Metaphor and the Self: A Role for the Arts in Understanding Suffering and Treating the Person in Distress, Lynn Underwood, International Neuroethics Conference, Brain Matters 3: Values at the Crossroads of Neurology, Psychiatry, and Psychology, October 24-25, 2012
Research shows that the metaphors we use affect our behaviors and attitudes in significant ways. (Holding a cup of hot coffee rather than a cold drink can cause us to have a more friendly attitude towards those we meet; Boroditsky’s work showing how reading about a description of crime as a virus rather than a beast can influence our decisions on the best ways to control the same criminal behaviors.) These effects usually happen implicitly – we are not aware of them. The machine metaphor recurs in our descriptions of the brain and the overall functioning of the body and has become an automatic default. It can be useful in simplifying complex systems, and medical training encourages this. Even efforts to promote humanism in medicine slide in this direction, as communication, empathy and ethical decisions are formulated in mechanistic terms.
This kind of thinking can get in the way when we treat conditions for which no “physical” cause can be found. Self-reports made by the person and their experiences of suffering are essential to the identification of the roots of the problems and opportunities for treatment. However if one buys into the machine metaphor too much, the experience of the person is given less weight in the overall assessment, while objective features such as brain scans, blood chemistry and physiologically evident symptoms are given the final say. Measurements based solely on a machine model lead to interventions that presuppose a kind of person that is incongruous with the way we live our lives, and what is most important to us.
Visual art, film and literature can give insight into the nature of the human person that offers alternative metaphors for the human person, and opens opportunities for creative approaches to treatment and evaluation of outcomes. This presentation would elaborate on those, and give specific examples of how they can help yield more effective treatments and decisionmaking.