He suggests psychiatry has an identity crisis because of the nature of mental illness. I'm not sure if I would call it an 'identity crisis', but I agree that how the nature of mental illness is understood does matter. Jethwa argues for psychiatry being a clinical neuroscience and suggests, following Bullmore et al (2009) (see previous post), that British psychiatry over recent years has taken an increasing 'neurophobic' position. He goes on, "It is imperative that the scientific underpinnings of psychiatry are explicit within mental health services and in interactions with patients and the public in general". The trouble is that he hasn't been explicit about the neuroscientific basis of psychiatry. He seems disappointed that psychiatry can't be more explicit. I have said before (eg. see previous post) that modern psychiatry is setting itself up to disillusion trainees by promoting neuroscience as the solution to mental illness in the way Jethwa hopes it can be. I fear that it may have lost another good quality trainee in his case. I hope I'm wrong!
Neuroscience cannot be a solution to mental illness because there is no such thing as "mental ilness" (Szasz, Breggin). However, neuroscience can explain the kinds of changes that occur in the brain because of relational deprivation, child abuse, neglect, attachment issues that have long term negative mental implications and outcomes. (Dan Siegel, Bruce Perry, Bessel van der Kolk). Addiction is one example of a condition that has its roots in trauma. (Gabor Mate) Borderline personality 'disorder' (which would more accurately be called a 'attachment disorder' or 'emotional dysregulation disorder') is another. Neuroscience as well as other empirical research demonstrates why this is the case. Why so called critical psychiatrists do not bother to read this research is beyond comprehension.
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