Monthly Archives: June 2013

Are Souls Real?

By Liah Greenfeld

The soul is an important subject for many people, but few of us would say it is scientific in the sense that it can be studied and understood by science. Science studies real things, which are referred to as “empirical,” and many of us are not entirely sure that souls are real. Many neuroscientists, in fact, don’t even believe that they exist; I would bet $1000 that 99% of them would not consider them “empirical.”

In this post, I would like you, my readers, to participate in proving such neuroscientists wrong. We are going to do this together, you and me, and we are going to do so empirically, that is relying on evidence or data. You and I are going to demonstrate empirically the reality of the soul.

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Gender and Neuroscience

By Liah Greenfeld

Readers’ comments to my recent post raised for me some questions about an important topic: gender. I don’t know how to answer these questions, but it seems interesting to ruminate—chew—on them, and I invite you to do so with me. Perhaps, you will have answers. The comment that specifically drew my attention to the issue was an angry one: The person who sent it strongly disagreed with my suggestion that the actions of many so-called “home-grown jihadists” or “Muslim extremists” in the West are very similar to those of mentally ill perpetrators of violent crime, and that, because their dedication to Islam is often of a recent date, it may not be Islam at all that motivates them, but their mental illness. The commenter called me various names and asked, in so many words, how someone with a Ph.D. can doubt that a wicked and, among other evil things, “misogynistic” religion such as Islam, which advocates the subjugation of women, is the motivation behind heinous crimes such the recent Boston Marathon bombing or the beheading of a soldier in London.

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Home-Grown Terrorists: Actually Terrorists or Mentally Ill?

By Liah Greenfeld

We shall probably never forget the terrifying images on our TV screens in the past six weeks or so. First, there were the two explosions at the finish line of Boston Marathon: screams, the wounded–shocked and bleeding–wheeled away from the scene in chairs that were waiting for exhausted but triumphant runners by running first responders with harassed faces. Then reports from the hospitals, heard with baited breath–so many killed (a child! a young woman!), so many people crippled for life. I was one of the three and a half million residents of the greater Boston area ordered to stay at home and keep away from the windows, but everyone, I imagine, found chilling the sight of a ghost city, with not a soul on the streets for hours–the beautiful, vibrant, famous city of Boston brought to a deathly still. And just several weeks later, not yet recovered, we were treated to the image–caught on live TV–of a young man in broad daylight in London with a meat cleaving knife in his hands, red to his elbows and dripping with blood of another young man, whom he had moments ago beheaded (!) and whose corpse could be seen in some distance, lying abandoned in the middle of the street.

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Is Depression A Real Disease?

By Liah Greenfeld

Last month’s issue of The British Journal of General Practice contains an editorial “Depression as a culture-bound syndrome: implications for primary care” by Dr. Christopher Dowrick, Professor of Primary Medical Care at the Institute of Psychology, Health, and Society of the University of Liverpool. Dr. Dowrick claims that depression “fulfills the criteria for a culture-bound syndrome,” i.e. , one of the “’illnesses’, limited to specific societies or culture areas, composed of localized diagnostic categories,” like, for instance ataque de nervios in Latin America. In the case of depression the culture area affected is “westernized societies.” Putting the word “illness,” when applied to culture-bound syndromes into quotation marks indicates that Dr. Dowrick does not consider such syndromes real illnesses; it follows that depression–a culture-bound syndrome of westernized societies–is also not a real illness. Dr. Dowrick further argues that depression as a diagnostic category cannot be seen as “a universal, transcultural concept,” because it has no validity and utility, and it does not have validity and utility, because “there is no sound evidence for a discrete pathophysiological basis” for depression. I find myself in absolute agreement with Dr. Dowrick’s two specific statements above (that depression is a culture-bound syndrome of westernized societies, and that there is no discrete pathophysiological basis for this diagnostic category), and yet completely disagree with the implication that depression is not a real disease.

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The Real Trouble With DSM-5

By Liah Greenfeld

Let us take a little break from the discussion of the historical development of modern emotions and modern mental disease—that is, of the modern mind-—pursued in the previous posts of this blog, and instead focus on the present. May 22 is the official publication date of the much-talked-about DSM-5, a significant day for all who are in any way concerned with mental health, patients as well as professionals who are trying to help them, and therefore for many in the Psychology Today community. The manual has been subject to severe criticism for months preceding its publication; it appears that hardly anyone has a good word to say about it, the time and effort spent in its preparation seems to have been largely wasted. The poor baby is likely to be dead on arrival, stillborn, its own family having turned away, unwilling to embrace it. Just a week ago the mighty NIMH all but completely renounced it.

But why is it such a disappointment? And who or what is to blame for the problems with DSM-5? The answer to the first question, I would say, lies not in anything DSM-5 contributes to the previous versions of the manual (whether in terms of additions or subtractions), but in what it does not change in them at all. The answer lies in that it does not solve the fundamental problem of psychiatry and psychology, i.e., does not provide them with the understanding of the human mental process—tthe mind—healthy or ill. This is, obviously, not a problem which the DSM-5 creates, or which was created by any of the preceding versions of this document. It is the problem at the core of the psychiatric/psychological/mental health establishment in its entirety-—both its research and its clinical branches, and including in the first place its central, most powerful, and richest institution, NIMH.

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Review: Mind, Modernity, Madness by Liah Greenfeld

 

Greenfeld’s book persuasively demonstrates the lack of consensus in the scientific community and beyond, over the causes, treatment and prevalence of schizophrenia and manic depression, both in America and worldwide. As this review is being prepared a new edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, is being released in the United States to some controversy. Liah Greenfeld’s call for a broader understanding of the role of culture in the growth of the illnesses of schizophrenia and manic depression seems perfectly timed to join the debate over the balance between science and culture in the diagnosis and treatment of these complex illnesses.

Catherine McKenna, MAKE

The Modern Mental Disease

By Liah Greenfeld

Modern humans—that is, people who live in societies such as ours, democratic, prosperous, relatively secure, and offering its members numerous life-choices, people like you and me, in other words—are different from humans who lived or live in other types of societies. We experience life differently from them: perceive reality differently and feel emotions that other humans did not have.

Human experience was revolutionized in the 16th century England. In the previous posts we have already discussed such new emotions as ambition, love, happiness, and their connection to the new form of consciousness, which came to be called “nationalism” and formed the cultural framework of modernity. Nationalism implied a special image of society as a sovereign community of equal members (a “nation”) and of reality in general. In its original, English, form it was essentially democratic. As it spread, it carried the seeds of democracy everywhere. Considering a living community sovereign (the source of all laws), it implicitly but drastically reduced the relevance of God and, even when combined with religion and presented in a religious idiom, which happened often, was to all intents and purposes secular. It was dramatically different, in other words, from the fundamentally religious, hierarchical consciousness which it replaced, and it shaped the way we live today. Among other things, the new consciousness made the human individual one’s own maker: it implied we had the choice to decide what we want to be; it dramatically increased the value of human life, encouraging us to realize it to the fullest extent—in other words, it gave us dignity and freedom. The society built on its premises of equality and popular sovereignty was an open society, in which the individual had the right to define one’s own identity, a society which made one’s identity one’s own business.  It is not coincidental that the new emotions discussed in previous posts, which emerged when the English society was redefined as a “nation,” were in some way connected to the individual’s ability to define oneself and that the two great modern passions—ambition and love—in fact answered a new need which this ability created: the need for help in identity-formation.

Unfortunately all these benefits of nationalism—the dignity, freedom, and equality, both empowering and encouraging the individual to choose what to be – did not come unaccompanied by costs, and for all the enrichment of our life experience contributed by love and happiness, these costs would be impossible to disregard.  The liberty to define oneself has made the formation of the individual identity problematic. A member of a nation cannot learn who or what s/he is from the environment, as would an individual growing up in an essentially religious and rigidly stratified, non-egalitarian order, where everyone’s position and behavior are defined by birth and divine providence. Beyond the very general category of nationality, a modern individual must decide what s/he is and should do, and thus construct one’s identity oneself.  Modern culture cannot provide individuals within it with consistent guidance, with which other cultures provide its members. By providing inconsistent guidance (for we are inevitably guided by our cultural environment), it in fact actively disorients us. Such cultural insufficiency is called anomie. Already over a century ago, it was recognized as the most dangerous problem of modernity. For many people, the necessity to construct one’s identity, to choose what to make of oneself, became an unbearable burden.

At the same time as the English society was redefined as a nation, and ambition, happiness, and love made their first appearances among our emotions, a special variety of mental illness, different from a multitude of mental illnesses known since antiquity, was first observed. It expressed itself in degrees of mental impairment, derangement, and dysfunction, the common symptoms of which were social maladjustment (chronic discomfort in one’s environment) and chronic discomfort (dis-ease) with one’s self, the sense of self oscillating between self-loathing and megalomania and in rare cases deteriorating into the terrifying experience of a complete loss of self. Some of the signs of the new disorder were similar to the symptoms of familiar mental abnormalities. In particular, the new illness, like some previously known conditions, would express itself in abnormal affect—extreme excitement and paralyzing sadness. But, in distinction to the known conditions in which these symptoms were temporary, in the new ailment they were chronic and recurrent. The essence of the new disorder, however, was its delusionary quality, that is the inability to distinguish between the inner world and the outside, which specifically disturbed the experience of self, confusing one regarding one’s identity, making one dissatisfied with, and/or insecure it, it, splitting one’s self in an inner conflict, even dissolving it altogether into the environment. Sixteenth-century English phrases such as “losing one’s mind,” “going out of one’s mind,” and “not being oneself” captured this disturbed experience, which expressed itself in out-of-control behaviors (that is, behaviors out of one’s control, out of the control of the self), and, as a result, in maladjustment and functional incapacitation.

None of the terms in the extensive medical vocabulary of the time (which included numerous categories of mental diseases) applied to the new mental illness; neither could it be treated with the means with which the previously known mental illnesses were treated. It required a new term—and was called “madness.” It also called into being the first hospital in the sense in which we understand the word (the famous Bedlam), the first medical specialization, eventually named “psychiatry,” and special legislation regarding the “mad.”  It is this clearly bipolar and delusional disease which would be three centuries later classified as distinct syndromes of schizophrenia and affective (depressive and manic-depressive) disorders.

We shall follow the history of this modern disease and analyze it in the following posts.

[Originally published on Psychology Today]