On the plane from Boston to Denver with Kung Fu Panda II as movie choice, my mind wanders to integration of ideas across fields. I’m heading to Colorado where I’ll exchange ideas with a small band of MD’s and Ph.D’s about gastroenterology, pain control, and psychology. Whenever we do this, the gastroenterologist and the anesthesiologist start to sound like psychologists and the psychologists start to sound like they are more interested in biological explanations. Already I passed on a case study in advance of my arrival in which one MD participant tentatively offered up a psychological explanation of a medical problem. And, I’m wondering why this “switch” happens so predictably.
My thought: Whenever you put smart creative people together, they start to “mix and match” ideas which begin to blend, much like a lasagna in the oven…with the flavors blending together. People who are interested in ideas are attracted to other ideas which intersect with their own.
Blending psychology and biology becomes a zen-like experience in which the participants, while at first resorting in automatic fashion to their own “more comfortable” positions, start to move toward a “middle path” in which distinctions fall to the wayside (“what does it mean to say something is psychological? Biological? Is there really a difference?).
B.F. Skinner would sometimes refer to “the skin” as a boundary between behavioral and biological explanations, where behavioral factors were located “outside the skin” and biological, cognitive (thinking), and emotional factors were located “within the skin.” With respect to the study of human behavior, he argued that the voyage to “within the skin” was fraught with dangers of inference or guesswork. Others, in that vein, argued that psychologists and biologists who sought answers to psychological questions “inside” were engaging in long-shot theorizing that bordered on “science fiction.”
And while Skinner was right in encouraging us to beware of highly inferential thinking and to conversely seek more parsimonious explanations, any attempt to understand a problem with physical symptoms (e.g., nausea, pain, weight loss) invariably leads to a type of thinking in which we draw a path from outside the skin (life stressors) to inside the skin (physiological changes and abnormalities).
And so, a meeting that began a few years ago with a few interesting folks in a restaurant mapping out ideas on a paper tablecloth with crayons marches forward to the hills of Colorado. A place where the lines often drawn by individuals in their respective areas of clinical work and study fade, at least for a few days.