Thought provoking piece from American psychiatrist Allen Frances, on Aeon:
“‘There is always a well-known solution to every human problem – neat, plausible, and wrong.’
From Prejudices (1920) by H L Mencken
There has never been a problem facing mankind more complex than understanding our own human nature. And no shortage of neat, plausible and wrong answers purporting to plumb its depths…
The best we can do is embrace an ecumenical four-dimensional model that includes all possible contributors to human functioning: the biological, the psychological, the social, and the spiritual. Reducing people to just one element – their brain functioning, or their psychological tendencies, or their social context, or their struggle for meaning – results in a flat, distorted image that leaves out more than it can capture.
Until 30 years ago, the NIMH [National Institute of Mental Health, US Federal body established in 1949] appreciated the need for this well-rounded approach, and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.
But in 1990, the NIMH suddenly and radically switched course, embarking on what it tellingly named the ‘Decade of the Brain’. Ever since, the NIMH has increasingly narrowed its focus almost exclusively to brain biology – leaving out everything else that makes us human, both in sickness and in health. Having largely lost interest in the plight of real people, the NIMH could now more accurately be renamed the ‘National Institute of Brain Research’.
This misplaced reductionism arose from the availability of spectacular research tools (eg, the Human Genome Project, functional magnetic resonance imaging, molecular biology and machine learning) combined with the naive belief that brain biology could eventually explain all aspects of mental functioning. The results have been a grand intellectual adventure, but a colossal clinical flop“
Quite a powerful read, pulling no punches, but also clearly declaring which camp the author is in – there’s a clear pro-psychotherapy agenda here, but it isn’t a hidden agenda.
Some of the author’s points, particularly “the naive belief that brain biology could eventually explain all aspects of mental functioning” stand out as potentially relating to other domains in health, particularly pain. A good reminder to remain ever vigilant for ‘cool’ trends in research that are reductionist, neat, and plausible…. but wrong.
– Tim Cocks
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