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Intern. J.

Neuroscience, 117:11091148, 2007


C

Copyright _ 2007 Informa Healthcare


ISSN: 0020-7454 / 1543-5245 online
DOI: 10.1080/00207450600934556

THE PSYCHOMOTOR THEORY OF HUMAN MIND

UNER TAN
Cukurova University
Adana, Turkey

Thisstudypresentsanewtheorytoexplaintheneuraloriginsofhumanmind.Thisisthepsychomotor
theory.Theauthorbrieflyanalyzedthehistoricaldevelopmentofthemindbraintheories.Theclose
relationsbetweenpsychologicalandmotorsystemsweresubjectedtoaratherdetailedanalysis,using
psychiatricandneurologicalexamples.Thefeedbackcircuitsbetweenmind,brain,andbodywere
showntooccurwithinthemindbrainbodytriad,innormalstates,andpsychoneuraldiseases.Itwas
statedthatpsychiatricsignsandsymptomsarecoupledwithmotordisturbances;neurologicaldiseases
arecoupledwithpsychologicaldisturbances;changesincorticospinalmotorsystemactivitymay
influencemindbrainbodytriad,andviceversa.Accordingly,apsychomotortheorywascreatedto
explainthepsychomotorcouplinginhealthanddisease,statingthat,notthemindbraindualityor
unity,butthemindbrainbodytriadasafunctionalunitmaybeessentialinhealthanddisease,because
minddoesnotendinthebrain,butfurthercontrolsmovements,inareciprocalmanner;mentaland
motoreventssharethesameneuralsubstrate,cortical,andspinalmotoneurons;mentalevents
emergingfromthemotoneuronalsystemexpressedbythehumanlanguagemaybecloselycoupled
withtheunityofthemindbrainbodytriad.So,thepsychomotortheoryrejectsthemindbrainduality
andinsteadadvancestheunityofthepsychomotorsystem,whichwillhaveimportantconsequencesin
understandingandimprovingthehumanmind,brain,andbodyinhealthanddisease.

Keywordsbrain,disease,health,mind,motorsystem,psyche

Psychomotormeans. . ..oforrelatingtomovementormuscularactivity
associatedwithmentalprocesses(TheAmericanHeritageDictionaryofthe
Received14January2006.

AddresscorrespondencetoProf.Dr.UnerTan,CukurovaUniversity,FacultyofSciences,
DepartmentofPhysics,01330Adana,Turkey.Email:unertan@cu.edu.tr

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EnglishLanguage,fourthedition,2000).ThisarticlewillusePsychformind,
andmotorforthemotoneuronalsysteminbrainandspinalcord.Accordingto
Hebb(1980),broadlyspeaking,themindisthatwhichcontrolsbehavior(p.3).
Inthepresentwork,thepsychomotorsystemwillbeshowntobecloselyrelated
tothemind/body(ormind/brain)problem,whichhasarelativelylonghistory.
Themind/bodyproblemisconcernedwithdeterminingtherelationshipbetween
bodyanditsmind.Thepsychomotortheoryisanattempttoexplainthe
possibilitiesofmind/brainunityand/orthemind/braindualityinrelationto
motorsysteminhumans.Tounderstandthistheory,onehastofirstanalyzethe
historicaldevelopmentofthemindbrainrelations,atleastbriefly.

HISTORICAL DEVELOPMENT OF THE MIND/BODY CONCEPT


Thefirstsystematicconceptofmindandbodyprobablyoriginatesfrom
Plato(429347BC).Heidentifiedmindwithsoul.Platospeaksofthesoul
asimprisonedinthebody,buthedoesnotexplainwhatbindssoultobody.
Aristotle(384322BC)didnotagreewithPlato.Hebelievedthatthesoulis
theformofthebody.Histheoryseemstobematerialistic,buthearguedthat
theintellectmustbeimmaterial(akindofdualism).
Thefirstsystematicstudyconcerningthemind/bodyrelationshiporiginatesfrom
theseminalworkofReneDescartes(15961650),aFrenchmathematician,
philosopher,andphysiologist.Heisthewriteroftheworldsfirstessayon
physiologicalpsychology,DeHomine.UntilDescartes,therewasno
metaphysicalsplitbetweenmindandbody.Hisideasaboutthemind/brain
dualityandthemind/braininteractionismwereoutlinedinhisbook.Heargued
thattherationalsoulisdistinctfrombody,butmakescontactwithitatthepineal
gland;bodyaffectsmind,mindaffectsbody;mentaleventscancausephysical
eventsandviceversa.ThisiscalledinteractionismorCartesiandualism,that
is,thedualistinteractionisttheoryofmind.Descartesbelievedthatthepineal
glandwastheonlycontactsideofthemind,becausethisglandwasnot
bilaterallyduplicated.Heisfamouswiththeprinciple:IfIdeceive,Imust
exist,cogitoergosum(Ithink,thereforeIam).

BaruchSpinoza(16321677)arguedthattherearetwoattributesofthesame
substance;realityis,therefore,acaseoftwoperspectivesonthesamething:

physicalmatterperceivedthoroughsenses,andmentalstuffexperiencedby
mind.SpinozaabandonedDescartestwosubstanceviewinfavorofdouble
aspecttheory,whichstatesthatthementalandphysicaleventsaredifferent
aspectsofthesamesubstance.Theessentialsubstance,God,istheuniversal
essenceornatureofeverythingthatexists.

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Psychophysicalparallelism,usuallytracedtoGottfriedWilhelmLeibniz
(16461716),alsoacceptsthemind/bodydualism,butavoidsanycausal
connectionbetweenmindandbody.Parallelistsarguethateverymental
eventislinkedtoaphysicaleventsothatwhenoneoccurs,sotoodoesthe
other.Thepsychophysicalparallelismstatesthatmindandbodyexistina
harmonythathasbeenpreestablishedbyGod.
Alltheaforementionedviewsarepointingoutsomedistinctionbetween
mindandbody.Actually,toavoidthemind/bodyproblem,onemustdeny
thisdistinction.Thisdenialhastakendifferentformsinhistory.Forinstance,
immaterialism,bestrepresentedbyGeorgeBerkeley(16851753),denies
eventhepossibilityofmindlessmaterialsubstanceinhisbook,ATreatise
ConcerningthePrinciplesofHumanKnowledge(1710).Accordingto
Berkeley,thereisnomind/bodydualitybecausewhatisthoughtofasbodyis
merelyaperceptionofmind.
Materialismarguesthatmatterisfundamental,eveninthemind/body
problem.Materialismentirelydeniestheexistenceofmentalevents.Inaless
extremeform,materialismdescribesmentaleventsasdependentonbodily
events.Thisviewwasbestexplained,acenturyafterDescartes,byJulien
OffraydelaMettrie(17091751),whowasborninBrittanyandstudied
medicineatParis.Becauseofpublicoutcryoverhismaterialism,heself
exiledtoHolland.HethenpublishedLhommeMachine,whichwaspublicly
burnedandLaMettriewasforcedtoseekprotectionfromFrederickthe
GreatatBerlin,wherehecontinuedtopublishonvarioustopics,untilhis
deathin1751.LhommeMachinewasindeedaseminalbook,which
accentuatedthatthementalprocessesareidenticalwiththeirphysiological
causes.PierreJeanGeorgesCabanis(17571808)arguedthattohavean
accurateideaoftheoperationsfromwhichthoughtresult,itisnecessaryto
considertheBrainasaspecialorgandesignedespeciallytoproduceit,asthe
stomachandtheintestinesaredesignedtooperatethedigestionandtheliver
tofilterbile. . .(Cabanis,1805).
Thenineteenthcenturylargelyengagedwiththemind/bodyproblem.Progress
wasmadeinunderstandingthelocalizationofcerebralfunction,basedonthe
ideathatthebrainservesastheorganofmind.Itwasgenerallyacceptedthat
mentaleventsmaycauseradicalalterationsinthestateofthebody.Atthesame
time,thenatureoffunctionalnervousdisordersalsomadeprogress.In1870,
ShadworthHollowayHodgson(18321912)publishedatwovolumework,The
TheoryofPractice,introducingthetermepiphenomalism.Inhisbook,Hodgson

arguedthatthefeelingshavenocausalefficacy;mentalstatesinthecentral
nervoussystemmaybeonlyepiphenomena,incapableofreflecting

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backtoinfluencethenervoussystem.Insupport,ThomasHenryHuxley
(18251895)presentedhismostinfluentialpapersonthehypothesisthat
animalsareautomata,infrontoftheBritishAssociationforthe
AdvancementofScience,in1874.Hepointedoutthatstatesof
consciousnessaremerelytheeffectofmolecularchangesinbrain;animals
are,therefore,consciousautomata.
In1874,anotherinfluentialbookwaspublishedbyWilliamBenjaminCarpenter
(18131885),whoopposedtheepiphenomalismofHodgsonandHuxley.
Carpenterarguedthatthesensationalconsciousness,theprimaryformofmental
activityisexcitedthroughinstrumentality.Acertainphysicalimpressionismade,
forexample,bytheformationofaluminousimageupontheretinaoftheeye.
. . .Lightexcitesnerveforce,andthetransmissionofthisnerveforceexcitesthe
activityofthatpartoftheBrainwhichistheinstrumentofourVisual
Consciousness.Nowinwhatwaythephysicalchangethusexcitedinthe
Sensoriumistranslated(sotospeak)intothatpsychicalchangewhichwecall
seeingtheobjectwhoseimagewasformeduponourRetina,weknownothing
whatever;butweareequallyignorantofthewayinwhichLightproduces
Chemicalchanges.. . .Andallwecansayis,thatthereisjustasclosea
successionofsequencesasintimateacausalrelationbetweenantecedentand
consequentintheonecase,asthereisintheother(Carpenter,1874).
Interestinglyenough,CarpenterhasfurthersuggestedthelikeCorrelationmay
beshowntoexistbetweenmentalstatesandtheformofNerveforcewhichcalls
forthMotionthroughtheMuscularapparatus. . .eachkindofmentalactivity,
Sensational,Instinctive,Emotional,Ideational,andVolitional,mayexpress
itselfinBodilymovement. . .(p.812).

Unfortunately,after241yearsfromDescartesDeHominetoCarpenters
PrinciplesofMentalPhysiology,theprimaryobjectiontointeractionism
madelittleprogress.In1871,JohnTyndallwrotethepassagefromthe
physicsofthebraintothecorrespondingfactsofconsciousnessis
unthinkable.Grantedthatadefinitethought,andadefinitemolecularaction
inthebrainoccursimultaneously;wedonotpossestheintellectualorgan,
norapparentlyanyrudimentoftheorgan,whichwouldenableustopass,by
aprocessofreasoning,fromtheonetotheother(Tyndall,1871).
ThemostimportantbrainchildofDualaspectmonismwasGeorgeHenryLewes
(18171878),awriter,actor,biologist,philosopher,andapsychologist.His

book,PhysiologyofCommonLife,convertedtheyoungPavlovtobea
physiologist,andhisfivevolumebook,ProblemsofLifeandMind(1874/1879)
wasamajorcontributiontopsychology.ThePhysicalBasisofMindwasthe
thirdvolumeofProblemsofLifeandMind.Accordingtohistheory(neutral

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monismordualaspectmonism),thereisonlyonekindofstuffandthat
mindandbodydifferonlyinthearrangementofthatstufforinthe
perspectivefromwhichitisapprehended;whenseenfromthesubjective
pointofview(e.g.,thinking),thepsychophysicalseriesismental,andwhen
seenfromtheobjectivepointofview(e.g.,whenoneobserveswhathappens
duringthinking),itisphysical.
Withinthenineteenthcenturythemind/brainproblemwasespecially
importantbecausephysiologistsandpsychologistsfocusedonthenatureand
cerebrallocalizationofmind.Infact,onecanfindideasaboutfunctional
localizationthroughoutantiquity.Forexample,onecanfindideasaboutsoul
globallylocalizedtothebrainintheworkofPytagoras,Hippocrates,Plato,
Erisistratus,andGalen,amongothers.Thepneumaticphysiologistslocated
thementalcapacitiestothefluidofthecerebralventricles,tillthebookDe
FunctionibusSystematisNervosawaspublishedbyJiriProchaskain1784,
andtheinteresthadshiftedtothebrainstemandcerebrum.Amongthe
nineteenthcenturyachievements,themostimpressiveoneisthelocalization
offunctiontovariousbrainregions.Themostfamousmanofthiserais
FranzJosefGall(17581828),whowasborninBadenandstudiedmedicine
atStrasbourgandVienna.Hewasimpressedasachildbyvariationsinfacial
andcranialappearanceofhisfriendswithunusualtalents.Hisfirstlectures
arousedoppositiononthegroundsofhispresumedmaterialism,andin1805,
hehadtoleaveVienna,andaftertwoyearshearrivedinParis.Gallbelieved
thattherearecorrelationsbetweencharacterandtheexternalcraniological
signs:thesizeandshapeoftheheadreflectthesizeandshapeofthe
underlyingportionsofthebrain;mentalabilitiesareinnateandfixed,andthe
developmentofaninnateabilityisareflectionoftheinheritedsizeofits
brain.Indoingso,awelldevelopedabilitycanbepredictedfroma
particularlyprominentareaofthecranium(functionallocalizationofan
abilityinthecranium).AlthoughGallscorrelationalapproachwas
eventuallyabandonedinfavorofexperiment,hisaccomplishmentsinthe
historyoffunctionallocalizationcannotbeunderestimated;hewasthe
founderofbiologicallybased,functionalpsychology.
Interestinglyenough,morethan200yearslater,itwasfoundthatthe
cognitiveabilitiesmaybepredictedfromthecraniofacialmeasurements(see
Dayietal.,2002).
Thefirstexperimentaldemonstrationoflocalizationoffunctioninthebrainwas
realizedbyMarieJeanPierreFlourens(17941867),usingthemethodof

completeisolationofbrainparttoberemoved:asuccessiveslicingthrough

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thecerebralhemispheresproduceddiffusedamagetoallofthehighermental
functions.Florensconcludedthat
highermentalfunctionssuchasperception,volition,andintelligenceare
spreadthroughoutthewholebrain,operatingtogetherasasinglefactor,the
entirecerebrumfunctioninginaunitaryfashion(unitarysoulandan
indivisiblemind);thebrainistheorganofaunitarymind,itcouldnot,
therefore,befunctionallydifferentiated(Flourens,1824).
Thefirstspecificdemonstrationofsensorymotorfunctionoriginatesfrom
AlexanderBain(18181903),whoalsocreatedavaluablesurveyof
mind/bodyviews(MindandBody.TheTheoriesofTheirRelation,1873).
Hisimportantcontributionwasthesensorymotorassociationism
(associationistpsychology),whichwasanalyzedinTheSensesandthe
Intellect(1855)andTheEmotionsandtheWill(1859).BeforeBain,the
movementandactionwithregardtotheanalysisofsensationwasneglected.
Bainbroughtthenewphysiologyofmovementintorelationtoan
associationistaccountofmind.Hedefinedvolitionasthecompoundof
spontaneousmovementsandfeelings;thecoordinationofmotorimpulses
intopurposivemovementsresultsfromtheassociationofideaswiththem.
In1855,asBainpublishedTheSensesandtheIntellect,HerbertSpencer
(18201903)publishedThePrinciplesofPsychology.Spencerwasbornin
Derby(England)andlargelyselftaught.At17yearsold,heworkedasa
railwayengineer;in1848,hestartedtoworkasaneditorandthenasafree
lancewriterandreviewer.Spencerdiscoveredacephalographtoachieve
morereliablecranialmeasurement.Bainhadintroducedmovementtothe
sensationsofassociationismandarrivedatthefirstfullybalancedsensory
motorassociationalview;Spencergroundedpsychologyinevolutionary
biology.ForSpencer,mentalphenomenaareadaptations,thatis,incidentsof
thecorrespondencebetweentheorganismanditsenvironment;mentaland
physicallifearesimplyspeciesoflife,mindevolvescontinuouslyfrom
physicallife,reflexesfromirritations,instinctsfromcompoundreflexes,
consciouslifeandhighermentalprocessesfrominstincts:

Ifhighermentalactivitiesaretheendproductofacontinuousprocessof
developmentfromsimpleirritationthroughreflexes,thereisnojustification
fordrawingasharpdistinctionbetweenmindandbody;thebrainisa
physicalsystemandthecortexisthemostdevelopedlevelofthebrain
(Spencer,1855).

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Otherwise,themind/braindualitycontinuedfortwocenturiesandsupported
thenotionthatmentalprocessesmustfunctionaccordingtoprinciples
entirelydifferentfromthoseofthebrainitself.
Toovercomethelastobstacletoextensionofthesensorimotorviewtothe
cortex,thefollowingperiodwasneeded.PaulBroca(18241880),bornin
France,studiedmedicineattheHotelDieuinParis.Hewasanoriginalmember
oftheSocietedAnthropologieandafounderoftheRevuedanthropologyand
theDepartmentofAnthropologyattheUniversityofParis.

In1861,BrocasatintheaudienceasErnestAubertinpresentedapaper
citingseveralstrikingcasestoargueacraniologicalcaseforcerebral
localizationofspokenlanguage.AubertinwasastudentofJeanBaptiste
Bouillaud.Asearlyas1825,Bouillaudprovidedclinicalevidencetosupport
Gallsviewthatthearticulatelanguageislocalizedintheanteriorlobesof
thebrain.Thishypothesiswaskeptaliveforalmost40years.Aubertin
claimedthathewouldgiveuphisbeliefincerebrallocalizationifevena
singlecaseofspeechlosscouldbeshownwithoutafrontallesion.Broca
decidedtotakeupAubertinschallenge.Hisspeechlesspatient(Tan)had
diedfromgangreneonBrocassurgicalward.Brocapublishedthiscase,
presentingadetailedaccountofhispostmortemexaminationofTansbrain.
Hefoundasuperficiallesionintheleftfrontallobe.Thisfindingwas
confirmedafewweekslaterbyanothercasewithasimilarlesion.Thiswas
thefirstreportaboutthelocalizationofthearticulatelanguageintheanterior
portionofthebrain.However,tobesure,thecerebralcortexshouldbe
exploredexperimentallyinnormalsubjects.Thetechniquewasintroduced
byGustavTheodorFritsch(18381927)andEduardHitzig(18381907).
FritschandHitzig,in1870,publishedaclassicpaper,providingevidenceof
corticallocalizationoffunction.Namely,usinggalvanicstimulationofthe
dogbrain,theyprovidedthefirstevidencethatareasofthecerebralcortex
areinvolvedinmovementsofthecontralateralextremities.Theseresults
establishedelectrophysiologyfortheexperimentalexplorationofcortical
localizationoffunction,whichdemonstratedtheparticipationofbrainin
motorfunctions.AtapproximatelythesametimeinEngland,John
HughlingsJackson(18351911)startedbrainfromadifferentdirection.He
wasaphysicianattheNationalHospitalfortheParalyzedandEpileptics,
QueenSquare.Hisideascanbesummedupasfollows:
Allcomplexmentalphenomenaaremadeupofthesesimpleelementsfrom
thesimplestreflextothemostsublimethoughts;allfunctionsandfaculties

canbeexplainedintheseterms. . ..Itisassertedbysomethatthecerebrum
istheorganofmind,andthatitisnotamotororgan.Somethink

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thecerebrumistobelinkedtoaninstrumentalist,andthemotorcentersto
theinstrumentonepartisforideas,andtheotherformovements.Itmay,
then,beasked,Howcandischargeofpartofamentalorganproducemotor
symptomsonly?. . .Butofwhatsubstancecantheorganofmindbe
composed,unlessofprocessesrepresentingmovementsandimpressions. . .?
Arewetobelievethatthehemisphereisbuiltonaplanfundamentally
differentfromthatofthemotortract?. . .Surelytheconclusionis
irresistible,thatmentalsymptoms. . .mustallbeduetolack,orto
disorderlydevelopment,ofsensorymotorprocesses(Jackson,1873).
WithJackson,thetheoreticalanalysisofcerebrallocalizationreacheditsfull
developmentinthenineteenthcentury.Theseresultswerefullyconfirmedby
hisfriendandcolleague,DavidFerrier(18431928),whousingcontrolled
ablationsandfaradicstimulationofthebrain,succeededinmappingsensory
andmotorareasacrossawiderangeofspecies.Thiswasthedominant
paradigmforexplanationinbothphysiologyandpsychology.
Theconceptofsubconsciousnessemergedinthenineteenthcentury.This
wasanepochoftranceandtrauma(functionalnervousdisorders).Themost
prominentscientistofthisareawasFranzAntonMesmer(17341815),born
inaGermantown,andstudiedmedicineattheUniversityofViennawitha
dissertationontheinfluenceoftheplanetsonhumandisease.Mesmerhada
patient,MadameOesterlin(27years),whosufferedfromrecurringphysical
ailments.On28July1774,heaskedhispatienttoswallowasolution
containingironandaffixedmagnetstoherstomachandlegs.Hersymptoms
begantodisappear,andshecompletelyrecoveredwithcontinuedtreatment.
Unfortunately,theresultswerenotconfirmedbyothersandMesmerhadto
leaveforParis,wherehefurtherdevelopedhismagneticcure.However,he
alsohadtoleaveParisafterseveralspectaculartherapeuticfailures,anddied
neartheplaceofhisbirth.
InthehistoryofWesternphilosophy,oneofthemostinfluential
philosophersisImmanuelKant(17241804),whowasborn,lived,anddied
atKoenigsberg,EastPrussia.Duringhislifehedidnottravelmorethanforty
milesfromhisbirthplace.HismostoriginalcontributionishisCopernican
Revolution:therepresentationthatmakestheobjectpossibleratherthanthe
objectthatmakestherepresentationpossible;thehumanmindisanactive

originatorofexperienceratherthanjustapassiverecipientofperception;
perceptualinputmustbeprocessed(recognized),otherwiseitwouldbea
noiseornothing.Kantarguedthatmindplaysanactiveroleinconstituting
thefeaturesofexperience,limitingthemindsaccesstotheempiricalrealm
ofspaceandtime;thoughtswithoutcontentareempty,intuitionswithout

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conceptsareblind(Kant,1871).Inthephilosophicalclassic,Critiqueof
PureReason,heassertedthathumanperceptualapparatusiscapableof
orderingsenseimpressionsintointelligibleunities,leadingtotheconclusion
throughpurereasonthattheintelligibleunities,suchasGod,freedom,and
immortability,doexist.Kantdidnotdescribehimselfasdualist,incontrast
toPlatowhobelievedthatthereisaworldbeyondthematerialworld,soulor
mind;heinsistedthatnoneofrealityexists;realityandallthatisinit,
includinghumanbeingsarepartofthisouterworld,allpartofadream
world.Kantarguedthattheuniversedidnotconsistofmatterbutofforces.
Kantproposedthattheobjectiverealityistheessentialstructureofthe
knowingmind.Onlyobjectsofexperiencecanbeknown,whereasthings
lyingbeyondexperienceareunknowable.Theunknowablethingsin
themselvescanbeneitherconfirmednordenied,norcanbescientifically
demonstrated.Accordingly,heshowedintheCritiqueofPureReasonthat
thegreatmetaphysicalproblems,suchasGod,freedom,andimmortability,
cannotbesolvedbyscientificthought.
Duringthistimeperiod,anotherphilosopherofmind,JohannFriedrich
Herbart(17761841),wasconcernedwiththenewscientificpsychology,
makingacriticaldistinctionbetweenideasaboveandbelowthethresholdof
consciousness.HewasatransitionalfigurebetweenKantandFechner;he
wasnotabletolinkhisphilosophyofmindtothephysiologyofthebrain.
EvangelistaPurkyne(17871869)andErnstHeinrichWeber(17951878)
madefundamentalcontributionstotheexperimentalphenomenologyof
sensation,andJohannesMueller(18011858)elaboratedthedoctrineof
specificnerveenergies,suggestingthenervoussystemasintermediary
betweenmindandtheworld.Weberdescribedthejustnoticeabledifference,
whichreferstothesmallestperceptibledifferencebetweentwosensations.
Heplayedanimportantroleintheemergingscienceofpsychology.Weber
providedevidencefortherelationshipbetweenvariationsinphysicaland
mentalevents.AccordingtoMueller,themindisdirectlyawareofthestates
ofthenervoussystem.Thatis,thenervoussystemplaysaroleasan
intermediarybetweentheworldandthemindandthusimposesitsown
natureonmentalprocesses.Afterthat,thequantitativemeasurementofthe
mind/bodyrelationshipemergedinFechnerspsychophysics.
TheexperimentalpsychologyformallystartedwithGustavTheodorFechner
(18011887).Beforethat,therewasonlypsychologicalphysiologyand
philosophicalpsychology.FechnerwasborninPrussia.At16,hebeganto

studymedicineattheUniversityofLeibzig;afterearninghisM.D.hebegan
tostudyphysicsandmathematics.Hesufferedanervouscollapse,

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in1840,ashisarticleonsubjectiveafterimagesappeared.Hehadapainful
injurytohiseyeswhilegazingatthesunduringhisresearch.Thisresultedin
temporaryblindnessandprostration.Heresignedhispositionandhis
interestschangedtometaphysics.In1848,hereturnedtotheUniversityasa
professorofphilosophy;hewroteabook,Nanna,UeberdasSeelenlebender
Pflanzen,whichcontainedhisfirstphilosophicaltreatmentofthemind/body
relation(monistic,dualaspect,panpsychicalmind/bodyview).Fechner
wantedtodemonstratetheunityofmindandbodyempiricallybyrelating
increaseinbodilyenergytoanincreaseinmentalintensity.
Between1851and1860,Fechnerworkedonthemeasuringsensation
indirectlyandfoundajustnoticeabledifferencebetweenthetwosensations.
Workingoutthissubject,heconcludedhisbook,Elementeder
Psychophysik.Hisaimwastoestablishanexactscienceofthefunctional
relationshipbetweenphysicalandmentalphenomena,andformulatedhis
famousprinciplethattheintensityofsensationincreasesasthelogofthe
stimulus(S=klogR).Indoingso,hebelievedthathehadarrivedata
fundamentalphilosophicaltruth:mindandmatteraresimplydifferentways
ofconceivingofoneandthesamereality.Mentaleventswereshownnot
onlyasabletobemeasured,butalsobroughtintorelationtophysical
phenomena;psychophysicsbecameoneofthemethodsofthenewly
emergingscientificpsychology.WilhelmWundt(18321920),physiologist,
alsorejectedametaphysicalfoundationofpsychology.Wundtarguedthat
thelimitationsofthedirectstudyofconsciousnesscanbetranscendedusing
genetic,comparative,statistical,historical,andparticularlyexperimental
methods.Onlyinthiswaywoulditwouldbepossibletounderstandthe
consciousphenomenaascomplexproductsoftheunconsciousmind
(Wundt,1862).
HermannLudwigFerdinandvonHelmholtz(18211894)borninPostdam
(Germany),graduatedinmedicineat21yearsofageandwasinterestedina
physiologicalbasisofanimalheat.Hecalculatedtheconductionvelocityofa
nervousimpulse,bystimulatingnervesatvariousdistancesfromamuscleand
measuringthetimeittookformusclecontraction,andintroducedthetechnique
formeasuringthereactiontimeintophysiology.Between1865and1868,
anothergreatphysiologist,FranciscusCornelisDonders(18181889)developed
andassimilatedthereactiontimetopsychology.Dondersseparatedthetime

takentorespondtoastimulusunderconditionsofchoiceandnonchoice.In
doingso,Donderscalculatedthetimeintervaltakenbythedecisionprocess.His
discoverieswithrespecttomentalreactiontimesexertedamajorimpactonhis
contemporariesandreactiontimewasinstalled,alongwithpsychophysics,asa
methodofchoiceinearlyexperimentalpsychology.

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Themostinfluentialneurophysiologistandphilosopherofthenineteenthcentury
wasSirCharlesSherrington(18571952),whocompletedhismedicinestudyat
theRoyalCollegeofSurgeons.Firstheworkedontheeffectsofexcisionsof
partsofthecortexofdogbrains.In1885,hewenttoSpaintostudyanoutbreak
ofcholera;in1886hevisitedVenicetoinvestigatethisdisease,thenhetookthe
materialtoVirchowinBerlinforfurtherexamination.WhileinSpain,hewas
influencedbytheSpanishNeurologistRamonyCajal,andtookupthestudyof
thespinalcord,andbegantostudythespinalreflexes.Afterthepassingofthe
manofgeniuson4March1952,Sherringtonleftmorethan350worksonthe
foundationsofknowledgeofthefunctioningofthebrainandspinalcord.His
workIntegrativeActionoftheNervousSystem(1906)isstillasourceof
inspirationtophysiologistsallovertheworld.Sherringtondidnotretirefromthe
ChairofPhysiologyatOxforduntil1935attheageofseventyeight.After
makingexperimentswithcats,dogs,andmonkeys,hebecameaphilosopherand
wasinterestedinthemind/bodyrelationship.Hehadadualistpositioninthe
mind/bodycontroversy.Fivedaysbeforehisdeath,hesaidtoSirJohnEccles,
oneofhisprominentpupils:Formenow,theonlyrealityisthehumansoul
(Eccles,1975).

AccordingtoSherrington,

. . ..mindisattachedtoavoluntarymotoractperformedwithskill.What
themindisconcernedwithisnottheactbuttheaim.Itismoreawareofthe
fingerpartthantherestBecausethefingerspartstandsnearesttotheaim.
. . .Clearlywemustnotsupposelifeandmindareoneandthesame.The
finitelifeisaphenomenonaccessibletosense;thefinitemindisnot.
(Sherrington,1953)
Whatismostimportantforthesubjectofthepresentworkisthatmind,
recognizablemind,seemstohaveariseninconnectionwiththemotoract.
Wheremotorintegrationprogressedandwheremotorbehaviorprogressively
evolved,mindprogressivelyevolved.
OneofSherringtonsmostnotablestudentswastheCanadianneurosurgeon
WilderPenfield(18911976).HeestablishedtheMontrealNeurologicalInstitute
in1934.Inthe1950s,Penfieldwastryingtotreatepilepticpatients,removingor
destroyingthebraintissueresponsibleforseizures.Hemadeadramatic
discoveryatthesametime:stimulatingonlythetemporallobeelicited
meaningful,integratedresponsessuchasmemoryforsounds,movements,and
color.Thesememoriesweredistinctfromusualmemories,whichwere
unrememberedunderordinarycircumstances.Ifhestimulatedthesamearea

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again,thesamememoryappearedagain.Hebelievedthathefounda
physicalbasesofmemory(engram).Healsointerestedinmind;untilhis
deathin1976questionedthescientificbasisofmind,whetherthereisa
scientificbasisfortheexistenceofthehumansoul,andstated:
Throughoutmyownscientificcareer,I,liketheotherscientists,havestruggled
toprovethatthebrainaccountsforthemind.Butnow,perhaps,thetimehas
comewhenwemayprofitablyconsidertheevidenceasitstands,andask
question:Dobrainmechanismsaccountforthemind?.Canthemindbe
explainedbywhatisnowknownaboutthebrain?Ifnot,whichisthemore
reasonableofthetwopossiblehypothesis,thatmansbeingisbasedonone
element,orontwo?(Penfield,1975)
First,Penfieldofferedanentirelymechanisticinterpretationofthebrain
functions.Butsubsequently,hewasconvincedthatthismechanisticandmonistic
viewcannotexplainthefacts:somethingelsefindsitsdwellingplacebetween
thesensorycomplexandthemotormechanisms(Penfield,1975).
AsPenfieldworkedduringhistrainingwithSirCharlesSherringtonandfora
shortperiodunderSantiagoRamonyCajalinSpainhebelievedthatmindwill
beentirelyexplainedintermsofphysics,chemistry,andelectricity.Butlater,he
thoughtthatthismechanisticandmonisticviewdidnotadequatelyaccountfor
thefacts.Hehadasurprisingandremarkableexperienceasaformofdouble
consciousnessinoneofhissubjectsduringtemporallobestimulation.The
patientwasawareofhisimmediatesurroundings,andatthesametimehere
enactedscenesfromthepastwithvividsounds,andsoon.Anotherpatientfrom
SouthAfricawasalsoawareofhisenvironmentintheoperatingroom,buthe
was,atthesametime,laughingwithhiscousinsonafarminSouthAfrica.
AccordingtoPenfield,themindofthepatientwasindependentaswasthemind
ofthesurgeonlisteningtoandunderstandinghim:thus,myargumentfavors
independenceofmindaction(Penfield,1975).Penfieldconcludedthatthe
stimuluswasresponsibleforakindofTVprogramthesubjectwatched
objectively,whilethesubjectsmindwasdirectingtorecordtheeventsinthe
roomaroundhim.JustasonecanobjectivelywatchaTVprograminthe
companyofotherswhosepresenceoneisfullyconsciousof,sohereweretwo
differenttypesofconsciousness.Heemphasizedthatitisthemindthatmustfirst
programthecomputerbrain,whichhasnoabilitytomaketotallynewdecisions
forwhichitisprogrammed.Stimulationofthesamepointinthetemporalcortex

inducedthesamescenes.Thiswasrepeatable;inonesubjectthisoccurredsixty
twosuccessivetimes.However,inanothersubject,the

PSYCHOMOTOR THEORY
1121

stimulationofthesameareacausedfourapparentlyunrelatedresponses.First
heheardfootsteps,secondlyacompanyofpeopleintheroom,thirdly
likebeinginagymnasium,andfinallyaladytalkingtoachildatthe
seashore.Theexperienceswerenotasakindofhallucinationbutasareal
life.Intheend,Penfieldconcludedthatitiseasiertorationalizemans
beingonthebasisoftwoelementsthanonthebasisofone(Penfield,1975).
In1961Penfielddemonstratedtherealityofactivemindorfreewill.He
stimulatedanareainthecerebralcortexwithasingleelectrodeusingan
electricshockat60Hzfrequencyand2voltintensity.Whenthe
neurosurgeonappliedthisstimulationtothemotorarea,theoppositehand
moved,asexpected.Surgeonaskedthepatient,whyhemovedhishand.The
responsewas:Ididnotdoit,youmademedoit.Itmaybesaidthatthe
patientthinksofhimselfashavinganexistenceseparatefromhisbody(pp.
203204).Penfieldgoeson:OncewhenIwarnedapatientofmyintention
tostimulatethemotorareaofthecortex,andchallengedhimtokeephis
handfrommovingwhentheelectrodewasapplied,heseizeditwiththeother
handandstruggledtoholditstill.Thusonehand,underthecontrolofthe
righthemispheredrivenbyanelectrode,andtheotherhand,whichhe
controlledthroughthelefthemisphere,wascausedtostruggleagainsteach
other.Behindthebrainactionofonehemispherewasthepatientsmind.
Behindtheactionoftheotherhemispherewastheelectrode(pp.203204).
Sherringtonsmind/bodydualismwasfollowednotonlybyPenfieldinCanada,
butalsobyanotherpupil,SirJohnEccles(19031997).Ecclesisrecognizedfor
hisremarkableandoutstandingimpactontheneurosciencesformorethansix
decades.Moreover,hisessaysonthemind/braininteractiongenerated
considerableinterestanddebate.Hestudiedscienceandmathematicsat
MelbourneHighSchool,beforeenteringtheUniversity,sharedtheState
geometryprizeandgainedaSeniorScholarshiptotheUniversity.Hewasdeeply
interestedinmathematics,butchosemedicinetostudy.Hewasinterestedin
DarwinsOriginofSpeciesinthefirstyearzoologycourse,andinphilosophy
dealingwiththemind/bodyproblem.Becauseoftheunsatisfactoryexplanation
oftheinteractionbetweenbrainandmind,hedecidedtobeaneuroscientist.At
Oxford,hespenttwoyearsstudyingfortheFinalHonoursSchoolinPhysiology
andBiochemistry;hereadtheneurophysiological,biochemical,philosophical,
andtheologicalbooks.HeworkedwithRagnarGranitonthecrossedextensor
reflexes.In1935,SherringtonretiredandwasreplacedbyJ.Mellanby.Eccles
wasdisappointedandwasalsoconcernedabouttheincreasingpolitical
uncertaintyinEurope.HeresignedhisOxfordappointmentsandwenttoSydney
withhisfamilyin1937.Ecclesresignedin

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1943,however,becauseofadebatebetweenhimandthehospitalboard,and
acceptedtheChairofPhysiologyinOtago(NewZealand),whereherecorded
ventralrootresponsestodorsalrootstimulation,dorsalrootpotentialsupon
dorsalrootstimulations,whichweredescribedbyBarronandMatthewsin1938.
Theresultswereconsistentwithanelectricalhypothesisofsynapticand
neuromusculartransmission,aspublishedinNature(1945).

EcclesencounteredK.R.PopperinNewZealand.Hewasdeeplyimpressed
byPoppersphilosophy:thescientifichypothesesshouldbeclearly
formulatedandtestablebyexperiment;thestrengthofahypothesisdepends
uponthefailureofrigorousinvestigationtofalsifyitratherthanonevidence
whichapparentlysupportsit(Popper,1935).Hehadalonglastingdebate
withHenryDaleabouttheoriginsofthesynaptictransmission.Eccles
insistedofelectricaltransmissionincontrasttoDalewhoinsistedof
chemicaltransmission.Ecclesstatedhishypothesisofelectricalexcitatory
transmissionatcentralandganglionicsynapses,andtheneuromuscular
junction,proposinganumberofphysiologicalandpharmacological
experiments.Accordingly,hetestedthishypothesisin1946withC.McC.
Brooksbyrecordingthemonosynapticexcitationfromthespinal
motoneurones.Theresultswereinterpretedasconsistentwithhiselectrical
hypothesis,andwerepublishedinNature.
In1949,Ecclesrestatedhiselectricalhypothesisusingsynapticexcitationand
inhibitioninthespinalcord.However,hisstudieswithKufflerandothers
convincedhimin1948thattransmissionattheneuromuscularjunctionwasa
chemicalprocessmediatedbyAch.In1951,heconsideredhishypothesistohave
beenfalsified,andacceptedthatspinalexcitationandinhibitionwereboth
chemicalinnature.Afterthisyear,heacceptedaninvitationtoCanberra.

Hewasinvolvedinthemind/brainproblematthesametime.Hisdualistic
view,aneurophysiologicalhypothesisofwill,firstpublishedinNature,
createdintensediscussion.Hislectureswerepublishedin1953as
TheNeurophysiologicalBasisofMind:ThePrinciplesofNeurophysiology.
After1952onwardfornearly13years,Eccleswasmostproductive
inCanberra:74investigatorsfrom20differentcountriesworkedwithhimduring

thistime.Helaterwrote:Withoutdoubtitwasthehighpointofmyresearch
career. . .my14goldenyears,scientificallyspeaking(Eccles,1977).Hehad
sixlargeresearchlaboratorieswithcoworkersinterestedinneuropharmacology
andneurochemistry.In1958,herecordedthedorsalrootpotentialsintracellularly
fromintraspinalafferentfibers,andprolongedEPSPsfromdorsalhorn
interneuronesinvolvedinDRPs.Theperiodof19611965wasfullof
publications(29fullpapers,13reviewarticles,andonebook)dealing

PSYCHOMOTOR THEORY
1123

withpresynapticinhibition.Intheventrobasalcomplexofthethalamushemade
twointerestingobservations:arecurrentinhibitionandlargepostinhibitory
rebounddepolarizingresponseswithsuperimposedburstsofactionpotentials
(rhythmicthalamicactivity).Eccleslastperiodofexperimentalneuroscience,
concernedwiththecerebellum,beganinCanberrain1963andcontinuedinthe
UnitedStatesuntilhisretirementin1975.Theresultswerepublishedinaseries
ofarticlesinNatureandinabook,TheCerebellumasaNeuronalMachine.An
importantfactorinEcclesdecisiontoleaveAustraliawashisfeelingof
intellectualisolation,especiallyconcerninghisphilosophicalinterestin
mind/bodyinteraction.In1975,EcclesvoluntarilyretiredandmovedtoContra
inSwitzerland,wherehededicatedhimselftoworkonthemind/brainproblem.
HowtheSelfControlsitsBrainwaspublishedin1994.Throughouthismental
life,hehadbeenadualist,searchingformechanismsbywhichmindandbrain
interact.However,only18%ofhis568publicationsdealtwiththissubject.In
TheSelfandItsBrain,hesummarizedhisviews:

Itisaverystrongdualismandraisesthemostseverescientificproblemsin
relationshipbetweentheworldofmatterenergy,andtheworldofstatesof
consciousnessthatisreferredtoastheselfconsciousmind.Briefly,the
hypothesisstatesthattheselfconsciousmindisanindependententitythat
activelyengagesinthereadingoutfromamultitudeofactivecentersinthe
modulesoftheliaisonareasofthedominantcerebralhemisphere.(Eccles,
1977)
Healsosuggestedthatthemind/brainliaisonfunctionsinbothdirections,
fromthebraintothemindinperceptionandfrommindtobraininwilled
action:Theselfconsciousmindinteractswiththebrainonaggregationsof
corticalpyramidalcelldendrites(p.371).
Ecclesactivelyparticipatedintheexperimentsfrom1927to1975.Hehada
strongmotivationandstaminaforanoutstandingscientificcareer.Healsoowed
muchofhissuccesstohisproductiveresearchteams.Hewasaprofilicwriter
with568items,including19books.Hisexperimentsusuallybeganearlyinthe
morningeachweek,oftenlasting1620hours,occasionallyextendingintothe
followingday.Healwayshadthebestequipmentinhislaboratoriesincludingthe
firstclasselectronicandmechanicalworkshoppersonnelandfacilities.As
EcclesdecidedtomovetoChicagoin1966,hiswifepreferredtostayin
Australia,andtheirmarriagewasdissolvedin1968.InthesameyearEccles
marriedHelena,aneurophysiologistwhocollaboratedwithhimfrom1966until
hecompletedexperimentationin1975,afterwhichtheymovedto

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Switzerland,whereEcclescontinuedtoworkonthemind/brainproblem.
Untilwellbeyondhis90thyear,hehadalongseriesofbooks,articles,
reviews,comments,bookreviews,andobituaries,whichallwerehand
written.HewasalwaysassistedintheseactivitiesbyhiswifeHelena.Hehad
badhealth,however,from1994on,andhediedin1997intheHospitalLa
CaritainLocarno.
Thedualistinteractionistviewofthemind/brainproblemunderwenta
considerablechangebecauseofRogerW.Sperry(19131994),whooffered
themostcontemporaryhypothesisonthesubject.HewasborninHartford
(USA),stayedinOberlinforanMAinPsychology(1937),andreceivedhis
Ph.D.(1941),inZoology.Hearguedthatthebasicstructureofthe
mammaliancentralnervoussystemishardwired,andunmodifiableby
training.Hewasuncomfortablewiththeideathatelectricalfieldsorwaves
werecriticalforneocorticalprocessing.Hedemonstratedinmonkeysthat
motorcoordinationremainedunaffectedaftermultipletransactionsof
sensorimotorcortex.Heisfamousforthesplitbrainexperiments.In
commisurotomizedanimals,restrictionofsensoryinputononecerebral
hemispherewasshowntolimitthelearningactivitiestothathemisphere;the
otherbrainhalfwascapableoflearningbutremainednavetothosetasks
untiltrained;thelearningcurvesforeachhemispherewasthesame;itwasas
iftwoseparatebrainswerehousedwithinasinglecranium.Sperrycarried
outmuchworkduring1950sand1960sonthesplitbrainpreparation.Then
Sperrystudiedtheeffectsofcommissurotomyonperception.Theleftbrain
wasfoundtobeinvolvedinanalytical,sequential,andlinguisticprocesses,
andtherightbraininholistic,parallel,andspatialabilities.Moreover,the
combinedeffectofbihemisphericactivitywasmorethanthesimpleadditive
effectsofthetwoseparatehemispheres.Sperrythenbegantoexplorethe
emergenceofconsciousnessfromtheunifiedbrain:
Ihaveneverbeensatisfiedwiththematerialisticorbehavioristthesisthata
completeexplanationofbrainfunctionispossibleinpurelyobjectivetermswith
noreferencewhatevertosubjectiveexperience,i.e.,thatinscientificanalysiswe
canconfidentlyandadvantageouslydisregardthesubjectivepropertiesofthe
brainprocess. . ..Thementalforcesareinseparablytiedtothecerebralstructure
anditsfunctionalorganization.. . .Incontrasttomindbrainidentitytheory,in
thepresenttheorytheconventionaldifferencesbetweenmindandbrainare

acceptedandemphasized.. . .
Thebrainprocessconsistsofamultilevelhierarchiccompoundofentitiesand
eventsfromsubatomicupthroughcerebralcircuitandcognitivelevels,

PSYCHOMOTOR THEORY
1125

iscomposedmostlyofnonconsciouselementsthatarecommonbothto
consciousandnonconsciousbrainprocesses. . ..Thebrainprocessandthe
consciousprocessesareinseparablebutdifferent.Thedifferencebetween
mindsandbrainisthekindwhichexistsbetweenanemergentpropertyand
itsinfrastructure.. . .Subjectiveexperienceinthisinterpretationisconceived
tobeanemergentdynamicpropertyofcerebralexcitation,inseparablefrom
thematerialbrainprocess,butdifferentfromandmorethan,thecollected
sumofthephysicochemicalcomponents.. . .Theconsciousexperienceisa
propertyof,andcannotexistsapartfromthecerebralsubstrate.(Sperry,
1980)

AccordingtoSperry,emergenceoccurswhen,forinstance,subparticles,atoms,
andmoleculescreateanewentitywithnewpropertiesformerlynonexistentin
theuniverse.Sperrydidnotseethisasdualism,whichdescribesthemindasa
separateentityoutsidethebrain.Consciousnessemergesfromthecreativityof
cerebralnetworksasanindependententity,whichcontinuallyfeedsbacktothe
brain,causingnewdynamicprocessesinthebrain,feedback(downward
causation)withnewlyemergentstates,andsoforth.
Materialism(physicalism)referstotheideathathumansarecompletelyphysical
beings;thereisnomindseparatefrombrain;theconceptsofasoulormindare
onlymythical;everyeventincludingmentalphenomenamaybeexplainedby
matterandmotion.Materialismisthesimplestexplanationofreality:nopsychic
orspiritualtruthsexistindependentfromthephysicalworld.Philosophical
materialismclaimsthatthereisonlyonesubstanceintheuniverse:physical,
empiricalormaterial;everythingismatterandenergy;consciousnessisan
emergentpropertyofthephysicalbrain.TheexistenceofasupernaturalGodis
denied,butGodisidentifiedwiththematerialuniverse,asinPantheism.
MaterialismoriginatedinancientGreekphilosophy,inChina,andIndia,during
thesixthcenturyBC.Analyticalmaterialismdealswiththesocalledmind/brain
problem:whetherornothumanconsciousnesscanbeexplainedbyscientific
laws.Inthe1960sand1970s,itwasarguedthatthebrainandmindarethesame
materialthings.Reductionistmaterialismclaimsthatthemindisidenticaltothe
braininallrespects;mentalstatesareidenticaltobrainstates;mentalprocesses
arereducibletophysicalfacts.Behaviorismclaimsthatthereisnomind;vague
talkaboutfeelings,thoughts,desires,andsoonshouldbeeliminatedfromthe
vocabularyandreplacedwithscientifictermsreferringonlytobrainstates.

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MIND-BRAIN-BODY TRIAD IN HEALTH


Fromthebeginningsofancienthistorythereisdanceasanexpressionof
God.Throughmovementandsound,thiscreatedaconnectiontospirit.
Spiritualdancingisacrossculturalphenomenon.Dancewasusedto
promotespiritualandphysicalhealth,andvitality.Anancientdancetype,
trancedance,wasahealingvehiclethroughwhichpeoplecould
communicatewiththeirspirit.Today,therearedance/movementtherapies,
whicharethepsychotherapeuticprocessesimprovingtheemotionalstates,
cognition,andthesocialandphysicalintegrationoftheindividual.
Danceistheestheticexpressionofmindinbodilymovement.Danceoriginatesin
adiscretebodilykinestheticintelligence(Gardner,1993);skilledmovements
isaformofthinking(Bartlett,1958;Fischer&Bidell,1998);movementis
predominantinallformsofhumanintellectualactivity(Laban,1975;Laban&
Lawrence,1974).Rhythmicmovementsindanceinjectitselfintoallcognitive
actionsincludingourmindandselfconsciousbrain.Indeed,selfgenerated
movementisthefoundationofthoughtandwilledaction,theunderlying
mechanismbywhichthephysicalandpsychologicalcoordinatesoftheselfcome
intobeing(Wilson,1998,p.291).

Yogacreatesamind/bodyconnectionbyusingawarenessofthebreathand
concentrationofthemind.Inthemind/bodyapproach,exercisesaretaken
fromyoga,taichi,aikido,andfromdancemovementtherapy,toenhance
awarenessofbreathing,increaseabilitytobreathe,experiencetheinterplay
amongthephysical,mental,emotional,andspiritualaspectsofwellbeing,
feelingpowerful,andfeelinggraceful(Eckstein&Keeling,1991).
Consideringbreathandmentalactivity,itwasinterestinglyfoundthatthe
nonverbalIQ(CattellsCultureFairIntelligenceTest)increasedwithtidal
volumeofthelungsinhumansubjects(Tanetal.,2003).Itwasalsoreported
thataerobicdanceisbeneficialinthetherapyofanxiety(Kern&Baker,
1997).Moreover,exercisehasbeenreportedtohavetranquilizingand
antidepressanteffectsonparticipants(Berger,1984).
Inadditiontovoluntaryactivemovementasoccurredindance,thegentle

rhythmicalmovementsperformedwithhandsonasubjectcaninduce
positiveandlongtermchanges(Blackburn,2003):Theclients,although
passive,wouldbecomeawareofverypleasurablesensationsintheirbodies,
andlearntthentoreplicatethesemovementsforthemselves.Thismethod
wasproventobeeffectivenotonlyinhealthysubjects,butalsoinpatients
withcerebralpalsy,postpoliorelatedparalysis,musculardystrophy,and
Parkinsonsdisease.

PSYCHOMOTOR THEORY
1127

Dancewasrecognizedasatherapeuticagentfirstafterthe1930s(dance
therapy).Itwasusedinthetreatmentofanxietydisorders(Leste&Rust,
1990),Parkinsonsdisease(Westbrook&McKibben,1989),addictions
(MurrayLane,1995;Rose,1995),multiplepersonalitydisorder(Baum,
1995),andlearningdifficulties(MacDonald,1992).CohenandWalco
(1999)reportedthatevenincancercasesdancetherapymayhavebeneficial
effectsonthecognitive,emotional,andsocialactivities.
Thereportedstudiessuggestthatmovementmayoccupyacentralpositionin
cognitiveactions.Thereisaninformationprocessingsystemrelatingto
movementandcognitiveactions,suchasplanning,reasoning,andemotion
(Leineretal.,1989).Thecerebellum,knowntobeinvolvedonlyinvoluntary
andinvoluntarymotorcontrol,alsoplaysamajorroleinthoughtitself
(Leineretal.,1986);theresultinginformationprocessingsystemmaybe
essentialforthemanipulationofkinestheticmind.Inaccord,itwasposited
thatthinkingisanadvancedformofskilledbehaviorthatevolvedfrom
earlierformsofflexibleadaptationtotheenvironment(seeBarlett,1958).
Interestinglyenough,itwasreportedthatmentalpracticealonemayimprove
physicalskills(Hinshaw,1992;Oglesetal.,1994).
Disordersinthefrontothalamocerebellarcircuitmaycausecognitive
dysmetriaorproblemsininformationprocessing,whichmayplayarolein
theoriginsofschizophreniaandothermentalillnesses(seeAndreasenetal.,
1998).Thespinalcord,asapartofthecentralnervoussystem,shouldalso
involvedinthisnetwork.Namely,inschizophreniapatients,thespinalmotor
asymmetrydisappearedafterchlorpromazinetreatment(Tan&Gurgen,
1986).Thecerebellarcognitiveaffectivesyndromeisassociatedwith
disturbancesinlanguage(e.g.,agrammatism),personality(e.g.,blunted
affect),spatialcognition(e.g.,deficitsinvisuospatialmemory),and
executivefunctions(e.g.,difficultiesinplanning);cerebellarlesionsare
linkedtodisturbedaffect,andproblemsincognitiveprocessing,especiallyin
posteriorlobelesions(seeSeitz,2000).Theparallelevolutionofthefrontal
loberegions(speech?)andhandsinhominidssuggestsmotoractivityasthe
basisofhumanintelligence(Seitz,2000).
Therearemoreexamplesindicatingpsychomotorcoupling.Forinstance,
therearecognitive(e.g.,dementiaanddepression)aswellasmotordeficits
indefectsofbasalganglia,substantianigra,locusceruleus,andraphenuclei
ofthebrainstem.ThesesymptomsarecharacteristicforParkinsonsdisease
exhibitinganincreaseininhibitorysignalsleadingtoadecreaseincortical
excitationandmovement(seeDeLong,1990),andforHuntingtonsdisease

exhibitingareductionininhibitoryactionleadingtoanincreasein

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corticalexcitationandmovement(Middleton&Strick,1994).Cerebellumis
nowknowntoplayanimportantrole,alongwithbasalganglia,inplanning,
regulation,andattention(Akshoomoff&Courchesne,1994);the
developmentaldeficitsincerebellummayleadtopoorsocialandcognitive
developmentevenintheabsenceofanhippocampaldamage.
Theposteriorparietalcortex,anothermotorregion,isresponsibleforcreatinga
frameofreference(i.e.,spatial,visual,vestibular)formovement(Willingham,
1998).Ito(1993)suggestedonpage449thatthereisnoinherentdistinction
betweenthoughtandmovementatthelevelofthebrain;bothcanbecontrolled
byidenticalneuralsystems.Thereforeconceptsandideascanbemanipulated
justasarebodypartsinmotion(Seitz,p.24,2000).

Contemporaryresearchershaverecentlyproposedthattherearetwodistinct
cognitivesystems(Dualprocesstheory;Evans,2003):System1describesa
formofuniversalcognitionsharedbetweenhumansandanimals(instinctive
behaviorscontrollingspecificbehaviors);System2evolvedmuchmore
recentlythanSystem1(volitional)isthoughttobeuniquelyhuman,and
permitsabstractthinkingnotpresentinSystem1.Briefly,thedualprocess
theoriesofthinkingandreasoningproposethepresenceoftwomindsinone
brain.
Thespinalmotorsystemisalsoinvolvedincognitiveactions.Paillard(1955)
foundthatthenumberofmotoneuronesincreasedduringmentalarithmetical
calculations:theTreflexamplitudeenhanced,buttherewasnochangeintheH
reflex(Hoffmannreflex,acounterpartofthemonosynapticstretchreflex)
amplitude.Consideringhandedness,Davis(1937)reportedthatarithmetical
calculationsproducedEMGgradientsintherightforearmextensormusclesin
righthanders.Aswellknown,thepairedHoffmannreflexproducedbydouble
shockstimulationofthetibialnerveprovidesameasureofmotoneuronal
excitabilityunderavarietyofexperimentalandclinicalconditions.Itisalsoa
usefultoolinexaminingtheneurophysiologicbasisofalterationsinreflex
responseindifferentstatesofawareness.Usingthistechnique,Wallaceetal.
(1984)foundthatthefacilitationperiodofthepairedHreflexrecoverycurve
maybeausefulindicatorfortheacademicachievement.Accordingly,Tan
(1991)reportedthatthereisaninversecorrelationbetweenthelatencyofthe

Hoffmanreflexrecordedfromthethenarmuclesoftherightandlefthandsand
nonverbalIQ:highIQwasassociatedwithhighermotoneuronalexcitability,and
viceversa.Concerningthemoreperipheralnervoussystem,Tan(1996)found
thatthesensoryandmotormediannerveconductionvelocitywaspositively
linearlycorrelatedwithIQinmen.

PSYCHOMOTOR THEORY
1129

Withregardtothemind/bodyrelation,Dayietal.(2002)reportedthatCattell
IQ(nonverbal)linearlyincreasedwiththerightminusleftfacewidthinleft
handers,andnegativelycorrelatedinrighthandedmenandwomen;verbal
abilityinverselyrelatedtorightminusleftfacewidthinrightandleft
handedmen,butdirectlycorrelatedinrighthandedwomen;themental
rotationabilitypositivelyandlinearlycorrelatedwiththerightminusleft
facewidthinlefthandersandrighthandedwomen.Theauthorsconcluded
thatthestructuralfunctionalcouplingrevealedinthepresentworkmay
haveitsoriginsinparalleldevelopmentofthecraniofacialskeletonandbrain
undertheinfluenceofhomeoboxgenes(p.383).
IQiscloselyrelatedtospinalmotoractivity,assessedbyHoffmannreflexin
humans(Tan,1989a),andtohandskillinrightandlefthandedsubjects
(Tan,1989b,c;Tan1990).

MIND-BRAIN-BODY TRIAD IN DISEASE


Parkinsons Disease (PD)
PDisadisorderofmotorsystemexhibitingatriadofakinesia,rigidity,and
tremor.Itis,however,accompaniedbynonmotormanifestations,suchas
neuropsychiatric,perceptual,andcognitivedeficits.JamesParkinsondescribed
melancholiainhisoriginalreportconcerningthedisorderreferredtohisname.
Depressionisoneofthemajornonmotorsymptomsoccurringin4%to75%of
patientswithPD(Allainetal.,2000;Ranoux,2000).Thesurveys,however,suf
ferfromanumberofmethodologicalflaws(seeMcDonaldetal.,2003).Parkin
sonsdiseaseischaracterizedbyaseriesofmotorsystemdisturbances,suchas
tremor,rigidity,slownessofmovement,andabnormalitiesofposture.Inaddi
tion,therearenonmotorsymptomslikemoodchanges,andcognitivedeteriora
tion.Inmanycountries,includingtheUnitedStates,approximatelyhalfofPD
patientshaddepressivesymptoms(seeMcDonaldetal.,2003).Thediagnosisof
depressioninPDisparticularlydifficultbecausethesymptomsofPDoverlap
withthesymptomsofdepression(McDonaldetal.p.363,2003).Parkinson
patientsoftenhavepsychologicaldisturbances,suchapsychomotorslowing,
concentrationdifficulty,depressedmood,anddiminishedsexualactivity.
Theirfacialappearancetypicallyresemblesthatofmelancholics.Various
depressionscaleswereusedtoassesdepressioninPD,butthereisnoscale
specifictocomorbiddepressioninPD;theaccuratediagnosisofdepressionin
PDiscomplicatedbyvariousfactors;theDSMdiagnosticcriteriaformajor

depressiondonotadequatelydescribethePDpatientswithsubsyndromal

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depression(seeMcDonaldetal.,2003).So,theprevalenceofdepressionin
PDremainscontroversial.
Motor Neuron Disease (MND)
Amotoneuronaldiseasewithmentaldisordersistheamyotrophiclateral
sclerosis(ALS),whichissimplycalledasMotorNeuronDisease,actually
comprisingaseriesofmotorneurondisorders,suchasprogressivebulbarpalsy,
amyotrophiclateralsclerosis,spinalmuscularatrophies,KugelbergWelander
syndrome,Duchennesparalysis,WerdnigHoffmanndisease,Juvenilespinal
muscularatrophy,andinfantilespinalmuscularatrophy.MNDsmayaffectthe
upper(frombraintomedullaorspinalcord)andlowermotorneurons(from
spinalcordtoskeletalmuscles).AsaresultofMND/ALS,theskeletalmuscles
weakenandlosetheirabilitytomove;manymusclegroupsmaybeaffected,
includingthosethatcontrolswallowingandbreathingaswellasmusclesinthe
arms,legs,back,andneck.Generally,thetermsMNDandALSareused
interchangeably.Asearlyasin1932,acombinationofMNDwithmental
symptomswasreported,andpsychicdisturbancesaccompanyingALSwere
reportedinthenineteenthcentury(seeBak&Hodges,2001).Themostcommon
psychiatricsymptomsobservedinMNDareemotionalchangesincluding
depression,manicdepressiveillness,emotionalirritability,attimesculminating
inviolentanduncontrollableoutburstsofrage.Emotionalsymptomsareoften
observedwithotherchangesinpersonalityandbehavior,rangingfrom
suspiciousnesstooutrightdelusionsandhallucinations,includingpsychotic
symptomssuchasparanoidandcatatonicschizophrenia(Bak&Hodges,2001).
BecausetheMNDfrequentlyoccurredwithcognitiveimpairment,itwas
consideredasamultiplesystemdisorder.Barsonetal.(2000)foundthat22%of
patientswithMNDwerediagnosedwithdementia.Moststudiesonmental
functionsinMNDconcentratedonthedramaticdeclineseeninMND/dementia
complex.Theothercognitivefunctionsnotrelatedtodementiaarealsobeing
studiednowadaysinMNDpatients.Interestingly,Abrahamsetal.(1997)
suggestedalinkbetweenthepresenceofthepseudobulbarpalsyandtheseverity
ofcognitivedeficits;themotorcomponentofdementiainMNDmostlyinvolves
thebulbarandproximalupperlimbs,anddementiashowssimilaritieswiththe
frontalvariantoffrontallobedementia,whichalsoshowsmotorabnormalities.
ThecognitivesymptomsinMND/dementiaalmostalwaysprecedethemotor
symptoms;theoppositeisquiterare.Cooperetal.(1995)foundubiquitin

positivetaunegativeintraneuronalinclusionsinhippocampusandspinalcord,
oneofthefeaturesofMND/dementiacomplex.

PSYCHOMOTOR THEORY
1131

Itoetal.(2001)reportedamotorneurondiseasewithpreseniledementiaas
wellasbilateraldegenerationofthepyramidaltractoncranialMRI.Portetet
al.(2001)foundthat48%oftheirpatientswithMND/ALSwerecognitively
impaired,exhibitingmemoryimpairment,alterationinjudgmentand
reasoning,andsoon.Theauthorsconcludedthatthereisacontinuum
betweenMND/ALSandfrontotemporallobedementia.Thecontinuum
hypothesiswasalsosupportedbyWilsonetal.(2001),whoreporteda
diffuseintraneuronalUbinclusionsincortical,hippocampal,andsubcortical
regionsinMNDpatientswithcognitiveimpairment.
Interestingly,thespinalcordsofthepatientswithparkinsonism/dementia
complexwithorwithoutALS,orAlzheimerdiseasecontainedneurofibrillary
tangles,alsofoundincorticalgraymatterofpatientsexhibitingAlzheimer
diseaseandALS/dementiacomplex(Schmidtetal.,2001).Furthermore,the
frontotemporaldementiaexhibitingubiquitinatedinclusionsinhippocampusand
frontotemporalcortexmayinvolvelateralcorticospinaltractsandspinalmotor
neuronstypicalofMND.Thisisconsistentwiththehypothesisthatthe
pathologicalchangesofpureMNDandMNDwithdementiaformaspectrum,
andshowthatpathologicalinvolvementofthemotorsystemmayoccurinMND
dementiawithoutclinicalevidenceofMND(Holtonetal.,2002).

MNDwithdementiacanalsoincludedegenerationofthestriatonigraland
pallidoluysiansystems,inadditiontoneuronallossintheupperandlower
motoneuronalsystemandfrontotemporalcortex(Sudoetal.,2002).
TounderstandtherelationofMNDtocognitivedisturbances,morespecificand
moresensitiveneuropsychologicaltestbatteriesmustbeusedtodetectandstudy
theentiredisruptionofcognitiveprocessesindementiarelatedtoMNDs(Moretti
etal.,2001).Infact,thereareaccumulationsofargyrophilictauimmunoreactive
inclusionsinneuronsofspinalcord,brainstem,andneocortexintauTgmice,
similartohumantaupathies;becausetheinclusionsweremostabundantinthe
spinalmotorneurons,thetaupathyinthesemiceresemblesALS/PDC
(amyotrophiclateralsclerosis/parkinsonismdementia)whereintanglesare
abundantinspinalcord(seeTrojanowskietal.,2002).
BothAlzheimersandParkinsonsdiseasescouldsharethesameneural
substrates,thatis,morphologicallyhomogenousgroupsofsubcorticalneurons
extendingfromthemidbraintothetopofthespinalcord,includingthelocus
coeruleusandraphenuclei,aswellasthebasalforebrainandsubstantianigra.
Becauseoftheexistenceofadiffuseprojectionfrombrainstemoriginstothe
remoteareasofthebrainandspinalcord,Woolf(1996)introducedtheterm
globalneurons.Thissystemmightbeextendedtomotorneurondisease,which

can,likeParkinsonsdisease,coexistwithAlzheimerlikefeatures

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(Massmanetal.,1996);motorneuronscomprisepartoftheglobalcell
population.Indeed,thecommonpathologicalassociationfortheAlzheimers
andParkinsondiseaseisalsodemonstratedforthemotorneurons(Batailleetal.,
1998).Accordingly,GreenfieldandVaux(2002)proposedthatthesethreemajor
neurodegenerativedisorderscanbeassociatedbyacommonmechanism.

Restless Legs Syndrome (RLS) and Periodic Limb Movement


Disorder (PLMD)
RLS(nocturnalmyoclonus)isadisordercharacterizedbydisagreeableleg
sensations,usuallypriortosleeponset,causinganirresistableurgetomove
thelegs.Thecauseisnotknown.Itisoftenaccompaniedbycreapycrawly
sensationsinthelowerlegsthatmakethepersonuncomfortableunlessthe
legsaremoved.PatientswithRLSexhibitmajordepressionandthosewith
PLMDexhibitgeneralizedanxietydisorder(Saletuetal.,2002).

Psychiatric Disorders
Inanxiety,theelevatedfrontalEMGactivityisacommonfinding(see,e.g.,
SainsburyandGibson,1954;Hazlettetal.,1994).Goldstein(1964)reportedthat
theleveleffects(anxiousvs.nonanxious)weresignificantfortherightforearm
extensorsandrightmasseter.TherewereabruptbreaksinfrontalEMG,asin
trembling,inassociationwithclinicalanxiety(Malmoetal.,1951).Frindlundet
al.(1986)investigatedthemotorirregularitiesinrelationtoanxiety.Theauthors
foundthattheEMGlevelwashigherinhighthanlowanxietysubjects,and
concludedthegreaterEMGlevelsinanxioussubjectsareduetoagreater
numberofburstsofEMGactivityassociatedwithagitatedmovement.
MalmoandMalmo(2000)reportedchangesinEMGduringhallucinations,
whichareprominentamongthecoresymptomsofschizophrenia.Inouyeand
Shimizu(1970)recordedEMGsfromthespeechmusclesduringverbal
hallucinationsinnineschizophrenicpatients.TherewereincreasedEMGlevels
inmostpatientsduringverbalhallucinations.Cerny(1965)reportedincreased
EMGlevelsin9of28psychoticsduringhallucinations.McGuigan(1966)
studiedEMGimmediatelypreceededhallucinations.Hispatientpressedabutton
uponhearingvoices,andconsistentlyshowedincreasedamplitudeofthechin

EMGimmediatelybeforeauditoryhallucinations.Duringthesameperiod,that
is,priortohearingvoices,therewaswhisperingthatcouldbeheardonthetape.
Thisacommonfindingreportedbyothers,thatis,tongueandlipmovements
priortohearingvoices(butnotduringhallucinations).Thus,theverbal
hallucinationsmaybeprocessedbyneuralmechanismsfor

PSYCHOMOTOR THEORY
1133

language,butthemusclecontractionsgeneratingspeechappeartobegated
out(Gandevia,1994).AccordingtoLibermanetal.(1967),verbal
hallucinationsdependonsupraspinalneuralstructuresthatcontrol
movements.Thereisindeedevidencethatthecentralmotorspeech
mechanismsmayberesponsibleforverbalhallucinations.Accordingly,Bick
andKinsbourne(1987)showedthatverbalhallucinationsinschizophrenic
patientsceasedduringopeningthemouthwide,althoughotheractionsnot
involvingspeechmuscles(e.g.,afistandholdingittight)didnot.
Therearemoreevidenceindicatingthathallucinationsaremotoricinorigin
ratherthanbeingsensory.Silbersweigetal.(1995)couldnotfindenhanced
regionalcerebralbloodflowintheprimaryvisualandauditorycortices
duringauditoryverbalhallucinations,buttherewerealsoenhancedblood
flowinthemotorregionsofthebrain.So,theneuralmechanismsfor
hallucinationscloselyinvolvethemotorsystem,butthesemaynotbe
revealedbyEMGbecausethemuscularcontractionsduringspeechappearto
begatedoutduringhallucinations.
Theprevalenceofinvoluntarymovementsinschizophreniaapproaches100%
(Quinnetal.,2001),butthesepatientsreceivedprolongedexposureto
antipsychoticmedication.However,innumerousstudiesconcerning
schizophrenia,spontaneousmovementabnormalitieswerereportedtooccurboth
inmedicatedandneurolepticfreepatients(seeforareview,Walker,1994).
Cassidyetal.(1998)reportedmorespontaneousdyskineticlikemovementsin
individualswithschizotypalpersonalitythansubjectswithschizoidpersonality
orhealthycontrols.Recently,Walkeretal.(citedinNeumann&Walker,1999)
reportedanelevatedrateofspontaneousinvoluntarymovementsinschizotypal
personalitydisorder,whichisseeninsomerelativesofschizophreniapatients
withsimilarsymptomsofschizophrenia.Moreover,CaliguiriandLohr(1994)
reportedmoremanualforceinstabilityinneurolepticfreeschizophreniapatients
withpositivesymptomratingsthancomparisonsubjects.Vrtunskietal.(1986)
studiedresponsetimeandfinemotorcontrolduringaclassificationtaskin
schizophrenicsandnonschizophrenics;thelatterrespondedmorequicklyand
exhibitedasmootherandfastermotorresponseonalltasks,comparedto
schizophrenics.Theauthorssuggested:thedecisionsabouttheabstract
referentialmeaningofwordsandpicturesproducegreatercognitiveloadsin
schizophrenicsthaninnonschizophrenics.(Vrtunskietal.,p.275,1989)also
investigatedseveralaspectsoffinemotorcontrolinschizophrenics,andfound
thatthemotorsteadinesspriortothebuttonpresswasreduced;themotor
responsewasmadewithexcessiveforce(hyperdynamia),andagonistantagonist
synchronywasimpaired(morecontralateralmotoroverflow

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U. TAN

consequentofincreasedforceinthenonrespondinghand),suggestingan
involuntarymovement.
NeumannandWalker(1999)concludedonpage159that
Theseandrelatedfindingssuggestthatthebrainregionsthatgiveriseto
schizophreniaandspectrumdisordersmayalsoplayaroleinmotor
regulation.Further,becausemotordysfunctionisknowntoprecedethe
clinicalonsetofschizophreniabymanyyears(Walkeretal.,1994),motor
assessmentsmaybepromising,alongwithotherindicators(Neumann&
Walker,1996),foridentifyingindividualsatrisk.
Thereareindicesforthevarioussyndromesofmotordysfunction.For
instance,patientswithParkinsonsdiseaseshowapronouncedincreasein
movementtime,butnotinreactiontimeorinvoluntarymovement(Ebmeiret
al.,1992),whereasschizophreniapatientsmanifestincreasedreactiontime
andinvoluntarymovement,butnotmovementtime(Caligurietal.,1993).
NeumannandWalker(1999)studiedthechangesinaninstrumentalmotor
taskadministeredtotheadultsubjectswithschizotypalpersonalitydisorder,
andfoundthatthesesubjectsmanifestedamotorperformanceprofilesimilar
tothatshownbyschizophreniapatients.Thefindingsappearedtobespecific
forschizotypicpersonalitydisorder,especiallyfortherighthandresponses,
indicatingproblemsinleftbrainfunctioning,whichisfrequentlyreportedto
bedysfunctionalinschizophrenia(seeMilleretal.,1995),asitisforthe
schizotypalsubjects(Mikhailovaetal.,1996;Sailsburyetal.,1996).
Interestinglyenough,theheighteneddopaminereceptoractivationwas
reportedtoinducebothmovementabnormalitiesandschizophrenia
spectrumsymptoms(seeWalker,1994).
Therearemanyreportsindicatingacouplingofschizophreniawiththemotor
system.Forinstance,thereisalsoadysfunctionofsmoothpursuiteye
movementsaccompanyingthisillness.Thedysfunctioninsmoothpursuit
eyemovementsisoneofthecofamilialtraits,whichhavehigherrecurrence
ratesthanschizophreniaitself.Thispsychomotorevent,appearingonlyifthe
subjecttracksamovingtarget,occursinabout40to80%ofschizophrenic
patientsandabout25to40%oftheirfirstdegreerelatives(Holzman,2000).
Thus,manystudiesshowedahighprevalenceofdiscretemotordisturbances

inschizophrenicpatients.Inthiscontext,Tiggesetal.(2000)studiedthe
neurologicalsoftsigns,whicharediscretemotorandsensorydisordersthat
cannotbelinkedtospecialcerebrallesionsordysfunction(Tiggesetal.,
2000),inschizophrenicpatients.Thiseventwasobserved

PSYCHOMOTOR THEORY
1135

asearlyasin1919byKraepelin.Thisisseenmoreofteninschizophrenic
patientsthaninotherpsychiatricpatientsorhealthycontrols,independent
fromneurolepticmedication(Schroederetal.,1992;Guptaetal.,1995).
Moreover,theneurologicalsoftsignsarerelatedtodisordersofmotor
coordinationandnegativesymptomsinschizophrenia(Heinrichs&
Buchanan,1988;Manschrecketal.,1990).Tiggesetal.(2000)foundthatthe
regularityofrepetitivehandmovementswasconsiderablyimpairedin
schizophrenicscomparedtothehealthycontrols,especiallyontheleftside,
indicatingarighthemispheredysfunction.Theirresultswereconsistentwith
thefindingsofWalkeretal.(1994),whofoundapredominanceofmotor
abnormalitiesontheleftsideofthebodyinschizophrenics.Theseresults
indicatedthatarighthemisphericbraindamage,contrarytoaleft
hemispherehypothesis(seeCrow,1990).
Anotherpsychomotordisturbance,theobsessivecompulsivedisorderwas
foundtobefrequentlyoccurredinschizophrenics(23.5%),asreportedby
Poyurovskyetal.(2001),whodefinedobsessionsasintrusive,unwanted,and
repeatedthoughtsandcompulsionsastheperformanceofrepetitivegoal
directedritualsclinicallyindistinguishablefromschizophrenicmannerismor
posturing.Portoetal.(1997)hadfoundamuchhigherproportion(46%).
Themeaningandrelevanceoftheincreasedratesofneuromotoricdeviation
observedinpatientswithschizophreniaandtheirbiologicalrelativesremain
unclear.. . .Amonghighriskoffspring,anincreasedrateofneuromotoric
deviationisveryclearlyassociatedwithincreasedratesofcurrentmental
disorder. . .(McNeiletal.,p.281,2003).
Deviationsinthemotorsystem(ND)werefoundamongpatientswith
schizophrenia,ascomparedbothwithnormalcontrolsandwithpsychiatric
patientswithotherdisorders(Woodsetal.,1986;Heinrichs&Buchanan,
1988;CantorGraaeetal.,1994;Ismailetal.,1998).Interestingly,thereisa
significantassociationbetweenincreasedNDinschizophrenicsandtheir
globalseverityofillness(Ismailetal.,1998);thisconditionwasalsofound
inthementallyhealthyfirstdegreebiologicalrelativesofschizophrenics
(Ismailetal.,1998;Kinneyetal.,1986;Rossietal.,1990;CantorGraaeet
al.,1994;Eganetal.,2001).
Istheneuromotordeviationageneralcharacteristicwithinfamilieswith
schizophrenia?Inotherwords,woulditbeanindexforthepersonalriskfor
mentalillness,versusanindividualspersonalliabilityformentalillness.Some
studiesagreewiththisview:NDwouldbeasignforpersonalliability.Namely,

anincreasedNDwasobservedduringchildhoodinpreschizophrenics(Walker

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U. TAN

&Lewine,1990;Walkeretal.,1994).Chronicityamongschizophrenicswas
betterpredictedbyNDthananyotherpremorbidcharacteristics(Ricks&
Berry,1970,citedbyMcNeiletal.,2003).Ontheotherhand,the
developmentofschizophrenia,schizophreniaspectrumdisordersor
schizotypalpersonalitycouldbepredictedusingND(seeHansetal.,1999).
Neuromotoricitemsrepresentingoverflow(e.g.,choreaticmovements,
tremor)werecorrelatedwithmentalcharacteristics,suchaslanguage
disordersandenuresis;anincreaseinNDwasassociatedwithanincreasein
ratesofmentaldisorders(McNeiletal.,2003).

Depression
Thisisalsoapsychomotordisturbance.Whendepressionoccurs,movement
generallylessens(slowing),orchangestoanonproductiveagitation.In
general,thepsychomotorslowingisthemaincharacteristicofdepression.
Theclinicaldepressionasalsoknownasdepressivedisorderormajor
depressionischaracterizedbylossofpleasureinalmostallactivities,loss
ofreactivity,depressedmood,weightloss,andmarkedpsychomotorslowing
oragitationamongothers(seeDorisetal.,1999).
Therearepharmacologicalinterventionstotreatdepression,butthereisnot
anadequatepharmacologicaltherapy;antidepressantsareoftennot
beneficial;thepatientsoftenstoptakingantidepressantsgenerallywithin
threeweeks.Theexercisetherapyisusedforseveraldecades,andthe
literatureonthissubjectissteadilygrowing.Ingeneral,theaerobicexercise
wasfoundtobebeneficialinthetreatmentofdepression(see,e.g.,Moore&
Blumenthal,1998;Dimeoetal.,2001;Dunnetal.,2001;Brosseetal.,2002;
Neidigetal.,2003).However,Ernstetal.(1998)performedsystematic
literaturesearchesaboutcomplementarytherapiesinthetreatmentof
depression,andconcludedthatscientificdatatosupporttheefficacyof
complementarytherapiesisextremelylimited.Furthermore,Lawlorand
Hopket(p.763,2001)statedthattheeffectivenessofexerciseinreducing
symptomsofdepressioncannotbedetermined. . .
HaaseandTan(1965)studiedtheeffectsofamphetamineonthespinalmotor
systemincats.Stimulantdrugssuchasamphetamineswereusedinthetherapy

ofdepression,andtoimprovememory,attention,andthinking.Interestingly,
HaaseandTan(1965)foundthatamphetamineincreasedthealphaandgamma
motoneuronalactivityindecerebrateand/orspinalizedcats;thedurationand
frequencyofthetonicalphamotoneuronsincreasedconsiderably,butonlyin
extensorsystem.Thisincreaseinextensormotoneuronalactivitywas
accompaniedbyadecreaseinflexormotoneuronalactivity.Furthermore,Tan

PSYCHOMOTOR THEORY
1137

andHenatsch(1969)studiedtheeffectsoftheantidepressiveagentimipramine
uponthespinalmotorsystemofdecerebratecats.Theauthorsreportedthat,
followingimipramininjection,thedischargefrequencyoftheextensoralpha
motoneuronesincreased;thetonicallydischargingflexormotoneuronesceased
firing;therewasaregularandstrongreductioninthespinalrecurrentinhibition
andpresynapticinhibition;becausetheaffectedsystemsarenormallyinhibiting
theextensormotoneuronalsystemmorestronglythantheflexormotoneuronal
system,thenetresultwasapredominantincreaseintheextensormotorsystem.
Theauthorssuggestedthattheenhancedmotoractivityfavoringthepostural
extensormotricitymightbeanimportantbasisfortheantidepressiveactionsof
imipramineandrelatedsubstances.(p.337)
Thetwolatterstudiessuggestthatthepsychomotorslowingindepressioncanbe
successfullytreatediftheextensorsystemactivityisincreased,withoutusingthe
pharmacologicalagents.Exerciseincreasingthetonicextensorsystemactivity
maybeabeneficialmethodforthetreatmentofdepression,withoutusingany
medicine.Asmentionedearlier,thereareinconsistenciesinthescientific
literatureconcerningtheeffectsofexerciseondepression.Theydidnot,
however,studytheextensorandflexorsystemsseparately.Theexperiments
reviewedhereinsuggestthatexercisesespeciallyincreasingtheextensorsystem
activitymaybebeneficialforthetreatmentofdepression.

PSYCHOMOTOR THEORY OF HUMAN MIND


Thisarticlehaspresentedsomeofthebasictheoriesconcerningthe
mind/bodyorthemind/brainrelationsandscientificallyestablishedfacts
aboutthepsychomotorinteractions.Firstofall,theaforementionedstudies
indicatedthatinpsychomotordomain,notthemindbraindualityorunity,
butthemindbrainbodytriadasafunctionalunitisessentialinhealthand
disease,becausethementalevents(mind)donotendinthebrain;they
furthercontrolthemovements(body).
Thestudiessuggestthat(i)psychicsystemiscloselycoupledwithmotor
system;(ii)mentalandmotoreventssharethesameneuralsubstrate,the
motoneuronalsystem;(iii)brainistheliaisonbetweenmindandbody.
Accordingtotheaforementionedresultsthemotorandmentalsystemsshare
thesamemotoneuronaldomainwithinthecentralnervoussystem.Thisisthe
psychomotorsystem,beingthequintessenceofthepsychomotortheory,
whicharguesthatthehumanmindmaybeanemergentpropertyofthe

fluctuatingactivitieswithinthecentralmotornucleus,expressedbyhuman
language.Thepresentedscientificliteraturesuggeststhatthemental

1138

U. TAN

events(mind)arealwayscoupledwithcorticospinalmotorsystemthrough
thefeedbackmechanismsbetweenmindandbrain.Thisis,however,nota
dualisticview.Itisratheramonistictheory,suggestingthatallpsychic
eventsmayinfactbetheexpressionsofthefluctuatingmotoractivities
withinthebrain.Thus,thepsychomotortheoryemphasizestheleadingrole
ofthemotorsystemintheemergenceofthementalevents,whichwouldnot
bemorethananexpressionofthemotoricusinghumanlanguage.Inthis
context,Sherrington,despitehisdualisticphilosophy,accentuatedtheroleof
themotorsysteminrelationtomind,statingthatmindisattachedtoa
voluntarymotoractperformedwithskill. . .mindseemstohavearisenin
connectionwiththemotoract. . .wheremotorintegrationprogressedand
wheremotorbehaviorprogressivelyevolved,mindprogressivelyevolved.
Consistentwiththeclosecouplingbetweenthehumanmindandthehuman
motorsystem,theparallelevolutionofthefrontalloberegionsandhandsin
hominidssuggestsmotoractivityasthebasisofhumanintelligence(Seitz,
2000).
Accordingtothepsychomotortheory,thehumanmindmaybeanemergent
propertyofthemotorsystem,expressedbyhumanlanguage.Asalso
mentionedearlier,SirJohnEccles,acontemporaryneurophysiologist,a
NobelPrizewinner,andaprominentdefendantofthedualistinteractionist
theory,couldnotexplainthehumanmindwithoutconsideringtheleftbrain,
thatis,theliaisonbrain,whichisthedominanthemispherewhitlanguage
capacities.Asmentionedearlier,hesummarizedhisviews:. . .theself
consciousmindasanindependententitythatactivelyengagesinthereading
outfromamultitudeofactivecentersinthemodulesoftheliaisonareasof
thedominantcerebralhemisphere,whichismainlyengagedinlanguage.
Thus,thepsychomotortheoryemphasizestheprominentroleoflanguagein
theemergenceofmind.Accordingly,itcanbestatedthattherewouldbeno
humanmindiftherewerenohumanlanguage.Itcanalsobestatedthatthe
humanmotorsystem,humanlanguage,andhumanmindmaybecoevolved
inthehistoryofhumanbeings.
Inbrief,thementaleventsmayemergeasanactivemindfromthecentral
motoneuronalsystem,theoutputofwhichcaninducemovementsinthebody,
andtheoutputofthemuscularactivityfeedbacktothecentralmotoneuronal

system,emergingthemindatthesametime.Themotorsystemisthenucleus,
whichcoupledwithmindquitetightly,sothatanydisturbanceinthisnucleus
reflectsasamentaldisorderinthepreviouslyhealthypersons.Thisarticle
presentedexamplesaboutthemindbrainbodyrelationsinhealthanddisease.
Becauseofthecloserelationbetweenmentalandmotorevents,the

PSYCHOMOTOR THEORY
1139

motoneuronaldiseasesareusuallyseenwithmentaldisturbances.According
tothenewtheoryofhumanmind,theexistenceofanypurelymental
disorderisunconceivablebecausethementaleventsemergeonlyfromthe
motoneuronalsystem;thereisnoindependentmind.Therefore,mental
disturbancesmayonlyoriginatefrommotoneuronaldisorders;theremaybe
nopsychiatricillnesswithoutanaccompanyingmotoneuronaldisorder.
Theconceptsabouttheneurologicalandpsychiatricdiseasesareslowly
changing.Interestinglyenough,Parkinsonsdisease,Alzheimersdisease,and
motorneurondiseaseallsharethesamemotoneuronalsystemsincludingtheso
calledglobalneurons(seeGreenfield&Vaux,2002).Normalizingtheseglobal
neuronsmaybeenoughtotreatalltheneurologicalandpsychiatricsymptomsof
themotorneurondiseases.Accordingly,thepsychomotortheorymayopennew
strategiesforthetherapyofpsychiatricdisorders.Forinstance,itmaybequite
possibletotreatdepression,onlyincreasingtheextensormotoneuronalactivity,
asmentionedearlier.Themotorsystemmaybethekeyfactorinunderstanding
andimprovingbehaviorinhealthanddisease.

Theglobaloutputofthecorticospinalmotorsystemmaybethekeyelement
determiningthepsychologicalwellbeing.Inthiscontext,McNeiletal.(p.
219,2003)havestatedthat. . .anincreasedrateofneuromotoricdeviation
isveryclearlyassociatedwithincreasedratesofcurrentmentaldisorder.
Withregardtopsychomotorcoupling,Walker(p.453,1994)reportedthat
Theheighteneddopaminereceptoractivationinducesbothmovement
abnormalitiesandschizophreniaspectrumsymptoms.Theseandrelated
findingssuggestthatthebrainregionsthatgiverisetoschizophreniaand
spectrumdisordersmayalsoplayaroleinmotorregulationatthesametime.
Further,becausemotordysfunctionisknowntoprecedetheclinicalonsetof
schizophreniabymanyyears(Walkeretal.,1994),motorassessmentsmay
bepromising,alongwithotherindicators(NeumannandWalker,p.159,
1996),foridentifyingindividualsatrisk.
Sperry(1952)alsoaccentuatedtheprominentroleofthemotorsystemin
cognitiveactivities,nearlyhalfacenturyago:

Theprincipalfunctionofthenervoussystemisthecoordinatedinnervations
ofthemusculature.Itsfundamentalanatomicalplanandworkingprinciples
areunderstandableonlyontheseterms. . .eventhehighesthumancognitive
activities,eventhoserequiringnomotoroutput,thereareinevitablytobe
foundcertaincriticallyessentialmotoricneuralevents.(p.298)

1140

U. TAN

GoldandStoljar(p.869,1999)arguedTheideaisnotofcoursethat
neurosciencewillexplaineverythingaboutthemind;perhapsthereare
aspectsofthemindwewillneverexplain.Incontrasttothisstatement,the
psychomotortheoryseemstobeofutmostimportanceforunderstandingand
improvingthehumanmindinhealthanddiseaseinthenearfuture.

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