Tuesday, January 20, 2015

The future of psychiatry depends on not being reductionist

I wanted to follow up the comment on my previous post by Allan Seltzer. As he says, "Mind cannot be reduced to brain". To be clear, mind is enabled but not reducible to brain. Psychiatry hasn't always been as clear about this as it should have been. In fact, it has always hankered after a simple reductionist solution to the issue of mental illness. It tends to think the problem must be a brain disorder, but this is an illusion. We're surprised when this is pointed out and it seems to leave us with too complex a clinical situation to manage. So we naturally shy away from it.

Is it realistic to think that psychiatry's future may be non-reductionistic? Probably not! Psychiatry hasn't changed much since its modern inception with the introduction of the successful anatomoclinical way of viewing disease. It's understandable that mental illness has been expected to follow the path of physical illness, which is seen as being caused by bodily pathology. The trouble is that it doesn't. I agree with Allan that psychiatry should become non-reductionistic. But there are too many entrenched interests to be overcome, not least that much of research is based on hoping for the physical clue to mental illness. People will continue to wish for a simple, quick, cheap, painless and complete cure for their mental health problems. It's easier if the solution's in the brain.


Allan Seltzer said...

The future of psychiatry is to morph into neurology. Freud could not do this in 1895 in his Project for a Scientific Psycholgy. 100 years later however, the emphasis on the biology of mental disease will likely reveal a clear biochemical substrate at some point. Right now it is pseudoscience to tell a patient that you have a chemical imbalance and take this Rx. Psychiatrists who do not engage in formal psychotherapy of some school or other are not serving their patients or the survival of the profession in the face of competition from PhDs and MSWs much good.

Anonymous said...

"100 years later however, the emphasis on the biology of mental disease will likely reveal a clear biochemical substrate at some point."

In this science fiction scenario you've got technology to change molecularly, allegedly, someone from believing they are Jesus to merely believing IN Jesus, so psychiatry and hence nation states, possess the technology to change the beliefs of humans directly biologically, and you think such a God-like power would only be used to change the maligned beliefs of those called "psychotic" Ha! That shit would be in the water supply and freedom of thought would go out the window, whole nations would fight wars by simply changing the beliefs allegedly inside the brains of the citizens or leaders of the enemy nation. It would be utterly over for mankind. Decide a potential sex partner has the "wrong molecularly substrated belief of not believing you're a good person to have sex with", bang! zap her with the brain changing gun. It's absurd fantasy to think humanity is even within a 1000 years of having anything like a way to engineer biologically a fix to what someone's opinion calls "fixed false beliefs".

Absurd. Neurology is about stopping seizures and tumors and global one way ticket cognitive degeneration diseases.

Psychiatry is about calling someone who believes something others don't want them to believe "sick".

It's a practical, logical impossibility to gain a thorough, complete understanding of a supposed quantum physical biological state of "believing the NSA is spying on you" and having the power to change that belief biologically, without also have the complete understanding and power to change absolutely ANY belief.

The way these quacks would have it is that you take uncle Ed who believes the CIA is after him to the 22nd century neurologist and he "fixes this belief". It's bullshit.

You may as well send a 22nd neurologist drone over Pakistan and insert the belief that the CIA is their friend and they should inform to the CIA and help the CIA, biologically.

It is utterly, utterly absurd to even think for a second, that your brain just generated what you believe like your bladder filled up with urine.

The fact that morons who believe this have the power to forcibly drug law-abiding, innocent, helpless people, is an absolute disgrace to humanity.