A Response to the Hyper-focus on Brain-based Research and “Disease”

Noel Hunter, PsyDWilliam Schultz
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The past several years have born exciting developments for those critical of the current psychiatric paradigm. We have witnessed outright criticism of the DSM by prominent psychiatrists (i.e., Thomas Insel, Allen Frances) while others have admitted that no “biological markers” exist for any DSM-defined disorder (Kupfer, 2013). Amazingly, however, the suggested response to these problems is to continue pursuing the search for the biological underpinnings of so-called “mental illness” through an almost evangelical hyper-focus on brain research. In other words, the leaders of mental health are essentially saying “We have spent 100 years diligently categorizing all the ways that people may suffer emotionally, searched for genetic, brain, and chemical abnormalities, and developed hundreds of drugs to target these ‘diseases’, yet we are no better off than we were 100 years ago. So, we have decided to double-down and spend more money and dedicate more intense efforts at doing the exact same thing in the future”.

This response is problematic for so many reasons. The International Society for Ethical Psychology & Psychiatry (an organization whose mission is to educate the public about the “de-humanizing and coercive aspects of many forms of mental health treatment, and the alternative humane ways of helping people who struggle with very difficult life issues”) has issued a publicly available paper scientifically challenging these efforts and suggesting ways in which our finite resources may be more effectively directed. The paper is available for download here.

We begin this paper by discussing the controversies surrounding the DSM diagnostic system and the current efforts being made to increase our understanding of the brain. Notably, $100 million has been committed to the BRAIN initiative in the United States, largely funded by pharmaceutical companies and organizations that design brain scanning technologies. Other countries are developing similar initiatives. Clearly, there is a high level of financial and corporate interest in pursuing these efforts.

Not all is corrupt, for there are many reasons that the government and its citizens, more specifically, are interested in supporting these efforts. For instance, many believe that extreme behaviors can be better understood if we know what is occurring in the brain, stigma may be reduced if we see that there is a “real” disease process occurring, or that tax-payer and private money is being spent effectively. While many of these reasons may be logical and well-intentioned, biologically reductive “mental illness” research is likely (or “very likely” or “almost certainly”) to fail because it is based on erroneous assumptions. These erroneous assumptions are contradicted by robust research findings. While there are certainly brain correlates with various traumatic and stressful environmental circumstances, these do not insinuate disease nor can they be separated from the environment in which they developed. Additionally, many current brain-based research studies have shown the powerful effects of psychotherapy, meditation, dietary changes, and other non-pharmaceutical or biological interventions.

While brain research is certainly interesting as an academic exercise, and may, in fact, provide us with some interesting ideas for effective interventions, the consequences of the search for “disease” in the brain cannot be ignored. These include: skewed research funding, biased treatment preferences, and clinically harmful assumptions and prejudices. Though brain-based initiatives for understanding human behavior should have its place, limited funds need to be redistributed in line with current research findings. Poverty, trauma, child abuse and neglect, discrimination, loneliness, bullying, drug use, and inequality are directly associated with such conditions, and are also correlated with certain kinds of observable changes within our brains. Psychosocial support that directly addresses these issues has been consistently associated with long-term benefits superior to those of biological interventions. We need to acknowledge that the resources available for mental health research and care are limited, and that every dollar and person-hour spent pursuing brain-based solutions to psychological distress comes at a direct cost to those resources available for psychosocial research and support.

We conclude with the following:

“One final important component of such a system that needs to be mentioned is that of prevention—identifying and eliminating the seeds of potential psychological distress. Considering that factors such as poverty, inequality, family disharmony, and various forms of social discrimination lie right at the root of so much of those distressing conditions that are called “mental illness,” this forces us to acknowledge that if we really want to address “mental illness,” then we really need to work together as a society and explore how we can address these broader social problems. This is no easy task, for sure, but if we honestly want to ask the question, “What causes ‘mental illness’ and how do we best ‘treat’ it,” then we need to be willing to look honestly at the research and accept the answers that emerge.”

The full paper with references is free and publicly available for download. Please share and spread the word!

36 COMMENTS

  1. The link is dead; it should be listed like this:

    http://psychintegrity.org/wp-content/uploads/2015/08/White-Paper-Brain-Scan-Research.pdf

    This is a set of ideas with which I strongly agree. It is astonishing and frankly offensive how much money has been wasted pursuing dead-end ideas about “mental illnesses” being understandable via studying brain processes. The idea that problems primarily developing due to neglect, trauma, stress, and lack of environmental resources will have better treatments developed via studying brain activity is delusional and pitiable on the part of researchers. An older therapist once said to me, “If you know absolutely nothing about psychosis, you say that schizophrenia is a brain disease.”

    How many more people could have been helped if the money wasted on this research were devoted to long-term psychosocial interventions like psychotherapy, peer supports, exercise/nutrition, job training, etc. These are the things that most distressed people want, not pictures of their brain waves and a pill to take. As the authors correctly noted, billions of dollars have already been wasted on this doomed effort and can never be recovered.

    Hopefully this “Titanic” amount of delusional research has already hit the iceberg and will later hit the seabed as more people become aware of this scam.

  2. I agree with your conclusions. Psychiatry continues to ignore the social factors and the lived experiences that can cause people to become vulnerable. But doing that would not continue to increase the flow for pharmaceutical profit that psychiatry and the medical industry has a vested interest in.

    Brain imaging, which is just another attempt for psychiatry to become a legitimate branch of medicine, will be in vogue until the research monies run out. Then they will be off to chase the next “illness” or “syndrome”, using and controlled by the people paying them to find it. The issue is the bad “research” and illogical conclusions they will form until that time that will injure more people than they already have.
    When does this madness stop?

  3. Well written critique, Noel and William. The entire psychiatric belief system is completely absurd and illogical, from my perspective (well, I see the profit motive for the psycho / pharmacutical industries themselves). But for people to actually believe problems in living are “brain diseases,” and waste billions of dollars researching such an odd theology, just seems ridiculous to me.

    And, especially now that it’s known that the ADHD drugs and antidepressants can cause the “bipolar” symptoms. And that the antipsychotics can cause both the negative and positive symptoms of schizophrenia via both neuroleptic induced deficit disorder and neuroleptic / antidepressant / benzo induced anticholinergic toxidrome. It seems quite logical that the DSM is basically nothing more than a book describing the illnesses the psychiatric drugs create.

    So we must ask ourselves, do we as a society benefit from the psychiatric industry and it’s “brain disease” theories and drugs? And, as your article fairly clearly points out, from a health care perspective the answer is no. So we must look at the psychiatric industry’s other function, social control. Do the majority within society benefit from having a faction of the medical community pretending to be doctors treating diseases, but in reality just tranquilizing people to cover up societal problems like child abuse, medical errors, drug abuse, and other societal problems? I’m quite certain justice would be better served, and our money would be better spent, another way.

    • I mostly agree with your thoughts. It is incredible how psychiatric researchers maintain the level of denial and avoidance necessary to maintain the fiction in their minds that problems in living are understandable as “brain illnesses” and that imaging the brain will serve to identify causes of these problems in living. But I think the unconscious alternative is losing billions of dollars in profit, and for many, losing their jobs. That is a huge motivator to not see what are, to us, hugely obvious flaws in the logic and reasoning behind conceptualizing severe problems in living as “brain diseases.”

      This debate reminds me of the movie The Insider, in which Russell Crowe’s character isshocked at the length tobacco executives went to to deny and avoid the evidence starting them in the face that smoking destroys people’s health. Their motivator was also profit and power.

      I do not quite agree that the conditions concretely described in the DSM represents nothing more than illnesses created by psychiatric drugs. People do have real developmental problems due to lack of love, bullying, abuse, trauma, poverty, lack of education, discrimination, and other stresses. In severe cases the impaired functioning of some people approximates the descriptions seen in the false illness labels “borderline”, “psychotic” etc. But the difference is that these issues are not illnesses but rather problematic, self-defeating ways of relating and understanding the world based on what the person has experienced and been challenged by in their relationships throughout life.

      There was an old psychodynamic therapist called Donald Rinsley, from the Menninger Clinic in Topeka, KS, who wrote beautifully about problems now today called “borderline”, “bipolar” and “schizophrenic”, and conceptualized these conditions as levels of ego-functioning existing along a continuum. These are not “illnesses”, but working cross-sectional hypotheses or superficial descriptions of the way problematic ways of relating and understanding oneself and others flow into one another. In particular they depend on the degree and way in which a person uses or does not use splitting (seeing things as all-good or all-bad, which depends on the degree and kind of positive or negative experience with others a person has had throughout life). I have a picture of that continuum here:

      https://bpdtransformation.files.wordpress.com/2015/03/cam00157update2.png

  4. Hi Noel and William,

    Here is some friendly constructive criticism from someone who basically agrees with you and is pro ISEPP:

    1. You keep putting “mental illness” in quotes, suggesting that you don’t think that mental illness exists, but you don’t say what you mean by this exactly.

    2. You quote BPS as follows:

    ‘”mental illnesses” are best conceptualized as problems in living that result from traumatic and societal ills which overwhelm one’s capacity to cope, and that “treatment” should be based in a psychosocial framework that honors individuality”‘

    How do you or BPS know that this thing that you are not quite defining (“mental illness”) is best conceptualized as problems in living resulting from traumatic societal ills, etc.? Isn’t this view contracted by, for example, someone who has mental problems due to a massive vitamin B12 deficiency? What is the framework that the quote refers to? Why is it so great? Is it the best thing to do or just an alternative?

    3. You say

    ‘On the other hand, the mainstream mental health field, and biological psychiatry in particular, in conjunction with various political and corporate powers, is pushing further in a direction of conceiving emotional distress as a brain disease; a direction often referred to as “biological reductionism”‘

    That seems kind of vague and speculative and is not really fair or a good definition of biological reductionism. I don’t think that anyone is saying that just emotional distress in general is a brain disease.

    4. You say

    ‘Further, a brain-based approach to sometimes difficult-to-understand behaviors and experiences of those in extreme distress may be seen as a desperate effort to explain such phenomena without blaming anybody or insisting that someone “just get over it.”‘

    It’s not clear to me what this means.

    5. You say

    “The problem with this approach, however, is that the brain-based initiatives for clinical research rely on a disease model that is based on erroneous logic, a faulty reductionistic view of human nature, and a contradiction of the most robust research findings within the mental health field.”

    What is the erroneous logic you are referring to?

    6. The overall point of the paper seems to be that you are against brain research because you think resources are limited and

    “…focusing our resources on providing psychosocial support for individuals, families, and communities and working towards a social system in which meaningful and rewarding activity, education, and work is accessible to everyone. ”

    You argue against brain research, but don’t say exactly what should be funded instead. Also, why not fund both? If you have a good idea, I don’t see why that means that there should be less brain research. Your paper almost sounds like “We shouldn’t do brain research, we should fix society instead.”

    7. Your argument is much broader than what I would guess from the title. It’s not just about brain scan research.

    Finally, I suspect that you are basically right about brain research, but I keep thinking that one essential point is consistently missed in these arguments. Even if you have the hardest hard science view of this and even if you think that mental problems like depression reside entirely within the person in distress, it may be that a person has a “brain malware” problem – a problem caused by the thoughts that the person is thinking rather than the underlying biology. I think that depression may be like that, for instance. It may be analogous to a laptop that is running malware where no hardware intervention is going to help. Notice that you similarly can’t tell if a laptop has “laptop depression” with a voltmeter (no simple biomarkers). Notice, also, that future research into sophisticated electronic detection of laptop malware isn’t going to really change anything. The answer is always going to be to stop running the malware. It may be the same with brains where problems caused by habitual ingrained thought patterns are never going to be effectively helped by some future super-drug.

    – Saul

    • I appreciate your comments, Mr Yousef. However, I am not sure if the actual connection between vitamin deficiencies and “mood disturbances” have thoroughly been proved. In most people, the brain, body, and spirit are so malleable and impressionable that it may be the thought that the vitamins work that actually causes one to feel better. This may be true in many; if not all; diseases or disorders in the “human/animal spectrum.” That may be one reason that many times; people denote “mental illness” with quotes and maybe we should denote “physical illness” with quotes. also. Thank you.

  5. But how do you know if someone’s problem is biologically based or not? Isn’t this then an argument for more brain research?

    There is no reason to suspect that problematic thought and behavior is a product of brain malfunction, so to engage in endless “research” into such reflects a sort if wishful thinking that against all odds, sooner or later we’ll find something neurological to blame it on.

    Isn’t there more of an argument for more research into how alienation under corporate capitalism leads to emotional distress and trauma?

  6. —Amazingly, however, the suggested response to these problems is to continue pursuing the search for the biological underpinnings of so-called “mental illness”

    Your quotes are misplaced, it is “mental” illness. The claim that an illness is “mental” misleads. Neither pneumonia nor schizophrenia are mental conditions.

      • “Schizophrenia” is a chimera, if I use the term correctly. “It” is simply a catch-all phrase which encompasses all sorts of thought, behavior and circumstance. It is an attempt to explain the seemingly incomprehensible by labeling it, thereby implying a “scientific” understanding.

        • I have had pneumonia twice. The first time resulted from stress in dealing with the concurrent factors of a highly uncaring employer towards my sister’s cancer and in dealing with her illness. The second time was a response to the horrific, unnecessary, toxic, addictive psychiatric drugging they were doing to me. Who is it not to say that even pneumonia does not really come from the mind or the pain the mind unintentionally or intentionally inflicts on the body? People do suffer distress in their minds; but they are great creative, imaginative , sensitive, vulnerable creatures. Who is to say this is not a factor in causing what we mistakenly call “schizophrena” or some other alleged “mental illness?” Our bodies, brains, spirits, and souls are “hard-wired” even before birth and conception to be a specific unique being with a specific unique purpose and path in life. When any of this is compromised, diverted, denied, or criticized, etc.; then the usual result may be some type of disease or disorder. However, this does not mean we are “defective” or need drugging; not even in the case of many alleged “physical illnesses.” No, this means unconditional loving acceptance of who we really are as wonderfully created before conception and birth. I suspect there are those who disagree with me about this occurring before conception and birth. I respect your disagreements. But, today, in all of modern society; we have lost this particular truth and there is so much suffering because of it. Many of our “illnesses” are suffered by those who could not or ever be what their parents, teachers, government, society, etc thought they should be and even criticize, abuse, punish, judge, etc. for their inability to be as they have been made; instead of what these institutions want to be made. Being what you are not causes so much misery in this world. All you need do is look at the media, the internet, tv, magazines, etc. There is way too much suffering in this present world and much I have learned comes from a world that denies a person to be who they truly as created before conception and birth. Thank you

          • Another way of looking at this is to posit that our infinite existence manifests in infinite forms; our individual consciousness or soul is reflected through many dimensions of existence. Minus a 4 dimensional time/space-bound constraint there is no before or after, birth or death, just all of us reverberating through the multiverse.

            Don’t know if this is politically incorrect for a socialist or not.

  7. Who decides what is “mental illness”, you ? Someone else ? As much as I would like to believe sometimes that all these scientists experimenting doesn’t mean anything and it’s all bunk and all you need is some guru to work their talk juju on you, the real problem as I see it are ethical, trust based ones.

    Really it’s all the same crap and typically can boil down to the best course of action to not see a psychologist or psychiatrist at all or engage with what any of these patronising “services”.

    How does it all work ? In what way is psychiatry well meaning ? Well only perhaps is that the ultimate goal appears to be that you stop struggling while you enable their livelyhoods, take the negative label(s) and then either have your independant thought,health or both destroyed.

    • Focus on a persons health, make sure that’s good and then figure out a way for them to be happy, content, useful, whatever it is that’s going to work out for everyone.

      That seems like the best way to me, as long as you’re there thinking to yourself that you are better or know more or looking for control or to protect your own interests you should be doomed to failure.

  8. I agree that bullying and discrimination are among the leading causes of mental distress. Unfortunately, this duality is rampant in academia and the mental health field. Clinicians, social service staff, professors, and clinical supervisors can easily be bullying and often are quite controlling and demeaning, and even peer to peer bullying is not so unusual, as this is what is modeled in the system. So what kind of environments are recommended for wellness and equality to occur?

    • And when I talk about ‘bullying,’ I’m not referring to one mean-spirited person. Bullying is in a system, a culture–either blatantly or subtly. There are a lot of ways for a culture to be bullying and disenfranchising. This is the most challenging paradox to reconcile, here, since most of us have confirmed that it is the culture which causes us mental distress, especially the “mental health” system culture. Really begs for an innovative and original perspective, ascended beyond such paradox.

      • I agree, Alex. Bullying only occurs when it is supported by the status quo. Even the typical school targets of bullying (gay, dark-skinned, physically weak, lacking social skills, to “brainy”) are determined by social criteria and are condoned to some degree by the society at large. The only way to stop bullying is to confront oppression on the larger scale. I’ve always thought it deeply ironic that people talk about kids bullying other kids in school and say, “Kids can be SO mean!” Guess where they learn it? From the adults, many of whom run the very oppressive school system these kids are forced to attend! If I had to name 5 kids who bullied me in school, I don’t think I could come up with the names, but 5 teachers would be exceptionally easy to identify. Bullying is always a sign of living in an oppressive society.

        • I never experienced bullying until I got to the mental health system! That was so over the top. And I call it bullying because anyone I turned to justified the bullying and made me out to be paranoid. So despite my exhaustive efforts to find support and guidance among advocates, I had no advocacy in the mental health world, I was on my own.

          My solution was to take legal action, as I was fortunate to find a willing staff attorney at a non-profit employment law training center. That was not easy, especially since I was still recovering from psych drug toxins, but I had to do it, what they did was blatant discrimination and sabotage. My film also targets social bullying, within the family and also the mental health system. Making this film helped me to get a lot of clarity and start to move on from this victim identity which I was internalizing.

          Main thing was for me to confront it directly in a way that was reasonable, but the system doesn’t back down, and is relentless in its need for control. Such denial!

          Eventually, after leaving all this behind and finding my way back to compassionate living, I had to interpret this all another way, from a spiritual perspective. That shifted all the victim energy, and empowered me by teaching me the lessons behind these experiences.

          It was a multi-tiered process to heal from institutional bullying. More than anything, it meant finding my true path, away from this toxic garbage. That’s the blessing.

  9. Excellent article!
    Part of the issue tat this brings out is the growing divide between true clinicians, researchers, and psychiatry bureaucrats. Research used to be more clinically driven to test out observations that clinicians were concerned about. Now, research has become an industry in itself, with many researchers having little actual clinical experience. This leads to research being done, and results being accepted, even if there is little clinical relevance or sense to it.
    An other aspect that falls into the category of biological research is genetic research. There is a lot of money wasted in looking for genes that may be connected with various DSM diagnoses or symptoms. These studies, though few actual positive results have been found, tend to be presented as if they are looking for “diseased” genes. The truth, if any gene connections are ever found, is more likely to be that certain traits in response to environmental trauma may effect the emotional outcomes. For example, a child who is more emotionally in tune may respond differently to abuse than a child who has natural traits of self assertion. For suicide, a person who has some genetic predisposition to risk aversion may be less likely to make a fatal attempt. While any genetic links could be of some interest, very few are that likely to indicate the most important aspects of aetiology.
    If we want to truly help people have better lives, we need to address the true causes of distress, as is well pointed out by Noel and William.

    • These are great points. My biggest problem with psychiatry conceptualizing normality as some kind of “resilience”. In essence it’d be best if we all were highly-functioning psychopaths, not bothered too much with trauma, burdened with emotions and so on. It pathologizes normal human emotionality and blames the victim for responding to abuse.
      I think a good analogy for that is obesity – another avenue where huge money has been spent to look for fat genes and magic pills when it’s obvious that most people who have weight problems are not victims of their genes but of the modern lifestyle and crappy diets. Even if some of us are somehow resistant to that and can remain slim even on junk food eaten on a sofa it does not make it “normal” nor does it make people who are obese genetically ill. Human are diverse and this diversity is an adaptive strength of our species, nor a weakness.

  10. “Considering that factors such as poverty, inequality, family disharmony, and various forms of social discrimination lie right at the root of so much of those distressing conditions that are called “mental illness,” this forces us to acknowledge that if we really want to address “mental illness,” then we really need to work together as a society and explore how we can address these broader social problems.”

    That is an excellent point and sadly also the reason why nobody is really interested in addressing the roots of the problem. Our socioeconomic system is rotten to the core and much more is at stake than just people’s “mental health” but very little is done to change it. There are glimmers of hope like the Occupy but it’s by far not enough to stop the crazy neoliberal train from destroying humanity and the planet.

  11. “Our socioeconomic system is rotten to the core and much more is at stake than just people’s “mental health” but very little is d0ne to change it.”
    “A focused response to the Hyper-focus on Brain- based research and Disease”
    Can’t the various cartels be distinguished by the various chemical and biological compounds, mixed heavy metals they produce and use (unimaginable how deadly poisonous to the human being ) and how numerous they really are and yet more are added daily. Added in so many places like in food, air, water , or as “medicine” direct injection or placement into blood stream and other places in the body. The cartels want no interference with business as usual and no outside regulation. The cheapest solution for them using the populations funds is “brain research” so in future better and more quickly be able to shut down anyone who may pose a threat or imagined threat to their profit making basically self regulated machines and systems. Better accepted disguised as medical care . After all they have many poisonous substances on hand. They want better targeting for these chemical and other various putrefactions to shut down unacceptable thinking and behavior and for more effective marginalizing of any opposition until the time , that time released eugenics can be dispensed with and full bore undisguised eugenics can commence. All the while using the talents of well meaning people to help them consolidate wealth power and control , even of who lives and how. After 68 years , most spent desperately fighting for my life and trying to figure out whats going on, feeling better than ever now physically ,mentally ,emotionally, spiritually, ,”med’ “and EleCTricity free ” accept to run lights and appliances. I’ve survived to see so many in troubles created by stumbling blocks purposely placed in their way .The People need to organize somehow to remove them.