“Doctor, are you working with my therapist?  Her therapy is helping me get control of my thinking.    If a thought doesn’t feel good, I’ve got to find another that feels better.  But, how can I do that when these meds you keep giving me make me feel all doped up. She says I need to understand that my emotions have evolved to help me get my mind off what feels bad.  Doctor, your drugs make me feel awful.  How can I use my emotions to understand what’s going on in my head if your meds are screwing me up?  Also, do you have an end game of getting me off these meds?  If I do get more control of my mind, can’t we change these meds to something less doping?  And, if I get better, then do you have another drug after that that is easier on me?   What I am getting at, Doctor, are steps to getting well, steps to get off my meds and not end up back in the psycho ward again. You know, I am getting to like the Grim Reaper more and more as these years with you pass by.  He has an end game.   But my psychologist is helping me to get normal.  Do you really have an idea of how to help me so that I can get normal? How are you coordinating my pharmaceutical therapy with my psychological therapy so that you guys are working together and helping me to not see you ever again?”

 Medications can be very effective in “normalizing” external behavior from an observer’s perspective, but what are these chemicals doing to the cognitive-biochemical-emotional neural feedback circuit? What are they doing to consciousness’ ability to control and change cognitive activities in response to emotional guidance?  How can emotions guide cognitive behavior when emotional or physiological neural networks are being targeted with artificially introduced chemical agents?

Emotions have an evolved role in guiding cognitive behavior and decision-making.  If emotions are perceiving physiological biochemistry, and cognition actualizes physiological biochemistry, how are emotions ‘out of control’ and in need of ‘emotional regulation’?  No! It is cognition that is ‘out of control’ and therefore, it is cognition that needs regulation.

Any use of pharmaceuticals designed to impact the emotional system also impacts the emotions’ correlations with (1) the mind’s cognitive activities and (2) the body’s physiological biochemical activities and (3) the emotions’ awareness of the body’s physiological and biochemical conditions. Biochemical agents must harmonize with emotional neurological construction and augment the brain’s neuroplastic capacity for developing new constructive habits.  The purpose of pharmaceutical therapy should be to assist consciousness’ power and ability to manipulate cognition and thus to help consciousness to respond to emotional guidance in a healthy and constructive manner.  That is not the intent of current pharmaceutical therapy.

 6.1 Psychiatric Medications Designed for Healing

There is a need for psychiatric treatment to use drugs and medications that help consciousness to regain its own power and responsiveness to its own emotional guidance system.  These medications should also help consciousness break away from a narrow and myopic world view which can spiral cognition out of control. There is a need for pharmaceuticals that can help create a biochemical environment where the personal powers of an individual’s consciousness can start making attempts to be more responsive to his or her emotional guidance system.  These new agents must also augment the brain’s neuroplastic capacity.

These new types of pharmaceuticals would aid individuals in their abilities to use their own cognitive skills and reflexes to co-function with their emotional guidance systems.  These new medications would aide and empower consciousness either to take the mind off the negative downward cognitive spiral of depression or to take the mind off the out-of-control upward cognitive spiral of mania.  As a patient’s new skills are developed and new neural circuits are cultivated, the need for, and the types of, pharmaceutical assistance changes. There always should be the goal to eventually remove pharmaceutical assistance entirely.  But, like the hand on the hot stove, the neurocircuitry within the brain can be “damaged” so extensively that no amount of training and development will ever succeed because entire functions of the brain may have been irreversibly programmed into destructive patterns.  In such cases, there is the possibility that the mind/body/emotion chasm may be permanent, resulting in a need for permanent pharmaceutical intervention and, in some cases, hospitalization.  Never the less, new pharmaceutical research is required within the paradigm of cognition, rather than emotions, driving physiological biochemistry.

 6.2 Masking Neurological Processes

There is a danger of medications masking destructive cognitive behaviors that normally are exposed through erratic, abnormal, and convoluted emotional feedback.  If these emotional reflections of aberrant mental and physical behaviors are camouflaged with pharmaceuticals and if irregular cognitive behavior is left unaddressed without proper psychological counseling and therapy, cognition may fester unabated and create a myopic vortex of circular mental and physical behaviors.  This psychosis can break out with disastrous consequences to the patient and to others, who may become characters in a manically-conceived tragedy played out in real life.

The approach proposed in this paper does not negate the importance of pharmaceutical therapy, rather, it redefines its purpose, which is to target the brain’s neuroplastic environment and to help individuals redevelop a healthy cognitive activity in response to their perceptions of emotional feedback about their physiological biochemical states of being.  As discussed earlier, a person has an evolved emotional guidance system that promotes cognitive behavior that feels good emotionally.  Negative emotions promote avoidance behaviors.  Mental illness may be defined as a consciousness’ inability to constructively respond to his/her own internal dialog between cognition and emotional perceptions and the inability of consciousness to actively engage in emotionally positive activities that are useful, healthful and life giving.  Pharmaceutical therapy should augment psychological therapy to create conditions for redeveloping the neural networks that reinforce evolutionary design.

6.3 New Opportunities in Medicine

The argument presented here for understanding emotions as a product of the evolutionary process opens up vast new opportunities and possibilities within the fields of psychology and pharmacology to rehabilitate the cognitive attributes of mental illness while recognizing and honoring the evolutionary role of emotions.  There is certainly a need to identify new medications that are appropriate for healing. Pharmaceuticals need to work with and augment the cognitive rehabilitation processes within psychotherapy.  And, most importantly, the argument presented here opens up the possibility of a new hope for patients.  Patients may now approach daily psychological and pharmaceutical therapies with the hope and anticipation of new healing possibilities within their journey back into well-being and joy.

A successful return to well-being and joy takes work on the part of both caregivers and patients.  If pharmaceutical intervention is required to stabilize a patient’s cognitive behavior, there is still a need to develop programs that reduce this pharmaceutical impact.  As a patient’s rehabilitation promotes the new skills and habits necessary for consciousness to respond to emotional guidance in a healthy and productive manner, less invasive drug therapy is required.  Any healing and return to wellness is dependent on the desire, determination and fortitude of patients to seek wellness and to develop healthy new habits and patterns of cognitive behaviors in response to their emotional guidance.   Likewise, the desire, determination and fortitude of the therapist, the psychologist, the psychiatrist and the pharmacist play their roles within the patient’s healing process of restructuring cognitive and emotional neurology and a return to well-being.