From the perspective of a patient who has wrestled with difficult psychological symptoms since the age of 7 (my initial breakdown) I knew early on that no scientist understands the brain, the most complex organ in the body, except on a most rudimentary level.
As a coping technique, I have learned to distinguish delicately between the aspects of my psyche that I can reliably influence and symptoms that ambush me and may take weeks of engagement to subside. Thus, for me the concept of a broken brain has freed me from unrealistic responsibility for the things that have proved quite resistance to my personal intervention.
Consequently, I can be happy about the things between my ears that work well and cope peacefully with those that don't. To sum up, the broken brain metaphor has been invaluable to me.
As usual, your treatment of these issues so well-considered and nuanced that it immediately leads me to worry that the real challenge is how the average person, who doesn't specifically subscribe to your blog or follow philosophical psychiatry, will ever be in a position to parse these conceptual distinctions and fine details without a hell of a lot of cues and extra guidance. In that sense, even if you're technically correct, I'm sympathetic to someone like Kendler who cuts right to the obvious problem of brain metaphors being easily misunderstood and overapplied. To be clear, I'm not objecting to anything you wrote; I want posts like this! Just unsure of how such rich understanding makes its way into public consciousness without getting hopelessly watered down into one generalized approach to language vs. another.
If anything though, I'm much less worried about brain metaphors in psychiatry, than in *psychology* at large. At least psychiatrists have been visibly wrestling with this issue for decades; in psychology you'll see tons of sweeping claims, and the way neuroscience is colonizing much of the field bothers me.
In the critical/theoretical circles where I've spent some time, one popular critique of brain-speak relies on Wittgenstein and especially, Bennett & Hacker's Philosophical Foundations of Neuroscience as the canonical text where his ideas are brought to bear on the "mereological fallacy." It's a compelling argument, but invariably so sweeping that it starts to feel like too much of a blanket, knock-down rebuttal. I would love to hear more of your thoughts sometime on the Bennett-Hacker position, and how exactly this should apply to psychiatry.
Something really bothers me about Bennett and Hacker's argument, because taken seriously, it basically precludes all the interesting contemporary neuroscience theoretical developments, like predictive processing. At the same time, it's really hard to argue against it in a compelling manner. I've had a long-standing argument with my good friend Richard Gipps on this issue, because, inspired by Bennett and Hacker, he believes saying that the "brain" predicts or calculates or anticipates is basically nonsense, but to me it's quite clear that the brain does indeed do something that resembles prediction, calculation, anticipation, etc. That should be a good topic for a future post!
A post on this would be awesome! No pressure though. I share your ambivalence: it *sounds* like the perfect knock-down argument but sort of precludes everything.
Rom Harre developed an interesting system inspired by Bennett & Hacker, where we carefully distinguish between "Person-grammar" (P-grammar), "Organism-grammar" (O-grammar), and "Molecular-grammar (M-grammar), corresponding to completely different methodologies and purposes. M-grammar and O-grammar would play an especially prominent role in neuroscience and psychiatric research, but still need to eventually be linked up with P-grammar for this to be fully interpretable. He even published a whole textbook on it with Fathali Moghaddam (Psychology for the Third Millennium).
Appreciate this Chris! Yes, it is difficult to communicate all this to patients and the public. Mainly what I try to do in that regard is basically a) emphasize complexity again and again, be wary of simple answers, simple answers likely wrong, b) show humility and acknowledge we are scientifically immature. I think if the public can understand that - mental health problems are complex and we know very little - they can do a much better job handling all the bad metaphors.
Yes - seems to me it's not necessarily the metaphors themselves that cause damage (though some are terrible), so much as the norms around how to interpret them, and how literally to take them. Including, implications for treatment and practical action.
Enjoyed this, particularly learning that Kraepelin was a critic of biological overreach - I sometimes imagine him as the personification of biological psychiatry!
From the perspective of a patient who has wrestled with difficult psychological symptoms since the age of 7 (my initial breakdown) I knew early on that no scientist understands the brain, the most complex organ in the body, except on a most rudimentary level.
As a coping technique, I have learned to distinguish delicately between the aspects of my psyche that I can reliably influence and symptoms that ambush me and may take weeks of engagement to subside. Thus, for me the concept of a broken brain has freed me from unrealistic responsibility for the things that have proved quite resistance to my personal intervention.
Consequently, I can be happy about the things between my ears that work well and cope peacefully with those that don't. To sum up, the broken brain metaphor has been invaluable to me.
As usual, your treatment of these issues so well-considered and nuanced that it immediately leads me to worry that the real challenge is how the average person, who doesn't specifically subscribe to your blog or follow philosophical psychiatry, will ever be in a position to parse these conceptual distinctions and fine details without a hell of a lot of cues and extra guidance. In that sense, even if you're technically correct, I'm sympathetic to someone like Kendler who cuts right to the obvious problem of brain metaphors being easily misunderstood and overapplied. To be clear, I'm not objecting to anything you wrote; I want posts like this! Just unsure of how such rich understanding makes its way into public consciousness without getting hopelessly watered down into one generalized approach to language vs. another.
If anything though, I'm much less worried about brain metaphors in psychiatry, than in *psychology* at large. At least psychiatrists have been visibly wrestling with this issue for decades; in psychology you'll see tons of sweeping claims, and the way neuroscience is colonizing much of the field bothers me.
In the critical/theoretical circles where I've spent some time, one popular critique of brain-speak relies on Wittgenstein and especially, Bennett & Hacker's Philosophical Foundations of Neuroscience as the canonical text where his ideas are brought to bear on the "mereological fallacy." It's a compelling argument, but invariably so sweeping that it starts to feel like too much of a blanket, knock-down rebuttal. I would love to hear more of your thoughts sometime on the Bennett-Hacker position, and how exactly this should apply to psychiatry.
Something really bothers me about Bennett and Hacker's argument, because taken seriously, it basically precludes all the interesting contemporary neuroscience theoretical developments, like predictive processing. At the same time, it's really hard to argue against it in a compelling manner. I've had a long-standing argument with my good friend Richard Gipps on this issue, because, inspired by Bennett and Hacker, he believes saying that the "brain" predicts or calculates or anticipates is basically nonsense, but to me it's quite clear that the brain does indeed do something that resembles prediction, calculation, anticipation, etc. That should be a good topic for a future post!
A post on this would be awesome! No pressure though. I share your ambivalence: it *sounds* like the perfect knock-down argument but sort of precludes everything.
Rom Harre developed an interesting system inspired by Bennett & Hacker, where we carefully distinguish between "Person-grammar" (P-grammar), "Organism-grammar" (O-grammar), and "Molecular-grammar (M-grammar), corresponding to completely different methodologies and purposes. M-grammar and O-grammar would play an especially prominent role in neuroscience and psychiatric research, but still need to eventually be linked up with P-grammar for this to be fully interpretable. He even published a whole textbook on it with Fathali Moghaddam (Psychology for the Third Millennium).
Appreciate this Chris! Yes, it is difficult to communicate all this to patients and the public. Mainly what I try to do in that regard is basically a) emphasize complexity again and again, be wary of simple answers, simple answers likely wrong, b) show humility and acknowledge we are scientifically immature. I think if the public can understand that - mental health problems are complex and we know very little - they can do a much better job handling all the bad metaphors.
Yes - seems to me it's not necessarily the metaphors themselves that cause damage (though some are terrible), so much as the norms around how to interpret them, and how literally to take them. Including, implications for treatment and practical action.
[Edit: I didn't realize you're currently working on a book for general readers - that's great!]
Thank you! Writing a book for general readers is hard!!
Enjoyed this, particularly learning that Kraepelin was a critic of biological overreach - I sometimes imagine him as the personification of biological psychiatry!
Yes! This 2015 article "Emil Kraepelin: Icon and Reality" by Engstrom and Kendler helped me see Kraepelin in an entirely new light: https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2015.15050665
Another excellent Kendler article