Friday, September 17, 2021

Is my brain health mine?

Current editorial in The Lancet talks about promoting good brain health. Ironically, it uses the concept of ‘brain health' to encourage a focus on social determinants of mental ill health. It suggests this might be a way of moving on from a reductionist view of mental illness. 

I suppose such an editorial reflects how seriously we need to take the neuro-turn in modern culture (see previous post). We now tend to view ourselves in terms of our brain. But, to quote from Thomas Fuchs (see previous post), "I'm rather glad not to be my brain, but only to have it". 

Disease has been understood as physical pathology since the mid-nineteenth century (see eg. previous post). Doctors also need to be person-centred (see eg. another previous post). The trouble is that primary mental illness does not have a physical representation as such in the brain, although of course the brain mediates our thoughts, emotions and behaviour, including mental illness. My brain can be diseased, causing for example delirium and dementia, but primary mental illness is functional not structural (see eg. previous post).

Does the health of my brain have to do with me and not just my brain? Is it not my health that’s at issue rather than my brain’s?

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