Historical evidence shows that mental symptoms were constructed in a particular historical and cultural context (19th Century alienism). According to the Cambridge model of symptom-formation, mental symptoms are mental acts whereby sufferers configure, by means of cultural templates, information invading their awareness. This information, which can be of biological or semantic origin, is pre-conceptual and pre-linguistic and to be understood and communicated requires formatting and linguistic collocation. Mental symptoms are hybrid objects, that is, blends of inchoate biological or symbolic signals (...) and cultural configurators. "Culture" plays a very deep role in symptom-formation because templates can attenuate or abolish the specificity of the biological signals involved. This means that signals from different brain sites can be configured as the same symptom and signals from the same site as different symptoms. Although always present, the neurobiological substratum is not fundamental in the understanding and management of mental symptoms. These can only be comprehended in relation to the manner of their construction and the cognitive and emotional biographies of each patient. Direct interference with the brain sites involved may dull mental symptoms but is unlikely to offer long-term cure. If the configuratory style and needs of the patient are not understood and dealt with, he is likely to keep re-constituting or replicating his symptoms in relation to other biological signals. In summary, mental symptoms are not passive happenings but genuine mental acts. Hence, the manner and motivation of their construction may be more important than the signal of brain distress that might have provoked them in the first place. (shrink)

Much of the current imaging literature either denies the existence of wakeful non-mental imagers, views non-imagers motivationally as 'repressors' or 'neurotic', or acknowledges them but does not fully incorporate them into their models. Neurobiologists testing for imaging loss seem to assume that visual recognition, describing objects, and free-hand drawing require the forming of conscious images. The intuition that 'the psyche never thinks without an image.... the reasoning mind thinks its ideas in the form of images' (Aristotle) has a long tradition (...) in philosophical psychology, from Aristotle through the British empiricists to the British-empiricist-inspired introspection paradigm of Titchener. The massive shift in early experimental psychology to the introspective-antagonistic paradigm of Watson's behaviourism, may have sprung from the contrary intuition that no one thinks in mental images. In both cases, people seemed to assume that what is in one's own mind is in everybody's mind. A third, mediating, intuition - that some people do not think with conscious mental imagery -- seems to be confirmed by empirical studies on many levels. From the early imagery interviews of Francis Galton through many modern surveys, including my own, a consistent diversity of self-reports on ones own mental imagery abilities suggests that some 2-5% of people are very poor- or non-visual- imagers who, yet, maintain normal visual recognition abilities. Comparable estimates have been made in auditory and other imagery modalities. (shrink)