It has been dubbed the “bible” of psychiatry, and indeed the Diagnostic and Statistical Manual of Mental Disorders (DSM) is taken by many as exactly that. Every new version of this publication, prepared by the American Psychiatric Association, is considered to contain the latest and more advanced criteria for the classification and diagnosis of mental disorders. Acceptance has not been unanimous, though. For many of its critics, the DSM has been too unreliable, far too prescriptive and yet quite vague, very much geared towards the compartmentalization of human behaviour, very much conforming to the wishes of the big Pharmaceutical companies –in short: very problematic. The news, then, that after more than sixty years of near hegemony –at least in the U.S.– the DSM is pushed aside by the US National Institute of Mental Health (NIMH), cannot but be welcome. A research framework is being introduced for collecting data for a new understanding of mental disorders, a "new nosology", away from DSM. Is there, at last, room for optimism? Are we finally about to enter an era of scientific psychiatry which will (hopefully) settle all disagreements and clear out all ambiguities for good?
 It has been some time since I last posted something to this blog, but I guess you know how it is. Time --or rather, lack thereof-- has taken the upper hand recently. I hope I will be able to post something soon, but in the meantime, this is just a short note about two lectures I will be giving in October and November, as part of Autumn 2012 Public Lectures Programme of CFAR.
_I was reading something on the BBC today, regarding the “decoding” by science of people’s “internal voices”. The article was about a new technique, whereby researchers are said to be able to reconstruct words, based on the brain waves of patients thinking of those words. I was reminded of an anecdote about Lacan, one of the most important post-Freudian psychoanalysts. In 1975, during a lecture tour in the United States, Jacques Lacan spoke at MIT before an audience of mathematicians, linguists, and philosophers. Noam Chomsky, the already famous by then American linguist philosopher and activist, attending the lecture, asked Lacan a question on thought. Lacan's reply was possibly not what Chomsky expected: “We think we think with our brains”, Lacan said. “Personally, I think with my feet. That's the only way I really come into contact with anything, solid. I do occasionally think with my forehead, when I bang into something. But I've seen enough electroencephalograms to know there's not the slightest trace of a thought in the brain.”
Last week I wrote about a scientific paper that claimed that “most published research findings are false”. I identified the three slightly different conceptions of truth that the abstract of that paper was alluding to, and suggested, as a work hypothesis, that we differentiate between “real truth” and “scientific truth”. I ended that post rather abruptly and at a somewhat provocative point. I claimed that science does not have anything to do with reality. I acknowledged, however, that this would need to be clarified. This is what I shall attempt to do today: to clarify. So science “does not have anything to do with reality”. How did we get to this conclusion? What does it mean?
The other day I came across a very intriguing research paper, bearing a very provocative title: “ Why Most Published Research Findings are False”. Published in 2005, this paper was written by John P.A. Ioannidis, a medical professor specializing in epidemiology. His claim is simple (I quote from the abstract of the paper): The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Now, as you might imagine, a scientific paper with such a subject matter would be sure to attract a lot of attention, both positive and negative, and that was indeed the case. But I do not intend to participate in the debate, and this is not the reason I am bringing up this paper here. I am more interested in the concept of truth, especially in the way it is employed in papers such as Ioannidis’, i.e. in current scientific research.
In my previous post I commented upon two experiments that attempted to address the question of free will from the point of view of modern neuroscience. I ended my post by suggesting a thought experiment to the reader. If a scientist informed you that he or she knows with scientific certainty the numbers you are going to play in the lottery, what would you do? My guess was that very possibly you would avoid playing those numbers, if for no other reason, just to prove this arrogant scientist wrong! The point of this thought experiment was to show that, at the level that our actual decisions are being taken, we are the sole masters in the house, and, crucially, that discussions about our “free will” and about all what science can, or cannot, claim in regards to it are a bit confused.
In a famous experiment of the 80s, neuroscientists claimed that they managed to show that what we, humans, call “free will” simply does not exist. The setting of their experiment was rather simple. A number of volunteers were wired with electrodes and their brain activity was monitored. Then they were asked to choose whether they would flex their fingers or their wrists. They were instructed to first report when they had made their choice and then actually flex their fingers or their wrists.
The neuroscientists running the experiment identified a consistent pattern in the recorded brain activity. Signals were appearing a split second before the volunteers were able to report that they had made their choice. A split second is not much, you would think, but when a scientist is able to show that a result in an experiment cannot be attributed to chance, then this scientist might want to interpret it.
This those scientists did. They explained this pattern of brain activity, observed just before an actual choice was made, as evidence that “unconscious neural processes” determined the volunteers’ actions before they were ever aware of making a decision. They gave it the name “readiness potential”.
I was reflecting, leaving the cinema the other day, on the very clear similarity between the film I had just watched, “Source Code” (2011), by Duncan Jones, and “Groundhog Day” (1993), by Harold Ramis. In the latter, Bill Murray’s character, a stroppy and cynical weatherman finds himself “trapped” inside this Groundhog Day, as it is called, by finding himself forced to relive every single moment of it, from morning till night.
In “Source Code”, Jake Gyllenhaal’s character, an American helicopter pilot, finds himself on a commuter train, “trapped” inside someone else’s body, during the same 8 minutes before the explosion of a bomb that will kill him and everyone else in the train. And then he lives these minutes again, and again, because, it turns out, he is on a mission.
It has been a long time since I last wrote about the plans to regulate "talking therapies" through the HPC. The new Government had indicated from the beginning that they were sceptical about those plans, and had made it clear that the issue was not very high up in their agenda of priorities.
Now, finally, we have got some very good news. The Government has decided to abandon any plans to further extend statutory regulation to any further professions --and this includes psychotherapy, psychoanalysis and so on.
When I decided to begin this blog, I was very optimistic. I envisaged one or two posts every week or so, or, at least one post every month. I thought that this was feasible, as well as useful.
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