The discourse in scientific literature changes over time. It happens because new methods become available, new discoveries are made, and new people are coming to the field. Is it so, or is it not? To find out, I went on a journey in 1934 (with books, it is very easy). The 1930s–1940s were characterized by all sorts of behavioral conditioning (B.F. Skinner), psychoanalysis (S. Freud), and developmental psychology (J. Piaget, L. Vygotsky, A. Luria). Less famous to cognitive scientists but nonetheless influential was Gestalt psychology, which, as the name suggests, originated in Germany. Gestalt directly translates as form, shape, figure, configuration. However, what Gestalt psychologists meant by Gestalt is an “organized whole”. This whole is more (or different) than the sum of its parts. This idea is reinforced in the book that I read, “The Organism: A Holistic Approach to Biology Derived from Pathological Data in Man (Der Aufbau des Organismus: Einführung in die Biologie unter besonderer Berücksichtigung der Erfahrungen am kranken Menschen)” by Dr. Kurt Goldstein. It was engaging and unexpectedly uplifting.

The author starts by putting forward the holistic hypothesis: mental life cannot be reduced to the sum of operations or processes. The main attack is launched on the reflex theory. Reflexes are involuntary reactions of the living organism to the environment. For example, when bright light lands on the eyes, the pupil contracts. Reflex theorists went further and suggested that behavior can be explained in terms of reflexes. The author rejects this claim. He argues that reflexes observed in the doctor’s office or under experimental conditions are far from the activities that an organism does in a real environment. He agrees that reflexes exist, but they are rather reactions of an isolated part when it is isolated in the doctor’s office. And since the part is never isolated in real life, the reflexes cannot explain behavior.

The author’s theory is that the organism approaches and deals with the environment as a whole, and environmental stimuli exert influence on the whole organism. Furthermore, depending on the state of the organism, the influence exerted by the stimulus may differ. The author calls it “state of excitation”, and this state influences the processing of the stimuli. In general, the effect of the stimulus depends on four factors: 1) external environment, 2) internal state, 3) the potential reactivity of the part of the organism involved, 4) quality of the stimulus (e.g., painful). These factors determine how the stimulus will be processed and what reaction will follow.

In the process of dealing with the environment, the organism is motivated by instincts, drives, and needs. However, the author neglects this hierarchy and instead posits a single essential overarching motivation. This motivation is self-actualization. The organism is self-actualized when it realizes its abilities through activity. The organism is self-actualized when its needs are fulfilled. Because the main goal is self-actualization, instincts or drives can be overridden if required. Self-actualization also means that humans experience agency and recognize themselves as active beings. Additionally, self-actualization is always associated with moving forward, with action, with changes. A healthy organism pursues activity.

In contrast, a diseased organism attempts to maintain the current state. This is the self-actualizing motivation: to avoid catastrophic situations and maintain the current state. Importantly, maintaining the current state does not equal resting or being idle; rather, it is behaving in a stereotypical, familiar mode of activity. The author concludes this based on his practice as a neurologist dealing with patients with brain injuries. His patients in their rehabilitation course demonstrated behaviors which he links to motivation to maintain the current state: 1) lack of self-perception of deficits, 2) avoidance of situations that may lead to unsuccessful performance, 3) need for an undisturbed state, 4) need for order. Interestingly, in some tasks, patients performed better and more efficiently than healthy people. It might have occurred because the stimulus activated only a part of the organism (pathological isolation), and so the resources for stimulus processing were limited to this part. Despite being fast, the patients were less flexible.

To arrive at the correct diagnosis when examining the patient, the author stresses the importance of trying to gather as much evidence as possible and to take into account all behavior and symptoms presented by the patient. Because everything is interrelated—the parts of the brain, the brain and the peripheral nervous system, and the nervous system and the body—diagnosis as well as treatment should include all of these aspects. For example, he says that patients with right-hand paresis learn quickly to write with their left hand as soon as they overcome psychological resistance, such as the emotion of fear. 

Fear is a recurrent topic in the book, but not necessarily as something negative. The author promotes a form of agentic indeterminism. Anxiety and fear are something that an individual can cope with. The amount of anxiety that each individual can cope with will be different; it is small for a patient with brain injury, but it is large for a creative individual. Coping with fear is thus an act of freedom.

The main conclusion, with which I agree, is that we should proceed to disassemble the organism to understand its parts only in order to assemble it again to understand the relationships between parts. So both approaches—dissective and holistic—should be applied to the study of the organism.

I liked the book. I didn’t feel the disconnect in time (the book is from 1934): the author advocates for unity of brain and body, for a holistic approach to the treatment of brain diseases, for incorporating the natural environment into research. These are all mainstream topics. Yet, there were some archaic contentions. For example, that animal life is different from human life. Or that if something was conscious at some point, it will always remain conscious. Also, there were strange detours into the sex lives of his patients. But nothing too controversial. My main complaint is that the book is too speculative. Claims are made, but the evidence is not sufficient to support them. Maybe instead of calling the book speculative, I may say it's visionary. 

Favourite quote: “The individual creature, as compared to the entirety of nature, shows the same sort of being that an isolated process in the organism reveals in comparison to the whole of the organism: it shows imperfection and rigidity; it exists only as being within the whole, only by support of the whole, like a reflex. Therefore, it is doomed to die as soon as this support ceases.”

September, 2026