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Kandel, The disordered mind. Or was Descartes wrong?

Kandel, The disordered mind.  Or was Descartes wrong? 

It’s become almost commonplace today, at least among those impressed by the latest results of neuroscience, to say that Descartes got it backward.  Not “I think therefore I am,” but “I am therefore I think.” The mind is composed of body.  The brain makes mind possible.

This is the argument of Eric R. Kandel, author of The Disordered Mind and Nobel Prize winner for his research on memory storage in neurons.  The reader need not be intimidated.  Kandel clearly explains recent developments in neuroscience for the non-specialist.  He tries, but fails, to put together the neuroscience of the injured brain with the experience of emotional distress.  He knows one is incomplete without the other, he calls for a “new scientific humanism,” but all he ever says is that both brain and experience need to be taken into account.  Sometimes that’s enough, but about some experiences, such as PTSD, he cannot get out of the brain.    

I feel therefore I am

It’s absolutely true that brain makes mind, and yet this is not how we experience ourselves.  “I feel therefore I am” is probably the first and fundamental experience of self, and it would not be wrong to say that feeling is at least as body-based as it is mind-based.  The fundamental experience, or at least the experience that makes life worth living, is the feeling of being alive, filled with the vitality of existence.* 

Neuroscience doesn’t capture the feeling of being human.  It’s about neurochemical events responsible for this feeling, but it doesn’t capture the experience of being alive, sad, happy, depressed, in love, etc.  The question is how much this matters, and how the neurological explanation can be made useful without diminishing the experience of life.

Thus, we now know that psychiatric illnesses, like neurological disorders, arise from abnormalities in the brain. (p 41)

It’s not true, at least not when stated like this.  These “abnormalities,” which exist, may be the brain’s normal reaction to an abnormal environment. What goes on in the brain is caused by the environment we live in, not just autonomous neurochemical events in the brain itself.  Everything I experience changes my brain.  But that doesn’t mean that all, or even most, psychiatric diseases arise from abnormalities in the brain.  Some do, some don’t, and many are a mix.  Besides, the term “arise” is too vague. 

Kandel talks about PTSD at some length, and I’ll get to that shortly.  His treatment of the topic is disturbing, but the scope of the book is broader and worth considering. 

A “new scientific humanism”?

As research into the brain and mind advances, it appears increasingly likely that there are actually no profound differences between neurological and psychiatric illnesses and that as we understand them better more and more similarities will emerge. (p 43)

This convergence will contribute to the new, scientific humanism. (p 43)

I have only a scant idea of what Kandel means by “the new scientific humanism.”  It would have helped had he defined “humanism” to begin with.  I think he means that experience still matters, particularly one’s own experience of events such as depression.

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Cognitive behavioral therapy is a terrible way to treat trauma. And it’s government approved.

IMG_0525_editedblack-1_edited-1The Department of Veterans Affairs may today deliver the worst trauma treatment known to man or woman.

The diagnosis of PTSD is an outgrowth of the protests over the Vietnam War. Distraught and disillusioned Vietnam veterans, together with psychiatrists such as Robert Jay Lifton and Chaim Shatan, developed the “rap groups” that provided psychological support in a community of other vets who had undergone similar experiences. Rap groups worked because they provided a place to share common experiences, including terror and remorse. Rap groups provided community and social support.

The effectiveness of rap groups eventually convinced the American Psychiatric Association to include Post Traumatic Stress Disorder in the third edition of its Diagnostic and Statistical Manual, though this is a long and convoluted story (see http://traumatheory.com/whats-going-on-with-dsm-5/ for more details). For some time, rap groups were employed by the VA, often with reluctance, for their members were not always easily managed (Sonnenberg, Blank, Talbott).

No more. David Morris’ recent account of his experience with cognitive behavioral therapy at the San Diego VA tells of a sign on the wall of a waiting room for a small group of vets who were about to enter therapy (p. 195).

PLEASE REFRAIN FROM TELLING WAR STORIES. YOUR STORY COULD BE A “TRIGGER” FOR SOMEONE ELSE.

If the traumatized cannot talk with each other, but only through a therapist, even in a group, then therapy is no longer about creating a community of support for those who suffer. It’s about isolating those who suffer from each other, so they can be processed individually, their trauma chopped into bits.

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