Why the brain is not enough

Recently a colleague passed along a really interesting article about prevention, neuroscience, and mental illness. (Find it here: http://chronicle.umbmentoring.org/prevention-neurobiology-and-childrens-mental-health/).

This article highlights some really interesting considerations when it comes to the role of brain science in treating mental illness. Particularly, given the recent federal granting efforts around the Brain Initiative, it’s interesting to think about the value placed on brain sciences, and how that has come to eclipse many other forms of knowledge.

The article’s author quotes a recent article from the NewYork Times by Benjamin Fong, who writes about how psychology has come to fully embrace cognitive neuroscience, and the potential pitfalls of such complacent bedfellows. He highlights many of the arguments surrounding the pros and cons of the Brain Initiative, and astutely reflects:

“The real trouble with the Brain Initiative is not philosophical but practical. In short, the instrumental approach to the treatment of physiological and psychological diseases tends to be at odds with the traditional ways in which human beings have addressed their problems: that is, by talking and working with one another to the end of greater personal self-realization and social harmony.” (see full article here)

This got me thinking.

Isn’t it weird that we’ve gotten to a point in history where “fixing the brain” is perceived as the easiest way to treat mental illness?

It wasn’t always this way. Historically, and even as recently as 20-30 years ago, the brain was viewed as an enigma, a black box that could not be understood. And it was early neuroscientists who, to their credit, started pushing the limits of what we knew about the brain and advanced the field by leaps and bounds to the point where we as a society have come to place high value on understanding the role of the brain in our lives – arguably to a fault.

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Historically, humans used to rely on each other or home remedies to treat mental and physical illnesses. Trusted home-remedies, and medicinal traditions were passed on through generations of humans.

Care was kept within community.

And yes, with scientific discoveries and medical advancements, we found out that a lot of the things we’d been doing were just plain wrong. Some of the traditional methods of treatment were doing more harm than good. Anyone who’s been to a museum display medical history can attest to this.

Scientific progress has brought humanity crucial advancements that have saved lives. There’s no doubt about that. But when applying science to the human psyche, things get a little trickier.

Traditional reductionist methods of scientific inquiry do not fit well when trying to examine human psychology. Our lives, and our understanding of them, are determined not just by our genetic makeup, but by the interactions with our surrounding environments. Those environments have the power to shape the expression of genetics and physical biology.

It’s nature and nurture in a never-ending tango. Each taking the lead from time to time, in somewhat unpredictable ways.

The problem with psychology embracing cognitive neuroscience so fully and completely is that traditional, reductionist perspectives on how the world works don’t fit well for psychology because of its inherent complexity and unpredictability.

 

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Unfortunately, recent scientific priorities have pushed us to favor quick fixes to change the brain, because the brain is easy. It’s an organ. It can be reduced to classic scientific fields of biology and chemistry; scientific fields that are easy (or easier anyway) to understand and manipulate in ways that science can predict.

And this is where Benjamin Fong’s point is well taken. There is a complete lack of practicality of the Brain Initiative for treating psychological problems. Understanding how the brain works is great, but humans, despite being made up of chemicals, are not just chemicals. Humans are social beings who rely on trust and relationships with one another to survive. Without that social structure, relationships, and community, humans cease to thrive. Chemical treatments to fix deep psychological wounds created by the pain of broken communities and shattered relationships just won’t cut it. Those broken communities and shattered relationships will continue to do damage until the factors contributing to that brokenness are addressed.

This brings to mind a book called GhostMap, which is lauded in public health circles as a true triumph of human ingenuity and the scientific method to stop a massive cholera epidemic in London, England. Instead of using a solely medical model approach to find an effective treatment for cholera for everyone who was sick, and then accepting fact that cholera would continue to be an epidemic the whole of London, the emphasis was placed on figuring out WHY cholera was spreading in the first place. What was it that people were doing that was contributing to the spread of illness?

And wouldn’t you know it, it was a lifestyle thing. Choices that humans were making about where to deposit bodily waste where it was too near the local water supply, thus spreading the bacteria that causes cholera.

Because of this discovery, people who were living in community with one another, to promote their own health, changed where they deposited waste, and subsequently stopped the epidemic. Instead of sinking resources and money into treating everyone who had the illness with medicine, one environmental change prevented the spread of the disease, halting the epidemic in its tracks.

They could have treated cholera with medicine alone – treating the illness.

But they wouldn’t have saved as many lives as they did by changing the behaviors and systems that were causing the epidemic in the first place.

Now I’m not saying that some of our most pervasive and complicated societal problems like poverty, violence and racism, are as easily solved as figuring out where to deposit waste. Nor am I saying that all mental illness is attributable to only environmental factors.

Brain in hand (via stock.xchng)

What I’m saying is that the answers to the bigger problems with mental illness do not lie in the human brain alone. That the Brain Initiative, for all of its strengths and laudable endeavors, is not the silver bullet to end mental illness.

Because when it comes down to it, we can treat the symptoms of mental illness by altering brain chemistry all we want, but until we grapple with some of the bigger factors that contribute to mental illness, we’re only putting Band-Aids over the gaping wound.

Fixing the brain is easy.

“Talking and working with one another to the end of greater personal self-realization and social harmony” as Benjamin Fong suggests?

That’s hard, but it’s what needs to be done.