{"id":4659,"date":"2011-02-05T11:33:26","date_gmt":"2011-02-05T16:33:26","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=4659"},"modified":"2011-02-05T20:42:23","modified_gmt":"2011-02-06T01:42:23","slug":"the-salad-days-of-2005","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/02\/05\/the-salad-days-of-2005\/","title":{"rendered":"the salad days<\/em> of 2005…"},"content":{"rendered":"
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There is an ancient Zen teaching: the master points up at the moon and asks the student: "What is this?"
The student replies "that is the moon."
The master corrects him: "No. That is a finger pointing at the moon."<\/font><\/em><\/td>\n<\/tr>\n<\/table>\n

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Psychiatry as a Clinical Neuroscience Discipline<\/strong><\/a>
Journal of the American Medical Association<\/font><\/strong>
2005:294(17):2221-2224
by Thomas Insel and Remi Quirion<\/div>\n

…<\/p>\n

Training in Clinical Neuroscience<\/u>:<\/font><\/strong><\/div>\n
The recognition that mental disorders are brain disorders suggests that psychiatrists of the future will need to be educated as brain scientists. Indeed, psychiatrists and neurologists may be best considered clinical neuroscientists<\/em>, applying the revolutionary insights from neuroscience to the care of those with brain disorders. The study of unconscious processes, motivation, or defenses, while at one time the sole province of psychoanalytic therapies, is now also in the domain of cognitive neuroscience. Systems neuroscience will be reformulating our notions of attention and emotion in the next decade just as it reformulated our understanding of language and perception in the last decade.<\/div>\n

Will a deep understanding of the psyche remain a central focus of psychiatry? The need for a sophisticated understanding of interpersonal relationships along with the use of evidence-based, nonpharmacological treatments [from psychoeducation to cognitive behavioral treatments] will be the tools of the effective healer in the future as much as in the past. Just as the need for rehabilitation following acute care for any serious injury or medical illness has been recognized, ideally the psychiatrist will increasingly be part of a team that provides culturally valid psychosocial rehabilitation along with medications to help those with mental disorders recover and return to a productive and satisfying life. What will be different is having the ability to target these treatments to specific aspects of the disease process.<\/p>\n

Redefining the foundation of psychiatry as clinical neuroscience also accelerates the integration of psychiatry with the rest of medicine. The separation of psychiatry from other medical specialties has contributed to the stigma of those who treat mental disorders as well as those who have them. Even beyond stigma, this separation has led to inadequate care. The recent scientific recognition of the importance of effective treatments of mental illnesses in cardiovascular disease and diabetes mandates the incorporation of psychiatry into truly integrated and effective treatment teams.<\/p>\n

…<\/div>\n

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In my last post, I was not completely fair, in that Tom Insel’s article was written in the salad days<\/em> of 2005<\/font><\/strong>, before we all knew the extent to which the Pharmaceutical Industry had permeated the Psychiatric hierarchy with the resulting scandalous perversion of our scientific dialog. It was happening, but most of us weren’t so aware as we are now. In my defense, the version of the paper on the NIMH site  cited by the Wired<\/strong><\/a> article was undated and I assumed it was a more recent production. The piece above references his original JAMA<\/font><\/strong> article from 2005<\/font><\/strong> when it was first published. I only discussed the very end of his piece as a way of balking at his equation that Psychiatry equals Clinical Neuroscience<\/font><\/strong>. I know that’s what he and his cohorts want, but I’m not sure it’s a justifiable wish. I left out the penultimate section [Training in Clinical Neuroscience<\/font><\/strong>] last time because I wanted to think about it a bit before responding. I’m certainly not opposed to training in neuroscience, but he’s suggesting more than just that.<\/p>\n

We have a lot of terms like salad days<\/em><\/div>\n