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Theoretical perspectives on consciousness and related therapeutic approaches.
An examination of different theoretical perspectives on consciousness and how these relate to the therapeutic approaches advanced by the theorists concerned.

A paper submitted by Brynn Binnell for the Mind, Brains and Behaviour course, as part of the Bachelor of Arts with Honours (Psychology) degree, 1996: University of the Witwatersrand, Johannesburg.

In this paper a variety of different perspectives on the nature of consciousness will be critically examined. The paper will also examine the different approaches to therapeutic intervention that result from the respective views on consciousness. Five broad streams of thought that relate to the question of consciousness have been identified and will be discussed in this paper. These are: the psychodynamic school of thought that originated with the ideas of Sigmund Freud; the phenomenological existentialist approach, that originated with the ideas of Edmund Husserl and Jean-Paul Sartre; the humanist approach that is best exemplified by Karl Rogers; the behaviourist approach, that originated with the ideas of J.B. Watson and B.F. Skinner; the cognitive-behaviourist approach, a pioneer of which was Stanley Beck. Lastly, some of the more recent theoretical developments will be discussed, including postmodern and/or poststructuralist theorists like Michel Foucault, Gille Deleuze and Felix Guattari.
Reference will also be made to the stance that the approach takes on the mind-body problem. Colin McGinn (1982) evaluated the various solutions to the mind-body problem in relation to the basic perspective that they were based on. He argues that one is forced to choose from among three (unattractive) positions:
"...Either (i) we favour the first-person uses and so encounter difficulty in giving a satisfactory account of how mental concepts are applied to others; or (ii) we favour third-person uses and so omit to register the special character of our first-person ascriptions; or (iii) we try to combine both uses, thus producing a sort of hybrid or amalgam of the two apparently unrelated elements" (McGinn, 1982: 6).
The different perspectives on consciousness that are discussed in this paper will be evaluated in terms of their relation to the above criteria.
Sigmund Freud held the view that the mind was divided into three functional structures. He departed from the commonly held views of his day that posited individuals as being "rational" beings. Instead he argued for the existence of an “unconscious,” resulting particularly in irrational impulses, unconscious desire and sexual drives (Freud, 1973: 2l).
Freud argued (in his first topography) that there were different psychical systems within the mind -the unconscious, pre-conscious and conscious. The unconscious was separated from the other two by a censor, or doorkeeper. The censor prevented the surfacing of the representations of “unacceptable” impulses or drives from entering into conscious thought (Freud 1905: 277-375). Freud later modified his position and introduced the second topography in On Narcissism (Freud, 1914) by referring to three structures in the mind: the id, which was the source of all biological drives and demands for immediate gratification; the super-ego, which was the internalisation of the parental representations of the values and morality of the society in which individuals found themselves; and the ego, which was the mediator between the two structures, having to satisfy the individual's demands for gratification, while keeping them out of danger from the environment (Freud, 1923: 439-483). However, there was still a division between consciousness and unconsciousness (Wollheim, 1985: 153).
It could be argued that Freud's metapsychology was based on a monist ontology. His lifelong project was to develop a theory that would be able to account for clinical (pathological) phenomena by grounding his theories in a physiological model (Freud, 1905:
221). However, as his theory developed, he tended to lean more toward an interpretation that would be able to give due consideration to the cultural factors that influence ones destiny. He attempted to understand the workings of the mind in terms of brain structures and functions, including electro-chemical flows of energy (Laplanche, 1989: 266).
Although his theory is a monist one, it is usually regarded as being skewed too much toward an exclusive first-person perspective. This makes it difficult to justify Freud's claim that his method is scientific. It could be argued, in his defence, that the ability of his theoretical approach to make predictions about the behaviour of individuals (based on knowledge of the early childhood situation) represents a scientific contribution of immense value. 
Freud's therapeutic technique was to look at the dreams produced by his patients as
their neurotic symptoms and interpret these. He also encouraged his patients to "free
associate, " by which he intended that they should speak about everything that came to mind and omit nothing. This was done in order to reveal their chains of associations to him. He argued that patients would be cured through the transference, which rearticulated the Oedipal bonds and enabled the patient to work through unresolved conflicts. This would enable them to overcome any "fixations" that may have taken place as a result of trauma in their life that they were unable to deal with effectively at the time of their occurrence (Freud, 1926: 7-23). Using this technique, Freud was able to provide effective and convincing accounts of clinical phenomena, such as somatization and other hysterical symptomatology (which are arguably not done at a conscious level).
Jean-Paul Sartre built on the work of Edmund Husserl in developing his existential psychoanalysis.  For Sartre, consciousness existed in two "modes." There is the (primary) pre-reflective consciousness, which is non-personal and always conscious o/something. Then there is the (secondary) cogito, which consists of the thetic or positional consciousness.  It is also important to note that he claimed that the ego is not in consciousness, but is itself (along with the world) an object of consciousness. Thus, he would argue that, strictly speaking, one should never say "my consciousness" but rather "consciousness of me" (Sartre, 1969: 432). This is different to Freud's view of the ego, which he equated with consciousness. This also relates to Sartre's view of the self, which he argues can exist in two "modes." The first is the in-itself, which is the inert non-conscious being which merely exists (in material reality). The second "mode" of being is the being for-itself. This is the consciousness of being that arises from a nihilation of being-in-itself. It does not exist as a separate structure in materiality like the in-itself, but is the conscious realisation of self, of being, or the possibility of non-being - ones own nothingness (Sartre, 1969 611). 
The attempt to practice scientific observation and classification implies that there is an objective world-out-there, and the existentialist and phenomenological approaches reject this view. They argue that it is not possible to ever know any world that exists apart from one's own consciousness. One should rather view the things in the world as phenomena, that is, one should always be aware that one is not seeing the world as one would a photograph, but as an "experience" that includes the conscious organism that is doing the viewing. An objective (external) evaluative process cannot be used in therapeutic situations, as what would be most important is the unique perspective of the perceiving subject himself. He explains his rejection of the empiricist causal model of explanation by pointing out that:
“[Existential psychoanalysis] …abandons the supposition that the environment can act on the subject under consideration. The environment can act on the subject only to the exact extent that he comprehends it, that is, transforms it into a situation.” (Sartre, 1969:78).
         Sartre also rejected the attempt to engage in psychological analysis that attempted to compress the vast complexity of human nature into a combination of typical traits, or typical abstract desires and tendencies that could be posited as "explaining; the patient. Instead, Sartre stressed that it was necessary to focus intensely on the individual subject. He argues that it was necessary to study and attempt to understand:
“…What is individual and often even instantaneous. The method which has served for one subject will not necessarily be suitable to use for another subject, or for the same subject at a later period." (Sartre, 1969: 732).
In terms of McGinn's criteria, Sartre has made a convincing case for the (Husserlian) argument that one is able to ground all the sciences in a phenomenological ontology. The argument is that if one "brackets out" all of one's (culturally learnt) pre-conceived notions about reality and focuses on the details and description of this experience, one will be in a position whereby one is able to intuitively grasp the "universal" truth of things. However, this approach is usually considered to be too focused on the first-person perspective (as its representatives themselves claim this to be the case). It is also dubious whether one should attempt to "ground all the sciences" on one's intuitions of reality.
A frequent criticism of the "phenomenological enquiry" method is that it fails to provide sufficient normative regulation. This is partly due to its failure to locate the subjects of an enquiry historically and socio-politically in the social structures. For example, under the Apartheid system in South Africa, the education system was based on a phenomenological pedagogical approach. Yet this philosophy was unable to guide the (government) researchers and policy-makers to the “intuition” that the system was fundamentally flawed and unjust. It could thus be argued that it is precisely the strong reliance on a first-person perspective that leads to this deficiency in the phenomenological approach. That is, it does not provide a sufficiently objective (third-person) perspective on reality. This is of direct relevance to the defects of the existentialist approach. Sartre was a Marxist revolutionary who argued that “perverts” are the healthier in society because they refuse to conform to the dominant ideas of “normality.” They act freely and establish new paths (and Althusserian subject positions) that others are able to follow. However, most people would be extremely uncomfortable with this notion when applied, for example to paedophiles or sociopaths. The Sartrean reply to this would be that society only produces “antisocial” subjects because it is presently structured in a way that is fundamentally unjust and exploitive. 
An approach that is closely related to the existentialist one is the Humanist approach, as exemplified by the ideas of Karl Rogers. He founded the “client centred” approach to psychotherapy. Rogers argued that all individuals have the “germ” within them that, if allowed to grow and develop, would result in their self-actualisation. For Rogers, psychopathology arose when individuals' own unique personalities are made to conform to the demands of their environment. Rogers argues that this state comes about when individuals receive conditional positive regard from their care-givers in childhood. That is, they are not encouraged and supported to develop their own unique potential, but are made to feel that they will only be loved if they behave in a certain manner. A state of incongruence results between the demands of the environment (i.e., the family, the workplace) and the demands of the self (Thorne, 1993: 312).
His view of consciousness is that individuals are not victims of unknown (environmental or unconscious) forces that decide their destinies on their behalf. They are able to know their desires and are able to change their lives consciously and rationally for the better (Thorne, 1993: 312).
The Rogerian therapeutic approach is therefore aimed at providing unconditional positive regard to the client, who is thus encouraged to live his/her life in accordance with his/her own true self (Thorne, 1993: 312).
The criticisms of this approach have already been dealt with in the section on existentialism. However, the Rogerian approach is even more defective as a tool for normative regulation as the therapist is told not to intervene or confront the client under any circumstances (unlike the strongly interventionist existentialist approach). Roger's reply to this is that the client will not act anti-socially once they are provided with the support and empathy that has been lacking in their lives hitherto.
Another approach that gained widespread currency in the earlier part of the last century was the behaviourist approach of J.B. Watson and B.F. Skinner. Watson argued that the science of psychology should only be interested in phenomena that were observable and measurable. He built on the experiments of Ivan Pavlov (on dogs) and developed the concepts of behavioural conditioning. Skinner introduced the notion of reinforcement as an aid for learning and behaviour modification. The behaviourists were not interested in “mind” at all as they argued that this notion was a relic of a superstitious interpretation of human behaviour (Watson, 1930; Skinner, 1953).
The behaviourists maintained that it was far more important to consider the environmental stimuli - the conditioners and the reinforcers of behaviour. Mind was viewed as an epiphenomenon, and as such was seen to be unable to exert any causal transformations of (or in) the environment. One could diagrammatise their view of the relationship between (environmental) stimulus and (behavioural) response thus:
STIMULUS → RESPONSE
It can immediately be seen that they are not interested in the nature of that which takes place between the stimulus and the response (→  ). (Morris, 1988: 29).
The therapeutic approach that emerged from these ideas was one that sought to ignore the mental and "psychological" material that had been of central importance until then. It was argued that pathological behaviour should be modified by means of a schedule of conditioners and reinforcers that would have the effect of rewarding good behaviour and punishing the bad. Many of these techniques proved to be remarkably effective, particularly with obsessive-compulsive disorders, anxiety disorders and phobias (Watson, 1930; Skinner, 1953).
Although behaviourism was an important step forward, it was widely criticised by philosophers as being inadequate. In terms of McGinn's criteria, behaviourism is a perfect example of a system that meets the second criterion, that is, it is able to provide a convincing account only from a third-person perspective. They provide no account of the (cognitive) processes that are involved in the production of any particular response.
These and other criticisms of the behavioural approach fostered the emergence and development of the Cognitive-Behaviourist approach. One of its pioneers was Stanley Beck, who argued that it was necessary to view mental events as being causally related to behaviour. An analogy was also drawn between a computer and the human mind. Thus, between stimulus and response was the “black box,” and it was the task of psychologists to explain the mechanisms and functionings of the contents of the black box.
STIMULUS → MENTAL PROCESSES → RESPONSE
The therapeutic approach that followed from Beck's cognitive model was to include various mental conditioners and reinforcers in the behaviour schedule that was administered. Thus, an individual that was suffering from poor self-esteem could not only be placed on a fitness, health and beauty training course, but could also be instructed to monitor themselves for “automatic negative self appraisals.” That is, they would be made to monitor their own mental activities and record these in a schedule. The occurrences of the negative thoughts would be progressively diminished, while the positive ones strengthened and reinforced. This approach has proved to be remarkably effective in a number of areas. For example, depression, anxiety, obsessive-compulsive disorders, phobias and other behavioural problems.
In the 1950's H.J. Eysenck wrote an influential paper in which he denounced the psychodynamic approaches as being unscientific and, in particular, for not providing effective (and observable) treatment of psychological disorders (Eysenck, 1953). The issue remains controversial however, as psychodynamic theorist argue that the benefits of their forms of treatment tend to get to the (childhood) roots of psychological problems and that once cured, there is a much lower rate of recidivism.
The cognitive behaviourist approach is an example of an attempt to study mental phenomena while satisfying both the first and second criteria of McGinn (i.e. it is one of the attempts toward meeting the third criteria). The direction taken by the cognitive behaviourists has certainly been a productive one in terms of the contribution to the theoretical body of knowledge, as well as to the understanding of psychopathology and its treatment. At the philosophical level there have been a number of noteworthy contributions to understanding the relationship between mind and body, in particular, to provide a sound philosophical basis to the cognitive behaviourist approach. An example is the supervenience of the mental thesis proposed by Davidson (Rosenthal, 1991: 432). This thesis holds that the mind supervenes on the physical brain. This allows for the possibility of there being a token identity between mind and brain. That is, a particular state of mind (or consciousness) can be produced by any type of machinery (e.g., different types of brain structures), but that the mental properties are not able to vary while the physical properties are kept constant. This thesis is referred to as being a non-reductive materialism/monism (McGinn, 1982: 27-29: Rosenthal, 1991: 432-437).
However, there remain a number of theoretical (philosophical) issues that are as yet unresolved. McGinn concludes that:
“Our efforts to arrive at a satisfactory theory of the relation between mind and body have not met with total success. We have, it is true, gone some way towards explaining how the mind can be different in nature from the body yet be intimately connected with it. But we have not explained how a physical organ of the body, namely the brain, could be the basis of consciousness - how a physical object can come to have an ‘inner’ aspect” (McGinn, 1982: 36).
Finally, it is necessary to consider some of the more recent theoretical developments, particularly in the areas of social and community psychology. It is argued that we are living in a “postmodern” world and that this has several important consequences or features. Most notably among them is the “decline of the meta-narrative.” That is, the existing theoretical schools or approaches are grand theories that try to capture the infinitely complex reality in which subjects are immersed - and fail. They are given the appearance of having succeeded because they narrate and explain at least one strand of this infinite complexity. However, it is claimed that these theories have no value because they are discourses that merely reflect the existing power relations.
Another important development is the “attack on the subject” launched by theorists like Louis Althusser (1967) and Michel Foucault (1972). This theme has been developed considerably by Deleuze and, Guattari who maintain that the subject is unconscious of the socio-political machinery that envelops him/her. They argue that all the psychologists to date have based their theoretical premises on this already-politicised subject who is under the illusion of freedom. For example, they claim that Freud’s oedipal triangle is an important factor to consider in the socialization of subjects, but that the most important tasks of enculturation (and social control) are already taken-in by the infant before they even reach Oedipus (Deleuze & Guattari, 1990: 438).
One could relate this to Jacque Lacan's famous statement that: "...the unconscious is structured like a language..." (Lacan, 1979). Society is argued to function according to a body of rules and structures that permeate every act and statement that is performed or enunciated by “bodies”. One is born into a system that pre-exists one. They argue that it is usually the case that one continues to exist without ever becoming aware of this “ultimate” reality. According to this view, the consequence of the administration of the Freudian therapeutic technique would be the re-Oedipalization of the body, as it fails to access the more foundational social nature of reality. A Freudian therapeutic intervention would have the effect of “objectifying” the subject, such that he/she sees him/herself as the foundation or cause of their circumstances. They argue that this is false, as the foundations or causes of one’s situation can only be located in the social body -not the individual body (Deleuze & Guattari, 1992: 498). 
Deleuze and Guattari propose that the current forms of therapeutic intervention result in the production of “docile” and re-Oedipalised bodies, as they argue that this returns one to the “neurotic pole.” They claim that this is related to the “capitalist machine” to which subjects are presently connected, which is best able to function with neuroticised bodies. They argue that is preferable that individuals explore their “schizophrenic pole.” They state further that this can not be done in the context of an individualistic therapeutic intervention, but should rather be done collectively.  They call on individuals to get out of their therapy and “take a walk out in the sunshine” (Deleuze and Guattari, 1990: 87).
However, these theorists are not proposing any alternative strategies or “recipes” for “freedom.” It is true to say that the major thrust of their work is to reject any approach that seeks to direct or exhort others to some form of action. Deleuze and Guattari maintain that the production of schizophrenic (or nomadic) bodies is a process that will take place automatically as it is built into the logic of the capitalist machine (Deleuze & Guattari, 1992: 276).
Most of these poststructuralist theoretical constructions are based on a monist and materialist view of the mind-body problem. They reject the very idea of the mind-body problem, which they claim is a relic of the previous social formation (the despotic machine for Deleuze and Guattari; the Classical epistemè for Foucault). They claim that the mind-body dichotomy typifies the dividing of reality into sets of binary oppositions that characterised thought until the present time. They claim to have collapsed this dichotomy (along with all the other binary oppositions). They would, therefore, also reject McGinn’s three criteria as a schematization of the range of philosophical possibilities. However, one could argue that they have indeed made a useful contribution to the third criterion. Their “approach” tends to favour a third-person perspective, yet it also accounts for the occurrence of subjective (first-person) phenomena. Although this is in a completely novel (if not revolutionary) way. It remains to be seen what the impact of poststructuralist thought will be on future generations.
On a more sober (and practical) note, what appears to be emerging is an eclecticism, such as that proposed by Windy Dryden (1992, 1993).  This “approach” holds that it would be a mistake for a psychologist to hold true to any particular therapeutic style of intervention (e.g., Freudian, existentialist, or behaviourist), but that they should assess each individual client/patient to decide what form of intervention would be appropriate for their (individual) situation. This is in line with the argument that the world has become too complex for any one theory to accommodate cohesively or coherently.
Dryden argues that the different therapeutic intervention systems currently available are not mutually exclusive. In practice today any can be used, depending on the needs of the client (Dryden, 1992, 1993). Individuals who have neurotic symptoms or deep emotional disturbances would benefit from a Freudian approach to treatment. Individuals who are psychologically healthy (i.e., not neurotic) but feeling alienated or that their lives are meaningless, empty or without purpose may benefit from an existential approach to treatment. It is especially true that Freud's approach can never be used with psychotic patients, while the existential approach has shown that it can produce positive results with schizophrenic patients (Dryden, 1992, 1993; Frankl, 1965; Laing, 1971, 1976,1990; May, 1972). Individuals who have behavioural, obsessive-compulsive, anxiety or phobic disorders may benefit more from a cognitive behaviourist approach (Dryden, 1992). However, it should be emphasised that eclecticism does not mean that the different approaches can or should be blended – “mixed and matched.” This would result in their effectiveness being diminished considerably.
In conclusion it can be stated that, while a number of widely diverging theoretical perspectives have been discussed in this paper, there is no one dominant paradigm in evidence. Each theoretical approach can be put to productive use, depending upon the specific context within which the psychologist finds him/herself. It is also true to say that it may be more appropriate in certain situations to abandon individual therapy altogether, in favour of a more collective, community-based approach.

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