Draft of an article for Cortex
December 13, 2003

Making the Unconscious Conscious, and Vice Versa:
A Bi-directional Bridge Between Neuroscience/Cognitive Science and Psychotherapy?

Paul Grobstein
Department of Biology
Center for Science in Society
Bryn Mawr College
Bryn Mawr, Pennsylvania 19010

pgrobste@brynmwr.edu
http://serendip.brynmawr.edu/local/grobstein.html
610 526-5098
FAX 610 526-5086

Running Title: Making the Unconscious Conscious, and Vice Versa

 

Abstract

A recent historical gap between neuroscience/cognitive science and psychotherapy is being productively closed by, among other things, the suggestion that recent understandings of the nervous system as a modeler and predictor bear a close and useful similarity to the concepts of projection and transference (Pally, 2004). The gap could perhaps be valuably narrowed still further by a comparison in the two traditions of the concepts of the "unconscious" and the "conscious" and the relations between the two. It is suggested that these be understood as two independent "story generators" - each with different styles of function and both operating optimally as reciprocal contributors to each others' ongoing story evolution. A parallel and comparably optimal relation might be imagined for neuroscience/cognitive science and psychotherapy.

 

Introduction

Let us, for the sake of argument, imagine that human behavior and all that it entails (including the experience of being a human and interacting with a world that includes other humans) is a function of the nervous system (Dennett, 1991; Crick, 1994; Grobstein, 2003). If this were so, then there would be lots of different people who are making observations of (perhaps different) aspects of the same thing, and telling (perhaps different) stories to make sense of their observations. The list would include neuroscientists and cognitive scientists and psychologists. It would include as well psychoanalysts, psychotherapists, psychiatrists, and social workers. If we were not too fussy about credentials, it should probably include as well educators, and parents and ... babies? Arguably, all humans, from the time they are born, spend significant amounts of their time making observations of how people (others and themselves) behave and why, and telling stories to make sense of those observations.

The stories, of course, all differ from one another to greater or lesser degrees. In fact, the notion that "human behavior and all that it entails ... is a function of the nervous system" is itself a story used to make sense of observations by some people (myself included; Grobstein, 2002) and not by others. It is not my intent here to try and defend this particular story, or any other story for that matter. Very much to the contrary, what I want to do here is to explore the implications and significance of the fact that there ARE different stories and that they MIGHT be about the same (some)thing.

In so doing, I want to try and create a new story that helps to facilitate an enhanced dialogue between neuroscience/cognitive science, on the one hand, and psychotherapy, on the other. That new story is itself is a story of conflicting stories within ... what I will call the "nervous system" but others are free to call the "self," "mind," "soul," or whatever best fits their own stories. What's important is the idea that multiple things, evident by their conflicts, may not in fact be disconnected and adversarial entities but could rather be fundamentally, understandably, and valuably interconnected parts of the same thing.

"Non-conscious Prediction and a Role for Consciousness in Correcting Prediction Errors" by Regina Pally (Pally, 2004) is the take-off point for my enterprise. Pally is a practicing psychiatrist, psychoanalyst, and psychotherapist who has actively engaged with neuroscientists to help make sense of her own observations. I am a neuroscientist who recently spent two years as an Academic Fellow of the Psychoanalytic Center of Philadelphia, an engagement intended to expand my own set of observations and forms of story-telling. The significance of this complementarity, and of our similarities and differences, is something I hope will emerge in this commentary.

Are We All Telling Stories About the Same Thing?

Many psychoanalysts (and psychotherapists too, I suspect) feel that the observations/stories of neuroscience/cognitive science are for their own activities at best irrelevant (cf. Pulver, 2003), and at worst destructive (Fratarolli, 2002), and the same probably holds for many neuroscientists/cognitive scientists. Pally (like me) clearly feels otherwise, and it is worth exploring a bit why this is so in her case. A general key, I think, is in her line "In current paradigms, the brain has intrinsic activity, is highly integrated, is interactive with the environment, and is goal-oriented, with predictions operating at every level, from lower systems to … the highest functions of abstract thought" (Pally, 2004). Contemporary neuroscience/cognitive science has indeed uncovered an enormous complexity and richness in the nervous system, "making it not so different from how psychoanalysts (or most other people) would characterize the self, at least not in terms of complexity, potential, and vagary." (Grobstein, 2002). Given this complexity and richness, there is substantially less reason than there once was to believe psychotherapists and neuroscientists/cognitive scientists are dealing with two fundamentally different things

Pally is, I suspect, more aware of this than many psychotherapists because she has been working closely with contemporary neuroscientists who are excited about the complexity to be found in the nervous system. And that's an important lesson, but there is an additional one at least as important in the immediate context. In 1950, two neuroscientists wrote

"The sooner we recognize the fact that the complex higher functional Gestalts which leave the reflex physiologist dumfounded in fact send roots down to the simplest basal functions of the CNS, the sooner we will see that the previously terminologically insurmountable barrier between the lower levels of neurophysiology and higher behavioral theory simply dissolves away" (von Holst and Mittlestaedt, 1950).

And in 1951 another said

" I am coming more and more to the conviction that the rudiments of every behavioral mechanism will be found far down in the evolutionary scale and also represented in primitive activities of the nervous system" (Lashley, 1951).

Neuroscience (and what came to be cognitive science) was engaged from very early on in an enterprise committed to the same kind of understandings sought by psychotherapists, but passed through a phase (roughly from the 1950's to the 1980's) when its own observations and stories were less rich in those terms. It was a period that gave rise to the notion that the nervous system was "simple" and "mechanistic," which in turn made neuroscience/cognitive science seem less relevant to those with broader concerns, perhaps even threatening and apparently adversarial if one equated the nervous system with "mind," or "self," or "soul," since mechanics seemed degrading to those ideas. Arguably, though, the period was an essential part of the evolution of the contemporary neuroscience/cognitive science story, one that laid needed groundwork for rediscovery and productive exploration of the richness of the nervous system. Psychoanalysis/pychotherapy of course went through its own story evolution over this time (Levine, 1996; Schwartz, 1999). That the two stories seemed remote from one another during this period was never adequate evidence that they were not about the same thing but only an expression of their needed independent evolutions, a matter to which I will return below.

Prediction and Transference

An additional reason why Pally is comfortable with the likelihood that psychotherapists and neuroscientists/cognitive scientists are talking about the same thing is her recognition of isomorphisms (or congruities, Pulver 2003) between the two sets of stories, places where different vocabularies in fact seem to be representing the same (or quite similar) things. I'm not sure I'm comfortable calling these "shared assumptions" (as Pally does) since they are actually more interesting and probably more significant if they are instead instances of coming to the same ideas from different directions (as I think they are). In this case, the isomorphisms tend to imply that, rephrasing Gertrude Stein, "there is actually a there there". Regardless, Pally has entirely appropriately and, I think, usefully called attention to an important similarity between the psychotherapeutic concept of "transference" and an emerging recognition within neuroscience/cognitive science that the nervous system doesn't so much collect information about the world as generate a model of it, act in relation to that model, and then check incoming information against the predictions of that model. Pally's suggestion that this model reflects in part early interpersonal experiences, can be largely "unconscious," and so may cause inappropriate and troubling behavior in current time seems to me entirely reasonable. So too is her thought that interaction with an analyst can help by bringing the model to "consciousness" through the intermediary of recognizing the transference onto the analyst.

Further Steps Towards a Common Story

The increasing recognition of substantial complexity in the nervous system together with the presence of identifiable isomorphisms provides a solid foundation for suspecting that psychotherapists and neuroscientists/cognitive scientists are indeed talking about the same thing. But the significance of different stories for better understanding a single thing lies as much in the differences between the stories as it does in their similarities/isomorphisms, in the potential for differing and not obviously isomorphic stories to productively modify one another, yielding a new story in the process. With this thought in mind, I want to call attention to some places where the psychotherapeutic and the neuroscientific/cognitive scientific stories have edges that rub against one another rather than smoothly fitting together. And perhaps to ways each could be usefully further evolved in response to those non-isomorphisms.

Unconscious stories and "reality". Though her primary concern is with interpersonal relations, Pally clearly recognizes that transference and related psychotherapeutic phenomena are one (actually relatively small) facet of a much more general phenomenon, the creation, largely unconsciously, of stories which are understood to be but aren't necessarily reflective of the "real world". Ambiguous figures illustrate the same general phenomenon in a much simpler case, that of visual perception. Such figures may be seen in either of two ways; they represent two "stories" with the choice between them being, at any given time, largely unconscious. More generally, a serious consideration of a wide array of neurobiological/cognitive phenomena clearly implies that, as Pally says, we don't ever see "reality," but only have stories to describe it that result from processes of which we are not consciously aware (Grobstein, 2003).

All of this raises some quite serious philosophical questions about the meaning and usefulness of the concept of "reality." In the present context, what's important is that it is a set of questions that sometimes seem to provide an insurmountable barrier between the stories of neuroscientists/cognitive scientists, who by and large think they are dealing with reality, and psychotherapists, who feel more comfortable in more idiosyncratic and fluid spaces. In fact, neuroscience and cognitive science can proceed perfectly well in the absence of a well-defined concept of "reality" and, without being fully conscious of it, do in fact do so (Grobstein, 2003). And psychotherapists actually make more use of the idea of "reality" than is entirely appropriate. There is, for example, a tendency within the psychotherapeutic community to presume that unconscious stories reflect "traumas" and other historically verifiable events, while the neurobiological/cognitive science story says quite clearly that they may equally reflect predispositions whose origins reflect genetic information and hence bear little or no relation to "reality" in the sense usually meant. They may, in addition, reflect random "play" (Grobstein, 1994), putting them even further out of reach of easy historical interpretation. In short, with regard to the relation between "story" and "reality," each set of stories could usefully be modified by greater attention to the other. Differing concepts of "reality" (perhaps the very concept itself) gets in the way of usefully sharing stories. The neurobiologists/cognitive scientists' preoccupation with "reality" as an essential touchstone could valuably be lessened, and the therapist's sense of the validation of story in terms of personal and historical idiosyncracies could be helpfully adjusted to include a sense of actual material underpinnings.

The Unconscious and the Conscious. Pally appropriately makes a distinction between the unconscious and the conscious, one that has always been fundamental to psychotherapy. Neuroscience/cognitive science has been slower to make a comparable distinction but is now rapidly beginning to catch up. Clearly some neural processes generate behavior in the absence of awareness and intent and others yield awareness and intent with or without accompanying behavior (Dennett, 1991; Damasio, 1994, 1999; Weiskrantz 1986, Norretranders 1998, Grobstein, 2003). An interesting question however, raised at a recent open discussion of the relations between neuroscience and psychonalysis, is whether the "neurobiological unconscious" is the same thing as the "psychotherapeutic unconscious" (Grobstein, 2003c), and whether the perceived relations between the "unconscious" and the"conscious" are the same in the two sets of stories. Is this a case of an isomorphism or, perhaps more usefully, a masked difference?

An oddity of Pally's article is that she herself acknowledges that the unconscious has mechanisms for monitoring prediction errors and yet implies, both in the title of the paper, and in much of its argument, that there is something special or distinctive about consciousness (or conscious processing) in its ability to correct prediction errors. And here, I think, there is evidence of a potentially useful "rubbing of edges" between the neuroscientific/cognitive scientific tradition and the psychotherapeutic one. The issue is whether one regards consciousness (or conscious processing) as somehow "superior" to the unconscious (or unconscious processing). There is a sense in Pally of an old psychotherapeutic perspective of the conscious as a mechanism for overcoming the deficiencies of the unconscious, of the conscious as the wise father/mother and the unconscious as the willful child. Actually, Pally doesn't quite go this far, as I will point out in the following, but there is enough of a trend to illustrate the point and, without more elaboration, I don't think many neuroscientists/cognitive scientists will catch Pally's more insightful lesson.

The Story of the Two Story-Tellers

I think Pally is almost certaintly correct that the interplay of the conscious and the unconscious can achieve results unachievable by the unconscious alone, but think also that neither psychotherapy nor neuroscience/cognitive science are yet in a position to say exactly why this is so. So let me take a crack here at a new, perhaps bidimensional story that could help with that common problem and perhaps both traditions as well.

A major and surprising lesson of comparative neuroscience, supported more recently by neuropsychology (Weiskrantz, 1986) and, more recently still, by artificial intelligence (cf Searle, 1997) is that an extraordinarily rich repertoire of adaptive behavior can occur unconsciously, in the absence of awareness of intent (be supported by unconscious neural processes). It is not only modelling of the world and prediction and error correction that can occur this way but virtually (and perhaps literally) the entire spectrum of behavior externally observed, including fleeing from threat, approaching good things, generating novel outputs, learning from doing so, and so on.

This extraordinary terrain, discovered by neuroanatomists, electrophysiologists, neurologists, behavioral biologists, and recently extended by others using more modern techniques, is the unconscious that the neuroscientist/cognitive scientist speaks of. It is a terrain so surprisingly rich that it creates, for some people, a puzzlement about whether there is anything else at all. Moreover, it seems, at first glance, to be a totally different terrain from that of the psychotherapist, whose clinical experience reveals a territory occupied by drives, unfulfilled needs, and the detritus with which the conscious would prefer not to deal.

As indicated earlier, it is one of the great strengths of Pally's article to suggest that the two terrains may in fact turn out to be the same in many ways, but if they are the same then the question becomes in what way are the "unconscious" and the "conscious" different? Where now are the "two stories"? Pally touches briefly on this point, suggesting that the two systems differ not so much (or at all?) in what they do, but rather in how they do it. This notion of two systems with different styles seems to me worth emphasizing and expanding. Unconscious processing is faster and handles many more variables simultaneously. Conscious processing is slower and handles many fewer variables at one time (Miller, 1956; Norretranders, 1998). It is likely that there are a host of other differences in style as well, in the handling of number (Dehaene, 1999), for example, and of time (Grobstein, 2003b).

In the present context, however, perhaps the most important difference in style is one that Lacan called attention to from a clinical/philosophical perspective - the conscious (concious processing) has as an objective "coherence," that is, it attempts to create a story that makes sense simultaneously of all its parts. The unconscious, on the other hand, is much more comfortable with bits and pieces lying around with no global order. To a neurobiologist/cognitive scientist, this makes perfectly good sense. The circuitry involved in the unconscious (sub-cortical circuitry? (Grobstein, 2003a)) is an assembly of different parts organized for a large number of different specific purposes, and only secondarily linked together to try and assure some coordination. The circuitry involved in conscious processing (neo-cortical circuitry?), on the other hand, seems to both be more uniform and integrated and to have an objective for which coherence is central.

That central coherence is well-illustrated by the phenomena of "positive illusions", exemplified by patients who receive a hypnotic suggestion that there is an object in a room and subsequently walk in ways that avoid the object while providing a variety of unrelated explanations for their behavior. Similar "rationalization" is, of course, seen in schizophrenic patients and in a variety of less dramatic forms in psychotherapeutic settings. The "coherent" objective is to make a globally organized story out of the disorganized jumble, a story of (and constituting) the "self."

What all this suggests is that the mind/brain is actually organized to be constantly generating at least two different stories in two different styles. One, written by conscious processes in simpler terms, is a story of/about the "self" and experienced as such (see Damasio, 1995, 1999) for developing insights into how such a story can be constructed using neural circuitry). The other is an unconscious "story" about interactions with the world, perhaps better thought of as a series of different "models" about how various actions relate to various consequences. In many ways, the latter is the grist for the former.

In this sense, we are safely back to the two story idea that has been central to psychotherapy, but perhaps with some added sophistication deriving from neuroscience/cognitive science. In particular, there is no reason to believe that one story is "better" than the other in any definitive sense. They are different stories based on different styles of story telling, with one having advantages in certain sorts of situations (quick responses, large numbers of variables, more direct relation to immediate experiences of pain and pleasure) and the other in other sorts of situations (time for more deliberate responses, challenges amenable to handling using smaller numbers of variables, more coherent, more able to defer immediate gratification/judgment).

Implications of the Story of Two Story-Tellers in the Brain/Mind:
Bidirectional Story Telling

In the clinical/psychotherapeutic context, an important implication of the more neutral view of two story-tellers outlined above is that one ought not to over-value the conscious, nor to expect miracles of the process of making conscious what is unconscious. In the immediate context, the issue is if the unconscious is capable of "correcting prediction errors", then why appeal to the conscious to achieve this function? More generally, what is the function of that persistent aspect of psychotherapy that aspires to make the unconscious conscious? And why is it therapeutically effective when it is?

Here I think it is worth calling special attention to an aspect of Pally's argument that might otherwise get a bit lost in the details of her article:

"… the therapist encourages the wife to consciously stop and consider her assumption that her husband does not properly care about her, and to effortfully consider an alternative view and inhibit her impulse to reject him back. This, in turn, creates a new type of experience, one in which he is indeed more loving, such that she can develop new predictions."

It is not, as Pally describes it, the simple act of making something conscious that is therapeutically effective. What is necessary is to consciously recompose the story (something that is made possible by its being a story with a small number of variables) and, even more importantly, to see if the story generates a new "type of experience" that in turn causes the development of "new predictions." The latter, I suggest, is an effect of the conscious on the unconscious, an alteration of the unconscious brought about by hearing, entertaining, and hence acting on a new story developed by the conscious. It is not "making things conscious" that is therapeutically effective; it is the exchange of stories that encourages the creation of a new story in the unconscious.

For quite different reasons, Grey (1995) earlier made a suggestion not dissimilar to Pally's, proposing that consciousness was activated when an internal model detected a prediction failure, but acknowledged he could see no reason "why the brain should generate conscious experience of any kind at all." It seems to me that, despite her title, it is not the detection of prediction errors that is important in Pally's story. Instead, it is the detection of mismatches between two stories, one unconscious and the other conscious, and the resulting opportunity for both to shape a less trouble-making new story. That, in a nutshell may well be why the brain "should generate conscious experience", to reap the benefits of having a second story teller with a different style. Paraphrasing Descartes, one might say "I am, and I can think, therefore I can change who I am". It is not only the neurobiological "conscious" that can undergo change; it is the neurobiological "unconscious" as well.

More generally, I want to suggest that the most effective psychotherapy requires the recognition, rapidly emerging from neuroscience/cognitive science, that the brain/mind has evolved with two (or more) independent story tellers and has done so precisely because there are advantages to having independent story tellers that generate and exchange different stories. The advantage is that each can learn from the other, and the mechanisms to convey the stories back and forth and for each story teller to learn from the stories of the other are a part of our evolutionary endowment as well. The problems that bring patients into a therapist's office are problems in the breakdown of story exchange, for any of a variety of reasons, and the challenge for the therapist is to reinstate the confidence of each story teller in the value of the stories created by the other. Neither the conscious nor the unconscious is primary; they function best as an interdependent loop with each developing its own story facilitated by the semi-independent story of the other. In such an organization, there is not only no "real", and no primacy for consciousness, there is only the ongoing development and, ideally, effective sharing of different stories.

There are, in the story I'm outlining, implications for neuroscience/cognitive science as well. The obvious key questions are what does one mean (in terms of neurons and neuronal assemblies) by "stories," and in what ways are their construction and representation different in unconscious and conscious neural processing. But even more important, if the story I have outlined makes sense, what are the neural mechanisms by which unconscious and conscious stories are exchanged and by which each kind of story impacts on the other? And why (again in neural terms) does the exchange sometimes break down and fail in a way that requires a psychotherapist - an additional story teller - to be repaired?

Implications of the Story of Two Story-Tellers :
Neuroscience/Cognitive Science and Psychotherapy

Just as the unconscious and the conscious are engaged in a process of evolving stories for separate reasons and using separate styles, so too have been and will continue to be neuroscience/cognitive science and psychotherapy. And it is valuable that both communities continue to do so. But there is every reason to believe that the different stories are indeed about the same thing, not only because of isomorphisms between the differing stories but equally because the stories of each can, if listened to, be demonstrably of value to the stories of the other. When breakdowns in story sharing occur, they require people in each community who are daring enough to listen and be affected by the stories of the other community. Pally has done us all a service as such a person. I hope my reactions to her article will help to further construct the bridge she has helped to lay, and that others will feel inclined to join in an act of collective story telling that has enormous intellectual potential and relates as well very directly to a serious social need in the mental health arena (Surgeon General 1999, 2001a, 2001b). Indeed, there are reasons to believe that an enhanced skill at hearing, respecting, and learning from differing stories about similar things would be useful in a wide array of contexts (Dalke et al, 2004).

 

Acknowledgements

I very much appreciate a series of productive engagements and conversations with a number of psychotherapists, including Jarl Dyrud, Warren Hampe, Gary Flaxenburg. Elio Fratarolli, and Sydney Pulver. The latter two served as my mentors while I was an Academic Fellow at the Psychoanalytic Center of Philadelphia. My thanks to Susan Levine and to Bruce Levin for making this possible. My thinking was further advanced by a panel and open discussion http://serendip.brynmawr.edu/psychoneuro03) co-sponsored by the Center for Science in Society at Bryn Mawr College and the Fellows Program of the Pyschoanalytic Center of Philadelphia. Readers of this article are warmly invited to read and contribute to an on-line forum associated with that discussion at http://serendip.brynmawr.edu/forum/newforum/psychoneuro03-read.html. Invaluable contributions to my thinking were also made by a number of undergraduates (particularly Rachel Berman and Anneliese Butler) and graduate students (particularly Jeff Oristaglio and Debra Plotnick) at Bryn Mawr College, as well as a number of colleagues (including Peter Brodfuehrer, Jim Martin, Anne Dalke, Lucy Kerman, and Sharon Burgmayer).

 

References

CRICK F The Astonishing Hypothesis New York: Scribner, 1994

DALKE A, MCCORMACK E, and GROBSTEIN P Theorizing Interdisciplinarity Submitted
Available at http://serendip.brynmawr.edu/local/scisoc/DalkeGrobsteinMcCormack.html

DAMASIO A Descartes' Error New York; Avon, 1995

DAMASIO A The Feeling of What Happens New York; Harcourt Brace, 1999

DEHEANE S The Number Sense Los Angeles: Getty Center, 1999

DENNET D Conscioiusness Explained New York: Little, Brown, 1992

FRATTAROLI E Healing the Soul in the Age of the Brain New York: Viking, 2001

GRAY JA The Contents of Consciousness: A Neuropsychological Conjecture Behavioral and Brain Sciences 18: 659-722, 1995

GROBSTEIN P Variability in Brain Function and Behavior. In Ramachandran VS (Ed) The Encyclopedia of Human Behavior, Volume 4. New York: Academic Press, 1994, pp 447-458.
Draft vailable at http://serendip.brynmawr.edu/%7Epgrobste/pragmatism.html

GROBSTEIN P Who's Afraid of Emily Dickinson? Or … How I Learned to Stop Worrying and Love the Brain. Newsletter of the Psychonalytic Center of Philadelphia, 2002
Available at http://serendip.brynmawr.edu/bb/brainpsychoanal.html

GROBSTEIN P Getting It Less Wrong, The Brain's Way: Science, Pragmatism, and Mulitiplism. In Ritvoi AD (Ed) Interpretation and Its Objects. Amsterdam: Rodopi, 2003a, pp 153-166.
Draft available at http://serendip.brynmawr.edu/bb/EncyHumBehav.html

GROBSTEIN P Timing The Conscious and the Unconscious:Some Implications for Thinking ... and Thinking About Time, http://serendip.brynmawr.edu/local/scisoc/time/time.html, 2003b

GROBSTEIN P Wednesday Evening http://serendip.brynmawr.edu/forum/newforum/psychoneuro03-read.html#6880, 2003c

HOLST E VON and MITTLESTAEDT H Das Reafferenzprinzip Naturwissenschaften 37: 464-475, 1950. Translation in HOLST E VON The Behavioral Physiology of Animals and Men Miami: University of Miami Press, 1973 pp 139-173

LASHLEY K The Problem of Serial Order in Behavior In: Jeffries, LA (Ed) Cerebral Mechanisms in Behavior New York: Wiley, 1951, pp 112-136

LEVINE S Useful Servants New York: Jason Aranson, 1996

MILLER GA The Magical Number Seven, Plus or Minus Two: Some Limits on Our
Capacity for Processing Information The Psychological Review 63:, 81-97, 1956
Available at http://www.well.com/user/smalin/miller.html

NORRETRANDERS T The User Illusion New York: Viking, 1998

PALLY R Non-Conscious Prediction and a Role for Consciousness in Correcting Prediction Errors. Cortex xx: : xx-xx, 2004

PULVER S On the Astonishing Clinical Irrelevance of Neuroscience Journal of the American Psychoanalytic Association 51: 1-17, 2003

SCHWARTZ J Cassandra's Daughter New York: Penguin, 1999

SEARLE J The Mystery of Consciousness New York: New York Review, 1997

SURGEON GENERAL, Mental Health: A Report of the Surgeon General, Washington: Surgeon General's Office, 1999
Available at http://www.surgeongeneral.gov/library/mentalhealth/home.html

SURGEON GENERAL Mental Health, Culture, Race, and Ethnicity, Washington: Surgeon General's Office, 2001a
Available at http://www.surgeongeneral.gov/library/mentalhealth/cre/

SURGEON GENERAL Report of the Surgeon General's Conference on Children's Mental Health, Washingon: Surgeon General's Office, 2001b
Available at http://www.surgeongeneral.gov/topics/cmh/

WEISKRANTZ L Blindsight Oxford: Oxford University Press, 1986