Introduction

In October 1994, a conference on “Mind/Brain” was held in Osaka, Japan, with the participation of several members of the Chicago psychoanalytic community. In addition to publishing some of their contributions (Levin and Kent in Volume 23, and Gedo's “Epigenesis, Regression, and the Problem of Consciousness” and “Creativity: The Burdens of Talent” in this volume), the Annual is presenting two papers from the conference by Japanese neuroscientists. Although these refrain from spelling out the significance of their findings for psychoanalysis, we believe that they are of sufficient importance to warrant publication in the analytic literature.

Professor Utena approaches the mind—body problem from the viewpoint that attempts to reduce human functioning to either of these constructs are misguided: only consideration of the person as a whole can do it justice. He centers his chapter on the freedom of the person to make optimal adaptive choices—freedom that has progressively increased through evolution with the development of a complex brain. Examples of loss of freedom drawn from psychiatry, such as addictive behaviors or automatisms released by brain damage, are best studied, not in the laboratory, but in the social context of the patient's natural milieu. Within such a framework, freedom of choice can be conceptualized as a complex adaptive function. In cases of central nervous system (CNS) impairment, the greater the adaptive challenge posed by the environment, the greater the loss of freedom appears to be. (In Gedo's terms: apraxic patients can find compensatory assistance if symbiotic partners are available.) The same is true of certain types of schizophrenia in which “negative symptoms” predominate. Such loss of freedom may be reversed by therapeutic approaches using biological, social, or psychological methods—preferably all three in combination.

Utena's clinical illustrations make clear that all behavior is necessarily the outcome of the simultaneous input of the CNS