In my imaginary Catholic world, a physician treating mentally ill patients could have a pocket copy of the compendium of teachings describing how God works in, through, and for the mentally ill and disabled.
Sadly, this is not the case. Instead, I wander the halls of the psych hospital with question marks buzzing in my brain, wondering whether my patients can cooperate with grace or can receive sacraments. I will now have fun flouncing around in the fields of philosophy. Sorry to anyone who actually likes to proceed in an orderly fashion.
Psychosis and Choosing the Good
By nature, a human being has a body with many organs, and a soul with several faculties by nature. According to Aristotle (complemented by modern medicine) the faculties of the soul
- special senses (e.g. taste, touch, proprioception),
- the common sense (no, not "common sense," but the common sense, which compiles sensory information into a whole),
- the imagination,
- the passive and active intellect, and
- the will.
Like the unborn and the elderly, the mentally ill have absent or impaired faculties. I suggest the common sense, the imagination, or the intellect is most affected in them. But does this mean they are not persons? No! Does this mean they cannot accept grace? No. (Their wills exist and can act independently of their intellects, perhaps like mine does when I make an act of the will to accept the God is Triune, although my intellect can only shrug and say, "well, St. Thomas said some true stuff about it, but I'm stumped.")
I tend to identify with my intellect. This is not a true or good thing, as seen above. I fall into the same error as our culture does--I need to be more humble, accepting that I am body and soul, matter and spirit. Even so, it is a smaller error to identify with one's intellect than to identify with one's body. The "best" error, the one closest to the truth, would be to identify with one's will. Maybe the attraction to identifying with the intellect (or will) is an old remnant of Eve's mistake, wanting to see herself like God (who is his intellect and will).
Body and Soul: We're Embarassingly One
How bodily we are! Scholastic education is awesome, but it makes me tend to think soul and body are basically separate. That's impossible to think in a psychiatric hospital.
Bodily illnesses have cognitive consequences. Liver failure? The poisons in your blood that your liver can't take care of will make you forgetful and disoriented. Brain injury, even so suble that we can't see it microscopically? Pseudobulbar affect causes people to burst into tears or laughter with the slightest provocation (or none at all). Schizophrenia is associated with decreased cortical mass. More obvious examples are Kluver-Bucy syndrome, Pick's disease, and frontotemporal dementia.
And mental illnesses have material remedies! I saw at least three patients with extreme and overt psychosis become connected with reality in a few days after giving them antipsychotic drugs! Pills can take away delusions and hallucinations. (One woman insisted that I call her First Lady Savior; I just saw her earlier this week and she is completely coherent and herself again. Thanks olanzapine.) The walls between form and matter are becoming preeeeeetty thin here.
Anyway, I just wanted to muse on these things, because I can't really start chatting it up about form and matter with my fellow medical students or attendings. (I never realized how awesome it was at TAC to sit down at a lunch table and talk about first principles.) Maybe this will jog some interesting thoughts in people and we can muse more in the comments?