The Trilingual Perspective of Treatment

Human Culture Phase Sequence

PSYCHOTHERAPY APPROACH

NEUROBIOLOGICAL APPROACH

Complex assembly

Assemblies of assemblies of assemblies

Assemblies of assemblies

Assembly of neurons

Neuron

• Modify context of value system(s) by introducing other "coordinates" [perspectives] and other "attractors [as counter transference]

• Continue the recategorization process until the contextual changes in the value system(s) become solidly affirmed.

• Modify synaptic connectivity of value system's; the chemical constraints will hopefully have the greatest effect at the level of the circuitry most out of balance.

• Continue the pharmacotherapy until new metastable synaptic organizations may have the chance to affirm themselves over the dysfunctional ones.

Neuron

Nerve impulse

Nerve membrane

Membrane protein

Chemistry

Pharmacotherapy and psychotherapy represent legitimate options, NOT mutually exclusive, operative at different levels of the hierarchy's dynamics.

Pharmacotherapy targets the lower levels of the cognitive hierarchy (represented at the center of the figure), specifically the processes at the level of the membrane structures (receptor sites). These chemical modifications exert a ‘bottom-up” diffuse effect upon the upper levels of the hierarchy, inclusive of – but not limited to – the assemblies responsible for symptom formation. It is questionable if these changes affect in any intrinsic way the organization of the pathological value system, but they might diminish its influence and allow for the dynamic operation of other organizing value systems. At these higher levels of the hierarchy psychotherapy could represent a significant complementation.

Psychotherapy targets the pathological attractors; it expresses them into consciousness and disconnects or modifies their affective loading; it also counteracts them by emphasizing other, more adaptive value systems that have been shadowed by the maladaptive ones. In this way it exercise a “top-down” focused effect upon the activation of specific assemblies of assemblies, and assemblies of cells, modifying their Hebbian linkages. It is questionable if these changes affect in any intrinsic way the organization of some basic metastable neuronal circuits, now operating in a way reminiscent of Edelman’s routines and subroutines, which might explain the persistence of low-level symptoms. At these lower levels of the hierarchy pharmacotherapy could represent a significant complementation.

Other Illustrations:

The Three Main Libraries of Knowledge

The Psychological Phase-Space

The Pathological Attractor System

The Disease Illness Spectrum

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