Archive for the ‘dichotomies’ Category

More Dichotomy Week stuff: A call to end the notion of a mind-brain split, in an article in Psychiatric News from earlier in August.

Here’s where I’m coming from, out of a graduate program that emphasized the effects of culture on thought, with attention to evolution…Culture does not exist without biology. In the simplest sense, you have to have brains and bodies to create and perceive stimuli. That’s kind of a no-brainer, but it’s easy to underestimate how complex brains and bodies are. It’s usually not obvious how concretely and specifically our brains shape aspects of culture like Google, South Park, internet messenging, and so forth. (Some quick, incomplete, and not necessarily accurate suggestions: Google is a response to a universal human demand that provided information be relevant; South Park involves dominance hierarchies, irreverence, and shock value; and internet messenging is about human communication taking over any available medium.)

Biology can’t exist on its own either, unless you call everything biology. All genes in existence are here because they gave an edge to reproduction and survival over millenia, including in situations involving cultural phenomena like changing in-groups and out-groups, gossip, status, etc. If those environments had been different, we would have different genes. Looking just at the present day, cultural phenomena like knowledge of nutrition, parenting classes, social norms, and many other things, affect how children’s bodies and brains are built as they grow up. As an example, norms about acceptable emotions and how to display them will affect, for example, whether a child displays anger or fear in response to an interpersonal conflict – but they are very unlikely to make that child show joy or relief; cultural norms encourage some available biological states over others, but they don’t determine them so strongly that biology is irrelevant.

At any given moment, a person’s brain and body is the result of everything that has previously happened and everything that is currently happening between and among their genes and their body/brain and their environment. It’s not nature versus nurture, it’s not even nature plus nurture.

But it’s also not just a big tangled un-studyable mess. For example, we can look at some phenomena (like when people display what emotions) and conclude that cultural upbringing teaches children which specific emotion, out of several potential emotions, they should display in an interpersonal conflict with an equal. Or we could look at another phenomenon – like the ability to understand others’ beliefs and desires – and find out that there are very minimal innate tendencies that are heavily enriched by lots and lots and lots of interactions with others.

And this is where it starts to be possible to talk about all the different, specific kinds of ways culture/biology works, and to talk about things like cultural variation in mental illness and evolutionary explanations for mental illness. Which I will do, after some other interludes.

This is post 3 of Dichotomy Week.

This is post 2 of Dichotomy Week. Post 1 was on the psychological concept of a division between biological and situational depression.

Conflating what causes depression with whether behavior is someone’s fault is detrimental to everyone, because confusing science about etiology (and subsequent treatment) with moral judgments about blame confuses the science and confuses public understanding about science, and makes developing appropriate treatment and getting people to use it harder, because in that environment treatments also carry undertones of blame (medication = not to blame, meditation/yoga = to blame somewhat, nebulously-defined “life changes” = it’s your fault and you don’t need medication, rather than seeing all of these as useful, some of them as infeasible for some people at some times, and some of them both feasible and necessary, not necessarily in that order).

It’s very hard to disentangle moral judgments from science in most peoples’ minds, as opposed to working within the framework by trying to reclassify depressed people in terms of whether their depression is biological/real versus situational/to blame. I think the framework is the problem, but I’m not sure there’s a lot we can do about it; finding who deserves blame for their problems is a ubiquitous human thing to do, even when blame does not contribute to solving problems and other things do.

On the other hand, maybe giving people a distinct classification system to channel moral judgments into might help keep those judgments away from etiology. Personally, if we have to have one, I favor a system classifying people into those who are pursuing vs those who are not pursuing effective treatment, as measured by lowered depression, not by whether they’re pursuing a particular kind of treatment. If we’re going to have blame no matter what, we might as well try to channel it into a better, albeit still very imperfect and problematic, path.

It’s Dichotomy Week! Or at least Dichotomy Several Days.

The question (which I’m not going to answer):

Is it chemical depression, or situational depression?

Endogenous depression, or reactive depression?

Biological depression, or situational depression?

Depression, or normal low mood, sadness, or grief?

I hear these terms used by (for the most part) three sets of people. (Begin anecdotal assertions here.) The first consists of patients who are trying to explain that their problems yes, in fact, are serious enough to require medication, and that they do *not* fall in the (presumably lightweight ) situational/reactive depression category. They’re not necessarily questioning the dichotomy itself, just arguing that they’re on the side that shouldn’t be censured for using medication.

Continue reading ‘the two kinds of depression: depression that sucks, and depression that sucks’ »