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Human science

Human science

by Marshall Scott

Some years ago – at least 20, and possibly more – I attended a conference in Chicago on neuroscience. I don’t remember a whole lot about the conference, but I do remember one thing. The keynote speaker on the first night said something like this: “The goal of the neurosciences is to understand how all human behavior is a function of the biochemistry of the human brain.” Now, I’ll admit that’s not an exact quote; but that is what I remember: “All human behavior is a function of the biochemistry of the human brain.”

That incident returned to me as a read a recent column by David Brooks in the New York Times. In it Brooks writes about the recent publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (known in health care, sometimes affectionately, as DSM V). The gist of Brooks’ column is to note that in fact the categories of the behavioral sciences are not nearly as specific as those of, say, geology or physics. As Brooks put it, “The problem is that the behavioral sciences like psychiatry are not really sciences; they are semi-sciences. The underlying reality they describe is just not as regularized as the underlying reality of, say, a solar system.”

I had my own experience of that in my first clinical pastoral education residency. I was sitting with a psychiatric nurse and he said, “Let me show you something.” He opened up the DSM – I think it was DSM III, with DSM III R (as in Revised) about to come out. He opened to one diagnosis that showed symptoms A, B, C, D, and E. He opened to a second diagnosis that showed the same symptoms, but listed in order of B, A, D, E, and C. Finally, he turned to a third diagnosis that listed the same symptoms as C, B, A, E, and D, and had this footnote: “This diagnosis is appropriate for adults but not for adolescents, for whom these behaviors may be considered normal.” So, I would agree with Brooks that the categories in the behavioral sciences are neither as discreet nor as subject to verification as those of other disciplines.

At the same time, I wouldn’t say that they are not really sciences. First, all these disciplines (and I have my vocation in one of them) are trying to be just that: disciplined about their study of their fields and about their areas of expertise. Chaplains do research, and we have our own studies in which we try to narrow our questions to identify a specific, verifiable, reproducible result. When Brooks writes, “Mental diseases are not really understood the way, say, liver diseases are understood, as a pathology of the body and its tissues and cells,” he is both understating what we do know about, say, brain chemistry, and also, I think, overstating what we know about liver chemistry. He can say, “What psychiatrists call a disease is usually just a label for a group of symptoms;” but that’s also true of a number of conditions that we do not attribute either to brain chemistry or to attitude, like many of the immune disorders. We might know that Symptom A is caused by Biological Change B, and have no idea what has caused Biological Change B – whether the subject is dementia or diabetes.

Indeed, I think Brooks buys too easily into the belief that the “hard sciences” are really all that firm. I would argue (in fact have argued) that the material sciences come again and again to faith statements (have you ever really seen a quark? Or even an electron?) propounded as facts because they make sense in the language of the faith (which is the language of mathematics). Indeed, most folks in those fields admit this. They don’t necessarily use religious language for that, or refer to metaphysics. Instead, they talk about their wonder and the sense of discovery about what they don’t know and want badly to know; and about what they believe to be because it makes sense in light of what they already believe and know, even though they can’t verify it (at all, much less to a lay community).

In any case, Brooks is really positive in his column. The very uncertainty of the behavioral sciences doesn’t discount the importance of the practitioners; it ennobles them: “I just wish they would portray themselves as they really are. Psychiatrists are not heroes of science. They are heroes of uncertainty, using improvisation, knowledge and artistry to improve people’s lives.”

I do, of course, agree with him, and not just about folks in psychiatry and psychology. The same is true of the pastoral care and spiritual direction provided by congregational clergy, chaplains, and volunteers. “They are combining an awareness of common patterns with an acute attention to the specific circumstances of a unique human being.” In my business we call that “studying the living human document” of the person in front of us. It’s also true, really, of “scientific” medicine, whose practitioners also know that each patient is unique. The study of what it means to be human, and the application of that knowledge to benefit specific humans, is an ancient practice that has always sought to organize the process of care in the face of the uncertainty inherent in any human encounter.

Which brings me to the most important thing that I think Brooks has forgotten: that “science” is about knowing; and that different sciences bring to bear different ways of knowing. Some of those are experiential and experimental, even if not terribly sophisticated. You know quickly that poison ivy isn’t good for you, without knowing the specific irritating oils it produces or the particular characteristics of human skin. Some of those are social, and even quite personal – experiential certainly, but not amenable to verification or reproducibility. Some of them are matters of insight, and even – dare I say it? – of revelation! So it is that until the Enlightenment, and for some time after, theology was understood as “queen of the sciences.” That wasn’t to deny the value of examining the material world around us and learning from it. Rather, it was to appreciate that there were other ways of knowing (“sciences”), and that simply appreciating the material wasn’t complete.

And so it is in understanding the human person. We’ve learned a lot since Augustine wrote, “I became a question to myself;” but we haven’t gotten an answer to the question that we could call enough. In an NPR news story also about DSM V the reporter comes back to the observation that “the human brain is the most complicated thing in the universe” (a faith statement if ever I heard one). I would go farther to say that about the human person, which I certainly do not believe is simply encompassed in the biology, or that we will “understand how all human behavior is a function of the biochemistry of the human brain.” In that article, psychiatrist Michael First commented, “When people walk into our offices they come for help, not some explanation of the neurobiology of what’s going on.” The “queen of the sciences,” and the behavioral sciences, and, really, all of the sciences have their uses in that quest: to provide help. Or to paraphrase John 9, it’s not nearly as important to know what caused a condition as it is to reflect God’s activity in the world by responding. Knowing the mechanism may well be useful to that end; but it’s not enough.

The Rev. Marshall Scott is a hospital chaplain in the Diocese of West Missouri. A past president of the Assembly of Episcopal Healthcare Chaplains, and an Associate of the Order of the Holy Cross, he keeps the blog Episcopal Chaplain at the Bedside.

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