Posted tagged ‘psychology’

Talking the Mental Illness Talk–OK. Walking the Walk?…

June 10, 2008

…Not so much, according to Michelle S.

Responding to my recent post on the Iraq War suicides and what they can tell us about the question of brains-and-minds, one of my favorite commenters (and a former student, much admired and much missed) weighs in from a position of much greater knowledge than I possess on issues of brains and mental illness. Michelle knows what she’s talking about and says it better than I could — so here is what she has to say:

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I would love to think that some hope is justified here. Unfortunately, I don’t think that’s the case.

While it’s a major development (no pun intended) that the military is finally starting to take PTSD and other brain-related maladies seriously, I don’t think they’re anywhere near the level of understanding or action that is necessary to make any real progress. It’s one thing to admit that something exists–or at least sort of admit that it exists–but another to really do something about it. Admittedly, some of the military leaders seem to be trying. On the other hand, a lot of soldiers are still afraid to admit that they might be suffering from a mental illness.

Hell, plain old civilians are afraid to admit it, and for good reason in some cases, I might add. Stigma is far from gone in the US. As a country we offer sympathy and support for anyone suffering from an illness of the heart, the lungs, the kidneys, whatever, but the brain is still different to us somehow. We manage to forget that it is still an organ, albeit a really darned complicated one.

Then there’s the problem of mental illness in general–in fact, nearly any brain-related problem–being grossly misunderstood. I actually had a young mother say to me once, in regard to her two year old, “He’s so moody! I’m just terrified that he might be bipolar!” Dear, your child is not bipolar. He’s two. His “mental illness” is that he is a two year old. (And, I’m sure, by the time he’s five she’ll have him on ritalin–but NO ONE wants me to get started down that road.)

The public needs good, solid information about what mental illness is. The MSM has yet to provide that, in my opinion. Meanwhile, schizophrenics in particular continue to be demonized, even while they’re forced to live in a society that only treats mental illness as an afterthought. Have you heard even one Presidential candidate address the near-crisis that is geriatric mental health in the US? Ok, I’m preaching on a topic that is dear to my heart here, I know, but come ON–experts in that field are shouting at the top of their lungs about this problem. They have been for years. Why is no one listening? Why is insurance coverage for mental health such a joke?

Perhaps things are starting to improve. Perhaps the brain as a whole, with all of its complex subtleties, capabilities and limitations, will get the attention it needs and deserves. I hope that your hope is justified. But I think (and therefore I am–maybe) we’re a long way off.

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Image:  Francisco de Goya, detail from No. 62 in the series Los Caprichos, 1799. Source:  Wikimedia Commons.

Burrowing into tragedy: a story behind the story of the Iraq War Suicides.

June 5, 2008

Cross Posted at Cosmic Variance (thanks Sean).

My thanks to all here who gave me such a warm welcome on Monday (and, again, to Sean for asking me here in the first place).

This post emerges out of this sad story of a week or so ago.

Over Memorial Day weekend this year there was a flurry of media coverage about the devastating psychological toll of the Iraq and Afghanistan wars. The single most awful paragraph in the round-up:

“According to the Army, more than 2,000 active-duty soldiers attempted suicide or suffered serious self-inflicted injuries in 2007, compared to fewer than 500 such cases in 2002, the year before the United States invaded Iraq. A recent study by the nonprofit Rand Corp. found that 300,000 of the nearly 1.7 million soldiers who’ve served in Iraq or Afghanistan suffer from PTSD or a major mental illness, conditions that are worsened by lengthy deployments and, if left untreated, can lead to suicide.”

(For details and a link to a PDF of the Army report – go here.)

This report, obviously, is the simply the quantitative background to a surfeit of individual tragedy – but my point here is not that war produces terrible consequences.

Rather, the accounts of the Iraq War suicides — 115 current or former servicemen and women in 2007 – struck me for what was implied, but as far as I could find, not discussed in the mass media: the subtle and almost surreptitious way in which the brain-mind dichotomy is breaking down, both as science and as popular culture.

How so? It is, thankfully, becoming much more broadly understood within the military and beyond that “shell shock” is not malingering, or evidence of an essential weakness of moral fiber. PTSD is now understood as a disease, and as one that involves physical changes in the brain.

The cause and effect chain between the sight of horror and feelings of despair cannot, given this knowledge, omit the crucial link of the material substrate in which the altered and destructive emotions can emerge. PTSD becomes thus a medical, and not a spiritual pathology.

(This idea still faces some resistance, certainly. I launched my blog with a discussion of the attempt to court martial a soldier for the circumstances surrounding her suicide attempt. But even so, the Army is vastly further along in this area that it was in the Vietnam era and before.)

Similarly, depression is clearly understood as a disease with a physical pathology that underlies the malign sadness of the condition. (H/t the biologist Louis Wolpert for the term and his somewhat oddly detached but fascinating memoir of depression.)

This notion of the material basis of things we experience as our mental selves is not just confined to pathology. So-called smart drugs let us know how chemically malleable our selves can be.

More broadly, the study of neuroplasticity provides a physiological basis for the common sense notion that experience changes who we perceive ourselves to be.

All this seems to me to be a good thing, in the sense that (a) the study of the brain is yielding significant results that now or will soon greatly advance human well being; and (b) that the public seems to be taking on board some of the essential messages. The abuses (overmedication, anyone?) are certainly there. But to me, it is an unalloyed good thing that we have left the age of shell shock mostly behind us.

At the same time, I’m a bit surprised that the implications of this increasingly public expression of an essentially materialist view of mind haven’t flared up as a major battle in the science culture wars.

Just to rehearse the obvious: the problem with cosmology for the other side in the culture war is that it conflicts with the idea of the omnipresent omnipotence of God. The embarrassment of evolutionary biology is that it denies humankind a special place in that God’s creation, destroying the unique status of the human species as distinct from all the rest of the living world.

Now along comes neuroscience to make the powerful case that our most intimate sense of participating in the numinous is an illusion.

Instead, the trend of current neuroscience seems to argue that the enormously powerful sense each of us has of a self as distinct from the matter of which we are made is false. Our minds, our selves may be real—but they are the outcome of a purely material process taking place in the liter or so of grey stuff between our ears.

(There are dissenters to be sure, those that argue against the imperial materialism they see in contemporary neuroscience. See this essay for a forceful expression of that view.)

I do know that this line of thought leads down a very convoluted rabbit hole, and that’s not where I am trying to go just now.

Instead, the reports of the Iraq suicides demonstrated for me that the way the news of the materiality of mind is is slipping into our public culture without actually daring (or needing) to speaking its name.

That the problem of consciousness is still truly unsolved matters less in this arena than the fact of fMRI experiments that demonstrate the alterations in brain structure and metabolism associated with the stresses of war or the easing of the blank, black hole of depression. The very piecemeal state of the field helps mask its potentially inflammatory cultural implications.

To me this suggests two possibilities. One is that it is conceivable that when the penny finally drops, we might see backlash against technological interventions into the self like that which has impeded stem cell research in the U.S.

On the other hand, I don’t think that the public can be motivated or even bamboozled into blocking the basic science in this field. Too much rests on the work; any family that has experienced Alzheimers knows just how urgent the field may be — not to mention anyone with a loved one in harms way.

This actually gives me hope for a shift in the culture war. For all the time and energy wasted over the last several years defending the idea of science against attacks on evolution, with the cosmologists taking their lumps too – the science of mind could force a shift in the terms of engagement decisively in the right direction.

Or I could be guilty of another bout of wishful thinking. Thoughts?

Image: Brain in a Vat, article illustration. Offered in homage to my friend and source of wisdom, Hilary Putnam, who introduced the brain-in-a-vat thought experiment in this book. Source: Wikimedia Commons.