…. or as Harry Callaghan said in “Magnum Force”;

“Briggs, I hate the goddamn system! But until someone comes along with changes that make sense, I’ll stick with it.”

An evening with Professor Peter Kinderman and The London Philosophy Club;- my response.

One of my favourite quotes comes from “Deconstructing the “Science Wars” by Reconstructing an Old Mold” by Stephen Jay Gould.

http://www.stephenjaygould.org/library/gould_science-wars.html

“our lamentable tendency to taxonomise complex situations as dichotomies of conflicting opposites.”

I think every “scientist” should print it out and keep a copy close to hand, especially when attempting to establish a position on any given subject, to avoid falling in to the trap of dichotomising that seems to come so naturally to us.

Listening to Professor Kinderman, I was repeatedly reminded of a book I had recently read called “Madness Explained; psychosis and human nature”. Towards the end of the talk, Peter mentioned that he was a colleague of Richard Bentall, who was the author of “Madness Explained”. That brought out a little chuckle.

I accept that there are deep flaws in the diagnostic model. But probably more the case that there are deep flaws in individual clinical interpretation and application of the diagnosis. To put it another way “we are flawed” and that includes clinical practitioners. There are GPs that are flawed, surgeons that are flawed, opticians that are flawed, podiatrists that are flawed, etc., etc. Some are very good, some are incompetent, and most fit in between somewhere on the sliding scale. The flaw is more in our nature which is imperfect, than the model system itself. I don’t think we should rush in to any rash and sudden throwing away of the system, I think we should let it evolve, as it has been doing, but help its evolution along the correct path rather than just throwing the whole thing away. Diagnosis has its uses; they are probably not directly useful, in most circumstances, for the individual’s “healing”. In fact, if you have a read of my post “Attachment to Diagnosis”, you’ll see that I actually think it can set up resistant obstacles to “healing”. But from a legal point of view, where receiving financial support, diagnosis appears an essential criteria in many cases. A knee-jerk throwing away of diagnosis is certainly not the answer, at least not until an viable alternative structure has been well established and proven to work. And in practice, that will never work. We have to adapt what we have and make it work. Sara Northey, as a last word, brought up the subject of the institutionalised necessity, in her practice, of giving a diagnosis and that diagnosis stays on a child’s medical records for life, which is clearly a problem and a problem that needs addressing. But as Peter emphasised, let’s address the problem directly, and not just throw the baby out with the bath water …

It is errant to suggest that the problems are not pathological, just because we don’t understand or haven’t yet discovered the nature of these pathologies, does not mean that we should simply say that they don’t exist. There is certainly a case for suggesting that “Big Pharma” are complicit in encouraging and benefiting from the case for “chemical imbalance”, but just because we might have problems with “Big Pharma” doesn’t mean we should turn a blind eye to the unquestionable fact that imbalances and dysfunction in the HPA Axis and the hormones Oxytocin, Serotonin, Dopamine, Cortisol and the Epinephrines, etc. play an role in “emotional disturbances”. And acknowledging their role does not mean we are condoning applying a chemical compensation, it just means that we are able to view the whole without prejudice and myopic points of view. And just as it is unquestionable that these hormones/neurotransmitters play a role, so it is also unquestionable that through cognitive processes we can rebalance these systems without drugs. CBT, MBCT, EMDR, DBT, etc. have clearly benefitted many of those suffering “emotional disturbances.

It seems obvious that if perceptions and interpretations (call them core beliefs, narratives, experiential patterns, etc.) created the imbalances, they can also restore the imbalances by changing those perceptions and interpretations. That is, at least, if you acknowledge the imbalances exist in the first place, which is a major hurdle (known as resistance) to therapy. Unfortunately, none of this cognitive, problem based model takes in to account that most “disorders” are actually rooted in developmental experiences incurred before full hippocampal function has been achieved and can lead to atrophy in the hippocampus. In fact, brain scans of Romanian orphans who have experienced extreme emotional and social isolation and neglect show global brain atrophy. Neuroscientists using fMRI scans have highlighted abnormal brain activity in a number of “disorders”.  Drugs DO work, medications that affect the inhibition of reuptake of transmitters have shown clear positive effects. Denying a chemical and structural pathology given such clear pathological evidence just seems a little absurd.

Human nature is, I believe, wired to take sides, and so predisposed to not view the bigger picture. Dichotomy is our middle name. This black and white perceiving, when magnified and in its extreme, is well documented as a dysfunctional symptom of a number of “disorders” like BPD, etc. yet it seems it is a normal human predisposition that had species survival value in the more uncertain environments of our phylogenetic heritage.

The point I am trying to make is that we should entertain all values and not just focus on those that best meet our prejudices. A few more quotes that I feel like throwing in to highlight this point;

“The mind, conditioned as it is by the past, always seeks to re-create what it knows and is familiar with. Even if it is painful, at least it is familiar. The mind always adheres to the known. The unknown is dangerous because it has no control over it.” ~ Eckhart Tolle

“If you are obliged to close yourself to the multiplicity of things, it follows that you will focus somewhat on a restrained area of things; and if you cannot freely value everything, nor freely weigh all things against other things, then, you must give disproportionate weight to some things which do not deserve this weight. You artificially inflate a small area of the world; give it a higher value in the horizon of your perception and action. And you do this because it represents an area that you can firmly hold on to, that you can skillfully manipulate, that you can use easily to justify yourself, your actions, your sense of self, your option in the world” ~ Ernest Becker

“When we are young we are often puzzled by the fact that each person we admire seems to have a different version of what life ought to be, what a good man is, how to live, and so on. If we are especially sensitive it seems more than puzzling, it is disheartening. What most people usually do is to follow one person’s ideas and then another’s depending on who looms largest on one’s horizon at the time. The one with the deepest voice, the strongest appearance, the most authority and success, is usually the one who gets our momentary allegiance; and we try to pattern our ideals after him. But as life goes on we get a perspective on this and all these different versions of truth become a little pathetic. Each person thinks that he has the formula for triumphing over life’s limitations and knows with authority what it means to be a man, and he usually tries to win a following for his particular patent. Today we know that people try so hard to win converts for their point of view because it is more than merely an outlook on life: it is an immortality formula.”
~ Ernest Becker, The Denial of Death

“The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.” ~ Bertrand Russell

“Free your Mind” ~ Morpheus; The Matrix

Advertisements