The Relevance of Neuroscience for Psychiatrists
The Relevance of Neuroscience for Psychiatrists
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Many psychiatrists are not familiar with the latest developments in neuroscience and many clinicians are a bit skeptical about the relevance of neuroscience in their practice. After watching these two videos, these clinicians may possibly change their minds.
Part 1: What Can Neuroscience Offer Clinicians?
Using case samples, Dr Akil introduces the concept of neuroscience and explains how some of the latest developments can be used in everyday practice.
Part 2: Using Neuroscience to Overcome Stigma
Dr Akil explains that through neuroscience, patients can be helped to understand that the disorder is medical and that it may be biological.
I believe that neuroscience may be one factor that can help reduce prejudice and animus toward those with psychiatric illness; however, the problem must be attacked on several levels. We need to help the general public see and appreciate the many thousands of creative, productive, and tremendously decent individuals who struggle with --and often surmount--major psychiatric illnesses, such as bipolar disorder, schizophrenia, and major depression. Dr. Kay Jamison is but one prominent example. When the general public comes to understand that those with psychiatric illness are not "The Other", but rather, our sons and daughters and brothers and sisters, perhaps then neuroscience will help us see mental illness in a more balanced perspective.
Ronald Pies MD
As Dr. Akil points out in Part I, we need to move from an either/or to a both/and perspective. The false dichotomies of mind & brin, scientfic & humanistic and psychotherapy & medication are but a few examples.
Though removing stigma from a societal point of view via understanding neuroscience may not be effective, giving patients a way to feel strong rather than weak, as people who are overcoming or needing to overcome some unfavorable neurobiology, can be enormously valuable to the individual in treatment. I think Part II describes this pretty eloquently. So many people don't do what they need to do medically because they think they should be able to do it on their own - be "like everbody else"- just by force of will. People are much more prone to do this with medical illnesses rather than mental disorders, still somehow perceving the latter as not "real" (no suprise, half the people on any given blog still don't see some diagnoses as real that have been validated for quite some time now!!) As long as you protect them from thinking that because it is biological or genetic it can't be managed or altered - a common misunderstanding in the genetics world, particularly in regards to obesity and diabetes-related genes - it can be very empowering and encouraging.
As Dr. Akil points out, I accept that once mental illness is developed, a genetic component should have been involved. The circuits need to be identified in order to get the appropriate diagnosis to apply the correct combination of treatments. However, (and everybody knows) that besides genetics, the development of mental illness depends so much on the individual’s mental set, and environmental factors such as learning behaviors from family dynamics (dysfunctionality), negative and traumatic experience from emotional, physical and sexual abuse and other trauma. This has been seen in research with identical-twins raised in different families and different environments. In certain ways, and at an early age, genetics can be manipulated, and genes can be mutated or prevented from developing into the predetermined condition, if and when we know the variables involved. I am referring to mental illness, not to physical illness; and who knows if it also applies to it, (due to the mind and body connection). I have seen survivors from war suffering numerous and unexplainable physical conditions. In my personal opinion, the person needs to know, not only the genetic component, and brain circuits involved, but their own personal history factors contributing to the mental illness. O.V., Psy.D.
As Dr. Akil points out, I accept that once mental illness is developed, a genetic component should have been involved. The circuits need to be identified in order to get the appropriate diagnosis to apply the correct combination of treatments. However, (and everybody knows) that besides genetics, the development of mental illness depends so much on the individual’s mental set, and environmental factors such as learning behaviors from family dynamics (dysfunctionality), negative and traumatic experience from emotional, physical and sexual abuse and other trauma. This has been seen in research with identical-twins raised in different families and different environments. In certain ways, and at an early age, genetics can be manipulated, and genes can be mutated or prevented from developing into the predetermined condition, if and when we know the variables involved. I am referring to mental illness, not to physical illness; and who knows if it also applies to it, (due to the mind and body connection). I have seen survivors from war suffering numerous and unexplainable physical conditions. In my personal opinion, the person needs to know, not only the genetic component, and brain circuits involved, but their own personal history factors contributing to the mental illness. O.V., Psy.D.
Unfortunately the idea that neuroscience can combat stigma is probably not true (Pescosolido et al, AJP, Nov 2010), or at least highly flawed. Pescosolido reported that where attribution of a neurobiological cause led to increased uptake of medical treatment but either neutral or increase of stigmatizing reactions.