DR E H REYNOLDS MD FRCP FRCPsych

KING'S COLLEGE, DENMARK HILL CAMPUS WESTON EDUCATION CENTRE CUTCOMBE ROAD, LONDON SE5 9PJ Tel: 020 7848 5756 Fax: 020 7848 5530 e-mail: edward.reynolds@kcl.ac.uk

CROMWELL HOSPITAL CROMWELL ROAD, LONDON SW5 0TU Tel: 020 7460 2000 Fax: 020 7460 5555

Correspondence to: BUCKLES YEW TREE BOTTOM ROAD EPSOM DOWNS SURREY KT17 3NQ Tel: 01737 360867 Fax: 01737 363415 e-mail: reynolds@buckles.u-net.com

WERE BABYLONIANS SELF-CONSCIOUS?

We are grateful to Dr. Cavanna and Dr. Nani for their interesting and thoughtful letter on the question of Babylonian self-consciousness.

As they noted and we emphasised, Babylonian accounts of obsessive compulsive disorder, phobias and psychopathic behaviour were entirely objective. As far as we are aware accounts of the subjective phenomena in these behaviours began in the 17th century AD. The Babylonians viewed these behaviours as mysterious, yet to be explained, a reasonable view which persisted right up to the 20th century AD with all it's self- awareness.

Cavanna and Nani suggest that either the Babylonians had no concept of free will and that the behaviours were beyond the subject's will and self control, or that they lacked any self-consciousness, two rather overlapping hypotheses. In either case they ask why not blame the Gods?

Even today it is widely agreed by patients and physicians or psychiatrists alike that these abnormal behaviours are to a very large extent beyond the subject's will and control, but this in no way undermines the concept of free will in these or normal subjects. Certainly there was no word in the Babylonian language for "mind", "consciousness", and "identity", but there were words for "self" i.e. ramanu, and of course for "I" (an?ku) and "me" (i?ti). The word ramanu does not appear significantly in medical texts, but it is altogether common in the epistolary texts, for the Museums have literally hundreds of letters written between all sorts of people from different periods. Two of many examples of self-awareness include: 1) "I (Sennacherib) deliberated (the matter) on my own" (ina shitulti ramani-ia amtallik) (1); 2) "They have neglected the orders which the King gave them and are acting according to their own (orders)" (2).

As for supernatural explanations modern Assyriology has a more inclusive way of reconstructing the ancient "causation theory" of Babylonian "illness". There were wounds, injuries, fractures and falls which are to be seen as accidents, as they are today. There were "animal" causes for snake bites, scorpion stings and the worms of Helminthology. Eye diseases were brought by the wind. Convulsions and paralysis were the work of demons. The concept of "muscle" and "nerve" had not yet entered the language. Nocturnal epilepsy was brought by ghosts. For delusions of persecution the persecutors themselves were the agents; the Gods, or more accurately, the "agency" of the Gods, brought such illnesses as scurvy and tuberculosis, all fevers and many skin diseases. All of these conditions were therefore viewed as externally caused in natural or supernatural ways. In the case of the behaviours we have discussed the Babylonians were more guarded, suspecting an internal or personal cause. As we reported, they described the behaviours as if the subjects had sworn an oath, an activity which would require some degree of self-consciousness.

The suggestion that in evolutionary terms self-consciousness somehow arose in the narrow gap between the Iliad and Odyssey seems to us very dubious, not least because these classic writings were no more than stories in what is known as the age of Heros, not historical documents. It is apparent to us that the Babylonians were self-conscious, but perhaps not to the degree or level of introspection and self-awareness in more recent western civilisations, as reflected perhaps in the later appearance of the subjective in addition to the objective aspects of the behaviours we have reported.

Edward H. Reynolds1 James V. Kinnier Wilson2

1. Department of Clinical Neurosciences, King's College, London, UK. 2. Faculty of Asian and Middle Eastern Studies, University of Cambridge, Cambridge, UK.

References.

1. Luckenbill DD. Sennacherib, King of Assyria: Annals.volume 2:109 col vii, line 3. Oriental Institute Publications, University of Chicago, 1924

2. Parpola S. A letter from Shamash-shum-ukin to Esarhaddon. Iraq 1972; 34; 22, line 15.

Conflict of Interest:

None declared

Reynolds and Wilson's article on obsessive compulsive disorder and psychopathic behaviour in Babylon gives us unprecedented insights into how these psychiatric disorders were identified and - to some extent - conceptualised by an ancient civilization. Surprisingly, the Babylonian descriptions are accurate and modern, and thoroughly objective. As noticed by the Authors, this objectivity is one of the most interesting aspects of the accounts that we can find in Sumerian and Akkadian tablets. The lack of a subjective perspective over obsessional thoughts and pathological ruminations is remarkable, given the intrinsically subjective nature of anxiety and psychotic symptoms. One possible hypothesis for this interesting observation is implicitly suggested by the Authors when they write that Babylonians, considering the origin and nature of mental illness as deeply mysterious, restricted themselves to the simple observation and record of the abnormal behaviour, rather than trying to give a physical or a supernatural account of these disorders. According to this hypothesis, the position of Babylonians was surprisingly wise and scientifically-minded: they did not speculate on psychiatric disorders mainly because they were aware of their limitations in understanding them. This attitude would reveal ante-litteram reflections on suspension of judgment (Socrates: "The only true wisdom is in knowing you know nothing") and appropriate use of language (Wittgenstein: "Whereof one cannot speak, thereof one must be silent."). Although this hypothesis has many merits, including its logical linearity, it falls short of accounting for certain historical inconsistencies. Why Babylonians provided supernatural explanations, such as the bad influence of gods or evil spirits on the human soul, for a variety of medical disorders but not for mental illness? What was so special that distinguished pathological behaviours from other disorders? If we take for granted the mystery-hypothesis, these questions are destined to remain unanswered. At least two other hypotheses can be put forward in order to account for the objective stance taken by Babylonians in describing psychiatric disorders. The first one is that psychopathic behaviours, obsessive compulsive symptoms and phobic reactions were regarded as performed in absence of free will. Since the abnormal behaviour was taken to be involuntary, Babylonians accounted for it entirely in objective terms. In so doing, they might have intended to underline that the aberrant actions were beyond the subject's will and control. This hypothesis clarifies why the psychopathic behaviour was regarded as different from other disorders. On the other hand, this solution is still subjected to the criticism aforementioned with regards to the mystery-hypothesis. Why did Babylonians not resort to a supernatural explanation, if people who suffered from psychosis seem to act under the control of an external will? Moreover, the absence-of-free-will-hypothesis raises the fascinating issue about whether or not Babylonians had a concept of volition similar to ours.

This issue leads us to the second and perhaps most intriguing hypothesis, which is based on Julian Jaynes' model of the bicameral mind (1). On the ground of detailed philological evidence, Jaynes' thought- provoking book The Origin of Consciousness in the Breakdown of the Bicameral Mind (1976) argued that in the second millennium B.C. the ancient populations had not as yet developed our modern concept of consciousness. According to Jaynes' theory, the notions of volition and decision, intimately bound with the idea of conscious will, did not emerge until a more sophisticated language allowed introspection and self- visualization. Since its development, this controversial evolutionary model for the origin of consciousness has been the subject of a continuing debate (2, 3). Among other things, Jaynes argued that Babylonians and other ancient civilizations lacked the linguistic sophistication of mental concepts which might be a pre-requisite for higher-order awareness or a fully fledged self-representation. This hypothesis gains support from philological studies of the Iliad lexicon, which notoriously lacks words directly translating our concepts of "consciousness" and even "mind" (4). In fact, in the passages of the poem which come from the oldest oral tradition, the Homeric heroes appear to act as if they were driven by uncontrollable external forces, rather than their own free will. The analogy with the "automatic" aspects of the obsessive compulsive disorder and the psychopathic behaviour described by Babylonians is astonishing. The idea of ancient Greeks and Babylonians without self-consciousness can seem bizarre at first sight. However, it is likely that concepts which are for us of ordinary use - that is, mind, self, consciousness, self-awareness, identity, etc. - went through a process of development and transformation in the course of Western civilisation (5). This last hypothesis might provide an answer to both questions mentioned above. Lacking a sophisticated concept of a unitary subjective Self, Babylonians could not distinguish between self- and nonself-conscious behaviour. Consequently, neutral and objective accounts were their only ways of describing obsessive compulsive disorders and psychopathic behaviours. Finally, they might have not resorted to a supernatural explanation for psychiatric disorders simply because they had no conception as yet of a conscious mind susceptible to be affected by divine entities.

References

1. Jaynes J. The Origin of Consciousness in the Breakdown of the Bicameral Mind. Boston, MA; Houghton Mifflin, 1976. 2. Kuijsten M. (ed.) Reflections on the Dawn of Consciousness: Julian Jaynes's Bicameral Mind Theory Revisited. Julian Jaynes Society Henderson, NV, 2006. 3. Cavanna A.E., Trimble M., Cinti F., Monaco F. The "bicameral mind" 30 years on: a critical reappraisal of Julian Jaynes' hypothesis. Functional Neurology 2007; 22(1): 11-15. 4. Taylor C. Sources of the Self. Cambridge; Cambridge University Press, 1989. 5. Crivellato E., Ribatti D. Soul, Mind, Brain: Greek philosophy and the birth of neuroscience. Brian Research Bulletin 2007; 71: 327-336.

Conflict of Interest:

None declared