On phrenology and neurobollocks
Recently I was reading a blog entitled www. wiring the brain.com by Professor Kevin Mitchell of Trinity College, Dublin.
In the Victorian era the study of the skull contours was linked to theories of the emotional life and character of that person, giving way to a language of understanding the mind.
After Freud there was a great expansion in our language in understanding the mind in the modern age in relation to the great social and technological changes.
After many years of Neuroscience we have a great number of insights into the workings of the brain that need to be translated correctly in our consultations with young people on the subjects of depression, anxiety and psychosis.
We do have to be careful about not spouting too much neurobollocks. Specifically as professionals we might give what appears to be a plausible explanation for the working of the serotonin, noradrenaline and dopamine systems in depression, anxiety, psychosis and ADHD, but we cannot give the specific explanation to the young person that is specific to their symptoms, context and experience.
A humbling thought indeed.
We cannot help but to help with a reasoned prescription of medication which we can explain to ourselves, our colleagues, patients, families, teachers and even the legal profession.
Stopping medication can be difficult if a young person does not want this to happen and so the issues of managing the medication becomes a negotiation along with the other important events in a young person's life, where success in relationships, education and finding work will have a much greater bearing on their happiness and the development of their identity.
Neuroimaging studies just do not have enough numbers of subjects to give us the true understanding and the molecular basis of depression is far more complex and unknown than the hypotheses justifying the prescriptions of medication.
Maybe under the great pressures we face the psychiatrist has to look into the details of the neurobiological explanations and contemporary neuroscience to avoid spouting neurobollocks like a salesman with the same pitch, day in and day out.
Now I understand how I would have felt as a Victorian phrenologist.