Category Archives: Mind

How Science Tries to Understand Mental Processes

By Dr David Laing Dawson

When science tries to understand human behaviour it can develop methodologies to look at multiple levels of our organization. These levels could range from subatomic particles to the behaviour of tribes, nations, the population of the entire world.

Within the medical sciences we are interested in the behaviour of cells, of neurochemistry, and, at the other end of this chain, the experiences and behaviour of individual humans.

Behaviour can be observed, and observed within different contexts, and under specified situations. Internal experiences require self reporting within a social context, and self reporting is notoriously unreliable. (Imagine asking Donald Trump what he is thinking and feeling, and why he is having these thoughts and feelings, and whether he has written many books.)

Until quite recently the behaviour of brain cells, of neurochemistry, could only be studied by measuring the rise and fall of various metabolites in blood and urine.

And between these extremes (human behaviour and the rise and fall of metabolites in blood and urine) there existed an enormous black box containing the interaction of chemistry, cells, neurons, organs within the brain, systems of arousal and perception, systems of neural organization, complex biochemical and electrical feedback systems….

With EEGs, CT Scans, MRI’s, Pet scans, molecular biology, genome mapping, our new ability to at least see which parts of the brain are active (metabolizing, using glucose and oxygen) and which are dormant when we talk, listen to music and/or hallucinate, that Black Box has shrunk. But it is still there.

Behaviour is a visible product of a long complex chain of events from cell activity, neurohormone production, arousal and filtering systems, inhibiting and stimulating feedback loops.

Ritalin is a stimulant. Yet when given to a boy with ADHD it usually slows him down. So my best guess here is that with ADHD our stimulant is stimulating an inhibitory mechanism.

Like many medications, the power of Chlorpromazine (Largactil) to quell psychosis was discovered by accident. This time in France. Heinz Lehmann brought it to Canada to use in a trial at The Douglas Hospital. It worked dramatically, but why and how it worked is another question. Following the methodologies mentioned above it was first determined that chlorpromazine and drugs developed within the same family affected the neurochemical, neurotransmitter, dopamine. From this arose the dopamine hypothesis of schizophrenia.

But we have since learned that each mental illness is the product of long, complicated pathways from neuron to dendrite to neuron to behaviour (sometimes through long chains and multiple pathways), and that different medications can affect the final behavioural outcome by affecting different parts of that chain, sometimes by stimulating production of a neurohormone, sometimes by emulating a neurohormone, sometimes by inhibiting a neurohormone, sometimes by blocking the transmission of a neurohormone, and sometimes by inhibiting the degradation of a neurohormone (hence the SSRI’s – Selective Serotonin Reuptake Inhibitors)

With the modern technologies we can describe with accuracy what exactly each drug does at a neuronal, biochemical level. But there remains a black box between that level and the actual observed behaviour. Though it is getting smaller and smaller and easily bridged with hypotheses.

But psychosis is not simply too much dopamine, nor depression inadequate serotonin. Although medically altering those two neurochemicals (neurotransmitters) does affect (usually) the chain of electrical/molecular events that leads to psychosis and depression.

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Skeptical Musings on Mindfulness

By Marvin Ross with an Addendum by Dr David Laing Dawson

I am pleased to say that I now have something in common with an apologist for Catholicism when it comes to Mindfulness. Susan Brinkman warns Catholics about the dangers of this practice in her book A Catholic Guide to Mindfulness. We have some criticisms in common although part of her objection to this overly touted strategy is that it is too closely linked to Bhuddism. She is concerned that people will abandon prayer and move away from talking to God for the relaxation of the mindful strategies.

Where we do agree is that Mindfulness is oversold and not well researched with valid studies. As we all have likely seen, mindfulness is promoted for stress reduction, depression, anxiety, pain control and likely more. Ms Brinkman cites a metaanalysis from Johns Hopkins University from 2014 that looked at 18,000 studies and found that only 47 (or .0026%) were methodologically sound. Over 99% of the studies to evaluate efficacy were not sound.

Of those 47 studies, “the research found only ‘moderate evidence’ of decreased anxiety, depression and pain and ‘low evidence’ of improved mental health-related quality of life.” She also points out that there is a great deal of money to be made by practitioners.

The poor methodological quality of mindfulness studies mentioned by Ms Brinkman have not gone unnoticed in the field. This past October, a new study was published that set out to evaluate studies over the past 16 years for signs of improved methodological rigour. They found that of the 142 research projects they looked at, there was only a slight improvement in methodology and the studies still appeared to lack scientific validity.

In reporting on this latest study, psychologist James Coyne asks this:

Should we still take claims about mental health benefits of mindfulness with a grain of salt?

His answer:

“A systematic review by one of mindfulness training’s key promoters suggests maybe so.”

Addendum from Dr Dawson sent from Australia

Two popular contemporary forms of counselling can each be summed up in a simple piece of advice, and a piece of advice most of us have heard at least once from our parents and grandparents. “Look on the bright side.” (CBT) and “Stop and smell the roses.” (Mindfulness).

They do not speak to mental illness, suffering, disease, or much of reality. But they do address the existential problem of we humans being conscious life forms with an awareness of ourselves as vulnerable bags of mostly water with limited life spans.

We must anticipate danger and threat to survive, but failing a math test is not a terminal diagnosis. We must, as I must now, remember to look first to my right (Australia) before crossing the road. This is a moment when it is not wise to let the roses distract.

We know it is not good to be pessimistic and constantly worried, but there are moments when anxiety and worry are required. We know it is not good to miss the calm, the peace, the beauty of this world and always be distracted by the traffic but I still need to remember to look to my right and then my left before crossing the street.

The popularity of Mindfulness (and Buddhism for that matter) speaks to how hard it is to find that balance, how hard it is to be a sentient being not always terrified, worried, fearful, angry, jealous and preoccupied by the intricacies of life and the certainty of death.

Yesterday at The Rocks in Sydney among the tourists and locals we several times watched a man trudge by dressed in brown monk’s robes, a large hat and boots, wondering what he was up to. Then in a moment when I was distracted he approached my wife and slipped a cheap beaded bracelet on her wrist, and then another on the wrist of our granddaughter, and then said something about money and showed her a book of initials beside a list of sums. The figures were each between 20 and 50 dollars. I muttered “no, no, no” as my wife reached for her purse and came up with five dollars. I told him it was bad karma to con people. I’m not sure if he said, “f***k off” or “father” as he left us. He also gave her a gold (thin plastic) medallion with the words “Work Smoothly” and “Lifetime Peace” printed on it.

We had at least five dollar’s worth of laughter and chatter from this, before falling back to enjoying the warm sun, the pigeons and Rainbow Larakeets, the parade of old and young humans from several continents, the busker at the corner, and the delightful teasing inquisitive grandchild sitting between us. My daughter arrived 20 minutes late having been stuck in Sydney traffic and forced to park four blocks away in an expensive arcade. This put her in a foul mood, which was quickly alleviated by a bit of paternal mindfulness and CBT.

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.