One strongly held view is that the mind is an entity distinct from the brain; this speculation has its historical roots: the early theories, termed dualistic hypotheses of the brain function, which stated that the material brain can be viewed mechanistically but that mind is some entity with different and undefined physical character. In such theories the mind was seen as synonymous with the soul, forming an integral part of the prevailing religious culture. For example, René Descartes (1596-1650) the french philosopher, perpetuated Plato's (428-348 B.C.) mind-body dualism philosophically separating the mind and the body (1). He stimulated the debate "How does the non material mind influence the brain and vice versa ?" His ideas permeated philosophical and scientific views right up to the present day, changing the way in which mainstream research approached the problem of self. Since the mind and brain were now usually viewed as isolated entities, research into these areas was inherently separate; biochemists concerned themselves with objective somatic mechanisms, psychologists wrestled with the subjective properties of the mind; philosophers and theologians carried with them the spirit and soul.

Few neuroscientists, such as the Nobel Prize recipient Sir John Eccles, asserted that the mind is distinct from the body, but most of them now believe that all aspects of mind, which are often equated with consciousness, are likely to be explained in a more materialistic way as the behavior of neuronal cells. In the opinion of the famous neurophysiologist José Maria Delgado (5) "it is preferable to consider the mind as a functional entity devoid of metaphysical or religious implications per se and related only to the existence of a brain and to the reception of sensory inputs".

If the brain has explained the mind, how to explain mental events as being caused by the activity of large sets of neural cells? Neuroscientists, timidly, have begun to combat the idea that this question is either purely philosophical or elusive to study experimentally and have been approaching the problem scientifically. They have begun to gain some understanding of possible brain mechanisms that may underlie the most complex process in human behavior and experience, such as the phenomena of consciousness, attention and thought.

Certainly, one of the most remarkable examples to illustrate the relationship between the brain and the consciousness are the findings which state that there seems to be "two brains" in each head (6), that is, each hemisphere (each half of the brain) is anatomically a mirror image of each other, since most structures are present in both sides and they communicate by massive bands of fiber systems. Functionally, however, each hemisphere has its own areas of mental specialization, a phenomenon we call "brain lateralization". For example, the left hemisphere is involved in highly verbal and rational functions, while the right hemisphere is related to artistic and spatio-visual functions. The interconnecting fibers play an important role in coordinating the activities of the hemispheres; their lesion may cause the individual to behave as if the two hemisphere were responsible for two separate consciousnesses, as firstly noted by R. Sperry (who was awarded the Nobel for that). In other words, if the "bridge" between the two hemispheres is destroyed one half of our brain cannot know what the other is doing.

Another significant finding in neurosciences is the correlation of mental events such as learning with chemicals and structural changes of the nerve cells (7). Currently, we know that in our brain new neuronal branches growth in response to environmental and cultural diversity, that is, to training and experience. Each neuron seems to contribute to many behaviors and mental activities. Modern techniques are now beginning to reveal how the brain accomplishes the remarkable feat of learning. Networks of artificial neurons on conventional computers are helping to explain the ability of the brain to process and to retain information. Also, modern cognitive sciences, which use a vast array of new techniques, are being able to study objectively many components of mental process, such as attention, awareness, visual cognition, language, mental imagery, etc., and are being correlated with neural activity by means of computerized functional imaging and are now open to scientific investigation.

Finally, we realize not only the brightness and fascination exerted on us by human mental functions, which is responsible for the creation and evolution of our society, but also by the darkness and despair of mental dysfunctions, which destroy and affect the internal and external environments of the human being. Also in this field, the impressive advances in neuroscience and genetics are revealing the anatomic, biochemical and hereditary bases of schizophrenia, mania, affective and mood disorders, anxiety, intellectual deficits, memory disturbances and many other (8, 9).

In conclusion, more and more we are realizing what so many influential philosophers and theologians of past centuries could not understand: that the brain is complex enough to account for the mysteries of learning, memory, emotion, creativity, consciousness, mystical-religious experience and madness. If we agree to think about the mind as it were a set of mental functions rather than a spirit, soul or immaterial substance, it will becomes easier to get on with the necessary empirical studies and thus substantial progress could be made not only in the search for the nature of man as a cognitive individual, but also in the alleviation of mental ills and in a better understanding of cultural and religious beliefs, which, along so many centuries have brought great pleasures - and afflictions - to Humankind.

We can imagine that the “irrational cognitions” so prized by cognitive therapists may develop on this abnormal, biogenetic substrate, and eventually become woven into the very fabric of the individual’s personality and world-view. Thus, rather than remain ensnared by the terms “mind” or “brain”, we would be better served by what Dr. Dan Stein calls, the “brain-mind.” Indeed, “…the two constructs are, in fact, impossible to disentangle.”5 This is essentially what the philosopher Baruch Spinoza (1632-1677) argued more than three centuries ago: “mind” and “brain” are not two substances, but one—variously understood in “mental” terms for some purposes, and in “physical” terms, for others. And, as Dr. Stein observes, the brain-mind “. . .is not a computational, apart-from-the-world, passive reflector, but rather a thinking-feeling-actor-in-the-world…"5

In short, we cannot afford to view our patients’ afflictions in the balkanized terms of “mental” vs. “physical”, “mind” vs. “body”, “psyche” vs. “soma”. Neither can we afford the luxury of supposing that only one type of treatment—medication or psychotherapy—will be effective for the illnesses we treat. On the contrary, the best available evidence suggests that each modality, or their synergistic combination, may be effective—depending on the specific illness. To be sure, as my colleague, Nassir Ghaemi MD, has cautioned, we must not be drawn into a haze of promiscuous eclecticism in our treatment; rather, we must be guided by well-designed studies and the best available evidence.6 Nonetheless, there is room in our work for both motives and molecules, poetry and pharmacology. The legend of the “chemical imbalance” should be consigned to the dust-bin of ill-informed and malicious caricatures. Psychiatry must now confront the mysteries and miseries of the brain-mind. http://webcache.googleusercontent.co...www.google.com