Reality of mental health problems

I’ve mentioned before several times (eg. see previous post) about the hope that neuroscience will explain mental illness. Psychiatry commonly assumes that there is an underlying hypothetical brain lesion, even if not yet discovered, causing mental health problems. But these are often mere conjectures (eg. see another previous post).

The problem with continually promising ourselves physical lesions is that we can tend to ignore psychosocial facts that are already available. As Adolf Meyer (1906) said, “it has become my conviction that the developments in some mental diseases are rather the results of peculiar mental tangles than the result of any coarsely appreciable and demonstrable brain lesion” (see previous posts about Meyer eg. Pathologist of the mind). This doesn’t mean ignoring organic factors when they exist. But, again following Meyer, “we had better use the facts at hand [psychosocial factors] for what they are worth” rather than “have to invent them [somatic factors] first in order to get anything to work with”.

Pragmatic treatment is about helping the person adapt and adjust. This may well not be easy, but it’s not a reason for avoiding trying to do so or deflecting the problem onto the brain.