Jeffrey M. Schwartz

Obsessive-compulsive disorder is a commonly occurring neuropsychiatric condition characterized by bothersome intrusive thoughts and urges that frequently lead to repetitive dysfunctional behaviours such as excessive handwashing. There are well-documented alterations in cerebral function which appear to be closely related to the manifestation of these symptoms. Controlled studies of cognitive-behavioural therapy techniques utilizing the active refocusing of attention away from the intrusive phenomena of OCD and onto adaptive alternative activities have demonstrated both significant improvements in clinical symptoms and systematic changes in the pathological brain circuitry associated with them. Careful investigation of the relationships between the experiential and putative neurophysiological processes involved in these changes can offer useful insights into volitional aspects of cerebral function

Neuropsychological research on the neural basis of behaviour generally posits that brain mechanisms will ultimately suffice to explain all psychologically described phenomena. This assumption stems from the idea that the brain is made up entirely of material particles and fields, and that all causal mechanisms relevant to neuroscience can therefore be formulated solely in terms of properties of these elements. Thus, terms having intrinsic mentalistic and/or experiential content (e.g. ‘feeling’, ‘knowing’ and ‘effort’) are not included as primary causal factors. This theoretical restriction is motivated primarily by ideas about the natural world that have been known to be fundamentally incorrect for more than three-quarters of a century. Contemporary basic physical theory differs profoundly from classic physics on the important matter of how the consciousness of human agents enters into the structure of empirical phenomena. The new principles contradict the older idea that local mechanical processes alone can account for the structure of all observed empirical data. Contemporary physical theory brings directly and irreducibly into the overall causal structure certain psychologically described choices made by human agents about how they will act. This key development in basic physical theory is applicable to neuroscience, and it provides neuroscientists and psychologists with an alternative conceptual framework for describing neural processes. Indeed, owing to certain structural features of ion channels critical to synaptic function, contemporary physical theory must in principle be used when analysing human brain dynamics. The new framework, unlike its classic-physics-based predecessor, is erected directly upon, and is compatible with, the prevailing principles of physics. It is able to represent more adequately than classic concepts the neuroplastic mechanisms relevant to the growing number of empirical studies of the capacity of directed attention and mental effort to systematically alter brain function..

APPENDIX: The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro-dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower-level and a higher-level mechanism. The clinical treatment has, when successful, an activating effect on the higher-level mechanism, and a suppressive effect on the lower-level one.

In this paper we discuss the two-system framework, examine its strengths, point out a fundamental weakness concerning the unity of conscious experience, and then propose a new hypothesis that avoids that weakness and other related concerns. According to our strong emergence hypothesis, what emerges are not merely mental properties in specialized, distributed neural areas, but also a new, irreducibly singular entity that functions in a recurrent manner to integrate its mental properties and to rewire its brain. We argue that the former function is suggested, in part, by the effects of anesthetics on sensory integration, and that the latter function is suggested by evidence garnered from the neuroscience of mindfulness, constraint-induced movement therapy for stroke, and neuroimaging data surrounding mental illness. We then discuss how our strong emergence hypothesis relates to the description and treatment of neuropsychiatric disorders. Finally, potential objections are addressed.

The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower level and a higher level mechanism. The clinical treatment has, when successful, an activating effect on the higher level mechanism, and a suppressive effect on the lower level one

[opening paragraph]: The working hypothesis of this special issue of Journal of Consciousness Studies on ‘The View from Within’ -- that the world of inner experience can be scientifically and systematically explored -- represents the re-emergence of a perspective which, while once considered the foundation of all psychological research, has fallen on hard times throughout much of this now concluding century. There are a variety of reasons for this, some of them elegantly reviewed in the contributions to this issue by Varela & Shear and Vermersch, among others. But the predominant explanation for the orchestrated demeaning of first-person investigations during recent decades is rooted in the elevated role that the materialist perspective has ascended to in Western societies