Abstract: CONSCIOUSNESS presents us with a challenging, disquieting, and somewhat contradictory mixture – parts of it are so simple they generally pass entirely without notice, while others are so far beyond our human capacity to understand, they seem permanently obscure. From the perspective of a working psychiatrist, it helps to separate these two aspects, so shedding light on this infinitely complex, yet vitally important topic.
This chapter therefore starts with its simplest characteristics – consciousness exists, but only when you are awake or unanaesthetised. It has a more straightforward relationship to ‘mind’ than is usually allowed – the two terms ‘mind’ and ‘consciousness’ overlap sufficiently for practical (psychiatric) purposes.
Next, comparing consciousness with the field of vision helps – the retina, after all, is neurologically speaking, an outgrowth of the very brain tissue itself. And the striking feature of eyesight is the focal point – a small area of high detail surrounded by blur, and the blurring increases the further you get from that point. Accordingly, it makes sense to acknowledge that the entrance channel to consciousness is also necessarily narrow – were it not, we would be overwhelmed too easily – “it all happened at once – so I lost track”.
Thirdly, there is no future in elucidating consciousness without tackling the challenge of ‘choice’, or Free Will. Parts of this aspect are indeed wrapped in permanent obscurity – like Richard Feynman said of Quantum Mechanics – if you think you understand it, you don’t. But as Samuel Johnson said in 1778, “All theory is against the Freedom of the Will; all experience for it” – time we paid more attention to the latter, it pays dividends to explore ‘experience’, here clinical experience, as fully as we can.
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