Category Archives: Mind

On DSM-V and the Diagnosis of Mental Illness

Allen Frances in “Diagnosing the D.S.M.,” The New York Times

…the D.S.M. is the victim of its own success and is accorded the authority of a bible in areas well beyond its competence. It has become the arbiter of who is ill and who is not — and often the primary determinant of treatment decisions, insurance eligibility, disability payments and who gets special school services. D.S.M. drives the direction of research and the approval of new drugs. It is widely used (and misused) in the courts… Psychiatric diagnosis is simply too important to be left exclusively in the hands of psychiatrists. They will always be an essential part of the mix but should no longer be permitted to call all the shots.

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Mind, Brain, and Mental Illness

Andrew Brown in “Depression is not a ‘brain disorder‘” in The Guardian

The mind is not just some decorative pattern read off the brain and mistaken for the real thing. Consciousness is not just the whistle on the steam train, as William James put it. Treating unhappiness as a problem in the brain is good for the profits of drug companies, but doesn’t actually make us all happier in the long run.

To say that the mind depends on the brain is easy enough – and true, so far as we know. But that doesn’t mean that they are the same thing, or that understanding the one will supply a sufficient understanding of the other. Talking about depression as a brain disease is a warning sign that someone has their ideas all wrong – and that’s not a problem with their brain.

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Biological Psychiatry, Psychodynamic Psychiatry, and a New Approach to Understanding Mental Illness

In Psychiatric Times, Dr. James Knoll IV writes in “The Humanities and Psychiatry: The Rebirth of Mind“:

What place do the humanities have in psychiatry? One might as well ask: What place does the mind have in the brain? What place does clinical experience have in medicine? What is the utility of the empty space within the vessel?…  In this article, I focus on the importance of the humanities to psychiatry, via the perennial conflict between biological psychiatry and psychodynamically oriented psychiatry. I hope to use a humanist approach to show that these “two cultures” depend on each other for balanced progress in the field…

Biological psychiatry has made truly impressive progress, yet it remains the case in 2013 that “biological psychiatrists do not hold the panacea for serious mental disorders,”particularly when standing on the lone pillar of science. The art of medicine remains a critical foundational structure in psychiatry, and both pillars are necessary for the stability of the field. One might say that the humanities and/or psychoanalytic thought helps provide science with the relevant questions on which to focus its “piecemeal work.”Put another way: the humanities provide the wonder, which science then illuminates.

It is sometimes the case that older theories are not proved false—rather, the very progress they contributed to now shows their limits.

In Mind, Modernity, Madness: The Impact of Culture on Human ExperienceLiah Greenfeld writes:

Today we know an awful lot about schizophrenia and manic-depressive illness. An enormous amount of information has been collected about the psychological and biological expressions of these diseases — about the personal experience and outward behaviors corresponding to them, the anatomical abnormalities which show themselves in certain groups of patients and neurochemical dynamics characteristic of others — about patterns of their transmission in families and certain genetic elements involved. But this information refuses to combine into a “case” — an explanatory argument based on the available evidence: there are gaping lacunae where pieces of the puzzle are supposed to dovetail; and none of the things we know can be said to constitute the smoking gun. We still do not know what causes these diseases and thus cannot either understand their nature or cure them. After two hundred years neither of the two approaches — the biological and the psychodynamic — in which psychiatry put its hopes brought these understanding and cure any closer. Therefore, I feel justified to offer a new – radically different — approach that has never been tried.

The historical recency, the timing of the spread in different societies, and the increase in the rates of mental disease of unknown etiology indicates that it cannot be understood in terms of any universal, biological or psychological, propensity of human nature, or explained by the characteristics of the individual human organism or personality as such. The observable trends (however incredible) pertain to and distinguish between specific societies and historical periods, and therefore must be accounted for historically. …

My intention is not to prove either the biological or the psychodynamic approach to mental disease wrong, but to complement them, adding to psychiatry a necessary element which has been heretofore missing. All the findings of the biological research, specifically, should be consistent with the approach I propose and, in cases they are not, the fault would lie with the approach rather than the findings. Culture, personality, and biology are different, but not mutually exclusive realities, and for this reason cultural, psychological, and biological arguments should not be mutually exclusive.

Social Neuroscience

By Mark Simes

In the October 12, 2009, online issue of the New York Times, Op-Ed Columnist David Brooks published a brief article titled “The Young and the Neuro,” recounting his visit to the 3rd Annual Social and Affective Neuroscience Society’s conference.  This article, following the trend of most New York Times articles whose subject purports to address the nexus of neuroscience and human behavior, shot to the top of the “Most Popular- E-Mailed” list and landed in my personal inbox from different senders no less than 8 times.  Since the focus of my research pertains specifically to the relationship between the social environment and the human brain, receiving this once or twice from colleagues or close friends would not have been extraordinary, however, the sheer popularity of the article and a glaring omission that directly concerns the goals of Liah Greenfeld’s overall project – and my work within this science – makes Brooks’ article worthy of comment here.

It is true that the trend for combining the social and behavioral sciences with neuroscience has recently gained momentum.  Brooks points out in his article that, “In 2001, an Internet search of the phrase “social cognitive neuroscience” yielded 53 hits. Now you get more than a million on Google.”  It is no secret that such a sub-discipline of neuroscience has been introduced in an effort to bridge the manifest gap between the knowledge ascertained about the human brain and any explanatory relationship to human mental experience; these dual aspects of brain and mind refuse to be happily married in either sickness or health.  Thus, some incorporation of the social sciences into neuroscience was inevitable.

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The Mind’s Irreducible Structure

By Mark Simes

The human mind is one of our most compelling subjects of scientific inquiry—and perhaps our most elusive. Despite impressive biological advances, neuroscience has yet to produce a logical and empirical analysis of the mind that exhibits universal, objective explanatory power of human mental phenomena on both an individual and species level. “The Mind’s Irreducible Structure,” published in Sociological Mind in July 2012, explores the limitations of the current neuroscientific approach to the human mind and argues for a reconceptualization of the relationship between human mental phenomena and the brain. In the article, I introduce a new interpretation of neuroscientific data and argue that this framework has the capacity to causally explain the link between social, psychological and biological levels of analysis.

A PDF of the article is here