Monday, July 15, 2024

The aspirations of psychiatry

King's College London press release announces that the "Wellcome Trust have awarded the funds [£5million] for a new 5-year ground-breaking research project ‘ASPIRE’, aiming to conclusively test if anti-inflammatories can be the right treatment for the right people with depression". Not sure how conclusive the results will be considering the description of the project on the Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe) website. 

Also not quite sure what the Wellcome Trust meant a few years ago when it acknowledged that a radical new approach is needed for mental health research (see previous post), as it now seems to be allocating funding again on the same basis by wasting it on 'pie in the sky’ fantasies about what's possible with mental health treatments. I'm not wanting to polarise debate unnecessarily in psychiatry, and advocate, like Nik Rose (see previous post), for critical friendship between social sciences and neuroscience. However, I think this does need an acknowledgement from neuroscience that too much neuroscience funding is being wasted on the unattainable.

I've been ruthless in my criticism of the conceptual foundations of the psychiatry of Carmine Pariante, the primary investigator of ASPIRE (see eg. previous post). I also did a cutting, satirical review of the book by Ed Bullmore (see previous post), that made the case, like ASPIRE, for anti-inflammatory medications being used as treatment for depression by targeting the right people on the basis of levels of inflammation. To me, it's nonsensical to talk about depression as an inflammatory disorder, like rheumatoid arthritis (see eg. another previous post). More fundamentally, looking for abnormalities of inflammation in the brains of depressed people is a conceptual category error (see eg. last post). 

Thursday, July 04, 2024

Summarising the argument of relational psychiatry

Depression of course is mediated via the brain but looking for abnormalities in the brain to explain why people are depressed is a category error. It is a fallacy to identify the brain with the person, in depressed people as much as in people who are not depressed.

I make this statement as a summary of the position of relational psychiatry (see eg. previous post), applying it to all functional mental illness, including schizophrenia and manic-depressive illness, not just depression. As I mentioned in a previous post, Bennett & Hacker call the category mistake of identifying the part with the whole the ‘mereological fallacy’. As I keep saying, psychiatry must stop identifying the brain with the person (see eg. another previous post). 

It is particularly people who have mental health problems who are reduced to their brains, and this is discrimination. However, such thinking permeates modern culture, reducing all people to their brains (see eg. previous post). Children are even being misled about the nature of mental illness (see eg. another previous post). What we need is a change from psychiatry being based on the notion that primary mental illness will be found to have a physical cause, to it moving on to a more relational practice (see eg. my article).