A Thought on Etiology
When looking for the etiology of a mental disorder,
one must not pre-suppose a single cause that would create that particular effect. Rather,
one must consider all the possible arrangements of mental processes that might create the
same symptomatic arrangement. The most difficult determination occurs when the dysfunction
has not been "caused" by a single specific situation or condition, but exists as
a result of a cumulative holistic matrix unique to the experience of the individual.
In these cases, any attempt to identify the source
of the problem is futile, as no one thing or combination of things can be seen as the
instigator. Rather, very specific experiences lent an overall tendency to the mind at
large that is not unlike the gravitational effect that would be felt throughout the
universe if a small object were introduced anywhere in the cosmos that had not been there
One new "gravitational" effect is so
small most everywhere as to be unnoticed and unmeasureable. But the effect of an
astronomical number of objects of varying sizes appearing at random positions could
collectively alter the orbits of planets that are nowhere near any of the sources of
disturbance. In short, when the symptoms are nebulous, or all pervasive in a subjects
mind, one may suppose a defined, specific cause for the disorder.
But if the disorder itself is specific (which makes
it easily identified by symptoms) chances are the source is nebulous. In these cases, it
is best to forego a search for the source and focus the therapy on the symptoms. Focusing
the therapy is not the same thing as treating the symptoms however. Since the disorder is
caused by the interactions of perhaps thousands of otherwise unrelated and infinitesimal
experiences, the symptoms are virtually therapy proof. What is needed is to create a
"climate" that is conducive to creating new experiences of the same general
nature that ultimately will supplant the existing experience matrix as the more likely to
intercede in determining the individual's behavior.
There is a great danger in employing classical or
operant conditioning based on a supposed etiology that explains the existence of a defined
syndrome. The syndrome is only definable because the cause is nebulous. If one determines
an etiology that is as definable as the syndrome, one has failed. If the syndrome is
specific the cause is nebulous, and conditioning applied to the symptoms will only mask
the existence of the actual disorder by making the patient "learn" to appear to
function normally. All the while, the original condition continues to exist, festering
away without outlet.
Again, only by creating a new holistic matrix that
is known to produce behavioral results of a more acceptable nature, can the tendency
experience of the dysfunctional holistic matrix fade into extinction by disuse.