Saturday, April 02, 2022

More on taking psychiatric critique seriously

Carmine Pariante, who I've mentioned several times before (eg. see previous post), asks in a Psychological Medicine article "Why is it so difficult to say ... the brain regulates emotions and behaviours, in the same way that the heart pumps blood, the stomach absorbs nutrients and the spleen hosts immune cells?" Of course he's right that the brain mediates relational and intentional processes (see previous post). But people feel and act, not their brains, nor even their minds nor their consciousness (see another previous post). To be alive, a person has to be whole. The brain is only part of the person; an organ, like the heart, stomach and spleen, but not the seat of the person as such.

Psychiatry is the science and practice of biological, psychological and social relationships of people and their disorders. Despite what Pariante says, this is not a dualist position (see eg. previous post). A correctly understood biological psychiatry requires an adequate concept of biology, namely that of life bound to the entire organism and its interaction with the environment (see eg. previous post). Psychiatry's primary object, despite Pariante again, is not the brain but the person living in relationships. This fundamental failure to appreciate this philosophical reality is damaging psychiatry.

Pariante, therefore, does not realise that it is not possible in principle to reduce mental illness to brain disease (see previous post). He believes what he calls "the humongous evidence that there are neurochemical abnormalities in people with depression" must be true. But he neglects to say that such evidence is plagued by so many confounders and inconsistencies that it's not possible to say what the biological causes, as such, of depression are. He doesn't say what they are because he can't.

As I said in my last post, biomedical psychiatry needs to take seriously its critique. Pariante has a long way to go to do that.


Richard Gipps said...

Pariante is, it seems to me, right to point out that it isn't difficult to say that the brain regulates behaviours and emotions in the same way that the heart pumps blood and the stomach absorbs nutrients. Where Pariante goes wrong, however, is in assuming that to say this would be to say something coherent or worthwhile. What would be analogous would be something like: the brain regulates bodily movements, hormone levels, neural activations throughout itself and the body, etc. etc.

DBDouble said...

Thanks, Richard. Adolf Meyer was fond of using the term ‘neurologising tautology’ for seeing the psychosocial in terms of the brain. As he also said, “All person disorders must show through the brain but not always in the brain”.