Showing 100 of 232 comments.
Yes – “choose to ignore” might be a better way to put it. I also think they are suffering from “confirmation bias” – the tendency to look for and favour information that confirms one’s pre-existing beliefs.
Exactly. They should go back to school and learn that correlation is NOT causation…
Why do psychiatrists keep forgetting the *science* of neuroplasticity? The organization of brain circuitry is constantly changing as a result of our experiences. For example, when mice are subjected to various psychological stresses (e.g. if they are restrained) their neurochemicals and their brain changes and these changes are reversible through psychological means (e.g. when these stressed, restrained animals are released, the brain returns to normal).
Similarly, when people are stressed or get depressed by things that happen to them, their brains change, but these structural changes come back to normal when these issues get addressed. Mental habits also change the brain – for example, mindfulness practices are known to change the structure and function of the brain in positive ways (e.g. increases in gray matter and cortical thickness).
Instead of focusing on this broader picture, psychiatrists focus only on the brain and think that the brain has to be somehow ‘treated’ with chemicals!
Scientists’ preoccupation with the brain comes from their obsessive need to have everything fit into the ‘theory of evolution.’ What they need to know is that there are different ‘epistemologies’ – i.e., different ways of understanding human experience.
I agree with what you are saying – their education is merely “brain washing” about the brain I suppose.. 🙂
Sorry to hear about your difficult experience. At least you are lucky enough to have found hope now – many others have not been that lucky..
Yea – I agree Alex. By the way, I am not too sure what percentage of psychiatrists intends to deliberately harm people. I feel that the way psychiatrists are trained in medical school needs to be blamed more – i.e., students being told that it is all about the brain, to focus on treating the brain and nothing but the brain. Most of these doctors blindly abide by that advice focusing on the nervous system and thinking it is the only way to practice good science – but then there are also those psychiatrist that ‘think out of the box’- as we see at MIA…
Anyway, this is my opinion.
I agree Steve Spiegel. Also the process of assigning labels to people and referring to these issues as “long-term conditions” (which often happens in psychiatric practice), not only disempower people but increase stigma as well.
Nocebo effects (effects resulting from ‘negative expectations’) can be very powerful. The following recent randomized study examined how the knowledge of a genetic risk can be physiologically more damaging than having that risk itself – a similar situation can happen for psychiatric conditions:
Turnwald, B. P., Goyer, J. P., Boles, D. Z., et al. (2019). Learning one’s genetic risk changes physiology independent of actual genetic risk. Nature Human Behaviour, 3(1), 48.
Thanks kindredspirit. So – I am assuming you are referring to negative aspects of how mindfulness is taught in mental health treatment settings (where the doctors assume ‘mindfulness’ to be just a tool in their bag), as opposed to MBSR 8-week training courses that were initiated by Dr. Jon Kabat-Zinn (where mindfulness is considered within its broader meaning). If that’s the case, I would agree with you. To address this issue, I suppose it is best for mental health providers to direct patients to do a full 8-week MBSR course (that explains and goes into details of mindfulness) instead of trying to teach/guide patients themselves using their superficial understanding of mindfulness.
I just read your comments. While I agree with some of what you have written, I disagree with several points.
MBSR practices (as introduced by Dr. Jon Kabat-Zinn) is not about “shaming people for thinking too much about distressing things” (what you have written). If you carefully read the book of his I mentioned earlier, you will be able to clearly see this for yourself. Also don’t forget that Jon Kabat-Zinn studied under several Zen Buddhist monks (including the monk you mention: Thich Nhat Han) and this monk has fully endorsed his book (in fact he had written the preface to his book).
You need to remember that there are many people who freeze at the mention of the word ‘religion’ or ‘spirituality’ (especially people who claim that they are “intelligent and scientific minded” and refer to spirituality as “new age mumbo-jumbo”). This is why Jon Kabat-Zinn decided to start MBSR without using any religious or ritualistic context (he explains this well in his book). This way, the Buddha’s universal and profound teachings are available to many people instead of just a handful – and many people have indeed entered spiritual lives after going through MBSR courses. You need to remember that although you like rituals, there are several people who would avoid them at all costs.
In a recent talk by Jon Kabat-Zinn I listened to, he states that “the Buddha was not a ‘Buddhist’.” What the Buddha did was to analyze the mind in comprehensive detail (i.e., describe how the mind works), and present it to the world – in other words, people refer to teachings of the Buddha as a ‘religion’ only because the teachings are not easy to understand. The teachings are nothing but the ultimate “science of the consciousness.”
By the way, MBSR courses (the 8-week course) teach many types of meditation, including walking meditation. Also, regarding your statement “over and over and over from every possible angle until you know it inside and out, that’s not ruminating, that’s a hallmark of the mind of a scientist, not a sick person” – you need to remember that there is a HUGE difference between rumination and analytical thinking. Rumination is about repetitive thinking and is not self-directed (the mind does it AUTOMATICALLY) and this is what becomes less with meditation training. I agree that analytical thinking is useful because that is what ultimately leads to wisdom.
Also, as you state, stopping “rumination” is NOT the end goal of MBSR (but since this aspect is easy to measure, studies often assess this end goal). Here again, if you read the book, you will understand. Further, research has shown that people who go through the 8-week program demonstrate structural changes in their brains – these changes are not just limited to monks.
Hi David Bruce P: I see that you have a lot of anger. I sincerely hope you will be able to find a way out of your current situation – whatever it is that is troubling you…
Hi Fiachra: Thanks. I have a passion for mindfulness practices and have studied them very carefully during the last ten years (both theory and practice). I have also personally benefited from them tremendously, and think others can benefit too if only they took time to understand them. Not sure what you mean by ‘official’ but I have a graduate degree in a health-related area. I also teach mindfulness (currently as a volunteer).
Hi Rachel: I agree that two hours is way too much meditation for a beginner, especially if it is introduced as simply “emptying the brain.” This is why mindfulness practices need to be taught by well-trained teachers who clearly understand the practice.
It looks like you have no idea whatsoever regarding what mindfulness is!!! Mindfulness is never about stopping thinking or about not resolving objective situational issues one maybe facing in life – in fact it is just the opposite! I would suggest that you read Dr. Jon Kabat-Zinn’s book “Full Catastrophe Living” – it is a good place to start for someone like you who doesn’t seem to know the basics of mindfulness practices.
It might also be useful for you to know that most of the time, people ruminate/worry about things that have not happened (and things that may never happen), or about things that have happened to them in the past etc (regrets). When practising mindfulness, one becomes aware of any thoughts and emotions and how they manifest moment by moment in one’s mind stream and this enables one to gradually cultivate self-knowledge and wisdom as well. Studies have also demonstrated that if one proliferates on a thought (it could be anger, depression, anxiety, etc.), these thoughts become more powerful whereas if you mindfully observe thoughts, they become less powerful.
Additionally, so many studies have demonstrated that mindfulness interventions result in healthy structural and functional changes in the brain and also that improvements in patient’s psychological symptoms CORRELATE with structural changes that happen in the brain.
I strongly suggest that you learn about these things before you argue in such a superficial manner. Dr. Jon Kabat’s book should be available in your local library – please read it.
Exactly. This is why observing thoughts (whatever comes up), and becoming aware of various emotions, etc., that happen to arise in one’s mind makes so much sense. Practicing mindfulness is not about purposefully not thinking about something (what you are saying). Thoughts arise and pass moment by moment in a way that they have been conditioned, etc. Please take a look at the following article – you will then understand the profound theoretical underpinnings of mindfulness practices:
Karunamuni, N., and Weerasekera, R. (2017). Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom. Current Psychology.
I don’t think at all that CBT is as bad as this book claims it to be! This looks like his opinion only – he doesn’t provide any concrete evidence (at least I don’t see it in this article). After all, the main thing an individual experiencing mental issues need is hope, support and other interventions such as training in mind-calming activities. This is in contrast to psychiatric treatments where patients are given disempowering labels that increase stigma (along with psychiatric drugs that do more harm than good in the long-term).
Also, as I see it, the mindfulness component is the most important component of CBT – perhaps this component should be greatly expanded for all CBT interventions. Mindfulness practices calm the mind, enable one to observe thoughts moment-by-moment and significantly reduce rumination, etc. (note that rumination is a large risk factor for mental health problems). Mindfulness practices also increase eudemonic wellbeing.
Thank you for your comment Monica. In my comment, what I tried to convey was that mindfulness is not dangerous or risky IF it is properly understood in terms of what exactly it is, what it is doing and how it can benefit different people in different ways.
Also it should be noted that lots of research has demonstrated that neurogenesis (the generation of new neurons in the brain) can happen after traumatic brain injuries and also that mindfulness meditation promotes neurogenesis. So, I don’t see any reason to believe that a brain that is ‘heinously injured by drugs’ cannot overcome any damages that may have happened due to drugs.
Through mindfulness practices, one can even overcome worrisome thoughts like “for me life is heinously bumpy and risky” without letting such thoughts overpower their lives.
All the best for your potential book!
I think you need to know that mindfulness meditation is NOT merely about ‘paying attention,’ although paying attention is an important element of it. Mindfulness meditation is about understanding our subjective experience as well as about developing experiential self-knowledge and wisdom.
Mindfulness uses a different ‘epistemology’ (‘a way of knowing’) than what biomedicine uses to understand phenomena. Basically, mindfulness is about understanding how our minds work – i.e., the moment-by-moment manifestation of our mind-stream (note that we only experience one thought moment at a time). Through mindfulness we can understand how thoughts can enter our minds through sensory triggers (the five senses or as a stimulus independent thought). We could also get to know how we develop various attachments (through conditioning processes) and how these shape how our feelings manifest, etc. Mindfulness is also about significantly reducing rumination – this is very important considering that rumination is a huge risk factor for mental problems.
Mindfulness is not dangerous at all and ANYONE can benefit from it, just like how everyone can benefit from physical activities. However, if someone finds that they cannot meditate right away, they can do other practices like mindful walking meditation, yoga, tai chi and even simple physical activities that are carried out mindfully, before starting formal meditation practices. Mindfulness is also known to increase eudemonic wellbeing (you can call it ‘spiritual happiness’). The practice of Mindfulness is also known to bring about favourable changes in the nervous system (I can provide lots of research evidence if you want), just like how physical activities brings about changes in muscle cells.
Also, I suggest that you read the following article to get a better understanding of the theoretical underpinnings of mindfulness meditation:
Karunamuni, N., and Weerasekera, R. (2017). Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom. Current Psychology.
Additionally, I personally find ‘loving-kindness’ meditation to be tremendously beneficial [you can check out this meditation on the internet – it is about directing thoughts of compassion towards yourself and then extending to all people and even to enemies]. Loving-kindness meditation can precede mindfulness meditation.
Many drugs are so unnecessarily prescribed (for various conditions) these days – big pharma comes up with drugs often with only profits in mind and as we know, they indulge in various unethical practices (such as selective reporting and data mischaracterization) to get these drugs approved – these drugs must be ultimately getting into our ground water and tap water as well.
Most of these drugs (although biochemically active) appear to somewhat work only due to the “placebo effect.” For example, meta analyses have shown that most active drugs and placebos have similar effect sizes (especially for health conditions that have continuous outcomes) – see the following reviews:
Howick J, et al. (2013) Are Treatments More Effective than Placebos? A Systematic Review and Meta-Analysis. PLoS ONE 8(5): e62599.
Kirsch, I. (2014). Antidepressants and the Placebo Effect. Zeitschrift Fur Psychologie. 222, 128-134.
I agree Steve McCrea. Also, I think people who offer mindfulness programs should perhaps also offer yoga and tai chi classes for those who feel that they are not yet ready for mindfulness. Even exercises done mindfully appear to be quite effective (as suggested by recent studies). As people engage in these other practices, people need to be told that they are welcome to engage in mindfulness practices whenever they feel ready to do so.
Buddhist teachings also offer various entry points to meditation as discussed in the ‘four foundations of mindfulness.’ I also think loving-kindness meditation can also go a long way to gradually make someone receptive to standard mindfulness practices. Studies also show that loving-kindness meditation by itself can also be quite powerful (I think they can be especially beneficial for children).
Prisoners Dilema: I feel that you don’t understand what mindfulness is – perhaps you can start by reading the Wikipedia page (on mindfulness).
I agree however that it is not a ‘doing but a happening’ – but, if you simply say that to someone, they are going to be highly confused on how to practice it. This is why it is good to give some guidance to people on how to carry out mindfulness meditation (such as how the ‘mind’ works, etc.).
By the way, your statement “Meditation is about getting rid of the mind” is your own personal definition – it is not a standard definition. I suggest that you read the reference I suggested as well (Lutz, 2008).
Out: this might surprize you, but Buddhism is a “science” – it is the science of the mind (consciousness). I also attend a Buddhist meditation centre (Western) and I have often wondered where the “religion” is in Buddhism. Of course there are rituals like offering flowers and incense (all of which by the way have reflective meaning), but don’t forget that even in modern society, various rituals (i.e., established, ceremonial acts or features) are often carried out for example at weddings, graduation ceremonies, funerals, etc., (that help create community and mutual support). Even shaking hands and saluting are rituals.
Regarding Kabat-Zinn, I have often felt that he is very honest. So, if you think he is dishonest, you would need to show me some good evidence! In a recent youtube video that I watched, he says he doesn’t call himself Buddhist because different people interpret the term “Buddhist” differently and some people may feel offended if he uses this label.
In that youtube video, he also says that ‘the Buddha was not a Buddhist,’ which makes a lot of sense to me. The Buddha explained consciousness, without making the assumption that the brain has to be included in all explanations of consciousness, which as we know seem to be an obsession that almost all scientists have nowadays.
Out: Can you give me a few specific examples of things that Kabatt-Zinn says that has led you to conclude “his reasoning comes down to semanatics and I find it disingenuous”? You can give me page numbers from the “Full catastrophe Living” book, since I have this book with me too.
Regarding the “science” of mindfulness – the evidence does not have to come through outcomes of interventions, because several factors (such as the skills of teachers, mode of delivery) can play a role in the effectiveness of interventions. You need to remember that science is also about developing theory, and refining theory. When considering mindfulness practices, we know that our minds naturally tend ruminate a lot (about fears, worries, regrets, etc., along with repetitive thoughts – and this is something that can be directly observed), and mindfulness practices are extremely beneficial to gradually overcome this habit.
This is especially important considering that many studies have shown rumination is a transdiagnostic risk factor (i.e., having the same underlying mechanism) for the development of various mental health issues. Studies have also shown that mindfulness practices are capable of reducing rumination, and cultivating mindfulness also appears to bring about beneficial structural changes in the brain. All this is additional scientific evidence.
Thank you for the clarification, Steve McCrea. Regarding your other comment (relating to Eastern worldviews conflicting with Western body/brain views) – this issue boils down to two very different epistemologies (ways of knowing). In other words, these two views do not conflict, but represent two very different ways of understanding ourselves and the world.
To ‘Out’: mindfulness is NOT a faith-based belief system. It did originate from Buddhist teachings – however as Kabat-Zinn himself has said, “the Buddha was not a Buddhist.” What the Buddha did was to comprehensively explain and describe the mind (consciousness). If you read some of my earlier comments (that you can access by clicking my username – BTW, I probably have directly addressed you as well! – unless there’s another “out”!), you will be able to understand how ‘scientific’ mindfulness is.
To Prisoners Dilema: Mindfulness is not a fad and it was not “created to be sold.”
Also, mindfulness is a type of meditation. All meditation practices can be divided into two main categories. One is ‘focused attention meditation’ and this meditation practice is mainly used to calm the mind (note that the mind has the habit of constantly roaming to all types of thoughts: this attribute is sometimes referred to as the “monkey mind”). The other type of meditation is ‘open monitoring meditation,’ where one is attentive moment by moment to anything that occurs in experience – this meditation is used to develop wisdom.
The following article describes the differences between these two practices:
Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Science, 12, 163-169.
Also, although meditation is ultimately about subjective experience, it can be taught in a general way – if you read my comment about children watching ‘floats’ that I posted just now, you will understand how it can be taught.
One can also envision that just like physical activity is healthy for the body, meditation and mindfulness practices are highly beneficial for the mind.
I agree with your comments shaun f. I think anyone can either directly benefit from mindfulness practices, or if they learn the techniques, that can benefit them sometime in the future. Also I am not sure why people are talking about ‘coercion’ in the comments – the article doesn’t even mention that children are being forced to practice (or perhaps I missed something). Usually kids are encouraged to do these practices in a fun-filled way – I had extracted the following sometime back:
“Children may be told that thoughts pass through the mind like floats pass by in a parade; some of the floats (thoughts) may grab their attention more than others, but just as they would not jump onto a float at a parade, they can simply observe their thoughts as they occur.”
Reference: Zelazo, P. D., & Lyons, K. E. (2012). The potential benefits of mindfulness training in early childhood: A developmental social cognitive neuroscience perspective. Child Development Perspectives, 6(2), 154-160.
Thank you for your comment Alex!
I wish you the very best…
Thank you ‘out’! It is very nice (and sweet) of you to say that. To be able to say ‘sorry’ shows you have tremendous mental strength.
I wish you the very best!
Thank you ‘out’! It is very nice (and sweet) of you to say that.
To be able to say ‘sorry’ shows that you have tremendous mental strength…
I wish you the very best!
(sorry I have posted this in the wrong location – I am unable to delete it!)
These discussions are not about you, or me making assumptions about you. My aim of making comments here is to seek/indicate different ways of addressing psychiatric issues. I hope you will read the article very carefully sometime – then you will understand what I am talking about. All the issues you have raised are addressed within that article as well.
“Arrogance of the assumptions”? I am sorry if you felt that way, however I would like to know what I said for you to conclude that please. Psychiatry (especially the type we are criticizing here) assumes that all mental issues are ‘brain disorders’ that can be managed with the right medicine. This is a belief system as there is no evidence for that (I won’t go into details as you would know enough about this, considering that you are commenting here at MIA).
Regarding meditation, most people who teach meditation to people interested in Buddhism simply teach how to focus the mind (although there are a very few teachers who go deeper into wisdom teachings).
Buddhist teachings comprehensively analyze and describe the mind (consciousness) – it is NOT a belief system. I suggest that you very carefully read the following peer-reviewed academic article:
Hi ‘Out’: I see that you are clinging to the idea that people need to find their own path to happiness, and there simply cannot be any principals/ideas that could be common to everyone. That is not true at all.
For example, there is compelling evidence regarding rumination and mental illness (I provided a few references but there is a very large body of strong evidence). So, any interventions that can reduce rumination can be of great help to anyone.
Also, meditation it is not merely about watching your breath. There is so much depth to it than that – for example, meditation enables you to get to know your own mind (i.e., to develop self-knowledge), and to cultivate wisdom. Also, when we practice meditation, we are able to understand how we are attempting to find happiness through mere autopilot striving and reacting to stimuli, as well as the difference between hedonic happiness (which involves short term happiness that come from fulfilling sensory pleasures) and eudemonic happiness (which is about cultivating contentment and wisdom).
Also, in contrast to what you say, meditation is not about ‘instant nirvana’ – it is a slow process of gradually cultivating understanding.
I can provide references for all what I have said above.
Thank you for your comment ‘twentyseven.’
The following (relatively old) article gives some techniques that can be used to build mindfulness into your life. You may find it useful:
Reference: The clinical use of” mindfulness” meditation techniques in short-term psychotherapy (1975). Gary Deatherage, Journal of Transpersonal Psychology, 7.
It can be downloaded for free online.
All the best to you!
Numerous studies have consistently shown that ‘rumination’ (regretting the past and worrying about the future, proliferating anger, etc.), is a transdiagnostic risk factor (i.e., having the same underlying mechanism) for the development of “psychiatric disorders” – check out the following reviews for example:
Kaplan, D. M., et al. (2018). Maladaptive repetitive thought as a transdiagnostic phenomenon and treatment target: An integrative review. Journal of Clinical Psychology.
Watkins, E. (2015). Psychological treatment of depressive rumination. Current Opinion in Psychology, 4, 32-36.
When considering this, mindfulness interventions can be especially valuable, as they appear to significantly reduce rumination – see the following reviews:
Tomlinson, E. R., Yousaf, O., Vittersø, A. D., & Jones, L. (2017). Dispositional mindfulness and psychological health: a systematic review. Mindfulness, 1-21.
Querstret, D., & Cropley, M. (2013). Assessing treatments used to reduce rumination and/or worry: A systematic review. Clinical Psychology Review, 33, 996-1009.
Everyone may not be READY however, to engage in mindfulness practices right away – so other interventions (e.g., to address various practical problems a person may have, engaging in physical activity or yoga) might prepare one for mindfulness practice. There are other benefits of mindfulness practice as well that I have talked about in several previous comments – if you like, you can check them out by clicking my username here.
Unless one includes a significant component of ‘mindfulness’ into CBT, I think it wouldn’t be all that useful for people.
True. It was perhaps funded by big pharma. I have seen some mindfulness studies that seem to be designed for negative outcomes (for example providing only one very short meditation session as the intervention, and then elaborating on the ineffectiveness of the outcome in media articles), that appear to be funded by big pharma.
I agree with you ‘dfk.’ This is why I think mindfulness interventions make so much more sense because instead of the need to challenge one’s ingrained beliefs and emotions, one can simply observe how thoughts and emotions come and go in the present moment (and also notice how they are influenced by one’s past conditioning).
Some aspects of CBT maybe useful for people however in order to solve various practical problems, and to gain hope and support for recovery. I too totally disagree with explore therapy and think it is quite unnecessary.
Everything we do (and not do) in life has side effects! And we may eventually view these so called ‘side effects’ as a wonderful thing that happened to us! This is the same for CBT.
We also need to remember that this situation is very different from the terrible side effects a person may experience as a result of taking psychiatric medicines – including the potential for these medications to make one drug dependent for life. There isn’t anything good about that.
Just saw this article. I agree with others here that you are perfect for this job!
Yes – there is so much evidence that brains are constantly changing with experience, and psychiatrists prefer to ignore that. Strangely, the academic article that this article cites also does not mention neuroplasticity (or epigenetics).
Why does everyone keep forgetting neuroplasticity and epigenetics? The organization of brain circuitry is constantly changing as a result of our experiences. Psychological stresses also change the brain and when these stresses are addressed, the brain changes back again. So, even if there are some differences in brains (seen in neuroimaging), there’s no reason to get exited about it. Yes, these research studies are a total waste of time and money.
Numerous studies have shown that rumination, worry, etc., substantially contribute to “mental issues.” The following review that looked at various ways in which rumination can be reduced found that mindfulness-based and cognitive behavioural interventions are most useful:
Querstret, D., & Cropley, M. (2013). Assessing treatments used to reduce rumination and/or worry: A systematic review. Clinical Psychology Review, 33, 996–1009].
One cannot simply tell someone not to ruminate because the mind automatically does that – the only way one can stop ruminating, worrying, etc., is by training the mind in meditation and mindfulness (and this can be accomplished through cognitive behavioural interventions that include a mindfulness component).
I think where the present day psychiatrists have failed is in trying to describe everything in terms of the material brain. Because mental activity is correlated with the activity of the brain, they wrongly assume that the brain has to be “treated” with medicines. However, numerous studies have repeatedly shown that our brains are constantly changing AS A RESULT OF our mental experiences. For example, psychological stresses bring about structural changes in the brain and these changes are reversible when these stresses are removed (neuroplastic and epigenetic mechanisms).
Regarding this, Dr. Beauregard says that the mind (the psychological world, the first-person perspective) and the brain (which is part of the ‘‘physical’’ world, the third-person perspective) represent two epistemologically and ontologically distinct domains that can interact because they are complementary aspects of the same underlying reality. Metaphorically, he refers to the language of the mind as “mentalese” and the language of the brain as “neuronese”! I think this is a great way to present this difference. Here’s the reference to that article:
Beauregard, M. (2007). Mind does really matter: Evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. Progress in neurobiology, 81(4), 218-236.
Relating to this, Buddhist philosophical teachings (upon which “mindfulness” originated), comprehensively describe the “mind” (consciousness) in terms of constantly changing sense impressions and mental phenomena (“mentalese”), and how various factors such as past conditioning as well as various attachments we hold influence the manifestation of experience. The following article comprehensively describes the moment-by-moment manifestation of the mind:
I agree squash. This is probably why this childhood issue has received a lot of attention these days – perhaps they want to promote pills for all those who had problems during childhood!
By the way, I know several people who have used mindfulness practices to overcome these types of issues – mindfulness practices are known to bring about measurable changes in the structure and function of the brain in positive ways.
Jessica: Could you please correct the link to the Lancet article – it goes to an ‘error’ page (second paragraph after the picture, in the sentence “A recent study, published in the Lancet, provides..”). Thanks.
Yes – it is a very sad situation that even a prestigious journal like Lancet publishes these types of articles. However, I think there appears to be a small increase in mainstream news articles that correctly report information on psychiatric drugs – I came across the following BBC article today:
Also, this is a review of existing trials – almost all of these existing studies have been funded by large pharmaceutical companies that appear to engage in a great deal of selective reporting, medical ghostwriting, data mischaracterisation and academic malfeasance. Some of the biases in these trials are exposed in the following article:
Lancee, M., et al. (2017), Outcome reporting bias in randomized-controlled trials investigating antipsychotic drugs, Translational Psychiatry, 7, e1232.
Old head: As I see it, the intention of these discussions we are having at MIA is to ultimately generate ideas regarding how mental issues (let’s refer to them as “problems in living”) people have can be resolved. It is not about whether someone has said/not said something in previous comments, or about how good/bad someone’s comments are, etc. So, I am just asking you the simple question “If someone comes to you psychologically agitated what would you tell that person?” If you do not wish to answer, at least you can reflect on this. 🙂
Hi Oldhead – I think you are being too extreme in denying people’s lived experiences. Regarding your reply:
(i) psychiatry is not medicine: Of course psychiatry is not medicine, but there are other ways of helping people without giving psychiatric medicines.
(ii) emotions are not symptoms – yes, but people sometimes feel psychologically agitated enough to be unable to go to work anymore, feel suicidal, etc., – they seek help, so there can be a system in place to bring back these emotions to ‘normal’ (functional) levels.
(iii) unhappy people are not sick – I agree, but as I have stated in (ii), people have difficulties that THEY experience, and express the need for some type of help with. Unlike for physical conditions, they do not need any medicine, but some type of emotional assistance can help.
If someone comes to you psychologically agitated and if this person has limited social support and spiritual support, what would you tell that person? – would you simply say “get over with it”? I would like to know.
I haven’t carefully read all the comments here – therefore my apologies in case I am repeating something. As I see it, people do occasionally struggle with mental issues (“problems in living”) for which they seek ways of coping. However, ALL symptoms listed in the DSM (that is currently used to assign various disease labels) appear to happen as a continuum in the general population [reference: Understanding Psychosis and Schizophrenia (2017) by the British Psychological Society Division of Clinical Psychology]. It is just that as a result of specific life experiences, some people sometimes have extreme readings in some of the symptoms.
As I see it, instead of assigning labels to people (which massively contribute to stigma), why not use some type of a coding system that can be used by doctors only to record an individual’s list of symptoms such as their level of stress, the level anxiety, fear, etc., so that the progress of the patient can be monitored. A code may look like A3S5W8. Once these numbers return to normal levels, the person can be considered as ‘recovered’ (or if someone doesn’t like the term ‘recovered’, they can consider that person as no longer needing further help for their “problems in living”). I think such a system (instead of the current DSM disease labeling) can go a long way in reducing stigma and would also reduce further progression of these conditions because the client would no longer believe that they have some kind of a “brain disease” (we need to remember that negative expectations lead to negative outcomes through “nocebo effects” – i.e., opposite of placebo effects).
Thank you for your reply. Of course, we all are different in terms of our susceptibilities to stressors, and some of these can be genetic. I think pharmaceutical companies love to keep the “genetic” story alive, because they can profit from it by promoting their drugs. Also, you are right about 10 out of 8000 cases (I probably shouldn’t have divided the number!). However, as Steve McCrea has explained here, the contribution of genetic factors are insignificant and are of not much use to investigate either.
Now, regarding other factors: numerous studies have shown that unhealthy mental habits such as rumination, worry, etc., activate the default mode system of the brain and lead to various psychiatric problems [for example, check out following reference: Querstret, D., & Cropley, M. (2013), Assessing treatments used to reduce rumination and/or worry: A systematic review, Clinical Psychology Review, 33, 996-1009]. So, any interventions that would reduce excessive worrying, etc., can bring about good mental health. Engaging in and being involved in various activities (such as physical activity) can help. Also, numerous studies have shown that mindfulness practices considerably reduce rumination, worry, etc., and also result in measurable changes in the structure and function of the brain in positive ways (such as increases in gray matter and cortical thickness, brain connectivity, etc.). Mindfulness practices are also known to bring about changes in genetic expression (you can do a search on google).
Yes, height and weight can be genetically determined. However, factors like nutrition and exercise play a considerable role as well. Regarding psychiatric problems, no study has pinned down any genes responsible for these conditions. If we take schizophrenia for example, genes appear to explain only about 0.001 percent of outcomes – check out the following article: https://theconversation.com/there-are-no-schizophrenia-genes-heres-why-57294
Also, numerous studies have shown that it is our experiences that bring about changes in brain chemicals and also result structural changes in the brain. For example, when mice are subjected to various psychological stresses (e.g. being restrained) their neurochemicals and their brain changes and these changes are REVERSIBLE through psychological means (e.g. when stressed, restrained animals are released). If someone loses their job, all the rumination, worry, and regrets, etc., will change their brain chemicals and when the person gets a job again (or if their life circumstances change), these chemicals return to normal again. Other research has shown jugglers gain more grey matter in certain areas as a result of engaging in juggling. Taxi drivers gain grey matter in other areas. Even attaching to different intentions is known to change the brain.
So, stated differently, the organization of brain circuitry is constantly changing as a function of experience or learning. This phenomenon is well known to neuroscience and is often listed as a key discovery of neuroscience, and yet, it is very much ignored. Additional research has shown that our experiences are capable of bringing about changes in genetic expression (this is the field of ‘epigenetics’ – I can provide references if you need them).
The brain is very complex organ with billions of neurons and trillions of synapses that connect and interact in complex ways – there is so much we do not know about this organ. So, introducing chemicals to it following a hit-or-miss fashion (with someone’s idea of “treating” mental illnesses), simply messes up the natural biochemical pathways, and adversely affect the functioning of the brain in the long-term. Psychiatric drugs work for some people (who can tolerate their side effects) only due to their “placebo effects.”
Regarding the labelling that is currently going on – these labels not only disempower the patients but also lead to increased stigma (i.e., referring to someone as ‘bipolar’ or that someone is a schizo, as well as other DSM labels that often end with “disorder”). Additionally, receiving a label and being told that these are ‘long-term conditions’ (which is what is happening now) could lead to further progression of these conditions through nocebo effects (i.e., negative expectations leading to negative outcomes: opposite of placebo effects).
Research has also found that ALL symptoms listed in DSM (used in the labeling process) are normally distributed in the population – that is, they happen as a continuum in the population [reference: Understanding Psychosis and Schizophrenia (2017) by the British Psychological Society Division of Clinical Psychology]. It is just that as a result of specific life experiences, some people sometimes have extreme readings in some of the symptoms. At the same time, we cannot deny that people need help to cope with whatever they are experiencing.
As I see it, instead of assigning labels to people, why not use some type of a coding system that can be used by doctors only to record an individual’s level of stress, the level anxiety, etc., so that the progress of the patient can be monitored. A code may look like A3S5W8 – meaning anxiety rating of 3, stress rating of 5 and ‘worrisome thoughts’ rating of 8. Then, once these numbers return to normal levels, the person can be considered as not needing further help.
I think such a system should perhaps replace the current DSM labeling.
The Buddha systematically analyzed the mind (consciousness) – as I see it, this comprehensive analysis surpasses any theories of psychology that are known to us today.
If you refer to meditation as “navel-gazing” – that itself shows how clueless you are about mindfulness/meditation practices!!! By the way, I would have preferred you to have pointed out a particular component of that paper that you disagree with rather than generally stating that you have a negative view about peer-reviewed journals and social science journals. Perhaps you didn’t even bother to read the paper – ignoring other perspectives is not real science at all.
Please remember that science has insurmountable limits in elucidating the mind because it clings to materialism just like clinging to religion! This is why I like Dr. Rupert Sheldrake’s TED talk titled “The Science Delusion” – he explains that there is a difference between “science as a method of inquiry based on reason, evidence, hypothesis generation and collective investigation” vs. “science as a belief system or a world view.” My sincere wish for you this new year is that you will discover the tremendous value of meditation and mindfulness practices soon!
rasselas.redux: It is NOT ‘New Ager propaganda.’ When discussing these things we need to separate different epistemologies (i.e., ways of knowing). One epistemology is the conventional paradigm (which is the scientific method) according to which the mind is merely a non-material property arising from material properties – that is what they observe and think. But there is another different but very important epistemology. To understand this, consider the following statements:
Everything in the world and the universe is experienced in the mind (i.e., consciousness). Think of it this way: It is the mind (consciousness) that analyzes the world and the universe, analyses various organs in our body, analyses how the brain works and analyses even the mind itself. The ‘mind’ constitutes constantly changing sense impressions (i.e., experiences via our senses such as seeing, hearing, etc.) as well as mental phenomena (feelings, perceptions, intentions, etc.). It is this ‘mental world’ (non-material) that Buddhist teachings have systematically analyzed. This is clearly described in the article I posted earlier – please note that it is an article published in a peer-reviewed academic journal – NOT ‘New Ager propaganda.’
Stated differently, the scientific method (that interprets only in terms of the ‘material world’) is useful to study only the material world but not appropriate AT ALL when it comes to understanding the mind. Remember that brains don’t talk for themselves – it is the mind that analyses it. People who simply say that the ‘brain is the mind’ forgets that the inquirer is interlocked with the item under inquiry. One has to think outside the box to understand this.
Please let me know if you understand what I am saying – if not, I will try to explain further. You can also read the following (open access) article to understand this better:
Karunamuni, N. (2015). The Five-Aggregate Model of the Mind. SAGE Open, 5 (2).
The article I mentioned earlier (article titled: “Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom”) is also very useful and it is publicly available from the following MindRxiv preprint website link: https://mindrxiv.org/mfs63/
Happy holidays to you too Sam. I understand the concerns you have regarding your wife.
Something we need to realize is that science is completely ignorant when it comes to issues of brain/mind. This is mainly because science focuses exclusively on materialism and simply assumes the ‘mind’ to be merely electrical activity that happens inside the head. As a result of these assumptions, many so-called “experts” simply follow various (mostly materialistic) theories, which are often none other than personal viewpoints. These “experts” also often give the impression that everything regarding these things is clearly understood. I could write a great deal about this, but it would take up too much space, and perhaps you may have realized this yourself when attempting to find information about these issues.
Regarding d.i.d., I assume that you know this label is also merely a classificatory category of DSM, and you would have heard how unhelpful DSM “disorder” categories can be. So, this brings us to the “problems of living” issue that you are facing. My question to you at this point is: is your wife affected by her condition or is it just you worrying about her condition? If it is the later, it is just you who need some help! 🙂
As I explained, because science clings to materialism (just like clinging to a belief system), it currently ignores other ways of understanding the world (i.e., other ‘epistemologies’). In this regard, I really like Buddhist descriptions of the mind, where the mind is understood as being everywhere extending through infinite space and time (if you want to understand this further, you can read the article I suggested in an earlier comment). Even if one doesn’t understand these (Buddhist) explanations of the mind, one can still engage in mindfulness practices. When practising mindfulness, one gets to know one’s own mind, and gradually develop the ability to simply become aware of thoughts like worries without becoming a victim of these thoughts and anxieties.
I feel that mindfulness practices could help you (and perhaps also your wife in case she needs them). Why not take an 8-week MBSR (Mindfulness-based Stress Reduction) course in mindfulness (this course consists of one class per week, for 8 weeks, with some assigned homework practices). These courses are available in most cities (you can check on the internet). Then, if you find them to be helpful, you can encourage your wife to take the course too. The course would instruct in different types of practices like compassion meditation, awareness of the breath, body-scan meditation, choiceless awareness, etc. You can also learn mindfulness via internet resources, but it might be best to first learn the basics before you explore further.
Science has not been able to understand the mind (i.e., consciousness) because it clings to materialism just like clinging to a belief system. However, if we consider science to be an “intellectual activity involving the systematic study of the natural world,” then questioning materialism is also science – one has to think outside the box in order to do this.
Regarding the mind, ancient Buddhist teachings have systematically and comprehensively analysed the mind – for example, check out the following academic article:
Karunamuni, N., and Weerasekera, R. (2017). Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom, Current Psychology.
Thank you Bradford. I haven’t read too many books by the Dalai Lama, however, I have heard that they are quite good. I learnt mindfulness directly from a Sri Lankan teacher.
For anyone who wants to know how mindfulness works and how the mind is explained in Buddhist teachings, I suggest reading the following academic publication:
Karunamuni, N., and Weerasekera, R. (2017). Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom. Current Psychology.
[This article is publicly available from the following MindRxiv preprint website link: https://mindrxiv.org/mfs63/ ]
Hi samruck2: As you say, your wife’s issue appears to be a plasticity issue.
Numerous studies have convincingly shown that it is our experiences, learning, etc., that brings about structural changes in the brain (via neuroplasticity and epigenetics pathways). In other words, our experiences are constantly changing the chemicals and even the structure of the brain (such as atrophy). This has also been demonstrated in animal studies – if an animal is subjected to psychological stresses (such as being restrained in a tight space), their brain chemicals gradually change, and structural changes in the brain can also be observed. When these animals are released however, their brains come back to normal.
I didn’t read details about your wife’s exact problem, but if she spent a lot of time being depressed, anxious, being ‘depressed about being depressed,’ etc., these could lead to atrophy.
By the way, did she ever try mindfulness meditation practices? These practices have been demonstrated to significantly reduce rumination, mental proliferation, worry, etc., [reference: Querstret, D., & Cropley, M. (2013). Assessing treatments used to reduce rumination and/or worry: A systematic review. Clinical Psychology Review, 33, 996–1009]. Also, engaging in these practices bring about healthy structural and functional changes in the brain (I can give many references if you want).
Dear littleturtle: So, it was you who assigned yourself the label of “mental illness”! How can we rely on such subjective assessments! 🙂
This is why I really like Buddhist descriptions of the mind. According to these teachings, all human beings are constantly seeking gain, honour, happiness and praise while avoiding loss, dishonour, sadness and blame. This is how most of us spend our entire lives. We get angry and sad when we are criticised and get happy when we are praised. Even in the comments here we see many examples of this! 😀
Now, when we feel sad, if we “feed” on these mind-states (that is, constantly ruminating and thinking “oh my loss, how terrible!”), these mind states grow in power. In contrast, when we learn to let go (by practicing mindfulness of the present moment) we gradually cultivate what is known as “eudaimonic well-being,” which is a durable form of happiness that is not dependent on circumstances and involves peace and contentment. Eudaimonic happiness has been found to be a powerful predictor of positive mental health.
So, littleturtle, something I can suggest you to do is to gradually develop mindfulness practices. This is something I have myself greatly benefited from.
littleturtle – I applaud your determination to “get at the TRUTH.” I am interested to know however why you came to the conclusion that you “have mental illness.” Did you conclude that yourself?
I think all this discussion raises the important question “what is normal”? If we consider normal to be “happy, happy, all the time” then we will all conclude that we have mental problems.
This is why subjective experience is very important – one maybe very sad throughout his/her life, but yet consider themselves to be normal. Another person may not be that sad, but any sadness they have maybe interpreted as abnormal and needing some sort of “treatment.”
I like your addition. By the way, I think most sleep problems result from primarily psychological issues rather than biological (although lack of sleep can secondarily contribute to biological changes). Various psychological habits can be useful to aid sleep as well – one of my favorites is what is known as “loving-kindness meditation” (one can google and find out how this meditation practice is carried out).
Hi littleturtle: Biology does affect our mental states. As you say, severe vitamin deficiencies, etc., can affect the brain, but the vitamin deficiencies need to be quite severe, otherwise we will see almost everyone having mental problems. In any case, if mental issues were merely a case of vitamin deficiencies, all that everyone has to do it to take a daily multivitamin pill.
Here at MIA, people do not deny that biology plays a role. What they are attempting to address is that many psychiatrists blame the brain (biology) for almost ALL the mental issues listed in the DSM – then as a result, they prescribe medicines that the pharmaceutical companies come up with. Now, the pharmaceutical companies come up with these medicines on a ‘hit or miss’ basis (although they provide complicated neuro-jargon explanations to justify how these pills work). Additionally, because pharmaceutical companies mostly have profits in mind, the trials they conduct (to demonstrate the effectiveness of these pills) are known to have a great deal of selective reporting, data mischaracterization, etc. For a few people these pills may work due to the placebo effect but many endure terrible life-long side effects (as described in several MIA blogs).
Think of it this way: When you disturb a natural system by adding an agent (molecular substance) that YOU interpret as the problem for the issue at hand, you create many additional problems – many of these chemicals that are introduced (in the name of “therapeutic agents”) interfere with normal biochemical functioning of the brain and adversely affect the brain in the long term.
Alternatively, as described in the resent MIA blog “Psychotherapy is THE Biological Treatment,” – there is a great deal of evidence that it is HUMAN EXPERIENCE that brings about structural changes in the brain (and these changes are reversible). This is why we prefer to put aside biology and focus on the field of psychology.
Yes, I fully agree that the currently prevalent “a pill for everything” attitude has to change. However, people do struggle with mental issues (“problems in living”), and it is good to seek standard ways (psychological) in which they can cope. Regarding this, I happened to come across the following link on how informal groups can help themselves: https://www.medicalnewsbulletin.com/meditation-therapy-rumour/
I have felt that Freud’s theories are merely untestable personal ideas. In contrast, mindfulness practices and understanding the moment-by-moment manifestation of subjective experience makes so much more sense to me.
As I said earlier, I am not denying evolution – the process has even been demonstrated directly in peppered moths (in terms of their color change). All I am saying is that it is not a perfect theory (as I have stated in the other points of my previous comment).
Frank: Since you mentioned “absolute truth,” I thought of writing something about that too.
This world and the universe can be analysed in different ways – we all know that. We analyse in terms of physical elements (even involving quantum physics where the wave nature of matter is examined), we analyse in terms of biology, social groups and their interactions, etc. But there is a very different level of analyses, or an ‘ultimate level’ of analyses. This involves analysing the mind (i.e., consciousness) – this is the ‘ultimate level’ because it is the mind that analyses all other levels I mentioned including the mind itself.
Science has not been able to tackle the riddle of consciousness because it clings to materialism almost like clinging to a belief system. However, if we consider science to be an “intellectual activity involving the systematic study of the natural world,” then questioning materialism is also science – one has to think outside the box in order to do this.
Regarding the mind, ancient Buddhist teachings have systematically and comprehensively analysed the mind. Please take a look at the following article (it is an ‘open access’ article):
Karunamuni, N.D. (2015). The Five-Aggregate Model of the Mind. SAGE Open, 5 (2).
A more detailed analyses of the mind (related to this article and based on ancient teachings) is provided in the article titled “Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom,” published in the academic journal ‘Current Psychology’ (I posted a link to it in one of my previous comments here).
If you read these articles and carefully attempt to understand them, you will realize for yourself why this level of analyses is referred to as the ‘ultimate level’ (you will understand that there cannot be a level above it). All religions appear to be aiming for this level of analyses (as described in the first article I mentioned above), although it is in ancient Buddhist teachings that a clear systematic description of consciousness is provided.
(Note: I am posting this as a separate comment to avoid a thin/long answer thread that would result if I directly reply to your comment).
Hi Frank: I am not denying evolution altogether – what I am saying is evolutionary theory should not be used to justify or prove the validity of other assertions that we make because evolutionary theory is not a perfect theory. Many years ago I used to accept evolutionary theory as an ‘absolute truth’ that can never be denied (I just loved the theory!). However when I used to write assignments (university level), I did wonder how it was always possible to come up with various explanations (in terms of survival advantages to an animal) no matter what the observed trait (phenotype) that an animal displayed! There was always a way to twist the explanation to suit the theory – we first look at the trait and then do the explanations!
Regarding intermediate forms: these intermediate forms are present for only some species – not for all species. Also, I know about the ‘long periods of time’ explanation (that you gave), but think of the stages of evolution of an electric organ in fish – the preliminary beginnings of such an organ (electricity generating cells) could harm the fish itself before it can become a fully developed organ! Also, how would you explain the other points I listed in my earlier comment? Let alone those, in this current article, how would you incorporate evolutionary theory to explain how psychotherapy changes the brain? When I read the article, I just let go those sentences to focus on the main theme of the article (which is about ‘neuroplasticity,’ for which there is indisputable evidence).
Definitely. Perhaps you can change your name now to “FeelinEncouraged” 🙂
Well said Steve McCrea!
However, I think Explorer86 also has a point. The theory of evolution is currently used often in scientific articles as if it is the absolute truth. People forget that it is merely a theory, especially when it is used to justify or prove the validity of other statements.
Below are some problematic aspects about the theory of evolution that I had noted down sometime back:
– Unless an organ (for example, electric organs in fish or other organs) is fully developed, it would not provide any survival advantage for an animal and refining an organ after its preliminary beginnings (note that preliminary beginnings of many organs do not have a survival advantage to an animal) would require a great number of random mutations that somehow happen in a favorable direction.
– If we take altruism, it is very acceptable to say that altruism (genes), get selected because of their advantage for the group. However, if one animal in a litter has an aggressive gene making it kill all its other siblings, it can be hypothesized that this trait would have a greater survival advantage – but we know that this does not happen, and the reason why is not explained by the theory of evolution. In sexual selection too, one could argue why an aggressive trait does not get selected over a pretty display.
– A growing body of recent research has begun to show that mind states (such as meditation) can influence DNA expression, and these types of findings would be very difficult to incorporate into the theory of evolution.
– How do we explain why homosexuality-trait persists in humans – if we consider evolutionary explanations, such a trait would be eliminated as soon as it arises! (as there won’t be offspring produced by that individual).
– The absence of many intermediate forms in fossil records is also problematic for the theory of evolution.
Yesterday night there was a news clip (NBC) about depressed children where they showed an MRI scan of a brain of a depressed child (compared with that of a normal child). They interpreted these MRI scans as evidence of a biological difference. Even the reporter stated something like “how can you deny biological differences when you see that!” It was stated that this child is now on medication.
What this type of reporting fails to realize is that our brains are always changing in terms of its activity – when we are having some emotions (such as being angry or depressed) the scan will be different from what the scan would look like when one is calm. See for example the following clip (~3 minutes): https://www.youtube.com/watch?v=Fw-a0MXXTpA
Additionally, receiving a label and being told that these are long-term conditions not only increases stigma but also could lead to further progression of these conditions through nocebo effects (i.e., negative expectations leading to negative outcomes: opposite of placebo effects).
Instead of basing judgments about psychotherapy (based on what different well known people have said about it), I think everyone can agree what people in distress need are hope, support and other interventions such as training in mind-calming activities (e.g. meditation and mindfulness practices, etc.). It is also useful to address their practical needs (direct them to resources on how they can find a job, etc.). So, psychological interventions can go a long way in healing. Also, if anyone does not like the word “healing” they can use the words “to overcome problems in living.” In contrast, what typical psychiatrists do is to give people fancy labels, tell that there is something wrong with their brain circuits and give medicines that ultimately interfere with normal biochemical functioning of the brain.
Perhaps the therapies you mention (e.g. homeopathy) are useful for some physical ailments (we don’t know how they act though) and they may also have some temporary calming effects on the brain.
I prefer to focus on psychological states that change the brain mostly because the research evidence is very strong in this area. Studies have shown when mice are subjected to various psychological stresses (e.g. being restrained) their neurochemicals and their brain changes and these changes are reversible through psychological means (e.g. when stressed, restrained animals are released). If someone loses one’s job, all the rumination, worry and regrets will change their brain chemicals and when the person gets a job again, these chemicals will return to normal again. But if they are told that they have a “brain disease” (which is what is happening in psychiatry now) that would only lead to a whole lot of additional psychological stresses to that individual.
Placebo effect happens due to expectations (psychological state) one has regarding a treatment. Meta analyses have shown that most active drugs and placebos have similar effect sizes. See the following:
Howick J, et al. (2013) Are Treatments More Effective than Placebos? A Systematic Review and Meta-Analysis. PLoS ONE 8(5): e62599.
This means most main-stream medicines are effective only because of their placebo effect. Psychiatric drugs also help some people (those who can tolerate them) only due to their placebo effects. Talking of placebos, in the following new study (involving deep brain stimulation), patients who underwent a sham programming session improved as much as the patients who received real brain stimulation.
Holtzheimer, P. E., et al. (2017). Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial. The Lancet Psychiatry, 4(11), 839-849.
Mapping can be done for CHANGE. For example with less psychological stress, the amygdala shrinks. So the direction of causation is from changes in psychological constructs to changes in brain structures (see for example: https://blogs.scientificamerican.com/guest-blog/what-does-mindfulness-meditation-do-to-your-brain/ ). I think I gave other examples in my earlier comments in other blogs. Additionally, psychological stress can result in epigenetic changes – gene expression changes. For example, see the article: Nestler, E. J. (2012). Epigenetics: Stress makes its molecular mark. Nature.171, 171–172. doi: 10.1038/490171a
Rossa: These are placebo effects – the placebo effect can be very powerful. Check out the recent article titled “Brain in vain?” published in ‘The Lancet Psychiatry.’
Steve McCrea: I saw this comment only now! For obvious biological causes one does not have to see a psychiatrist. Yes, I agree this common sense understanding (regarding stress, depression, etc.) has been overridden by all the brain based explanations and neuro-jargon talk!
Slaying the Dragon – there are different levels of analyses – if you read my other comments here, you will understand.
Hi Steve McCrea: This is not speculation – there is a LOT of literature on brain plasticity (=neuroplasticity). Scientists generally have an idea on what a healthy brain looks like (in terms of connectivity, the size of a amygdala, hippocampus, etc.), so they can tell what is a healthy change and what is not (based on correlational data) using this map. Measurable changes in the brain happen with experience.
Regarding the mind – I like to think of the mind as constantly changing sense impressions and mental phenomena. Remember that it is the mind (consciousness) that thinks about trees outside, about our body structures such as the digestive system, nervous system, the body organ brain and even the mind itself. Although it is a different ‘level of analyses’ it can be understood – this is described in the article titled “Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom,” published in the journal Current Psychology.
(If you are unable to obtain the article, you can get it from this ‘MindRxiv archive’ link: https://mindrxiv.org/mfs63/ )
Hi streetphotobeing: Regarding your comment, although there are complex molecular mechanisms involved, what triggers them are psychological experiences of people. Brains do not change for no reason at all. Additionally, although neuroscientists use authentic sounding neuro-jargon to justify what happens in the brain (all the complicated reactions – some of which you have referred to), these are merely ideas of people.
I agree with you Robert. Yes, neurons continuously change with our experiences. Psychological stresses change the neurons in various ways and they come back to normal when these psychological stresses are addressed. This is what is called neuroplasticity – a key discovery of neuroscience.
Keep both psychologists and psychiatrists for now until psychiatry can be totally eliminated – people need jobs to live. Also, as Steve Spiegel has suggested, psychiatrists could also address the current drug epidemic.
Thank you for your honesty and the courage to write.
I have always held the view that psychiatrists are not “bad people” but are doing their jobs (using check-lists and giving medicines) thinking and truly believing that it is the correct thing to do (due to extensive training they have been provided by people who also simply ‘believed’ in these things). As long as I remember, when I said this in a comment long ago (that psychiatrists are not purposely harming), some at MIA did not agree with me.
I suppose a big re-think is necessary for the field of psychiatry to go forward (such as eliminating meds altogether and taking over psychological therapies perhaps until this profession is gradually eliminated).
I wish you the very best in your endeavours…
Thank you Joanna. I noticed that you are willing to “grow” from people’s comments to your blogs, which I think is wonderful. So, thank you!
Regarding neuroplasticity – although many people probably think of neuroplasticity simply as “compensatory mechanisms for drug induced damage,” there is much more to it than that. As you say, the organization of brain circuitry is constantly changing as a function of experience or learning. When we consider learning, most training benefits are stimulus or content specific – such as brain changes in taxi drivers, piano players, jugglers, etc., where specific areas of the brain change in response to training.
Interestingly, other research has shown that systematic mental training, as cultivated by meditation, can induce learning that is not stimulus or task specific, but process specific. “Process-specific learning” denote learning effects that do not only improve performance on the trained task or tasks, but also transfer to new tasks and domains.
This is described in the following article:
Slagter HA, Davidson RJ, Lutz A. (2011). Mental training as a tool in the neuroscientific study of brain and cognitive plasticity. Front Hum Neurosci, 10;5:17.
Regarding subjective experience – I think here we are talking about typical instances where a person decides to access mental health care. Of course other factors like different people encouraging/forcing the person to see a psychiatrist (i.e., based upon their beliefs on how mental issues need to be handled, etc.), can play a role for some cases. However, I think if we solve the problem regarding how mental issues need to be addressed (an evidence based method that everyone can agree on – just like how we currently have a good system in place for physical illnesses), then others may not force an individual simply based on their own belief systems.
Thanks. Yes, stress contributes in a big way. Being stressed results in physiological changes in the body in addition to neural changes. I think receiving the diagnostic label of Alzheimer’s can also be quite debilitating for anyone, and the label itself could lead to further progression of the disease through nocebo effects (i.e., negative expectations leading to negative outcomes: opposite of placebo effects).
Frank – In this comment, I like your statement “It’s a matter of the ‘mentally ordered’ ones identifying the ‘mentally disordered’ ones”! To this, I thought of adding that according to Buddhist teachings, everyone is mentally ill – until they become enlightened!
Regarding Alzheimer’s – the ‘Einstein Aging Study’ (a longitudinal study) demonstrated that psychological stress predicts cognitive impairment. So, various stress reduction techniques could go a long way in preventing and in stopping the progression of this condition as well.
Reference for the study: Katz, M. J., et al. (2016), Influence of Perceived Stress on Incident Amnestic Mild Cognitive Impairment: Results From the Einstein Aging Study. Alzheimer disease and associated disorders, 30(2), 93-98.
Regarding neuroplasticity – the following articles describe that neurogenesis (generation of brand new neurons) can happen in the adult brain:
Frank – What I meant by “normal people” are people who live conventional lives (each and every one of us). These are people who can experience physical illnesses or “problems in living” anytime and as a result, seek help.
Also, what I said was these neuroplastic changes (that happen as a result of psychological stresses) are reversible – just like physical activity related changes are in muscle cells. People who have brain damage (such as from a stroke or accident) can also benefit from mental exercises (and therapies) that result in neuroplastic changes (i.e., the reversal of brain damage). But the term ‘neuroplasticity’ does not merely refer to changes that happen as a result of brain damage. Check out the reference (Popoli et al., 2012) I suggested and also the references I posted in the previous blog.
Hi Frank – In my comment, I am referring to normal people who expect help from any health system. So, I do not understand what you mean by “help being forced upon people.” In any case, everyone has subjective experience all the time.
Regarding neuroplasticity – you cannot deny research evidence. Even animal research has shown changes that happen in the brain. For example, mice that are subjected to various psychological stresses (such as being restrained) show dendritic atrophy and loss of dendritic spines, and these changes are reversible through psychological means (when these restrained animals are released). Check out the following article: Popoli M, et al. (2012). The stressed synapse: the impact of stress and glucocorticoids on glutamate transmission. Nature Reviews Neuroscience. 2011;13(1):22-37).
As I see it, the words you use “repair” and “damage” are not appropriate to describe neuroplasticity. What happens in neuroplasticity is “change” – and these changes are reversible.
I wish this article were written using straightforward language using simple sentences! 🙂 I had to read each sentence more than three times in order to understand what exactly is being said here!
As I see it, whether it is a physical illness or a mental problem (i.e., “problems in living”), the reason one would seek help from a professional is ultimately due to an individual’s subjective experience. If this subjective experience of pain (mental or physical) reaches a certain threshold level (this threshold can be different for different people), and interferes with one’s day-to-day activities, then they seek help. For physical illnesses, we have established systems of treating patients – no one questions that. With mental issues psychiatrists assume there has to be a physical cause (they assume this although there is no evidence for it).
Regarding all this, what I don’t understand is why everyone ignores neuroplasticity (a key discovery of neuroscience). Neuroplasticity is a situation where neurons and neurochemicals continuously change with human experience (just like physical activities change our muscles). For example, when someone experiences psychological stresses, these stresses result in changes in the brain but when these stresses are addressed, the brain becomes normal again (I gave many references for this in comments to Joanna’s previous blog). As I see it, this is how ‘mental pain’ issues should be addressed. This can be addressed either by targeting the stressor itself (e.g. finding a job for someone who lost their job), or by changing the way people deal with stresses (e.g. providing hope and support to the patient, as well as with other interventions such as training in meditation/mindfulness practices). The current practice of giving fancy psychiatric labels to patents (and being told that these are long-term conditions) only aggravates their stress level and the medicines that are given interfere with the normal functioning of the brain.
It is the mind that thinks about materialism, about non-materialism, about the brain and even about the mind itself. So, you cannot say “there isn’t a mind.” The mind constitutes sense impressions and mental phenomena that are constantly changing.
Hi Joanna: Regarding your statement, “biological markers of distress are more likely to be secondary, or correlative than causal,” I don’t think it is a matter of ‘more likely’ but a matter of how it is, especially since there is overwhelming evidence suggesting that it is human experience that continuously changes the structure of the brain. In other words, as I see it, and as stated by ‘FeelinDiscouraged,’ and others here, ‘confusion of cause and effect’ is one of the biggest problems in psychiatry.
Regarding references for experience changing the structure of the brain, I mentioned the mouse study with a reference in this blog. Below are some additional references. There are probably more recent references – I must do a new search sometime.
Nestler, E. J. (2012). Epigenetics: Stress makes its molecular mark. Nature,171, 171–172.
Davidson, R. J., and McEwen, B. (2012). Social influences on neuroplasticity: stress and interventions to promote well-being. Nature neuroscience 15.5: 689-695.
Markham, J.A. & Greenough, W.T. (2004). Experience-driven brain plasticity: beyond the synapse. Neuron Glia Biology, 1, 351–363.
Bremner JD (2006). Traumatic stress: effects on the brain. Dialogues in clinical neuroscience, 8 (4), 445-61.
Radley, et al. (2005). Reversibility of apical dendritic retraction in the rat medial prefrontal cortex following repeated stress. Experimental Neurology, 196, 199–203.
Vyas, A., (2002). Chronic stress induces contrasting patterns of dendritic remodeling in hippocampal and amygdaloid neurons. The Journal of Neuroscience, 22, 6810–6818.
Hanson, J.L., et al. (2010). Early stress is associated with alterations in the orbitofrontal cortex: a tensor-based morphometry investigation of brain structure and behavioral risk. The Journal of Neuroscience, 30, 7466–7472.
Yang, S., et al. (2012). Enriched Environment and White Matter in Aging Brain. The Anatomical Record, 295,1406–1414.
Chang et al. (2015). Social isolation-induced increase in NMDA receptors in the hippocampus exacerbates emotional dysregulation in mice. Hippocampus. 25(4):474-485.
Fett et al., (2015). Social neuroscience in psychiatry: unravelling the neural mechanisms of social dysfunction. Psychological Medicine. 45(6):1145-1165.
(I posted this comment once before, but it may have got marked as spam – my apologies in case this gets posted twice.)
Thank you ‘FeelinDiscouraged’ – totally agree with you.
[I also liked your comment to Littleturtle and your creative connection to that Aesop’s story! 🙂 ]
Regarding the bio-psycho-social model: All ‘mental illnesses’ are purely psychological. Social factors contribute to these psychological issues (because we have social pressures to achieve status, avoid being seen as worthless, etc.).
Regarding the biological – it is psychological factors that bring about changes in biology (if we disregard things like tumour growth, etc., which are rare and purely biological – these of course have to be treated in a biological manner, such as surgery). In other words, psychological stresses, etc., bring about changes neurons and brain chemistry and these changes are reversible through psychological means. To take one example study: mice subjected to various psychological stresses (e.g. being restrained) show dendritic atrophy and loss of dendritic spines in the brain (reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645314/ ). However, these changes are reversible through psychological means (e.g. when stressed, restrained animals are released as described in the same article).
As I have mentioned before (in my previous comments to this series of blogs), Buddhist teachings from 2600 years ago explain the mind in great detail – such as how our attachments (whether it is towards our physical body, or for gaining pleasant feelings, social pressures, etc.), influence the manifestation of the mind-stream – all psychological stresses (that we refer to as ‘mental illnesses’ or ‘mental suffering’) happens as manifestations within this mind-stream that is changing moment by moment [reference: Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom, published in ‘Current Psychology’ (MindRxiv archive link: https://mindrxiv.org/mfs63/ ].
What’s your impression?!