Friday, October 09, 2015

Fixing the brain is not the new world for psychiatry

Joe Herbert starts well in his article on Aeon Why we can't treat mental illness by fixing the brain?. He explains that although we have some understanding of how a brain neurone is activated and how this activation is passed on to another neurone, we do not know the answer to the wider question of "how a collection of neurons makes a thought, a memory, a decision, an emotion". As he says, "The problem of relating events at the level of neurons with the known functions of the brain is a critical one." There is a "mysterious and seemingly unfathomable gap" between psychology and neuroscience, which "bedevils not only psychiatry, but all attempts to understand the meaning of humanity".

Herbert recognises within psychiatry that there is "no evidence at all that the levels of serotonin or noradrenaline in the brains of depressed people are any different from normal". As he says, "a pathologist looking at the brain of a depressed person could not distinguish it from the brain of someone who was mentally well".

This is all well and good. But then he goes on to spoil the article by speculating that "one day, someone, somewhere will make the critical step, or steps, and we will enter a new world of psychiatry". The advance would be one "that can relate what psychiatrists see in their patients to what can be seen in the brain".

I suppose such wishful thinking can be used to justify the research of his Cambridge Centre for Brain Repair. However, there's no need to wait, and I think we'll be waiting forever, for some new breakthrough at a cellular, chemical or 'systems' level. The problem is conceptual and philosophical, not scientific in that sense. Mental health problems can be treated psychosocially now. It's misleading to suggest that the way forward is by moving psychiatry to neurology (see eg. previous post).


Anonymous said...

There's nothing wonderful about the article, Why can't we can't treat mental illness by fixing the brain? Joe Herbert's article cannot "start out well" as you claim because there is no such thing as "mental ilness". What exactly is there to be fixed? The critical psychiatry folk of England could use some education about neuroscience findings and the latest understanding of attachment trauma. The intransigent position that people like Moncrieff take is truly unbelievable from a trauma informed perspective. I am pleased at the work that many psychiatrists in Engand have done insofar as buiding awareness around the dangers of psychiatric medications. But continuing to promote treatments such as CBT, for example, which clearly does not work for most people given findings in neuroscience is disconcerting (See Stephen Porges, Bessel van der Kolk, Dan Siegel, Mariane Cloitre). Critical psychiatry if it is to be critical at all must deconstruct false constructs such as 'mental ilnesss', 'disorder' 'serotonin deficiency' 'bipolar' 'genetic predisposition for depression' 'ADHD' and 'borderline'. Dan Siegel makes a good case by claiming that almost all of the symptoms of most all of the DSM diagnoses can be traced back to attachment trauma. 'Disorder' finds its origins in non-integrated states. Siegel also claims that developmental 'relational impairment' leads to 'neurological impairment'. If this is the case, people can be neither mental ill or disordered in reality. It's just something psychiatrists like to tell their patients. It's also something patients like to tell themselves if it is reappopriated in terms such as "End Mental Illness Stigma". We would all much prefer that the changes that occur in the brain as a result of attachment trauma were really the result of a biogenetic origin because then we would not need to tend to greater social issues such as child abuse, domestic violence, sexual abuse, etc. Trauma is all pervasive and its effects on the brain are now well known by the leading neuroscientists. So much for the claim of the great divide between psychology and neuroscience. You see what you want to see. You read the research you want to read.

The map is never the territory. And as Kierkegaard says, "The more we know, the less we know". I'll be thinking of you next time I watch Monty Python.

Anonymous said...

We are continually being lied to by the USA American government and our professional organizations all in the interest of corporate profits. Job security is a lie, the economy is a lie, SSRI's are a lie, Psychiatry is a lie, democracy is a lie, Iraq was a lie, Vietnam was a lie, IRA's are a lie, HMO's are a lie, the stock market itself is a lie, FDA dietary recommendations are a lie, Syria is a lie. There is no information your USA Government gives you that is not an untruth to support corporate profits at your victim's expense.

There is no democracy. There is no freedom. There is just enslavement in the next untruth of the New Fascist Police State of America. GOOD LUCK IN THE NEXT WORLD WAR. You will think you are winning until the long range bombers destroy every major city in America. It will happen within ten years. When you next Remember these words it will be too late.

Anibal Alberto Acosta Palacio said...

You may need to go and seek a consultation. I suggest antipsychotics. :)

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