The mind-brain problem: Ethical and clinical implications for psychiatry.

Dualism—the view that mind and brain are separate—remains common, even among mental health professionals, though it declines with age, likely due to generational shifts rather than personal maturation. Academic training often embeds physicalist, reductive views emphasizing biological causes such as gene expression and neurologic alterations. Radical determinism aligned with physicalism can diminish perceptions of responsibility, agency, and free will, affecting personal autonomy and legal systems by portraying individuals as less responsive to rehabilitation and more prone to repeat behaviors. In mental health, these views shape understanding of disorder origins, treatment approaches, patient self-agency, and stigma. Biogenetic models reduce blame but lower perceptions of self-control and increase perceptions of unpredictability.

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Abstract

The mind-brain problem, which explores the relationship between the mind and brain and the nature of consciousness, remains a scientific challenge. It is not a purely theoretical issue; it profoundly shapes our understanding of human nature. This paper reviews evidence on mind-brain problem views impacting ethical, clinical, and academic domains. Evidence shows that dualism is prevalent, even among mental health professionals. This belief declines with age, likely due to generational shifts rather than maturation. Prevalent metaphysical assumptions embedded in academic training (e.g., physicalist reductive views emphasizing biological causes - gene expression and neurologic alterations) may influence this generational shift. Regarding ethics, radical determinism-aligned with a physicalist view of the mind-can diminish perceptions of responsibility, agency, and free will, affecting individual sense of autonomy and legal systems by portraying individuals as less responsive to rehabilitation and seen as more prone to repeat behaviors. In mental health, the mind-brain problem influences four key areas: understanding the origins of mental disorders, treatment approaches, patient self-agency, stigma. Deterministic views reduce patient self-agency, impacting adherence and outcomes, while belief in control enhances responsibility and positive results. Biogenetic models reduce blame but may lower perceptions of self-control and increase perceptions of unpredictability in patient behavior.