying what is going on inside is the first step to recover,” he writes.
Depth psychology is all about understanding “what is going on inside,” and the new consciousness it provides enables individuals to be at peace with lingering symptoms of trauma or genetic anomalies, without accompanying resentment, shame, or hate. This consciousness unblocks our capacity for sublimation, whereby the creative energies that would otherwise get tied up in inner conflict are instead directed into fulfilling pursuits.
I’m concerned now that mental health’s medical-scientific complex will double down on research of limited value instead of helping to produce a consensus on what constitutes essential psychological knowledge. The Biden Administration has committed to expanding medical research, while psychiatry continues to hitch its star to big science. This calls to mind the rueful quip, “Why solve a problem when you can spend billions studying it.”
Harvard’s Dr. Harrington writes that “it would require an act of great professional and ethical courage” to limit the biological approach to mental illness to the most severe disorders, and to recognize, as well, that psychiatry’s current “medical mission” does not apply to most seekers of mental-health services. It is time, she writes, “for us all to learn and to tell better, more honest stories.”
Such stories are not always visible under a microscope. The story of humankind is the saga of evolving consciousness as it unfolded over our long prehistory and the five millennia since written language first appeared. The greatest human creations—the written word, the rule of law, human rights, and the establishment of democracy—are achievements of consciousness, not science. With access to the best psychological knowledge, we can transform an immature and conflicted consciousness, hounded by infantile misreckoning, into robust mental health. This state of being establishes an inner democracy governed by our better self.