The practice of psychiatry is both art and science. The true romance of the masterful psychiatrist is the skilled application of both art and science to the problems of his/her patients in order to resolve them. While my prior blogs were on the science side of the ledger, this and a number of following blogs will have entries on both sides of the ledger and will span the pre-scientific and the post scientific era, before and during the Age of Enlightenment in which we live.
In the early sixteenth century the Protestant Reformation was challenging Catholic dogma and authority. Questions regarding the meaning of scripture or knowing and understanding many phenomena became acute. It was an age of intense uncertainty. Newton, Leibnitz, Gallileo, Locke, Darwin, Boyle, and Mendel had not been born and their insights into the workings of the world were unknown. Into this uncertain environment where witchcraft, astrology, and superstition prevailed, came Michel de Montaigne in 1533. He looked at the world with profound philosophical skepticism expressed mostly in his influential book Essays written in an anecdotal, pungent, frank and personal style which appealed to William Shakespeare who was born in 1564 and who studied the Essays when he was a young man. Indeed Montaigne is almost quoted in The Tempest.
Shakespeare wrote his long poems in the early 1590s and his plays thereafter until 1612. Othello was written in 1602 and best exemplifies what has become known in the skeptical philosophical tradition as the problem of the other minds. As usual, Shakespeare's insights have continuing relevance even today and are often described as "timeless works". Simply stated we can observe others' behavior but we can only infer what is in their mind. Epistemological problems arise out of this basic cognitive structure. In a later blog I will attempt to connect the insights offered by the naturalist William Shakespeare to theory of mind coined by Premack and Woodruff in their paper on chimpanzees. I hope also to present some connections to linguistic origins and development and present relevant insights from ethology, and neurophysiology.
First, the play! For those who would like to refresh your recall of the plot go to Othello. On the surface it is a story of marriage, jealousy, betrayal, villainy, manipulation, race and murder. Under the surface however is an even more primitive story that is terrifying in its implications. I have an undisclosed, private part and a public observable part as does the other. To know the undisclosed intentions and thoughts of the other requires an inference that they are honorable and can be trusted. Iago is acutely aware of this discrepancy and the resident power for deception that is inherent. Language itself expands the possibilities for concealment because language can be used to obfuscate and mislead rather than to reveal and disclose. The human solution that has evolved is trust which is the basis of forming beliefs in others and is the basis of social interactions. Shakespeare states the issue through Iago when Othello asks Iago "By heaven, I'll know thy thoughts." and Iago responds "You cannot, if my heart were in your hand; Nor shall not whilst 'tis in my custody." In short, even if a person has access to the heart of a person, he does not have access to his mind because it is in his custody. He is foreshadowing the secrecy of his mind that will allow him to manipulate and control the feelings and thoughts of others and is thus the source of power. He will use this power to level the playing field with the general, Othello.
The stage for revenge is set out early in the play during the conversation between Iago and Roderigo. Iago reveals that he hates the Moor because he was passed up for a promotion in favor of Cassio who has mere book knowledge of war whereas Iago has proved himself in battle. He is insulted that his cognitive abilities and understanding of war have not been appreciated by Othello and thus he must be punished and shown to be inferior to Iago in this mental battle ahead. He will have an external honest and dutiful self and an internal, undisclosed, lying, scheming, and evil self. Roderigo and Iago rouse Brabanzio, Desdemona's father, a Venetian Senator, by shouting that his daughter is "covered with a Barbary horse" and his "daughter and the Moor are now making the beast with two backs". (two pungent metaphors both primitive and animalistic and bestial). Iago goes on to say that I must show out a flag and sign of love, Which is indeed "but sign." It is all for appearance sake.
Brabanzio goes to Othello and reveals that he has been deceived by his daughter. Later Iago cleverly reminds the trusting Othello of this fact before he suggests that Desdemona has been unfaithful. He brings Cassio into suspicion and there is an internal battle in Othello's mind for what he should believe about his wife. He then demands "ocular proof" to end his uncertainty and settle his doubt. Iago then responds that he slept in a bed with Cassio and Cassio muttered Desdemona's name. Then Iago lures Cassio into giving Bianca, a courtesan in love with Cassio, Desdemona's handkerchief which was a gift from Othello. Othello interprets this as a gift from Desdemona to her lover Cassio. Othello's jealousy (the green-eyed monster) has taken over his reason and he declares "I will chop her into messes." Jealousy distorts our reasoning and lowers the bar for convincing evidence needed to form belief.
Just as people in a psychiatric practice are highly individualized in terms of their presentation as well as their response to verbal and psychopharmacological interventions, each character in the play is sharply different that the other characters. What is even more important is the depth of error in reading the other characters. Othello cannot distinguish reality from what seems to be reality. He accepts Iago at face value. Desdemona sees Othello as trusting and not jealous. Othello sees Desdemona as unfaithful and lying whereas she is honest and faithful. Emilia, Iago's wife, is completely taken in by her husband until the end. These examples of interpersonal ignorance or psychological misjudgment are the direct result of the cognitive structural problem which I have been referring to as the problem of the other minds.