We cannot directly know the world as it is in itself, we only know our perception of it. This gap is one of the most important ideas of philosophy. Ludwig Wittgenstein famously opens his brief and enigmatic masterpiece the Tractatus Logico-Philosophicus with the statement ‘the world is the totality of facts, not of things’. He dismisses the very possibility of talking about the world as it is in itself. We can only talk of ‘facts’, that is, our own statements of how we find the world to be.
Wittgenstein felt that he had solved the problems of philosophy by discovering that they were in fact just problems with the way we use language. He stated ‘A proposition is a model of reality as we imagine it.’ So what did he mean?
We make sense of our world by making models. A model is like a personal map. Consider the analogy of actual maps. A map is not the territory it represents, but if accurate, has a structure that gives me useful information about the territory. A map represents the aspects of that territory that interest the map reader. Each of us makes maps that are suited to our own needs. A cabby’s map of London will be different from a London Underground map and different again from a geologist’s map. None are wrong. They represent the same world from different perspectives, and they have different uses. These models are therefore not only personal, but they are designed to be biased: both to our needs and also to our comfort.
But how do we create our models of the world? We make them with language, whether spoken, written or just in our thinking. Internal language is the tool with which we generate our models of reality. Our models of reality are the only hold we have on the world. It follows that language is an immensely important determinant of our understanding of the world. Our world and our language are, in a sense, the same thing.
The 20th century saw an explosion in the study of language. Language (language as such, not English or French etcetera), is an inborn tool for cognitive modelling in the human mind. Language as a communication device is secondary to this, and is partly an arbitrary system built on top of our innate cognitive modelling language. Probably only humans have language. Animals communicate, but they do not innately have this cognitive modelling tool, only a menu of messages. The inbuilt facility for language enables us to be human. It also projects us into a world where we can perceive and create meaning.
Wittgenstein points out that language functions by rules in the same way as a game of chess, but that many different games can be played if the same pieces follow different sets of rules. Thus our belief systems are determined by our ‘language games’. Wittgenstein sees language systems as determining the way we live and think rather than primarily serving the function of representation.
CPD further study and reflective notes
The notes in Boxes 1 and 2 will help you to read and reflect further on any of the brief articles in this series. If this learning relates to your professional development then you should put it in your annual PDP and claim self-certified CPD points within the RCGP guidelines set out at http://bit.ly/UT5Z3V.
Box 1. Reflective notes
Do we tend to exclude patients from our professional world by using medical language? If so, how could we try doing things differently?
To what extent are doctors and managers separated by their different language games? How might we bridge this gap?
Box 2. Further reading
Primary source
Wittgenstein L. Tractatus Logico-Philosophicus, 1961 edition translated by D Pears and B McGuiness. London: Routledge. Wittgenstein’s Tractatus is enigmatic — you have to get the hang of what he is trying to achieve — why not give it a try?
Further study
Hacker PMS. The Great Philosophers: Wittgenstein: on human nature. London: Phoenix, 1997. This is a short, cheap and accessible introduction to some of Wittgenstein’s central ideas.
If your reading and reflection is occasional and opportunistic, claims in this one area should not exceed 10 CPD credits per year. However if you decide to use this material to develop your understanding of medical philosophy and ethics as a significant part of a PDP, say over 2 years, then a larger number of credits can be claimed so long as there is evidence of balance over a 5-year cycle. These credits should demonstrate the impact of your reflection on your practice (for example, by way of case studies or other evidence), and must be validated by your appraiser.
- © British Journal of General Practice 2013