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Veuillez trouver ci-dessous un compte rendu de l'atelier [MET] Mind/Body (en anglais uniquement) rédigé par Bruno Latour pour l'enquête

We will provide a more complete debriefing of the workshop later, but I have noted here a few elements that might be of interest for the co-inquirers engaged in other workshops and discussions that are part of the AIME inquiry.

The set up was a marvelous example of the totally implausible protocol of AIME: in a circle were assembled a professor of literature and psychoanalyst from UCLA, Janet Hadda; her husband, Allan Tobin, who is a brain scientist and who has directed for many years the brain institute at UCLA; a psychiatrist and psychoanalyst from Toulouse, Jacques Boulanger; an ethno-psychiatrist, Tobie Nathan; a sociologist of music and care, Antoine Hennion; a publisher who has worked for many years on the drug industry, Philippe Pignarre; and the AIME staff including the philosopher Patrice Maniglier and the mediator from Bruxelles, Nicolas Prignot. We were assembled to study the documentation proposed by an equally original group called Dingdingdong (DDD) (http://dingdingdong.org) created by Emilie Hermant and Valérie Pihet to produce knowledge about Huntington's chorea, a rare genetic condition, by starting from the patients’ experience of living with this disease. Every participant had circulated in advance texts they had written to make themselves known to the others.

The knot of the meeting was that Allan Tobin had himself been involved for many years with Huntington's chorea and had already worked with the DDD collective. The protocol was thus ideal for seeing what happens when you try to follow the experience of “having a disease” while trying to avoid the trap of dividing this experience into its “physical” and “psychological” aspects. The effort to escape the MindBody paradigm is especially important for Huntington’s disease because its genetic basis is so clearly “deterministic” and the debilitating effects so apparently inescapable.

It seems impossible at first for psychologists, psychoanalysts and the patients themselves to add more to this genetic “layer” than a merely superficial and secondary “layer” of subjectivity. But the thrust of DDD is to have decided to add not a layer of subjectivity to the medical and genetic “levels”, but to produce knowledge about it, knowledge of direct relevance for the scientists themselves. This was the challenge: in a case where everything tends to direct attention to the MindBody conundrum, how many escape routes there are? Is there a way out of the notion of layers or levels?

Needless to say, we could not reverse the shape of the deep valley — the chreod in Waddington’s work — that usually defines those sorts of debates: inevitably the Master Narrative of MindBody kept recurring as the source of authority. It immediately retranslated what Allan Tobin was saying into the “material dimension” (even though Allan was multiplying alternative paths for what a gene does) or what Tobie Nathan was saying into part of the “psyche” (even though he was talking about elaborate rituals in the South of Italy — centered around the dance and music of Tarentella that offer many alternative paths to understand what it is to be agitated by chorea movements). The Master Narrative uses an ontology that distinguishes “external causes” from “internal causes” and deeply replies on the institutions of psychiatry to deliver a tone of certainty whose function seems to transform the proliferation of alternative paths back into a unidirectional transport of strict necessities (be they from the “material” or from the “psychological” domain). (In the jargon of AIME, [DC] takes over [PRE] as much as [REF]).

In that sense, the workshop was very productive since it was clear that the Master Narrative could not discipline the proliferation of alternative pathways that were overflowing everywhere: Allan Tobin did not fit in the predicted model of the geneticist-and-brain-scientist-who-defines-the-material-world, any more than DDD fits the predicted model of the patient-whose-lived-world-should-be-respected-because-there-is-a-relational-dimension to be taken into account; it was also impossible to fit the intervention of Tobie Nathan on the close relationship of the chorea with the rituals of Tarentella in Italy with anything like the “external causes” of the Master Narrative even though there are a lot of external agents in those rituals (the spiders, the music, the dance, the church, the elders, etc).

In that sense, we confirmed the importance of ontological pluralism and the great virtue of counting beyond two (one, “Mind” and, two, “Body” which, as Allan reminded us, for scientists of a traditional school, always really means that we should count only to one, that is, “Body”). But the multiplicity of alternative pathways was compounded by Philippe Pignarre when he reminded us of the work of Andrew Lakoff [1] and of Sue Estroff [2] : they show that the ways in which drugs function is another shot in the dark, so much so that it is impossible to take “chemical imbalance” as the “material cause” to which the subjectivity of the patients adds whatever dimension they fancy.

The arithmetic of philosophy gets much better when you begin to count beyond two or even three… that’s the whole idea of the Inquiry. Janet Hadda had offered a very moving case of another alternative pathway by commenting on the archives of the hospitalization of the great American poet, Ginsberg [3]. Here it is the hospital itself that has to be added to the life trajectory of what it is to “have a disease” or to “become a great poet”. But where would you fit within the MindBody framework the institution of the hospital as producing a benevolent Umwelt for a tortured young man on his way either to madness or to genius? And where would you fit the spider-carrying-remorse in the dancing ritual of the Tarentella? And, for that matter, where would you fit the dancing workshop in which DDD participates so as to give Huntington patients another trajectory for their “involuntary” gestures, a workshop where the professor of dance says that she has learned from the patients about dance? Allan himself had to recognize in the discussion that the very notion of “involuntary” gestures (patients are said to suffer from “anosognosia”, that is, we assume that they are ignorant of their own condition) is highly disputable.

It became clear in the discussion that there is no resemblance between a narrative in terms of trajectories of successive “transformative relays” (Pignarre’s proposition) and the narrative in terms of “external factors” to which are added “internal factors” where the only acceptable agents are carriers of necessities that simply have to be dosed according to the distribution of causes implied by the psycho-somatic gradient. In other words, the idea of matter, material world, at no point resembles the agents mobilized in the “reductionist” “material” “scientific world view”. Not, mind you, because there would exist another alternative world view that would lead us “beyond objectivity”, but because the “scientific world view” does not pay enough respect to the many ways scientists themselves — when they agree to follow their practice as Allan did — multiply the relays through which genes and neurons acts. Objectivity is a much more complex machinery than “matter” anticipates.

Everything happens as if there were two forms of monism: one is to say that there is only Body (and this is true even of the “Mind”, hence the alternative between “mindlessness and brainlessness” [4]); the other is to say there are only entangled multiplicities of pathways where some segments look like brains, others like rituals, others like institutions, others like organs, and still others like subjectivities. The world is not an onion organized by layers with necessities at the outer and arbitrariness at the innermost level.

What I found most revealing is that even though there is of course no public discourse to capture those entangled nets of alternative pathways (there is no world — no world yet — to keep together the DDD institute, the many conflicting reports of brain scientists, the institutions of psychiatry, the drug, the DSM and the spider-remorse-dance-music-ritual), the Master Narrative of MindBody and its tone of undisputed certainty clearly cuts across those pathways with great violence. So, the diplomatic task of AIME is easier to see: how can we invent a protocol a) first, to resist this violence; b) then, to foster this ontological pluralism; and c) finally, the most difficult, to offer an alternative Master Narrative allowing professionals to register their experience in a way that does justice to this experience.

Bibliography:

[1] Andrew Lakoff. Pharmaceutical Reason: Knowledge and Value in Global Psychiatry. Cambridge: Cambridge University Press, 2006.

[2] Sue Estroff. Le labyrinthe de la folie. Ethnographie de la psychiatrie en milieu ouvert et de la réinsertion. Paris: Les Empêcheurs de penser en rond, 1998.

[3] Janet Hadda Ginsberg in Hospital American Imago, Volume 65, Number 2, Summer 2008, pp. 229-259.

[4] Leon Eisenberg « American psychiatry has moved from a state of brainlessness to a state of mindlessness in the 20th century » Marcia Angell, « The illusions of psychiatry », The New York Review of Books, July 14th, 2011.

(Thanks Michael Flowers for proofreading this text)