{"id":64694,"date":"2016-04-12T18:46:04","date_gmt":"2016-04-12T22:46:04","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=64694"},"modified":"2016-04-13T08:29:41","modified_gmt":"2016-04-13T12:29:41","slug":"cartesian-dualism-in-appalachia","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2016\/04\/12\/cartesian-dualism-in-appalachia\/","title":{"rendered":"cartesian dualism in appalachia…"},"content":{"rendered":"\n
The ever-sensible British Neuroscientist we know as Neuroskeptic<\/a> has a particularly sensible blog post up [How To Avoid Neurohype<\/a>], tied to his equally sensible Daily Dot commentary [Why we’re living in an era of neuroscience hype<\/a>].<\/div>\n
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In my view, it’s this sense of “hard” vs. “soft<\/a>” truth that lies at the root of the craze for neurobullshit. We seem prone to a mind-brain dualism, thinking that the mind is something soft, malleable, and mysterious, whereas the brain is a hard, biological thing open to scientific probing. Therefore, we feel that if we can reframe a “mind” problem as a “brain” problem, then by doing so we’re already halfway to finding a solution.<\/font><\/strong> [In fact, the hard\/soft, brain\/mind fallacy dates back to Greek philosophy, and is known as Cartesian Dualism<\/a>.]<\/div>\n

Really, the human brain is no harder or easier to understand than the human mind, because they are ultimately the same thing. So, while it is possible <\/em>in principle to reframe a “mind” issue as a “brain” issue, it’s often not useful <\/em>to do so… Why is there so much neurobullshit around today<\/em>? I think the answer is that neuroscience really has made great advances in the past few decades, and these advances have been very visible… <\/p>\n

Ultimately, modern neurohype is driven by the appeal of “hard” or scientific approaches to problems, combined with the modern buzz surrounding brain science. The result is that neuroscience [or something resembling it] has become a selling point — a shiny new coat of paint, both for products and for ideas. Today, while we really do know more about the brain than ever before, our understanding is still very limited. Neuroscience is not yet advanced enough to tell us the answer to life, the universe, and everything.<\/div>\n<\/blockquote>\n
How does the ever-sensible British Neuroscientist we know as Neuroskeptic<\/a> stay so ever-sensible? It’s because he really is a Skeptic<\/a> and knows what that means. But in this case, I don’t think he pushes his observation far enough. His point has more ramifications than he credits. If I go to the Dermatologist having noticed a new skin growth and it turns out to be a skin cancer, I’m not the agent<\/font><\/em> of my illness. I’m its victim<\/font><\/em>. And if I’m going to get any help, it’s coming from medical treatment, not my own efforts. However, for many presenting with mental symptoms<\/font><\/em>, the afflicted often has plenty of agency<\/font><\/em> in their creation and maintenance. Or maybe life has thrown one of its curve-balls. Or a jillion other things. <\/div>\n

I had left general psychiatry for a particularly specialized niche, and on returning twenty-five years later, there was a distinct change in the way patients presented. It was a surprise that took some getting used to. Some announced their diagnosis [bipolar, ocd, dissociative disorder]. Many presented their emotional complaint as if it were a disease [depression, anxiety]. And I was supposed to do something with that pronouncement with no further information, as if "I have depression<\/font><\/em>" lead to some specific treatment. Even harder for me was "My antidepressant isn’t working anymore,!" "My depression is coming back,"<\/font><\/em> or "I have a chemical imbalance."<\/font>  <\/font><\/em>I had no illusion that I was going to do in-depth case studies in a general charity clinic, but I didn’t anticipate hearing something equivalent to "I found a new mole.<\/font><\/em>" And often, taking a real history was hard work. "What’s that got to do with…?"<\/font><\/em><\/p>\n

Many of the patients, even here in the Appalachian Mountains, had adopted this medical model<\/font><\/em> [in the scorned usage]. At first I thought it was something learned from their doctors or the tv ads, but it was more than that. It was something they had maybe initially picked up that way, but it was maintained by many because… [don’t know the because]. And it’s in the culture now "My neighbor, see she’s bipolar and…"<\/font><\/em>. The responsibility for improvement was jettisoned to some external locus of control – a new variant of an old psychological defense mechanism. It was enough of a change that I had to relearn how to interview certain people to get the necessary information. There are a lot of things you can do to help people even in the direst of circumstances, but you can’t do them if you don’t know what they are. And you can’t know that without their allowing you to join in a "look around." <\/p>\n

So "Therefore, we feel that if we can reframe a ‘mind’ problem as a ‘brain’ problem, then by doing so we’re already halfway to finding a solution"<\/font><\/strong> is not just what neuroscientists or some psychiatrists do. Patients do it too. Sometimes it’s a burden handed to patients by their psychiatrists or GPs. And sometimes it’s a thing that patients pick up and carry to extremes – going on a search for an elusive chemical cure instead of making changes in their lives or situations that would make for a more fulfilling visit to our planet. And occasionally, it becomes a place where patients can hide for a very long time to their detriment. <\/p>\n

One thing I found that was a surprise to me. While there are times when the long term use of medication is indicated, it seemed like everybody was on medications chronically. At first I thought it was something symbolic or perhaps magical. But it turned out that a lot of people thought that the medicine was treating the underlying problem which would progress if they stopped it. And the withdrawal syndromes reinforce that notion. Once people get such an idea, one has to walk softly in trying to dispel it and stop unnecessary medications or the patient will think you’re trying to take something vital away from them and move on to somebody who will just keep on refilling the Rx…<\/font><\/em><\/sup><\/div>\n","protected":false},"excerpt":{"rendered":"

The ever-sensible British Neuroscientist we know as Neuroskeptic has a particularly sensible blog post up [How To Avoid Neurohype], tied to his equally sensible Daily Dot commentary [Why we’re living in an era of neuroscience hype]. In my view, it’s this sense of “hard” vs. “soft” truth that lies at the root of the craze […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-64694","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=64694"}],"version-history":[{"count":13,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64694\/revisions"}],"predecessor-version":[{"id":64708,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/64694\/revisions\/64708"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=64694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=64694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=64694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}