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., [2008]. 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’, [2016]. 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.