Before reading this chapter please start with chapters:
First Concepts.
WOB is Optimal

There are two approaches for understanding reality: The Cartesian and phenomenology. The first was introduced by Rene  Descartes (1596-1650 ) who applied rationality to understand reality. His declaration: “I think, therefore I am” implies that thinking is rational.  Three centuries later Heidegger (1889-1976) realized that Descartes’ seemingly straight forward  declaration, which seems to us so obvious, conceals a stumbling block. He therefore    asked, what does Descartes mean by his “am”?  and  concluded that reality ought to be studied from the “am” perspective, known as phenomenology. The term   was coined by his teacher and friend Edmund Husserl ( 1859-1938). 

The thing-in-itself is a patient

The reality for me is the patient and my task is to promote his health.  I am less concerned with truth as such, and   regard philosophy as a source for interesting and fruitful ideas for promoting health.  I favor  statements that serve my treatment objective and ignore the  non relevant.  Take for instance Kant’s “the thing in itself” (Das Ding and Sich) whose nature  we shall never grasp. For me the thing-in-itself is the patient who suffers and needs help. We talk and interact and I promote his health.

v. Biological interpretation of synthetic a priori

The philosopher as a patient

When studying philosophy I imagine the philosopher who bases his arguments on his personal experience with his self, and the world. From the medical perspective some of his   profound philosophical statements may be naive and even ridiculous, Like  the “I think, therefore I am”.  Some time after arriving at this conclusion, Descartes sank into a deep coma. I watch him lying helplessly in his bed and say to him. Your mind is shut off, and with it your entire philosophy, yet for me you still exist despite the fact that you ceased to think. You are fortunate that WOB keeps you alive.  Soon you will wake up and my task will be accomplished.

Your cancer is different than mine

Modern  medicine is overwhelmed by Descartes’ philosophy and his reductionist  view of reality (the patient). While in acute conditions the  Cartesian approach is extremely fruitful, and advanced medicine to its great and amazing  achievements,   in chronic conditions it fails, and even harms the patient.  The present medical dilemma is highlighted by the exclamation of the patient with cancer: ”Your cancer is different than mine!” You reduce my cancer  to a set of (aberrant) genes, and enzymes, while cancer is more than that. It is a new life which cannot be reduced to atoms and molecules. Might phenomenology shed a new light on cancer?

v. Iatrogenic medicine

WOB and mind

I distinguish between two entities WOB (Wisdom of the Body)  and mind. Two operational metaphors which together encompass  the condition of the organism. Every symptom or sign in the organism ought to be expressed by these metaphors. Like diabetes which consists of WOB-diabetes, and mind-diabetes.  By mind-diabetes I mean how patient and  society conceive WOB-diabetes, and not  only the psychological aspects of the disease. Here are  some other examples, WOB-cancer and mind-cancer. WOB-schizophrenia and mind-schizophrenia, WOB-neurosis and mind-neurosis, WOB-homosexuality and mind-homosexuality, WOB-thalassemia and mind-thalassemia  The condition of the organism is expressed by a doublet  (WOB, mind) which cannot be taken apart.  WOB without mind is meaningless and so is mind without WOB.

Evolution of the mind

The newborn is a pure WOB. You might prefer the notion   that it is controlled  by WOB.  However  WOB is the controller and the controlled. As the child grows WOB creates its mind. The patient in coma is also a pure WOB since he is mindless. Actually WOB and mind are two interacting processes that change from instant to instant. WOB maintains life  and mind serves as an interface between WOB and the world.  By itself WOB maintains life optimally, yet is unable to get resources, which is the task of the mind.

WOB is and controls the zygote which has just left the ovary and moves   through the oviduct. Its  resources last for a week whereupon it embeds into the uterine mucosa which serves as WOB interface with the external world.  Soon  will this interface be replaced with the placenta. Following  delivery,  mother takes up the interface role.  As the child grows the WOB will create its own mind which ultimately will console itself with “I think therefore I am!.”

Mind is first of all an interface between WOB and the world, whose task is to provide resources. Thus,  the uterine mucosa, placenta and the mother are phases in the evolution of mind. The same is true also for the microbe whose WOB is supported by a  mind-interface between it and other microbes. Actually  the  microbe is a member of a microbe organism (society), and does not exist by itself. .

WOB is optimal

WOB  is extremely complex and composed of many interacting processes. Its sole function is to maintain life optimally. How this is accomplished is beyond our understanding and cannot be understood by taking WOB apart. WOB functioning and its optimizing capacity has to be taken for granted in the same way as we take gravity. Without gravity Newton’s laws are unthinkable,  and so is medicine without WOB.   Enter phenomenology!

Franz Brentano

Long before it received its name, phenomenology blossomed  in Brentano’s mind:  1. mental phenomena are the exclusive object of inner perception, 2.  they always appear as a unity, and 3. they are always intentionally directed towards an object. The last is particularly relevant to WOB requirements.  The mind of the growing child is molded optimally by WOB. Its understanding of the external world is “intentional”. For example,  WOB maintains our water balance, and since we continually lose water it signals the mind with thirst, which means: “Get me some water”. This is the medical interpretation of “intentionality” which is simpler than its philosophical interpretation.

How do  I dare to meddle in ontological issues which are obviously beyond my understanding?  Since I encounter in my daily practice Brentano's of all kind which help me to imagine how Franz studied his mind  when he was thirsty.  Yet intentionality has some philosophical stumbling blocks. What about mental phenomena that are directed towards non-existing objects such as Hamlet? How does Hamlet serve  WOB?  For what purpose might  WOB send a Hamlet signal to the mind, and what does it require?

Mind-Janus

Actually Hamlet is not a signal from WOB to mind. It originates in our culture and is transmitted to WOB by the mind.  The  mind-interface  receives two kinds  of signal, from WOB and from the outside world. He may  be likened to the Roman God Janus  who guarded gates and doorways, depicted with two faces looking in opposite directions.  Inwards mind listens to WOB, and outward it listens to culture and transmits its norms to WOB.

A young healthy female is told that she got a minuscule breast tumor. She then leaves the mammography lab only to face Death.   Her actual diagnosis is {WOB-cancer, Mind-cancer}. While WOB cancer is insignificant, Mind-cancer may kill her. Before entering the mammography lab she was healthy since WOB was silent. After being told, WOB is still healthy, and the threat comes from the mind. Mind-cancer dominates her condition. This is her Hamlet.

Before continuing let’s remember again the  distinction between phenomenological research performed by professional philosophers and phenomenological interpretation by a physician.

Edmund Husserl

Husserl   expanded  Brentano’s philosophy. Consciousness is   "the entire, real phenomenological being of the empirical ego, as the interweaving of psychic experiences in the unified stream of consciousness." Part of this whole, called
inner consciousness  is directed inward. It is the inner perception that listens to WOB like when it needs water.  This  signal (sensation)  has to be interpreted correctly, otherwise the mind will guide WOB to a toxic liquid.  According to Husserl   the fundamental constituents of consciousness are: sensation, an intentional act that interprets the sensation, and an intentional object that is referred to by means of the interpretation of the sensation. In our example, the signal or sensation,  is thirst. The intentional act: search for a fluid. The intentional object: water.  

Phenomenological epoché or bracketing

Any phenomenological description proper is to be performed from a first person point of view, so as to ensure that the respective item is described exactly as is experienced, or intended, by the subject. Thus, the epoché has us focus on those aspects of our intentional acts and their contents that do not depend on the existence of a represented object out there in the extra-mental world. Bracketing is the attention of the mind to WOB signals. If one is hallucinating, there is really no object of perception. However, phenomenologically the experience one undergoes is exactly the same as if one were successfully perceiving an external object.

When treating a hallucinating patient, we ought to distinguish between WOB-hallucination and mind-hallucination.

Martin Heidegger

Heidegger’s  Being and Time is a critique of rationalism. He achieves this by way of a phenomenology of the everyday. The everyday is that which is closest to us, yet traditionally it is denigrated as an illusion which has to be reduced to its essence in form of a theory.  We must start with the everyday because this is where we are, called in German Da-sein, or Being-there, which is extremely complex. Dasein is immersed in a world which is experienced as a significant whole.

In order to avoid confusing Da-sein with complexity unrelated to our daily life, Heidegger focuses on Dasein in its most undifferentiated state, that is it's everyday state. The phenomenology of Da-sein attempts to understand the nature of Being.

Our understanding of the everyday is "non-theoretical" and "atheoretical” Like our behavior whose nature defies any scientific theory. Our understanding of Being is implicit in everything we do. On the other hand rationalism abstracts from the richness of everyday experience. Being is not conceptual and so cannot be encompassed within a conceptual system. Instead our understanding of Being is primarily a tacit dimension of our embodied being-in-the-world.

WOB and Dasein

Dasein has been shown thus far to be essentially "being-ahead-of-itself". Phenomenologically Dasein is the totality of  WOB-Mind. In other words since mind is created by WOB,  it is its integral part, like other organs and processes in our body. Being-in-the-world means that each WOB state is the most optimal solution of this Being-in-the-world,  and therefore it appears as if Dasein is "being-ahead-of-itself".

Eppur si muove!

This exclamation sums up   Galileo’s heroic confrontation with the Catholic church. Phenomenologically speaking his truth is utterly irrelevant to that of Dasein.  WOB operates and exists in the Ptolemaic universe, where the sun rises and controls our activities. Which is acknowledged even by medical reductionists according to which  our biology is controlled by circadian rhythms.

v. Eppur si muove!

Mind disease of Dasein

Dasein is "initially and for the most part" absorbed and "taken in" by the world. Being-in-the-world leads Dasein to misinterpret itself, for Dasein "gets its ontological understanding of itself in the first instance from those entities which it itself is not but which it encounters 'within' its world, and from the Being which they possess". In the everyday, Dasein "fails to hear itself" because of the deafening "noise" of the "they".

When Dasein enters the mammography lab, it feels healthy. Then it is told that it got breast cancer. Suddenly Dasein "fails to hear itself" because of the deafening "noise" of the "they" who proclaim its death, while in reality it is still healthy since WOB did not complain. This deafening “noise” of “they” initiates its mind-cancer.

Death

Heidegger noticed that death is not something we can experience.  There is really nothing at all to say about "our death itself." What is important is not "death itself," but dying. Indeed WOB is not aware of death, It maintains life, and what we observe as dying are WOB solutions to maintain life. Like in the patient in coma.  To WOB death and dying are meaningless.

v. On death and dying
v. Death denial

Nevertheless Heidegger was preoccupied with death and dying. True,  death cannot be experienced but we are aware of the death of others. Heidegger maintained that “My awareness that I am going to die can give me the required perspective”.  He expresses this  relation to the end of Dasein by the phrase "being toward the end" (Sein zum Ende) or "being toward death" (Sein zum Tode).

He obviously   contradicts himself since death is outside of any phenomenology. Why then did he create such  poetic metaphors like “being toward death”?  Since Heidegger suffered from a mind disease or mind-death inspired by the Lutheran church, which he was  unable to resist. Despite his ardent belief in phenomenology he could not accept Nietzsche's "God is dead"..

Their cancer is different than mine

The Polyp-Cancer sequence illustrates “their”  reductionistic cancer progression. Cancer starts with an aberration of the cell genome,  called a mutation which transforms a normal cell into a malignant. The aberrant cell multiplies and creates a tumor. The entire cell population continues to mutate acquiring gene mutations which make the tumor more and more aggressive. Additional aberrations enable it to spread all over the body and finally killing it. 

v. Their cancer is different than mine


Yet cancer is more than that. It is a sophisticated Dasein. From its very beginning tumor and WOB maintain a balance. The disease progresses either because the tumor becomes more aggressive  or because WOB weakens. This balance is the essence of cancer as well as of any disease. This is what Dasein is about. It maintains a balance. Treatment may thus be directed either to weaken the tumor or to strengthen Dasein.   Medicine ignores this balance. It equates cancer with the growing tumor  and reduces Dasein to  aberrant genes residing in the genome which it calls the Book of Life.

Emmanuel Lévinas

Dasein’s unconscious

Any symptom in the human or a concept related to it is a doublet. In our case, the unconscious is  {Mind-unconscious, WOB–unconscious}. Freud and Jung deal with mind-unconscious simply because the patient in coma who is mindless, is not bothered neither by  the Oedipus complex, nor by a Jung  archetype.  The Id are WOB messages to the mind, which were Freud’s main concern. These WOB demands which opposed the cultural norm initiated a conflict which Freud tried to resolve.

Jung’s archetypes  are  rooted somewhat deeper than the Id. They are manifestations of instinctive behavioral patterns of live forms which mold the WOB. They operate  also in the patient in coma, yet Jung ignored their contribution to the patient’s health

Freud was a reductionist anxious  to establish psychoanalysis  as a science. Jung was attracted by mysticism, and  the irrational yet did not attempt to harness them during therapy. Yet Dasein is more than that. Prior to usurpation, to ontology, to theoria, to intentionality, Lévinas finds the embodied human.

v. Religion and mind disease
v. WOB and Theology

The Other

The Other is another person in its infinite totality. When the self encounters another person it attempts to absorb the alterity of what it encounters in to the selfs horizon. In its consciousness the other will appear as something foreign, a disequilibrium, beyond principle and volition. Nevertheless  the self  attempts to absorb it. The Other presents himself as a face which hides his unknowable nature, nevertheless it is grasped by the self, otherwise it could not broaden its horizon.

When Lévinas was born his Dasein was a mindless WOB. After crying  briefly the baby encountered its first Other which  had the Face of a mother. For the coming days, mother served as its mind substitute. As the child grew up it absorbed the alterity of its mother and gradually broadened his mind’s   horizon.  Communication between mother’s Dasein and the baby was instinctive and non verbal. Baby and mother are equipped with instincts like, imitation and empathy, which enabled the baby to grasp the Other.

This primordial experience matured later into the philosophical concept of the Other, However we are interested here  mainly in its medical implication. With time the baby met additional Others, who inspired it to stand, walk and talk.  Since birth, the self has absorbed everything it has encountered into the self. Compare this phenomenological description of the growing child with that of Freud who reduced the contribution of the Other to four stages of sexual differentiation.

v. Shamanism

The self is born out of ethical response to the other

When captive in a Nazi camp, Lévinas came to the conclusion about his responsibility to the Other. The ethical demand that emerges from an encounter with the other takes on fuller meaning when contextualized in Lévinas’s understanding of the face of the other as the trace of God’s face.

v. Medicine without ethics
v. Two codes of ethics in medicine

The absolute Other

The unknown, according to Lévinas, is God or the absolute other that is always outside the grasp of the self. The face of the other points to the face of the absolute other. The face of the other acts like an ideatum to the face of the absolute other.  God is part of unknowable aspect of the unknown. This God does not judge human behavior rather the judgment of morality becomes the responsibility of the self in the presence of the other.

There are other timeless and infinite deities, e.g., the Brahman, Spinoza’s God which is the natural world and has no personality. According to the  kabbalah,  the Infinite “bracketed” itself (epoché )(Tsimtsum)  and then created the world.    Lévinas’ God is different.  He does not rule and judge, which seems like a view of an atheist.  Was the observant Jew Lévinas an atheist?” Or perhaps Lévinas  founded a new post-modern religion which was the consequence of   Nietzsche’s “God is dead”.  What matters to me is that Lévinas’ God does not cause mind-diseases.

v. Religion and mind disease

References

Epstein Daniel, Near and Far. Ministry of Defence press. Israel, 2005
Heidegger, Martin. Being and Time translated by John Macquarrie and Edward Robinson Oxford: Blackwell, 1962
Husserl
Edmund, Stanford Encyclopedia of Philosophy. http://plato.stanford.edu/entries/husserl/
Levinas Emmanuel, Totality and Infinity translated by Alphomso Lingis. Duquesne University Press Pittsburgh Pa. 1969

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