FUCHS / MIND, MEANING, AND THE BRAIN ■ 261 © 2003 by The Johns Hopkins University Press Thomas Fuchs, MD, PhD Mind, Meaning, and the Brain KEYWORDS: Mind, brain, meaning, translation, depres- sion. A Systemic View of the Mind P ROGRESS IN BRAIN RESEARCH over the past two decades demonstrates the power of the neurobiological paradigm. However, this progress is connected with a restricted field of vision typical of any scientific paradigm. The psychiatrist should be aware of this restriction, because, unlike the brain scientist, he deals with patients, not with brains. The restricted view may be described by the terms of (1) reduction- ism, (2) reification, and (3) isolation. Reductionism: Neurobiology tends to regard sub- jectivity as a mere by-product of the brain’s ac- tivity as a symbol-manipulating machine or an information processor. Consciousness becomes an epiphenomon of the neuronal machinery that, operating behind our back, creates the illusion of a continuous self and of an autonomous will (Churchland 1995; Roth 1996). Reification: Mental or subjective states seem to be localizable in the brain; thoughts or feelings, it appears, may be observed in the colored illu- mination of cortical and subcortical structures. This results in the belief that brain images could also show the cause of a mental illness, or even the illness itself, which then manifests, for in- stance, in a reduced metabolic activity in certain areas of the cortex. Isolation: As a further consequence, this view isolates the individual patient and considers his illness separated from the interconnections with his environment. However, on these interconnec- tions his personal experiences and dispositions are founded, and it is the actual interpersonal situation that has triggered his present illness. Walter Glannon’s paper successfully counters these tendencies toward a neurobiological reduc- tionism with an extended view of the mind: “ . . . the mind is not located in any one place but is distributed among the brain, the body, and the environment.” Of course, who observes some- one’s brain will never see his thoughts, his pain, or his anxiety. For consciousness is not a localiz- able object or state at all but a process of relating to something: a perceiving of, remembering of , wishing for, aiming at, and so on. Thus on the phenomenological level, there is nothing like a “mental event” that could be isolated from the world and from the stream of conscious experi- ences. The mind exists only embedded in the world and in the temporal process of life. The same applies to the biological level: Con- sciousness is based on the continuous interaction of the brain with the organism, and of the organ- ism as a whole with the environment. The role of the brain for mental phenomena is thus compa- rable to the role of the heart in the circulatory system or of the lung in the respiratory system. Of course, the lung is the central organ of breath- ing, but respiration may not be restricted to the