Neuroscience: Psychotherapy’s Executioner?

Psychiatry and Psychology CategoryWithin the field of psychology more and more research is based on the functioning of the brain. Even in fields such as social psychology, which traditionally was opposed to looking at the relationship between brain and behavior, is neuroscience growing. More and more psychological disorders are being explained in relation to neurological function or dysfunction. Depression is caused by too few or too many neurotransmitters. Schizophrenia is caused by a “mis-wired” brain. Anxiety is caused by a hyper-reactive sympathetic nervous system (and possibly an abnormal amygdala). We are overweight because of hypothalamic problems and can’t sleep because our reticular activating systems are out of whack.

All psychopathology is now being described in neurological terms. Many believe this implies that all psychopathology is now treatable and curable by medication because all psychopathology has a biological basis. Cartesian dualism is alive and well; in fact, it’s never been stronger.

Does this spell out impending doom for psychotherapy? Can we simply medicate our problems away?

Bust of Rene DescartesLet’s return to philosophy to find out. The increasing emphasis on the brain is leading to a blurring between what is mind and what is body. Perhaps, Descartes’ philosophy isn’t as strong today as we thought. If body and mind are not separate entities then we no longer have a dualism but rather a monism. This implies that psychopathology is, at its core, nothing more than pathological brain function or structure. For example, according to the philosophy that underlies the neuroscience of psychopathology, depression is nothing more than a perhaps smaller cingulated gyrus and basal forebrain with abnormally low production or abnormally high re-uptake of serotonin and norepinephrine. This does not, however, imply that behavioral or cognitive therapies are not necessary and that all psychopathology is ultimately treatable by medication or electrode implants or neurogenesis or whatever the next neuroscience fad is.

Having no distinction between mind and body or brain and behavior (a monism opposed to a dualism) implies that affecting either mind or body affects both because they really are the same. As confusing as that sounds, it’s an important concept. It means that psychotherapy is not threatened with extinction by neuroscience or pharmaceuticals. Treating the mind (behavior) changes the body (brain). Conversely, treating the body (brain) changes the mind (behavior). There is room for both biological and psychological therapies. There are people who seek a purely biological cure and those who eschew biology for psychology. However, the ultimate solution lies in moderation — a balance between the two.

Jared Tanner, PhD

Jared Tanner has a Ph.D. in clinical psychology with an emphasis in neuropsychology. His interests are mainly neuroimaging and neuroanatomy. He spends his research time looking at the structure of gray and white matter in the brains of people with Alzheimer's disease and Parkinson's disease. With a focus on neuropsychology, he is also interested in how normal and abnormal brain structure relates to cognitive and behavioral functioning.
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