于香港回归十年时上路

背景音乐:Linkin Park -Hands Held High
不可侥幸,必须死扛~~
死心,铁心,横心,
上路,上路,加速度!
这次上路,还有退路么?
已被很多人问将来想做什么,父母,朋友,工友…一直躲躲闪闪,回答过很多不同的版本,一是因为真的搞不清楚自己喜欢的是否可以当作职业,二是心虚,无论是坦白或学习这个,都需要勇气,自信,毅力以及强悍的情绪驾驭能力。
在经过一年的摸索后,我对神经心理学的兴趣已经被主观判断(若干职业及人格量表)及客观事实(大一GPA)证实,除了情绪自控力有待考证和提升,未来的几个选项已经敲定。不打算隐瞒什么了,因为老娘打算用这篇日志铭志,有一些选项父母知道,当年要么以为我开玩笑,要么表示不屑或不赞同。在征得“你自己对自己负责”的默许后,我打算试一试,做一个完全个人的决定,本科神经心理学不影响研究生时改行学管理,但是我还是想在医学的路上留下几个脚印,如果不幸深陷泥沼,再向爸寻求帮助改行,家族的长项失传是件可惜的事,但是年轻的时候没去尝试走自己的路更遗憾。我的志愿分三个等级:由高(难)到低(易):脑神经外科医生(Neurosurgeon),精神分析师(Psychiatrist),临床心理学家(Clinical Psychologist),前两个选项须考入Medical School,如果失败,则考Graduate School 完成第三选项。前两个选项要求本科对药学有一定基础,因此有必要Take another major in Pharmocology or Biochemistry.此外,后两个选项对语言要求很高,这是目前老娘最头疼的问题,在经过和老外一年“同居”的宿舍生活和四个月“同工”的生活后,我发现人性和基本价值观是不以地域和文化转移的,个人的人种及人群分类能力有显著提高。文化常识可以经由Social Science和Humanity的选修课补充(我要把它们当成主修来对待)。
本科主修将集中在Neuroscience脑神经科学(兴趣:老年Alzheimer’s老年痴呆,Parkinson帕金森,幼年:Autism孤独症),
支撑课程:Biology,Biochemistry,Physiology,Philosophy,Statistics,Anthropology,Religion Study 核心分支为:临床心理学(Affective Disorder抑郁症),精神病学(Schizophrenia精神分裂症,MPD多重人格障碍),犯罪心理学(Substance Abuse成瘾机制,Antisocial Personality反社会人格),性心理学(Sexuality Mental Maladjustment 性心理障碍;Homosexuality同性恋).
 
节节攀升的Alzheimer,抑郁症,精神分裂症病发率是老龄化,转型期,高压社会的注脚,不仅仅是中国,全球范围内,患者比例在攀升,在科技进步使生理健康得到巨大改善后,心理健康水平反而在下降,也因此将越来越受到重视,未来战争的致命手段将包括生化辅助的心理战….
 
中国80后生人,是转折的一代,也是面临风险的一代….
 
老娘是其中的一员,如果回国发展,从现在起要时刻关注国内的新闻和同辈人的生活。
最好的结果是留在美国,这样,语言和文化的学习需要细水长流,关注当地华人社区的现状,在保证学习成绩的前提下,参与志愿服务,或打工,接触不同层次背景的人,从直观上理解人与人之间的冲突,人自身及社会内部的矛盾。
 
此外,把自己当成病人,学会自救,形成长期稳定的自纠机制,提高情绪管理能力。
培养自己的“灵性”:除了注意饮食,坚持静坐,瑜伽,了解世界三大宗教的教义典故(有助于对精神分析学的理解和应用),关键是保持一颗平常心以及童心。
多认识快乐搞笑的人,多看喜剧笑话,提升幽默感,多微笑,每天从自己的生活里挖掘笑料。
选择一个专/职业很多时候就是选择一种生活方式,所以试着将专业学习和个人生活联系起来,不管最后的结果是什么,希望本科对神经心理的学习能对个人的生活方式会产生良好而长远的影响。
 
给自己的预防针:路漫漫,黑暗期会时常出现,给自己一个安慰————久病成医,如果你不亲身体会痛苦,将来如何理解别人的痛苦…
还有,淡化自我内向投射,学会求助,增强与外界的沟通,适可而止,别把自己搞变态了(精神科大夫就住在精神病人的隔壁….)
 
不管发生什么,请保持一颗平常心和童心.
 
07/01/2007  萧于香港回归十年时上路…
 
 
 
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Cognition of a Street by Normal People

The picture of the street in reality

Cognition of the street by a patient suffering Schizophrenia

 

 

 

Schizophrenia, Cognition, Bats, and Limitation      

Introduction

  Consciousness has been defined as a kind of self awareness; the knowledge that we exist, and the ability to understand reality (even philosophize it). When pondering the validity of his own existence, Descartes reach the conclusion: cogito ergo sum: I think therefore I am. Even if there was some being controlling his body and there was no reality, by thinking he must exist. This is ray of light we are given by consciousness. Ultimately, consciousness does give us more than proof of existence. It gives the ability to rationalize and make sense of our existence and our reality.

As much strength as consciousness gives us it is still dependant on the mind, which is vulnerable its many inherent weaknesses. The human mind is as fragile as porcelain, susceptible to being shattered by bad luck or having its weaker parts chipped with just a slight of hand. Injury and stroke can have a shattering effect to the mind, resulting in severe changes of personality, loss of mental functions and  behaviors, and even death. Just like the thin rim of a cup is at risk to chipping, the mind has its own frailties. Genetic predisposition coupled with environmental influences (such as stress) can cause deterioration of the brain or onset of mental diseases. In addition to being fragile, the mind is also as intricate as knitted scarf with everything connected. Such as a scarf coming apart from a tear in the yarn, deterioration of a lower level process can block higher related processes. In the psychological disorder schizophrenia, consciousness and many cognitive processes are in jeopardy  when structure and function of the brain is altered. Implications of these cognitive effects in schizophrenic patients challenge and expand many of the currently held dogmas relating to the mind. Also studies of schizophrenia can lead to clearer recognition of the scientific limitations in understanding and treating schizophrenia, and the boundaries of human ability in conceptualizing mentality.  

Defining Schizophrenia (brief overview)  

Symptoms of schizophrenia are debilitating to patients, especially when left untreated. Schizophrenia is known to have both positive and negative symptoms, positive pertaining to abnormal added behaviors and negative being the loss of innately human behaviors and mind states. Positive symptoms may include hallucinations (visual and auditory), racing thoughts, paranoia, and delusions (Finlay, 2002). Negative symptoms consist of apathy, dysfunctional/deficient social behavior (including inadequate hygiene and poor social interaction), loss of emotion, and loss of working memory (Finlay, 2002). This disease is spread across all humans regardless of sex or culture, actually affecting 1% of the global population. This indicates the very essence the human mind, its functionality, and weaknesses are what have brought about the disease.  Although schizophrenia is widespread, there is a genetic predisposition towards the disease, with environmental influences often bringing about the disease from the predisposition (Finlay, 2002). Two such environmental influences that can trigger schizophrenia or worsen schizophrenia include stress and recreational drug use (Finlay, 2002). Acute (sudden) or insidious (slow) onset of schizophrenia typically occurs in the patients?adolescence or early adulthood (Finlay, 2002). Schizophrenia, like many other biologically based diseases causes structural and functional changes within the body, specifically the brain (Finlay, 2002). 

 

Qualia of Schizophrenia  

One of the essential ideas brought across in cognitive science is that we only can only know what is in our own head. To deduce anything about another persons mind we must observe his behavior. Then we try to recall or empathize our own mind state when we behave in a similar way. In truth, this has gotten humans far when it comes to understanding each other, but it is not without limitations. In the paper 揈piphenomenal Qualia? author Frank Jackson describes an individual (Fred) who can discriminate a shade of red unperceivable to any other human. This different shade of red is actually a color with its own intrinsic properties, so Fred can identify it under any circumstance and sensitive tests of the light spectrum (Jackson, 1982). Jackson argues that seeing this red is a result of our senses and therefore there is a unique feeling or state associated with this specific red. Qualia, being a product of the senses, has an associated feeling or brain state to the experience independent from behavior (Jackson, 1982).

Qualia is further expanded in the paper, What is it like to be a bat??by Thomas Nagel. In this paper Nagel argues we currently have no real idea of a rationalization of the  physical nature of a mental phenomenon. Nagel continues his argument stating that humans can relate to conscious organisms because humans understand something it is like to be that organism? In the case of bats there is something it is like to be the bat. An example of this is that bats uniquely sense the external world with sonar or echolocation (Nagel, 1974). So there is this unique mental state of echolocation for viewing the world (Nagel, 1974). Thus we can infer that there is a qualia unique to being a bat as opposed to being a human.

Given a bat is a completely different species with a very differently wired brain,  there is a large qualia gap between bats and humans, in comparison to the qualia gap between schizophrenics and non-schizophrenics. With different levels of qualia there will be some shared between patients and non-patients. With 1% of the population affected by schizophrenia (Finlay, 2002), one can infer that the characteristic of the disease (at a smaller level) is advantageous to humans existence and some extent of the mind states are shared. For example, a slight fear of the dark may have prevented deaths of our ancient ancestors so the trait of dark phobia was naturally selected. Phenotypes, varying degrees of a trait, have curved data and variance statistics. Unfortunately, outliers of character expression can be so severe that advantages shift to disadvantages, slight fear to paranoia for example. So, one can argue that there is some sharing of the qualia ranging from fear to paranoia. However, just as we cannot know what it is like for a bat to be a bat, we as non-schizophrenics cannot know the full extent of what it is like to be schizophrenic. We must imagine the extrapolation of fear to try to feel paranoia without having experienced it ourselves, and those imaginations are definitely limited by awareness. Thus schizophrenia has qualia that cannot be entirely felt without the structural and functional changes intrinsic to the disease.  

Cases of Schizophrenia  

Schizophrenia has the qualia of altering the perception of consciousness and reality. Consider these three peoples experiences of schizophrenic episodes:  

Snyder’s account:

            His onset was insidious, beginning with grandiose thoughts similar to that of the movie ?(Snyder, 2006). Snyder believed he could derive the fundamentals of fractals to get a unifying math theory and became so obsessed with the idea he was unable to continue college (Snyder, 2006). As years passed his schizophrenia progressed from slight paranoid acts, bolting doors of the house to keep out murderers, to becoming convinced that people were constantly watching him (Snyder, 2006). Eventually this delusion progress to the point in which he believed there was a group of watchers dedicated to observing everything (Snyder, 2006), These watchers where spying on him, not only from all public places, but also from every security camera (Snyder, 2006). It reached the point where Snyder believed they were responsible for all his external hardship (e.g. parking tickets) (Snyder, 2006).  

Stefanidis’s account:

            Erin Stefanidis, ironically, was a graduate student in a neuroscience program when schizophrenia hit her (Stefanidis, 2006). Despite all her education relating to the mind she was unable to rationalize herself away from her skewed reality of schizophrenia (Stefanidis, 2006). Instead of rationalizing the truth she rationalized how the delusions could be true, even using neurology to justify them (Stefanidis, 2006). She received her voice hallucination from the Deep Meaning?who convinced her that rats were in her head gnawing at her occipital lobe (Stefanidis, 2006). Given her studies she knew if this was true she would lose her vision so she rationalized that she was regenerating the neurons and their connections (Stefanidis, 2006). As her schizophrenia progressed she became convinced her neighbor spied on her, then broke into her house and implanted a tracking device in her stomach (Stefanidis, 2006). To rationalize that there was no evidence of a break-in, and no marks of an incision on her stomach, she concluded her neighbor and the tracking device were atomized (Stefanidis, 2006). Atomized, as she defined it, is when each of the atoms composing her neighbor and the device can be dissembled, brought through the barrier (either the house or her stomach), and then reassembled (Stefanidis, 2006).  

Cruickshank’s account:

            Andrew had the delusion that his wife was a cop trying to frame him (Cruickshank, 2006). This delusions put him in a mental hospital because it put his wife and son at risk (Cruickshank, 2006). After hospitalization, his wife divorced him, he did not receive custody of his son, and he was put on medication (Cruickshank, 2006). With everything combine he went into depression, After nearly a year of feeling lifeless and sleeping most of the time he decided to stop taking his medication and within 4 months the murmurs of voices began (Cruickshank, 2006). Within a few months he was convinced cameras were in his eyes, crows were sent as spies, and his son might be a borg? If his son was not a borg, then a friend was actually the father (at which point he gave his friend a death threat over the phone), and everyone close to him was involved in the conspiracy to frame him for several terrible crimes (rape, murder, pedophilia) (Cruickshank, 2006).

 

            Clearly one can argue for these patients there is something like being what they are, feeling the way they feel. In other words there is a qualia of incorrectly believing one is constantly being watched, that rats are inside ones mind gnawing at neurons, or that there are cameras inserting within ones eye that a group of people monitor. This paranoid irrational qualia of schizophrenia cannot be experience in the non-patients. For feelings and beliefs such as the ones experienced by schizophrenics, mental states must exist that account for the qualia. Since mental states reside within the brain, changes to the brain changes the nature of the qualia. Given specific external input, there are many changes seen in the brains of schizophrenics.

Numerous changes in the brain of schizophrenics has been observed in scientific research. One such change is that there has been sufficient and significant evidence to infer the medial temporal lobe (believe to be responsible for episodic or declarative memory) is actually smaller in schizophrenics than the non-schizophrenic population (Sim, 2006). Further studies suggest that the positive affects of schizophrenia, the active psychosis, cause the release of neurotoxins in the brain, leading to neuron deterioration (McGlaushan, 2006). Similar to Alzheimer抯 disease or syphilis, postmortem investigation shows neuronal death in schizophrenics and a decrease of synaptic connections (McGlaushan, 2006). With deficits such as those listed it can be safely stated that the mind of a schizophrenic is vastly different.

Since the mind of a schizophrenic is different we can make inferences about the qualia of schizophrenic versus non-patient. Given significantly different brains it can be inferred that a schizophrenics mind states are also different. Assuming mind states are different, then qualia is unique for the schizophrenic and the non-patient. Thus an individual with a non-schizophrenic mind do not even have the necessary tools to experience the qualia of a schizophrenic mind. As Nagel said, yet if I try to imagine this, I am restricted to the resources of my own mind, and those are inadequate to the task?(Nagel, 1974).

            Restrictions pertaining to our ability to fully experience qualia of brain states other than our own lead to an understanding of the limit of our scientific knowledge. No amounts of words can lead humans to the qualia of being a bat (Nagel, 1974). Similarly no amount of qualia can lead a person with non-schizophrenic mind to understand the qualia of what is like to interpret the world with a schizophrenic viewpoint. Experiencing a camera coming from your eyes is quite different than  imagining. Personally speaking, I have always thought with my neurological education something such as schizophrenia would not be accepted by my rational mind. However, after reading Erin Stefanidis’s case clearly I was wrong further proving that one cannot know a schizophrenic mind state or qualia without having the mind state themselves. Based off similar conclusion, Nagel brings up the point that currently there are limitations to our mind, one of which is the qualia of another person. Building off this idea, qualia is not something we are able to break down into its fundamental parts and because we are unable to do that we are limited to treatment as a hit and miss situation.   

Conclusions

As stated in the beginning, humans have been given the gift of consciousness and cognition. However underlying this gift is the mind which is as fragile as a porcelain cup and as intricate as  a knitted scarf. Injury, stroke, neurochemistry can all cause damage to the mind. With processes of the mind relying on one another damage to one part can cause a chain of detriment to the other brain processes. Schizophrenia is one of the ways the delicate balance of consciousness, cognition, and the mind can be broken. Schizophrenia leaves its victims with altered mind states disconnecting them from reality with hallucinations, delusions, loss of emotion, and loss of memory.

Altered states of the mind lead to different qualias of which are unexplainable and can only be understood by actually experiencing them. This limits our ability to scientifically dissect cognition, qualia, and consciousness. Furthermore we do not have all the tools to properly treat the test. For example, we use fMRIs to diagnose patients fairly efficiently. But understanding the readings like the one at the top of the page is like trying to understand humans from satellite images of the lights on earth taken in the night time by satellite. We can see the big cities and large roads however we cannot see all the small equally important towns and small roads. Instead we are left relying on more of a hit and miss approach leaving many patients suffering symptoms of trail and error diagnoses. Cognition is a gift however many aspects of this gift remain a mystery. 

 References

 Cruickshank, Andrew. (2006) Dairy of a Paranoid Schizophrenic. Schizophrenia Bulletin.

Vol. 32. No. 4. p 614-15.

Finlay, Janet. (2002). Schizophrenia. Research Channel. University of Washington.

http://www.researchchannel.org/prog/displayevent.aspx?rID=3195*

Jackson, Frank. (1982). Epiphenomenal Qualia. The Philosophy Quarterly. Vol. 32, No.

127. p 127- 136.

McGlashan, T. Is Active Psychosis Neurotoxin? Schizophrenia Bulletin. Vol. 32 No. 4 p.

609-613.

Nagel, Thomas. (1974). What is it like to be a bat? The Philosophical Review. Vol. 83.

No. 4. p 435-450.

Sim, K, et al. (2006). Hippocampal and Parahippocampal Volumes in Schizophrenia: A

Structure MRI Study. Schizophrenia Bulletin. Vol. 23. No. 2. p 332-340.

Snyder, Kurt. (2006). Kurt Snyder抯 Personal Experience with Schizophrenia.

Schizophrenia Bulletin. Vol. 32. No. 2. p 209-211

Stefanidis, Erin. (2006). Being Rational. Schizophrenia Bulletin. Vol. 32. No. 3. p 422-

423

 

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5 comments
  1. Jing said:

    年轻的时候没去尝试走自己的路更遗憾这句话说的太好了!

  2. Ares said:

    决定了?  那恭喜了。    走出自己的人生!

  3. Stephanie囧囧 said:

    To Ares & Jingjing: 谢谢….:)

  4. Nan said:

    加油!!!
    能够做自己想做的事情是最幸福的^^

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