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moment's notice. The discrepancy between the sphere of our subjective images and that of our objective observation involves no conflict because the line drawn between them is one that is generally accepted by us all. And so we pass easily from one mode to the other and express views in the street which would be wholly inappropriate to the laboratory, while in the laboratory we express views which would be quite ridiculous if introduced into the casual contacts habitual to the man of the street.
In our customary observations of the phenomena that comprise the outlying universe, there has been no need to take account of these subjective and habitual modes of thinking. As such casual modes are lacking in personal affective colouring, they have in no way interfered with our objective scientific evaluations, and the use of these parallel but contradictory modes of thought is rendered entirely legitimate in virtue of the social consensus by which they are universally endorsed. When we come to the subjective field of observation, however, the situation is completely reversed. For here our habitual, uncodified processes of experience with all their image-subjectivity become the materials of what is now our objective inquiry.
We all know too well to what extent our habitual and subjective views tend to cloud our perspective with respect to conditions that are personal and internal to our own lives. Such subjective images crowd upon us from every side. They are present in the prejudices of family interest, in our zeal for personal success, in the ever-pressing necessities of self-maintenance and the maintenance of one's family or kin, in the requirements of social approbation or professional recognition, in our obligations of private rectitude and external decorum. In these and a thousand similar acceptations belonging to our casual mood-life there exist subjective social images which exert a constant bias upon our clear observation of the native and inherent life of man's organism. When we come to an objective study of these casual processes our observation becomes seriously confused. The reason is that these processes may now no longer exist within the subject side by side with his accustomed outlook, but they must now be ranged in front of him where they take their place among the objective materials of scientific investigation. And so, in order to observe such factors in our mental life, it is required that we hold them off sufficiently far to view them in their objective delineation apart from our habitual, subjective interpretation of them.
In studying the materials of psychiatry or the elements of man's own personality we are confronted with the sensations, reactions and impressions that belong to this subjective, uncodified realm of his experi
ence. In dealing with these, his own subjective processes, man's thought is obstructed by a very serious impasse if he fails to discriminate between his mode of subjective images or uncodified experience and the mode that is dependent upon the ascertained sequences of observable phenomena. Feelings which are habitually subjective or personal within us as a casual daily experience must become the external objective materials of a correlated scientific inquiry. The mode which we have lived by in our casual conventional experience must now become systematized among the materials of conscious laboratory recognition.
It is presumed that psychiatry confronts this subjective and habitual mode of man's experience, but in point of fact it does nothing of the kind. For psychiatrists and psychoanalysts are, through their own subjective images, necessarily implicated in this widespread social involvement. As part of a social scheme that unconsciously maintains this subjective image-outlook, psychiatry itself is necessarily too involved in these subjective moods to bring to their contemplation a truly objective observation of them.
In the following pages I should like to indicate in what way it seems to me that psychiatry, in unconsciously fostering the mood level belong ing to man's casual and uncodified experience, lacks an objective criterion and in what way this need may be fulfilled. I should like to make clear, if I can, that the subjective states comprising the materials of psychiatry are not as yet amenable to scientific procedure because of the absence among psychiatrists of the organized principles of observation such as ordinarily govern scientific observers in estimating the data before them1.
The accuracy of all observation rests upon the existence, among the several observers, of a common accord of sense perceptions that affords them an accepted basis of evaluation. This biological unanimity has been an organic condition of man's evolution. Such an organic agreement is so commonplace and automatic a condition of actual daily practice as not to have acquired the outline of conscious definition. This common neural basis of our human reactions resides in a physiological identity of perception that unites the sense organs of each observer with every other. This neural substrate obtaining among the different observers affords them a basis of perception that is organically continuous throughout the species. It affords us a typical or common basis for the reception of common and typical stimuli.
1 See White, William A., "The Comparative Method in Psychiatry," The Journal of Nervous and Mental Diseases, 1925, LXI. 1.
To describe a substance as large or small, smooth or rough, motile or inert, to record its reaction to heat or to light, to note its chemical or physiological structure-all involves a process that is dependent upon an established agreement among the perceptual sensations and reactions common to different observers of it. No arbitrary and casual mood element enters in to distort the unerring sequences of objective observation.
These features of agreement among the sense perceptions of men have, through the accumulated experience of thousands of years, grown to be enormously complex and of exquisite delicacy of discrimination. Through the development of verbal symbols or language the most sensitive shades of meaning have their mental or social correspondence among millions of the same people and, through their linguistic equivalents, even among millions of different peoples. So that it would seem that the authenticity of man's impressions is based upon a biological neuro-social continuum effected through the phylogenetic concurrence mentally among the various elements or individuals composing the receptive background for such impressions.
I think we have quite failed to consider the significance of this organic consensual factor in reckoning our human values. We have failed to recognize how completely dependent we are upon this element of accord for the substantiation of even the most insignificant of our judgments. This consensual generic requisite for the correlating of the data of observation is an ethnic condition upon which we are constantly dependent. But, as I have said, we have not as yet thought about it because we have not as yet been required to think about it. This organic code has been too close to the practical processes of our daily living to have acquired for us as a people the distinction of conscious stabilized recognition.
It is the function of science to make conscious use of these consensual terms of agreement with a view to securing conditions for accurate observation. Science, as I have said, has consistently employed this consensual basis of agreement in estimating external objective conditions. For these external conditions have in no way conflicted with the private subjective prejudices of the scientist. The astronomer may observe the stars without jeopardy to his daily subjective prejudices. But with psychiatry the situation is quite different. It is precisely the subjective prejudices of our daily living that are the objective scientific data of psychiatry. My position is that in the absence of the stabilized recognition of these subjective processes through a consensual agreement in terms, psychiatry has neglected an essential condition of scientific
observation. It needs to be recognized that through the omission of this consensual factor of observation there has grown up, quite without our awareness of it, a definite category of phenomena that has entirely escaped conscious recognition and tabulation as the materials of an objective science. These materials are no other than the uncodified mental states comprising our own habitual and subjective modes of experience. Accordingly, if we are to establish a scientific approach to these processes, it is required that we raise them to the level of conscious stabilized recognition.
Psychiatry comprises the observation and correlation of the mental reactions occurring within the individual. These are its objective materials. Among these materials may be reckoned the individual's thought and his way of feeling in response to this or that condition of stimulation. We must count among them what is called the individual's habit of life and its relation to the habits of others about him. With Freud we have studied mental fixations, sex obsessions, divided states of the personality and the hundreds of subjective symptoms included under our wide range of psychic disease entities, such as hysteria, psychasthenia, schizophrenia, paranoia, and many others. But from the point of view of observation in regard to these subjective reactions of the individual, the method of psychiatry is not objective because it lacks a basis of perceptual consistency or consensual observation.
In our relation to the external world, because of the common neural substrate uniting our individual perceptions, an object is not rough or smooth or brown until these words or symbols have attained a common neuro-social agreement among the several observers of it. An organic consensus of visual, tactile and other sense perceptions, together with a consensus of terminology, is requisite to my description of any object before me. In other words, there are organic conditions of agreement. which are an indispensable part of my so-called objective determinations. Likewise, the mental state of a patient-be it fear, hate, anger, deception, infantile coquetry or what-not-does not become an objective mental state except as these words or symbols stimulate an equally organic concurrence among the several observers of such states. Just as in the outlying universe there is an organic concurrence of perception with its concomitant symbol equivalents, so within the universe of man's internal mood there is required concomitantly an organic concurrence of feeling with its corresponding concurrence of symbol equivalents. In other words, there cannot be a common organic accord in regard to subjective mental states of the individual in the absence of conscious, stabilized recognition
of these subjective states as they exist socially in the several observers of them.
The process by which we attain to conscious stabilized recognition is a social one. It is due to this social process that certain objective stimuli become registered as entities in our common experience as, for example, the sensation registered under the consensual symbol 'red' or 'dull1.' The same social process or agreement in terms is equally indispensable for the conscious registering of sensations that are the expression of man's emotional experience, for example, the sensation verbally symbolized as 'love' or 'hate.' Accordingly, only the social process of a consensual symbol experience can raise such emotional states to the level of conscious stabilized recognition. The emotional state which, under the routine of clinical description, we have been accustomed to regard as an isolated manifestation occurring in the reaction of the patient before us, but supposedly existing quite outside ourselves, becomes under the routine of consensual laboratory observation an emotional state shared in common by the several laboratory observers. Thus, through the operation of such a social process, the patient is provided with the consensual subjective symbols which lift his experience to the sphere of conscious stabilized recognition and give to his subjective emotions the outline of objective definition. Where our personal emotions are regarded only in isolation there is excluded the social process that makes possible their stabilized recognition. The purpose of the scientific laboratory the world over is but the stabilization of the processes of recognition through the conscious use of this consensual factor of a common symbol agreement.
If, as psychoanalysis demonstrates, an individual through a neurosis or a dissociation remains clinging to his mother, it means that emotionally he has withdrawn from the natural neuro-social bond uniting him with his fellows and he therefore becomes an object standing opposite to and withdrawn from his social medium. If his social fellows are not to corroborate his dissociated state through a like discontinuity of their own, their only recourse is to observe his reactions as objects apart from their own. In this recourse lies the only opportunity for the individual's self-recovery. But the scientific recognition of such a dissociated objective condition requires as definite a social consensus or symbol concurrence as the observation of the objects in the outlying universe.
1 "The Meaning of the Psychic Factor," paper by the author, read at the Fourth Annual Meeting of the American Psycho-pathological Association, May 8, 1913. Published in The Journal of Abnormal Psychology, Dec. 1913-Jan. 1914.