Friday, January 20, 2006

The Mind-Body Problem

What are the most common - and most damaging - myths about mental illness out there? Every semester I collect 'reflection papers' from the 300 undergrads in my courses, so I've developed a pretty good inventory of these myths over the years. You'd probably guess many of them . . . things like:

"Depressed people could just 'snap out of it' if they really wanted to";

"Schizophrenic patients have multiple personalities";

"If you have an eating disorder, you were probably sexually abused".

There are dozens more that come quickly to mind. Maybe I'll do a whole post on it some day. But if I had to nominate the one myth that's the most widespread and damaging in its influence, I think I might pick the "myth of mind-body dualism".

This is the idea that the mind and the body (brain) are completely different entities, made of completely different 'stuff'. It's an idea with an impressive pedigree (luminaries like Plato and Descartes), but that's not why most people believe it. No, it's believed because dualism just seems so obviously true. After all, it feels for all the world like there's a completely non-physical self inside - thinking and feeling and acting on its own, regardless of what the rest of the body is up to.

Anthropologists tell us that remote people groups all over the world are mind-body dualists. They've yet to encounter a clan, band, or tribe that's not. Likewise, researchers have found that children are natural born dualists - making claims about non-physical minds as early as age 4-5.

But science, of course, is about discovering things that aren't obvious. Sometimes it means discovering that our most obvious intuitions are dead wrong:

It feels for all the world like the sun revolves around the earth, and for thousands of years everyone just assumed it did. It seems perfectly obvious that light can't be both a wave and a stream of particles at the same time, but it is. It seems obvious that living things have to be animated by some essence of life (elan vital) that's fundamentally different from non-living chemicals, but we know now that it's not.

Likewise, we know from neuroscience that the mind is what the brain does. In fact, the mind and the brain are flip sides of the same underlying reality.

This means anything that changes your brain also changes your mind. But perhaps more importantly - it means anything that changes your mind also changes your brain.

If, as a psychologist, I can help change a patient's thoughts, I've also (by definition) helped change his brain. Changing behavior changes the brain. Changing feelings changes the brain.

In a nutshell: experience changes the brain.

Why is this important? Because when it comes to mental illness, so many people automatically assume, "Oh, well the doctor said I probably have a 'chemical imbalance' or something wrong with my brain, so that means I have to take drugs to fix it." But if we understand that experience changes the brain - that the mind and brain are flip sides of the same underlying reality - we won't make this logical error.

In most cases, so-called 'chemical imbalance' may be just as readily cured by a healing experience as by a healing chemical.

15 comments:

Jon said...

I really liked this post because it illustrates the importance of psychotherapy in the treatment process and it also explains (very eloquently I might add) why drugs are not the answer. Sometimes they may be helpful, but as you say, experience can often be just as important.

Dr. Deborah Serani said...

What a great post. The greatest thing we can offer our students, patients and the public at large is to help dissolve stigma.

~Deb

Psych Pundit said...

Jon,

Yes, it's still remarkable to me how many otherwise educated people fail to realize that experience changes the brain and thus, so-called 'chemical imbalance' does not imply the need for drugs.


Deb -

Great to hear from you (as always)! When it comes to dissolving stigma, I'm a big believer in the maxim: with understanding comes compassion.

kimberly said...

I want to thank you for this article. I think I have been rejecting mind-body duality for most of my life. If you don't mind a long-winded comment, I'd like to share my experiences.

During college, I began struggling with depression. My therapist thought I should take drugs, but I resisted. They told me the diabetes:insulin / depression:Prozac analogy, but still resisted, asking them, isn't there something I can do to get over depression other than taking drugs. They didn't understand what I was asking or why I would ask it.

In graduate school, my new therapist gave me one of David Burns' books to read. I devoured it, thrilled that there was something I could do. I told her that was exactly what I was looking for.

Over the past 10 years I have still struggled with depression, but I have used a combination of cognitive-behavioral approaches, talk therapy, exercise, diet, and relaxation to overcome it. Every time I have managed to rise out of depression.

I have found that over time my depressions aren't as deep and that each time I rise back up I am a little happier, a little more stable, a little less prone to depression.

In October, I suffered my second miscarriage in two pregnancies. I was really scared that I would not be able to overcome my grief and depression this time.

I own my own business, so I arranged with my partner to take two months off. I stayed at home, talked to very few people (husband and mother) and cried. I had no energy and no desire. I was deeply depressed again.

At my post-op appointment, the Dr recommended Celexa. I met with my therapist and we decided that I would take a week to reimplement my healthy strategies and then evaluate whetehr I needed the drug.

I began walking on the treadmill daily, eating better, and watching Starting Over (a reality program about women trying to improve their lives). At my next therapy appt we decided that the improvement over the past week indicated that I didn't need drugs.

Over the two months I started journalling again and exploring meditation and conscious living. I kept adding new habits and ending old patterns of behavior that were not working for me.

Right now, three months after my miscarriage, I am happier than I have ever been in my life. I attribute it directly to the choices I made immediately following my miscarriage and to the skills I have developed over the course of my life.

If I had just taken Prozac back in college I am not sure that I would have experienced as much personal growth.

Dr. Deborah Serani said...

BTW, just checked out your TLC program at KU. It's great!

Psych Pundit said...

Kimberly -

Thanks for your insightful comments. You've worked very hard to overcome your depression, and I'm glad to hear that it now seems to be a thing of the past. I also agree with you that simply taking a pill like Prozac - without making any of the important life changes you've talked about - would involve much less growth; the research also suggests that the 'Prozac only' approach renders a person more vulnerable to future depression relapse. Best wishes!

Deb -

Thanks. We've been getting some great treatment results with this program. I'll write a post about it in a month or two . . .

Anonymous said...

Kind of reminds me of the body/soul dichotomy you find in Western theology.

Greek philosophy (which influenced a lot of pop Christianity) was that the body and soul were two separate things, with the soul trapped in the physical body.

Ancient Jews (who wrote the Bible in the first place) were more holistic; the body and soul were both part of YOU, and you were incomplete without both.

This is the reason the Jewish and Christian afterlife is physical resurrection in a perfected future, not a soul in a spirit-world paradise.

Bill Smith said...

This is a great contribution. Posts like these--debunking persistent myths--are a wonderful resource and an example of what we can do with the internet.

Here's another myth that is extremely persistent but simply does not square with what we know about science--perhaps you can debunk it. I believe that it is cross-culturally true that people believe that the heart is somehow associated with love. Those who have studied biology realize that the heart is really just an exquisite blood pump.

Why does everyone "naturally" think otherwise? What is it about feelings of love or sadness that make it feel like our heart muscle is so centrally involved?

Sarah Malik said...

Thank you for this post. These ideas and words are so needed in the world. Yell them far and wide. Also - haven't we discovered that what we refer to as the brain is not just in the cranium but also in the heart and the intestines?

Psych Pundit said...

Bill -

You've raised an interesting question: why have so many unrelated people groups all over the world identified the heart (not brain) as the seat of consciousness? I'm not aware of any systematic research in this area (maybe there's a reader out there who is), but here's an educated guess . . . We can HEAR our hearts beating, and can observe the heart as the most obviously 'vital' organ of the body. So, perhaps it's an easy intuitive step to identify the heart as the part of us that's most alive - hence, most conscious. In addition, when we feel very strong emotion, most of us get some sort of interoceptive feedback from the gut/midriff (that visceral sense of emotion) that could pretty easily be mistaken as emanating from the heart.


Sarah -

The brain is unequivocally the hub of the central nervous system and the seat of consciousness. The gut, as you suggest, also has its own primitive, vestigial nervous system (the 'enteric nervous system'), but it doesn't have the requisite information processing capacity to qualify as a 'brain', per se. Finally, the heart has extensive innervation that regulates cardiac function, but again cannot be considered truly brain-like.

Anonymous said...

What is one myth that people have about mental illness? That patients have normal blood test results. But not all psychiatric patients do, a good indication that many psychiatric patients are physically ill. So, if a psychiatric patient goes to a doctor, the doctor ignores the patient's abnormal blood test results, and the patient gets worse, who's fault is that?

Patricia Wilcox, LCSW said...

I am working in a child welfare agency that provides trauma treatment for children. I recently posted a blog entry about the body effects of trauma that we see in our kids, and how it should guide our response to their acting out. My blog is at:
http://traumatreatment.blogspot.com/
Look forwarding to reading more from you.

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