Before getting into the further detail of the positions outlined so far, a brief summary is required to make clear the differences between a phenomenological approach and a natural approach. Givenness of the perceptual sort is how biology as a science began as attention to the patterns and processes that show themselves to consciousness: a careful attention to distinguishing the many species of living entity, be they plants or animals. For instance, perceptual observation and reasoning enabled the discovery of penicillin by Alexander Fleming in 1928 who observed the absence of sepsis mould in a petri dish and concluded that penicilium had killed it. The point is that the intentional history of the biological sciences began by making distinctions arguing, discussing these and agreeing findings. Biology interprets causes and follows a specific form of rationality. Such influences may contribute to a persons’ mental health. Natural causes are genetic and biochemical and due to the current state of functioning of a person’s neurology and physiology. The genetic aspect, for instance, is the physical substrate operating at a number of levels simultaneously, but its effects challenge the ego to respond to its own innate tendencies. The specific influence of genetics are revealed in Robert Plomin’s idea of heritability which is a numerical measure of the biological outcome, a biological cause on average, with respect to the whole of biopsychosocial causes (Plomin 2013; Plomin et al. 2012). Specifically, the amount of variation of height or intelligence or other factors that is entirely due to biological cause is divided by the total amount of variation due to all biopsychosocial causes in the “environment” which means due to all epigenetic, nutritional, prenatal and intersubjective causes of the expression of the factor.

Thus, in some instances there are likely to be biological forms of bipolar, borderline personality disorder or schizophrenia, where the ego is ‘innocent’. It has not contributed to the state of affairs that it is faced with but is challenged to understand and manage its emotions , choices and lifestyle and work to minimise the negative impact on itself. Thus, the numerical estimates of heritability also show a second phenomenon: the estimates of heritable biological cause by genetic inheritance indicate what percentage of personality and psychological syndromes are environmental and psychosocial. Specifically, heritability through natural cause estimates the level of psycho-socially ‘caused’ amounts of the same mental health problems where, in the absence of specific genes, a person can still suffer stress due to how they process the meanings around them or how their social context acts to maintain the distress. In the latter cases, the ‘causes’ are psychosocial stressors, conditioning and motivators in relation to individual ways of making sense. So whilst there can be biologically-caused bipolar disorder, for instance. Bipolar could be intersubjectively ‘caused’ as the outcome of trauma or prolonged stress that ‘cause’ changes in mood, although the felt-sense of living with bipolar disorder is the same. Both versions are a challenge for the ego to understand itself and work to manage its changes in mood and associated effects. For the biological form its ‘causes’ are specific events where the ego is also ‘innocent’. There have been recent successes in mapping of the human genome but this has raised more biological questions.

In the naturalistic view, there are 20 amino acids that comprise the DNA of all forms of life. In the human being, four nucleobases (adenine, cytosine, guanine, thymine) combine to produce a three billion letter genetic code held in 25 000 genes which then produce 250 000–375 000 proteins. One area where there is promise in human genetics is in understanding that there are 4 million methylation “switches” where methylation is one of a number of biochemical changes that can occur. Methylation is the addition of a methyl group to the DNA that affects the physical nature and abilities of the individual but not their offspring (Mill et al. 2008; Abdomaleky et al. 2005). Methylation turns on and off various aspects of the genes. This is a causative factor in human development as the switches bring on some types of mental and physical illnesses as well as the development of the individual. This has lead to the creation of the field of epigenetics which studies changes in gene activity that do not permanently change the DNA sequence because methylation is only a temporary effect. Epigenetics also investigates how nutrition can effect X and Y chromosomes and the trans-generational transmission of illness. For instance, poor diet during the first 10 years of life can produce a range of physical and mental health problems (Grossniklaus et al. 2013; Pembrey et al. 2006). The patterns of transmission are capable of identification because DNA entities form discrete codes and change in the structure of the DNA is identifiable.

However, there are those who believe that biological being is often considered to be factually the only correct view although the claim is contested in the denial of biological reductionism (Rose et al. 1984). What appears in a longer term view is that the biological sciences are in flux over the course of their development in a historical perspective. Biological causes and limitations exist in the real-world practical attitude of getting in around in the lifeworld (IV, 45, 126, 137). The intersubjective dimension is the larger whole in which the individual is merely a part. The intersubjective forms the set of influences that create the sense of self, and makes emotions, mood and self-interpretations differ in relation to the social environment. The ego selects its lifestyle and identity to a degree and as life goes by it may not realise the on-going contributions of any one of the constituent parts of the whole. One thing to note is that the biological aspect of human nature changes slowly, because general human character has been set by millions of years of evolution, having come from its primate ancestry and slowly evolved through previous versions of Homo Sapiens. Accordingly, some of its physical and mental abilities are determined by conditions that are no longer present, such as the need to protect itself against attack by animals or deal with frequent infections because of continually poor hygiene. Some aspects of emotional reactivity and the personality may well be adaptive to the past, as evolutionary psychology hypothesises. For instance, heterosexuality has been given the evolutionary interpretation that argues that there have been long-term selective factors at play in supporting cross-cultural universals about what make a man or a woman attractive to the opposite sex (Buss and Schmitt 1993). Biology, neuroscience, chemistry and physics have a lot to offer. But what is required for mental health care are clear statements of what it means in the specific work of explaining their findings and engaging individuals in improving their quality of life.

All sciences begin and end with meaning which is co-extensive with the intersubjective world but what heritability means is that biological cause can show itself as tendencies to be one way or another individually and socially that cannot be eradicated but only self-managed through understanding and self-control, if this is possible. When it comes to understanding intersubjective causes, Plomin’s research into the ways that separated identical twins are similar and different due to their differing social and physical environments, is a reputable approach to psychology as a science for the following reasons. Biologically, identical twins are the same at birth. (Although in recent years there has been more detailed investigation into how monozygotic twins are not identical (Haque et al. 2009)). However generally speaking, the reasoning stands because it’s possible to identify the psychosocial influences on twins who have had separate upbringings, it is a genuine comparison of like with like. Thus the influence of different social environments shows how identical twins differ entirely because of their socialisation. It is the case that biological cause is mixed with two other types of ‘cause’, each with its own influences (IV, 208). Indeed, biological research shows that social contexts are necessary in order to trigger genes in the same way that visual objects are necessary to produce the ability to see (Bee 2000; Greenough 1991). In the biological sciences, it is laudable that the human genome project has reformed genetics (Plomin and Craig 2001). But if biological sciences were to become the only justification for therapy, then the object will be improperly understood and practice derived from its findings will be inaccurate with respect to the tasks at hand. This is not to say that there is no helpful impact of understanding the biological aspects of mental health problems or their treatment. One solution is treating biological causes with biological remedies; and psychosocial ‘causes’ with psychosocial remedies. When it comes to neurology, the brain has been shown to be highly plastic in learning and re-growth. Even after damage, the functions of lost portions of it can recover in new areas. For instance, formal rehabilitation is effective to regain speech after a stroke and regain bodily movement. Plasticity extends to include on-going learning across the lifespan so that it is true to say that an individual’s brain reflects their lifestyle to date. Wholistically, neurology and lifestyle are co-influencing.

Natural psychological science attends to the material aspect of the brain, chemicals, biology and genetics and justifies psychological processes and interventions. But science does not state how it makes its conclusions in a wholly meaning-oriented way. Natural psychological science when it focuses excessively on natural being could be called the biological attitude or “medical model” because like natural science it uses statistics to numericise the spectrum of meaning into discrete packets to explore statistical correlations produced by experimental designs that claim to be able to create only one output from an input. However, non-phenomenological approaches such as natural anthropology, natural sociology and natural psychology attend to the biological nature of one-third of the human overall and then struggle to connect with first-person and social experience. Try as best they might, if there is no account of the overall multifactorial nexus of causes, then each of the biological, psychological and social regions cannot come together because the being of these areas are genuinely different. The registers of the biological or natural; social or intersubjective; or as the psychological (what lies within individuals) are often contemplated in isolation from each other. Some of natural psychology rejects meaning in preference for the meaningless focus on cortisol or other measurable processes that are concurrent with meaning. The focus on natural being is congruent but only around the being of the biological object . The meaningful does not clearly translate into neurotransmitters, biochemistry or the function of one part of the brain. It is the task of future empirical psychologies to indicate complex causes from each of the three registers of human being that comprise specific outcomes in multifactorial research. In a sense, there are individual brains to be understood. Specialisation of role and in society and repetitions throughout the lifespan create enlarged and diminished neurological structures according to the type of lifestyle. Biological processes are the legitimate object of biological science. This is because the natural formulation of natural causes of psychological problems leads to management of those natural reversible causes by natural means. When psychological management is requested after a natural formulation, without specifying how consciousness is related to the natural cause, there is a jump between regions without sufficient explanation or justification.

However, the understandings of nature, biology and neurology are constructions of thought and awareness that require translation into meaning to make them part of psychological understanding regarding how meaningful goal-oriented behaviour of “if… then…” motivations make cultural sense (IV, 86–87). Such motivations circulate and are brought about by empathy within communities. It is clearly acknowledged that there is a co-influencing between leib, brain and states of consciousness (IV, 294). The conclusion on the interplay between the three registers is stated as: “Needless to say, the future cannot be predicted with certainty, but only hypothetically, by supplying the intermediate parts. On the other hand, the past can be encompassed in the understanding by means of clear memory , and each motivational nexus it had can be comprehended… Everywhere natural causality, what is leiblich, and what is determined in consciousness by the leiblich play their roles together. In no way do these determinations need to be universal. The B[rain] can indeed be a necessary though not sufficient condition”, (IV, 296–297). This conclusion admits that there can be cases where there are different strengths of causative force in operation. So Husserl is not suggesting that what he can elucidate is true merely because he saw its essence . The ultimate arbiter is always empirical testing itself. The state of an individual’s brain or the true nature of their genetic inheritance is at the current time not ascertainable in every respect (although that may change in the future). Currently, biological science has not been able to go any further than being able to find preparatory information. It has to be noted that the state of an individual’s brain is variable in how it contributes to the total situation of the individual’s ego or personality style across the lifespan. It would be a naturalistic mistake to think that a “univocal determination of spirit through merely natural dependencies is unthinkable, i.e., as reduction to something like physical nature… Subjects cannot be dissolved into nature, for in that case what gives nature its sense would be missing. Nature is a field of relativities throughout, and it can be so because these are always in fact relative to an absolute, the spirit” of shared consciousness in culture (IV, 297).

This penultimate section of the chapter introduces intersubjectivity that is covered below in more detail but as it is implied in the discussion of the meaning it is necessary to say something of the manifold of others who are present in the current time and across history . When approached in a meaningful way the whole of intersubjectivity appears as forms of relationship: Insight is the apperception of self by self, the psychological understanding of self. It co-occurs with empathy, the ability to understand others and their perspectives. In addition to these terms there are a number of equivalent terms that describe what is being discussed to make various forms of psychological knowledge. The list of major topics in socially-oriented studies is as follows. Sometimes the phrases “psychological mindedness” or “emotional and social intelligence” are used (Goleman 1995). One assumption to avoid in western culture is that there is an excessive tendency in the natural attitude to assume that the individual is in fact most causative when in fact the social context is most influential as Karl Marx also noted (1972). Sometimes an excessive incorrect judgement is that all social interactions are due to the personal learning of the individual but that is decreased by citing the fundamental attribution error (Ross 1977). Social contexts and interactions between people are also understood by the words “systems” and systemic family therapy. Another area of developmental study is the multifactorial research of Michael Rutter on the resilience of children (Rutter 2006, 112). Individuals have different abilities to deal with adversity and this has lifelong semi-permanent effects on their abilities to be intimate, to attach and how they manage the emotions motivated by intimacy, its disappointments and its absence (Liljenfors and Lundh 2014; Owen 2006a). Insight, the higher understanding of self by self, and empathy , the understanding of others and their perspective, are both part of the whole of intersubjective life: pre-reflexively being immersed in family, work and culture. Empathy and apperception (the self understanding itself) are the most basic ground of being human that natural psychological science has long regarded as irrelevant and incapable of being a basis for itself. It is right too. Just by itself the natural attitude cannot ground natural science. Together insight and empathy are currently called “mentalisation” (Fonagy and Target 1996a, b, 1997, 1998; Fonagy and Luyten 2009), “mindreading” or “theory of mind” and social cognition (Moskowitz 2005) . An “individual has a theory of mind if he imputes mental states to himself and others. A system of inferences of this kind is properly viewed as a theory because such states are not directly observable, and the system can be used to make predictions about the behavior of others”, (Premack and Woodruff 1978, 515), which is an inaccurate wording as no inference occurs in immediately being able to understand others and self. In the realm of therapy the expectations and realities concerning the shared life is represented by the expression of the “core beliefs” discussed by Aaron Beck “of the most sensitive component of the self-concept (e.g. vulnerable, helpless, inept, loveless, worthless) and the primitive view of others (rejecting, hostile, demeaning)”, (1996, 4). All of the schools of thought are based on the on-going connection between the sense of self as it is apperceived by itself and the empathised and imagined sense of others and how they might be empathising the self. The building blocks of the meaningful connection with others are recognisable as the immersion in intersubjectivity in a pre-reflexive way where the emotions felt are evidence that is created automatically. Empirically, persons vary in the accuracy of their empathy with the notable exceptions of some people for whom such ability is continually weak or occasionally absent. However, these schools are parallel to the ideal study of empathy and intersubjectivity and parallel to the empirical studies of social cognition and emotional representations of how people reflect on the senses self and other (Owen 2002, 2006b). And importantly, it has to be realised that there are two ways in which the senses self and other can be focused on, against the background of the social experience that we have: Either there are pre-reflexive presences or there are properly reflected on senses capable of description and interpretation .