Saturday, January 30, 2016
One More on IACD: You Knew They Had to Talk About "Neuroscience"
I hate to do one of these “research shows” numbers, but in fact there is a good deal of evidence that throwing irrelevant neuroscience references into an argument makes it harder for most people to detect logical errors (see, e.g., Weisberg et al., . The seductive allure of neuroscience explanations. Journal of Cognitive Neuroscience, 20, 470-477). This persuasive device has even been referred to as “neuroseduction”, and it is used freely by those who want to sell a practice or idea that is not really all it is claimed to be. Not surprising, then, that we see many such references at www.instituteforattachment.org.
Let me begin by talking about some of the logical problems that arise when people refer to mental illness as a brain disorder, as IACD does with reference to RAD. In this discussion, I am indebted to a recent article in American Psychologist (Schwartz, Lilienfeld, Meca, & Sauvigne’, . The role of neuroscience within psychology: A call for inclusiveness over exclusiveness. Vol. 71, 52-70). These authors have produced a very clear and complete statement of the issues about neuroscience and mental health issues, and while I will summarize some of the high points, I would really recommend the article to anyone who has a serious interest in this area.
To begin with, of course mental or behavioral disorders are all associated with unusual brain functioning. To say this is simply to confirm that we don’t think a disturbed noncorporeal mind or spirit is at work in mental illness. Thinking, feeling, and acting emerge from events in the brain and other parts of the nervous system and would not exist without an active brain. However, there is presently no information supporting the idea that a specific event in a specific area of the brain causes a predictable behavior, thought, or emotion. Given that most of our brain-behavior information comes from work on non-humans, a great deal of generalization is required even to think we have knowledge of general connections between brain areas’ activity and other observable events. Indeed, we may never have specific information about such connections, because behavior, thinking, and emotion are all events that occur in a historical and place context that may influence them as much as activities in the nervous system do.
In addition to the issue of context, we also have the fact that the rules that govern the functioning of parts of the brain may not apply in the same way when parts are working together with other parts. We may have an excellent understanding of the internal combustion engine, braking systems, and so on, but these do not help us prevent or disentangle traffic jams where many brakes and engines come close to each other, or contribute to the creation of codes of traffic laws. No matter how well we know about how brains function, we may never be able to jump from that knowledge to mastery of rules of human psychological functioning--- like traffic events, those rules may well have to be studied separately from the nervous system. They operate at a different level of analysis, just as engines and traffic do.
Why then do we have so many people, including governmental agencies, talking about “brain disease” and “brain disorder” rather than mental illness? My guess is that this began with advocacy groups like the National Alliance for the Mentally Ill (NAMI), who recognized the stigma attached to mental illness and the lingering belief that the mentally ill could be all right if they just exerted themselves a bit. “Diseases” and “disorders” can’t on the whole be blamed on their victims, whose brains have been “struck” by events beyond their control, so it’s very legitimate to fund programs to study and treat these problems, while such funding for mental illness might be seen as questionable. But when NAMI and other advocacy groups got this new locution in place, of course, they provided powerful help for other organizations who were happy to throw “brain” into their mix and benefit from the resulting confusion.
Let’s look at some of the “brain” claims made by IACD. Here’s one: “Here at IACD we’ve learned that past experiences actually change our brain patterns.” This is not a discovery that was made at IACD, nor is it actually a discovery at all-- instead, it is a viewpoint based on the current paradigm that rejects the idea of noncorporeal mental elements. Experiences are remembered and alter behavior, and the only way this can happen (without the existence of a nonmaterial mind) is by changes in the brain. In other words, this is not a discovery, but an assumption that most psychologists make nowadays. So what is the point of announcing that IACD agrees with the mainstream that memory results from changes in the brain? To use Benjamin Spock’s statement about alcohol rubs as an analogy, this statement “smells important”. In addition, it enables the author of these IACD remarks to continue and state without evidence that early adverse experiences cause the brain to be organized in a maladaptive way, and then to make a second logical leap and claim that the result of this organization is denial of painful feelings and avoidance of affection and nurturing interactions. This, of course, makes poor parent-child relationships all about poor brain organization, and not at all about parenting skills or parental empathy.
The view just described can also be used by IACD to state without evidence that attachment disorder “delays brain growth. … the kids in our program are ‘stuck’ developmentally and neurologically” (www.instituteforattachment.ong/explore-our-services/family-treatment-program/). Confusion and circularity reign here. If brain events cause attachment disorder, how can attachment disorder alter brain events? (Of course, this does not matter if the neuroscience references are simply for persuasive purposes.) However, the statement about being “stuck” is the important one, common as it is in attachment therapy circles. It suggests that both physical and mental development cease and remain in a holding pattern as a result of early adverse experiences. This is not the case. Where a problem exists, developmental change can be distorted, whether because there is no solution to a problem or because a “work-around” draws from usually-unrelated structures or functions, but development does not stop.
Imagine, for example, physical damage to the brain that might result from an injury or from surgical treatment for cancer. If this occurs in the first months of life, other brain areas may be recruited to perform the function that would otherwise be lost. If it occurs during the preschool years, the child can be helped to find ways to compensate for the loss and come close to normal functioning. In neither case does the traumatized individual remain at the level of functioning present at the time of the injury, but development continues and turns toward the typical trajectory.
Is someone saying that emotional traumas are different? Sorry, you can’t do that if you’re going to define emotional problems as “brain disorders”. What then is the point of talking about this at all? Very simple-- it lays the IACD groundwork for the idea that treatment involves re-enacting the “attachment cycles” posited by attachment therapy, through a ritual dramatization of baby experiences, and thus, of course, rebuilding that brain. It also justifies another service offered by IACD, neurofeedback, which is claimed to alter frequencies of brain waves and “therefore” to improve daily life. Interestingly, the claims about neurofeedback, which actually does involve some aspects of brain functioning, are much less elaborate and vivid than other assertions about brain events on the IACD site-- but they do include an article by the egregious Sebern Fisher, well-known neuropseudoscientist.
Is all this fraudulent advertising as well as a blow against critical thinking? It’s hard to say, because there are so few specifics given, except for the neurofeedback bit. It is not, however, the transparent reporting so much advised by all mental health and public health groups. And the “neuroseductive” aspects are more than plain.