Steps Toward an Integrative Clinical Systems Psychology

Abstract

Clinical fields of the “sciences of the mind” (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding “systems” for “processes” of the brain. These terms have a supradisciplinary” meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. It provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like “structure”, “process” and “dynamics” as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like “life space” or “object representations” can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental.

Psychoanalysis and Neuroscience: The Bridge Between Mind and Brain

“…The old reduction of mental functions to brain structures still finds today numerous supporters and attempts. As Tretter and Löffler-Stastka (2018) pointed out, this attempt encompasses a lot of well-known epistemological, methodological, and conceptual inconsistencies (Block, 1980; Chalmers, 1996; Craver, 2007).…”

“…In our manuscript, we try to move through development of a systemic view of the mind, taking in considerations of psychoanalytic models from Freud to Bion, their connections with modern neuroscience and neural networks, underlying the role of the Free Energy Principle as a bridge between mind and brain. We try to assume a methodological parallelism as it was seen for instance by the founder of General Systems Theory, Ludwig von Bertalanffy (von Bertalanffy, 1967), in which a systemic non-reductive multi-level approach might offer better options for integration (Miller, 1978; Tretter and Löffler-Stastka, 2018).…”

“Systems medicine” in the view of von Bertalanffy's “organismic biology” and systems theory

“…This was also shown later by the thought experiment with the neurophysiologist “Mary” living without colours, who knows everything about colours but then makes a qualitatively new experience when she enters the outer world with all its colours (“Qualia” problem; Jackson, ). Consequently, brain parameters alone are not sufficient to characterize consciousness and its intentional content (i.e., to be aware of something), although basic dimensions of consciousness, namely, wakefulness and awareness, are essentially associated with a proper metabolic function of the brain, as it has been illustrated by positron emission tomography studies in coma vigil (Stender et al, ): Essential issues of a very central personal “self” as such, an internal representation of the self as a self‐related affective–cognitive schema (“Who am I?”), as self‐related processing (“Was that me?”), and so forth cannot be depicted (yet) sufficiently by brain research, also because of an imprecise philosophical and psychological definition of the “self,” the “I,” and so forth (Tretter & Löffler‐Stastka, ). Furthermore, a kind of neuropsychological “uncertainty relation” seems to exist (Tretter & Grünhut, ): Many structures (e.g., several brain areas) are involved in one function (e.g., vision), and one structure (e.g., prefrontal cortex) is involved in many functions (e.g., vision, planning, and working memory)—it is difficult to find the appropriate organizational level of contingencies of structure and function.…”

“…With regard to this second gap in the reduction of humans to their molecules, since 2005, we attempted to explore various research approaches in the context of a systems biological multilevel view for psychiatry, but still, a breakthrough cannot be revealed (Tretter, Winterer, Gebicke‐Haerter, & Mendoza, ). We underlined that the theoretical and empirical reduction of mental functions to brain functions is still in its infancies as the brain must be understood as a whole organ, and accordingly, the mind must also be conceived as a system or network of processes and states in the sense of a “structured whole” (Kotchoubey et al, ; Tretter & Löffler‐Stastka, ). Interestingly, neuroscience has even difficulties—not necessary in principle but at present de facto—to “explain” movements of the limbs by nervous coordination, for example, regarding the nervous system of the little worm named Caenorhabditis elegans (Schaffner, , ).…”

“…In a recent paper, we have discussed these issues, which must be addressed basically if a “system psychology” is to be designed (Tretter & Löffler‐Stastka, ). In our comprehensive conclusion, we assume that the future development towards a differentiated system psychology should proceed above all from the conceptual roots of psychoanalysis, because we are convinced that Sigmund Freud was one of the first systemic thinkers in psychology—he tried to use concepts like “dynamics” from physics abstractly and metaphorically to describe and explain psychopathological phenomena from a developmental perspective.…”