Q: Psychologists talk about a "self," "personality," "identity," "parts of a self," or "different selves," and so on, but none of these things can be seen. There's no place for a "self" or "identity" on models of the brain, and no "self" or "identity" on an MRI or a PET scan. Different people's have different theories about personality, and these theories contradict one another, and sometimes even themselves. Of what use is it to talk about such things? Why can't we stick with what can be biologically known and observed?

A: Some of the most important concepts in psychological healing, including psychotherapy, religious and quasi-religious healing, are based on models of the structure of consciousness. The "id, ego, superego" model of psychoanalysis, and the "seven chakras" model of Hindu spiritual healing, are examples. No one has actually seen an id or a fourth chakra (at least not in any way that can be scientifically validated) but plenty of people think that these models explain important aspects of human illness and recovery. Psychological healers base their diagnosis and treatment on them. These are examples of what might be called "psychic space," models of the inner life.

Psychotherapy provides an example of psychic space in action, as the patient and therapist try to understand why the patient acted or felt in certain ways that are confusing or self-destructive. For example, consider the case of a woman who stays in a relationship with a man who treats her badly. "He's not good for me," she says, "I know I should leave him, but I can't." He makes promises he doesn't keep, is alcoholic, unfaithful, unreliable. On the rare occasions when she confronts him, he either apologizes and makes promises which he doesn't keep, or blames her for their problems. He never really tries to change. She is attractive, has had other relationships, and men are interested in her now, so she isn't afraid that no one else will be interested in her. She is economically self-sufficient, so she isn't afraid of the economic consequences of leaving this relationship; in fact, he sponges off her. The answer must be sought and found in "psychic space," where something about this relationship means something to some part of her that isn't her conscious self, but is emotionally powerful enough to overrule it. The pattern of this relationship may invoke patterns in her earlier life which in some way she is compelled to repeat or try to resolve, but telling her that doesn't solve the problem. She has to acknowledge the nature of the need that keeps her stuck in this hopeless relationship, and experience the part of herself that is trapped in self-defeating dependency, in order to see her situation clearly enough to release herself from it.

When we talk in terms of "one part of herself being trapped" we are talking in terms of consciousness, of psychic space. You won't see that "part of herself" on a CAT scan. Similarly, talking about self-esteem--"She has a low opinion of herself, so she stays in this injurious relationship--" supposes different parts of herself in some sort of dynamic interaction (some sort of evaluating ego that has a low opinion of the person as a whole). Such explanations assume some sort of psychic space.

Hypnotherapy, the use of hypnosis in psychotherapy, provides another example of working in psychic space, as the patient voluntarily suspends certain features of her usual reality orientation in order to facilitate the exploration of parts of herself, which are not usually accessible to consciousness. Such "parts of oneself" may be referred to as "unconscious" or "dissociated," depending on the model of psychic space that one is using.

The positive results of psychotherapy, in relieving depression and improving self-esteem, increasing perception of reality and the effectiveness of personal decision-making, confirms the role of the inner life in emotional health. The relationship between emotion, attitude, and the immune system is being explored, and demonstrates that the condition of our inner lives may considerably affect whether we become ill or what the course of an illness may be.

Psychotherapy is not the only example of healing in psychic space. The medical intuitive Carolyn Myss offers a quasi-religious-psychological model of psychic space in her book, "Anatomy of the Spirit." Based on the Chakra system, combined with elements of Christian and Jewish mysticism and pop psychology, Myss diagnoses a number of emotional and psychosomatic illnesses as resulting from what she calls "spiritual" imbalances (although her patient's problems seem more moral than spiritual to me, actions against one's conscience or self rather than against an active relationship with divine truth). Myss is an intuitive diagnostician who goes into a "drifty state" and does "readings" on individuals. As she describes them, these "readings" are remarkable for disclosing information about the patients that she didn't know before. Her model of psychic space seems to me to be more a framework within which she can intellectually comprehend her intuitions than one that will be productive for people without her apparent intuitive gift.

In "The Sacred," Beck, Walters and Francisco describe an Iglulik group healing session. The patient, "so ill she can hardly stand," is a shaman who has violated various taboos, so she has to be healed by another shaman in a communal healing session, during which she confesses various transgressions (for example, "I once stole some salmon and ate it at a time when salmon was forbidden to me"). The shaman's role is to diagnose her, which prompts her to confess, whereupon the communal group asks that she be forgiven. The patient's illness seems to have been caused by the inner conflict between her desire to be abide by the rules of the community, her desire to not be bound by them, and her inability to find an acceptable way of reconciling those apparent opposites. The concept of a "conflict within oneself," whether in the realm of romantic relationships or of one's relationship with one's village, belongs to the realm of psychic space.

So does the placebo effect, which is confirmed in research and established as medical fact, to the extent that experimental medications have to show better than a 33% improvement rate, because about 33% is attributable to the placebo effect. A friend reports the results of an experiment studying the effects of a form of glucosamine on arthritis. An experimental group received glucosamine, and a control group received an inert placebo. It is a double-blind study; neither the subjects nor the people giving them their medicine knew which was which. Among the experimental group, over 80% of the subjects reported relief. But, among the control group, 40% of the subjects reported experiencing relief! Thus, belief in the curative effect of an inert substance produces physiological changes. And where in the brain does such belief take place? Although it obviously affects the brain, we can't localize any site of belief in the CAT scan. For the time being, at least, we have to say that it occurs in psychic space. The same dynamic is at work in the use of therapeutic agents from antidepressants to aromatherapy.

The fact that such different models of psychic space can be used to produce cures can be used to support the argument that the cures aren't about psychic space at all, but rather result from some form of suggestion between healer (of whatever stripe) and patient. The flaw in this argument is that, even if suggestion is the mechanism of cure, any model of how suggestion itself works has to posit one part of the person's self, or mind, producing a result on the rest; which brings us conceptually back into some model of psychic space, after all. The fact that such cures can change the course of people's lives and visibly and undeniably affect their physical and mental well being demonstrates the power of interventions in psychic space and explains why all cultures have concerned themselves in some way with this invisible, inner realm of experience.

In some ways psychic space is like cyberspace. A description of the physical infrastructure (computers, telephones, electricity, etc.) doesn't really describe the world wide web, yet it is quite real to the millions of people who use it, and affects our lives in all kinds of ways. Similarly, a description of the anatomical, chemical and electrical functions of the brain--which are infinitely more complex than the web, and far less understood--doesn't really describe human consciousness. The web depends on its infrastructure; it can't exist without it, but it also has an existence that somehow transcends it. Similarly, consciousness itself depends on the brain, but has an existence that somehow transcends it.