1 Boring Old Man

When I retired a lot of people kept asking me what I was going to do. Their questions made me aware that I had no idea, so I made up something. "I want to find my inner boredom" I would say. Later, I found a more accurate answer, "I want to think about what I want to think about." What I meant was that in the busy·ness of practicing and teaching and the many other things on my plate, my mind was not my own. It was filled with things I needed to attend to, and I wanted it back. I wanted to pick my own topics.

So for the first four or five years, I did a lot of things, but they had nothing to do with medicine or psychiatry. Then I started seeing patients again and got interested in the things I write about here, and I’ve really enjoyed doing it. In conventional terms, I guess I had burn-out, and after some needed respit care, I was good to go. But I still have to be vigilant about keeping my mind free "… to think about what I want to think about." It’s very easy for me to get on a topic, and feel like I have to stick to the task. Sometimes, that’s what I want to do, but sometimes it begins to feel like a homework assignment [self imposed].

… that mental illness was increasingly being recognised as a disorder of brain circuitry, rather than as a chemical imbalance, thanks to neuroimaging techniques and the discovery of some key biomarkers.

But he kept talking about it [Director’s Blog: Mental Illness Defined as Disruption in Neural Circuits, Insel Outlines the Psychiatry of the Future Treating Disorders of Neural Circuitry]. And the RDoC became the official language of the NIMH [Director’s Blog: Transforming Diagnosis]. So when Dr. Leanne Williams recently hit the airways with her RAD project [Precision psychiatry: a neural circuit taxonomy for depression and anxiety, How neuroscience could determine your mental health treatment, and Developing a clinical translational neuroscience taxonomy for anxiety and mood disorder: protocol for the baseline-follow up Research domain criteria Anxiety and Depression [“RAD”] project], I felt like it was time to look into this business of neural circuits. And so I wrote neural circuits 1…, thinking that a good place to start was with the work in Neurology with Parkinson’s Disease. And I’ve been chasing the references about the psychiatric applications of the concept.

But it’s not going like I planned. Williams’ papers describe a number of neural circuits as if they’re established, but chasing the references, my impression so far is that they’re pretty soft. I’ve written colleagues who I would expect to be in the know, and chased down some of their references too. But I can’t find any place to stand and I’ve ended up with a computer desktop full of saved .pdf’s, but little else to show for my efforts. I genuinely can’t tell if my unfamiliarity with the topic is the problem or if this really is one of those places where the people writing have blurred the distinctions between their dreams and their research. Of course, I suspect the latter based on our experience of the last couple of decades, but I don’t know enough yet to be sure about any of it. So I’m going to leave neural circuits 1… sitting there without any neural circuits 2… for a while, and read over my gathered material at a more leisurely pace – until something gels. Right now, it’s making my eyes cross and my brain hurt. As I said, I’m retired and "I want to think about what I want to think about."

Saturday, out of the blue, I posted a couple of jazz classics from 1956 [nocturne for flute [1956]…, breezin’ along in the trades [1956]…], favorites from my own adolescence – a time of cool jazz and the beat generation. What got 1956 in my mind? It was reading a paper from that year by a Dutch Psychologist about the use of statistics in research, a paper I hadn’t seen before: The Meaning of “Significance” for Different Types of Research by A. D. de Groot [Psychologist and Chessmaster]. And one thing lead to another. I found myself on Youtube listening to that music from long ago [the Shorty Rogers piece wasn’t my favorite of his, but the Chinook that Melted my Heart just wasn’t to be found].