Literacy in an age of extremes
I note a new bitter nihilism out there souring discourse about mental health. It has two forms:
- Data! Only data! Look at nothing else!
- Nothing important can be truly known through research, so don't show me any.
Dr. Thomas Insel, in his essay "Autism Spring" speaks with authority and reasoned optimism in saying "The answers — and there will be answers — will no doubt merge genetic risk and environmental exposure to help us reach the far side of the complexity of ASD."
I tire of the seemingly opposite but actually co-supporting nihilism of scientific debate over eating disorders. It would seem to be opposite sides of the spectrum to say "Nothing is known without research" and "research can't tell us anything real" but I find both positions lazy and simplistic.
Those who would dismiss everything not already in the AHRQ and those who don't know or care about such documents are in reality conjoined and co-morbid. They both use their positions for fig leaves over a lack of understanding or caring about the big picture. While people take positions that exclude the "other" extreme the discourse just gets dumber and less useful. These are not really positions on the topic: they are plays for power or defenses against small intellect or - most often - excuses for not wanting to do the hard work of integrating data and practice.
It is interesting that 10 years ago there was huge excitement over the potential for genetic research to find solutions for the majority of physical and mental illnesses, yet research has failed to live up to these hopes and expectations - owing to the complexity of the human genome and the way that genes function.ReplyDelete
One question I have, in relation to eating disorders (one of the main subjects of this blog), is that if we were to discover the precise role of genes + environment in the development of eating disorders (EDs), whether that would lead to more effective treatment, or even prevention?
As a scientist I like data. In fact, I love data. I love working with numbers and mathematical modelling. 'Hard', quantitative data are of more interest to me than qualitative data. Yet, I have to admit that in the field of EDs (and also autism), I also believe that qualitative studies are also of great value.
What I do dislike are wibbly-wobbly psychobabble-type theories that are dreamed up from nowhere and are unsupported by no evidence whatsoever.
I don't know anyone, literally not a single person, who takes either of the extreme positions you present, least of all any scientist or researcher. After all, science is a evolving, never-ending quest for understanding that requires open-minded inquiry.ReplyDelete
I do think that better understanding of the genes and environment interaction will aid treatment, yes. First, in clearing away misconceptions - which currently guide most treatment. Second, in showing us where the more and less fruitful paths are.
I do agree with you, Laura, that establishing a clear genetic cause of various mental illnesses clears away unfounded misconceptions.ReplyDelete
However, what might be the more fruitful paths? The most obvious one is pharmaceuticals, which I do NOT hold in high regard. There is a growing number of children and young adults in the UK being (over)-medicated with various forms of drug designed to act on the brain, the majority of which have unpleasant or potentially dangerous side effects, and the effects of long term administration of which are as yet unknown.
If genetic research leads to therapies that don't involve pharmaceuticals, then I am interested. If not, then I am not.
Cathy, pharmaceuticals are only one path and not one that I think of at all when I look forward to the coming data about brain disorders, strange to say.ReplyDelete
I am far more interested and optimistic about discovering how nutrition, activity, prenatal influences, stressful events and such may set patterns in place or trigger dysfunctional patterns.
Then, with that information, I look forward to how we usefully intervene to avoid certain things in certain people, and how we intervene to stop a process early in its development, and how we employ the plasticity of brain function to use experience and learning and skills-training to help a patient build a healthy wall against a particular weakness or predisposition.
In other words: I believe environment will play a greater role in treating brain disorder than it does is causing it!
Now that, I like the sound of Laura... apart from the reference to 'brain disorder'... But you know my feelings on that one already!ReplyDelete
Thanks for the mini-debate :)
Laura, you hit the nail on the head. I too, believe that as we better understand the role of neuroplasticity and how we can influence real change in the brain, much how the stroke victim can develop new pathways to regain function. This is what's really exciting. In the mean time there seem to be many hopeful adjunct treatments to assist the process of recovery.ReplyDelete