Monthly Archives: August 2015

Can neuroscience explain the causes of mental illness? Erm, maybe not.

counsellor in exeterResearchers from Monash University have discovered that patients with depression may have different sorts of brains to the rest of the population. Jerome Maller and others looked through thousands of brain scans and found that it was more likely that a patient with depression had occipital lobes which were wrapped around each other. The occipital lobes sit at the rear of the brain and are responsible for processing visual information. It seems that people with depression may have different kinds of brains.

Does this help to explain depression and, if it does, will it help people get better?

In a wide-ranging article for Therapy Today in July, Kenneth J Gergen questions the faith that practitioners have in neuroscience to help explain the causes of mental illness. One of the things he argues is that if we say that a particular brain state is the cause of a given problem, then any work on alleviating that problem should be focused on altering that particular brain state.

He uses the analogy of a faulty engine in a car. “If one’s automobile fails to function properly, engine repair may be required.” It doesn’t seem unreasonable that if you take your car to the garage that the mechanic should look under the bonnet and identify the broken piston and replace it. The fact that you’ve been in ten times that month with the same problem, and that when you drive off you are bumping along the same potholed, poorly surfaced roads has not featured in the mechanic’s diagnosis or remedy.

Gergen would argue that the cause of broken down car is the state of the roads and manner in which it had been driven over them. The piston is a symptom rather than a cause of the distress. Is the funny brain scan the cause of a person’s depression, or a symptom? Is the real cause of distress the society or system in which you find yourself?

How you answer these questions probably influence which side of the neuroscience debate you are on and how you see the nature of mental illness.

Are humans like aeroplanes? The problem with solution focused therapy.

counselling exeterSolution focused brief therapy (SFBT) is an extremely popular type of counselling which helps thousands of people everyday. Its success for clients lies in that, instead of being asked to dwell on the past, or to wallow in their problems, they are directed by the therapist to think about solutions for their difficulties. It has some very clear ways of doing this.

It is ultra-pragmatic and interested in only what works for the client. One of its foundational beliefs is “do what works and do more of it; if it does not work, do something different.”

Criticisms of SFBT are hard to find. Usually, difficulties are couched in the same terms that SFBT uses – does it really work? Is there empirical data for it? Does it ignore problems by focusing on solutions? These are different ways of asking: is SFBT effective?

I agree that it is effective and does help people. My issue with SFBT goes deeper. I would like to look at two simple philosophical problems that SFBT raises which explain why I don’t offer this type of therapy as a practitioner. The problems relate to the assumptions behind SFBT.

The first assumption is that: solving problems is good.
If I were a business person, an airplane pilot or a structural engineer, I would definitely think that solving problems is good. Is there a fire in engine number one? Bridge looks like it’s about the fall over? No profits for the third quarter in a row? These are all well defined problems that are perfect for a solution focused approach because it is clear that airplanes should try to stay in the sky, or land safely; bridges should stay up and business should make profits.

Humans are not like bridges, airplanes or businesses though. The function of all these things is well defined. What is the function of a human being? What should they optimally do? There are plenty of different answers if we look at the last 3000 years of literature, poetry and philosophy. I would doubt that the best and clearest answer to what human beings should do though is: solve problems all the time.

The second assumption is that: solving problems makes life go better.
Some people, who apparently don’t have very many day to day problems (the super rich, royalty) still suffer. See Diana, Princess of Wales for a good example. Many with intractable, unsolvable problems appear pretty happy. Few of us would want early-onset Parkinson’s disease but Michael J Fox has embraced his illness as a gift.

If we go along with the idea that human beings are rather like bridges or airplanes then life probably would go better if we managed our lives like pilots or engineers. I’m not convinced human existence can be simplified like this though

What is Psychobabble?

counsellor exeterAll of us, at some time, may have read something in a self help book, listened to a TV psychologist or laughed off an advertising slogan as “psychobabble”. Ever described yourself as “OCD” because you like a neat fridge? Or said you’re “addicted” to chocolate? You’re probably doing it yourself. But what is psychobabble? And is it always misplaced?

The term psychobabble is actually not that old. It originated in a 1975 book by journalist RD Rosen who noticed language being used to describe psychological ideas was not describing effectively what was going on. He argued that psychobabble was the use of jargon or cliché that “kills off the very spontaneity, candour, and understanding it pretends to promote”.

The term quickly spread to be used as a term of abuse in over-complicated psychological descriptions and also as a general overuse of psychological jargon in ordinary life.

Craig B Hallenstein developed this thread in 1978 by arguing that the overuse of psychological jargon, amongst other things, fostered the development of an elitist class of psychological workers who were privileged in various insights into the human condition.

The overuse of jargon probably does not promote understanding of ourselves and probably does contribute to an unhelpful divide between the people who access psychological help and those who dispense it. My own counselling approach seeks to dissolve, as much as possible, the line between the well and the unwell, since in a sense we all need to find our way and orientate ourselves between the givens of life, as psychotherapist Irvin Yalom talks about – death, meaninglessness and responsibility.

I’m also very interested in the way we do and don’t communicate with each other. Related to psychobabble is “business speak”. We all know and laugh about “blue sky thinking”, even if we don’t really know what it means – and technobabble – which, if something is described as “quantum”, we are probably being technobabbled.

In all these cases, hierarchies are cemented between those that know and those that don’t – and little actual communication is taking place. The use of psychobabble in counselling and psychotherapy does not seem all that different to me – perhaps we just need to be thinking outside the box?