{"id":61425,"date":"2015-11-12T22:09:29","date_gmt":"2015-11-13T03:09:29","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=61425"},"modified":"2015-11-12T22:09:29","modified_gmt":"2015-11-13T03:09:29","slug":"the-curse-of-insels-legacy","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/11\/12\/the-curse-of-insels-legacy\/","title":{"rendered":"the curse of insel’s legacy…"},"content":{"rendered":"
I was reading along in Dr. Makari’s<\/a> Opinion piece in the New York Times when I got to the final paragraphs where he artfully articulated something I’ve been trying to say for a very long time:<\/div>\n
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Psychiatry\u2019s Mind-Brain Problem<\/a><\/div>\n
New York Times – Opinion <\/font><\/b><\/div>\n
By GEORGE MAKARI<\/div>\n
NOV. 11, 2015<\/div>\n

\u2026<\/p>\n

Unfortunately, Dr. Kane\u2019s study arrives alongside a troubling new reality. His project was made possible by funding from the National Institute of Mental Health before it implemented a controversial requirement: Since 2014, in order to receive the institute\u2019s support, clinical researchers must explicitly focus on a target such as a biomarker or neural circuit.<\/font><\/b> It is hard to imagine how Dr. Kane\u2019s study [or one like it] would get funding today, since it does not do this. In fact, psychiatry at present has yet to adequately identify any specific biomarkers or circuits for its major illnesses.<\/p>\n

Critics worry that this new stipulation will limit clinical studies and foster what has been all too familiar in psychiatry \u2014 unwarranted speculation aimed at prematurely reducing many layers of intersecting causality to one. If so, the institute will become the latest in a long, unhappy line of those who pressed for a simple solution to the Janus-faced problems of mind-brain illness. In the meantime, Dr. Kane\u2019s study provides pragmatic clinicians with strong new evidence for an old idea: Individuals with mental illness should be fully engaged as beings whose rich psyches and ever-present social worlds are just as real as their brains.<\/div>\n<\/blockquote>\n
I’ve been hard on Tom Insel and tried to say why every time I write about him, but I don’t ever feel like I get it said. But it’s simple. He thought he owned the NIMH and its directions. Last week in an interview<\/a>, he blamed the NIMH’s inadequate analytic fire-power for not confirming his nebulous RDoC:<\/div>\n
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Five years ago, the NIMH launched a big project to transform diagnosis<\/a>. But did we have the analytical firepower to do that? No. If anybody has it, companies like IBM, Apple or Google do \u2013 those kinds of high-powered tech engines\u2026<\/div>\n<\/blockquote>\n
Clinical Neuroscience<\/font><\/i>, RDoC<\/font><\/i>, Neural Circuits<\/font><\/i>: These are some things he decided would lead us to the promised land, and so he made them preconditions for receiving NIMH grant money!<\/font> No offense, but the Director of the NIMH is supposed to create an environment where our best and brightest researchers can pursue their ideas. It’s fine to keep them out of the stratosphere and insist that they propose projects that have some general value and realistic goals, but that’s not what Tom Insel did. He essentially told them what things he was interested in having them work on. Is the RDoC something of value? Who knows? Mainly because it doesn’t even exist. And would it transform diagnosis? Who knows? Again, because it doesn’t exist. And about those Neural Circuits, take a look at this earnest resident pretending to talk to a patient [the talk that matters…<\/a>] about her Neural Circuits [instead of confronting her about her addictive behavior]:<\/div>\n