Stigma, The Brain And Brain Illnesses

By Dr David Laing Dawson

Every day the news contains at least one item describing our struggle to understand a difficult or troublesome or tragic human behaviour. As I write this there is an ongoing trial of a man accused of killing, dismembering, and then burning a Calgary man and woman and their grandson who happened to be on a sleep over with his grandparents. It is reported that the accused held a grudge against this grandfather because of a failed business arrangement years ago. The grudge “grew in his mind” until….

Then I read of a woman who committed suicide two months after the birth of a child. The grieving husband wants to shed light on post-partum depression but the emphasis in the article was about trying to alleviate the shame some women feel because they cannot breast feed.

This is the article that stuck in my mind because it emphasized the problem of stigma, the need for awareness, and the “let’s talk about it” approach to “mental health”. All well and good. But it continued the trend of trying to understand these tragic behaviours as the consequence of some kind of rational, all-be-it extreme, thought processes.

I understand this. When confronted by any odd human behaviour we try to “understand” it by applying two mechanisms: a logical sequence of cause and effect and empathy (how would I behave in similar circumstances?).

We live our lives believing in the supremacy of mind; we organize socially and act independently within an assumption of “mind”, of “free will”, of “choice” and consequences and personal responsibility. We are very reluctant to accept the fact that the brain can hijack this process, that the brain is the primary organ dictating human behaviour, that the brain, this biological computer system of cells and neurohomones and fragile connections, can go wrong. This reluctance has extreme advocates such as Bonnie Burstow who thinks…. or who’s brain leads her to think…

Actually I have no idea what she really thinks and why she thinks  it.

But phrases like “mental health issues”, euphemisms for mental illness, and much anti-stigma publicity continue to support the primacy of mind and downplay the role of brain. They continue to support the notion that all troubles, with a little support, acceptance and understanding, can get better, be overcome.

This does a tremendous disservice to those who suffer from true, serious mental illness.

From her culture, her family, and perhaps from all the current pop cultural emphasis on breast feeding, the new mother in question probably felt some degree of disappointment that she could not breast feed. But this was not an experience that propelled her, through a logical sequence of thought processes, to suicide.

No. Serious postpartum depression, and postpartum psychosis is as clearly as any serious mental illness, a brain problem. The brain has hijacked the thinking process. It is no longer rational. This is a brain illness.

Prevention of the tragic consequences of this illness requires knowing which women who have given birth are at risk, screening for and identifying this illness, recognizing it as a brain illness, and treating it vigorously as one would treat any serious and life-threatening illness.

Sure, let’s talk about it and de-stigmatize it, but we also need to recognize that it is an illness, a brain illness, and offer, make available, medical/psychiatric treatment, and occasionally protect by holding the sufferer in a safe environment while waiting for treatment to take effect.

And, contrary to what Bonnie Burstow and the anti-psychiatry people say, we now have effective treatment for depression and psychosis.

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One thought on “Stigma, The Brain And Brain Illnesses

  1. Yes it is time to talk about the folly of putting an over emphasis on stigma as causal. You have taken me back about 52 years when i worked in a well known Psychiatric Hospital Fulbourne. This hospital was trying the open ward policy in a big way. And there were some mis-steps. One of those mistakes was with a very beautiful young woman who had just given birth and who had a lovely little three or so year old. son The mother had had a very acute psychosis at the time of the boys birth . But with good care she had regained her stability and would come for appointments regularly pushing her delightful curly haired boy . He looked like the p Pear’s soap advertisement .
    The birth of the second child was seen as a risk for another episode and as a precaution the general hospital despatched her to Fulbourne shortly after the birth. And then there was nearly a tragedy. She was admitted into a single room and the nurse in charge insisted that the baby be with the mother. BONDING ! I was qualified and well trained and said that this was really unwise, but she had seniority over me and the baby and crib were put in with the mother. Later three of us were in the room doing something. The mother who was very agitated and to any trained eye was actively psychotic suddenly grabbed the baby and threw it forcefully across the room. The junior nurse caught it . This in my view happened because the senior nurse was trying to normalize an unfortunate brain disease.

    This was not a mental health issue . It was a serious brain disease. I imagine the mother eventually stabilized, but the in the then ‘here and now’ the baby and the mother needed real protection. Bonnie Burstow wrote in the Globe years ago. She believed in the Szasz and Laing rubbish. Normalizing serious mental illness serves nobody well.

    Liked by 1 person

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