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Paul Grobstein's picture

"Brain damage," "mental health," and education

The juxtaposition of the discussions of a kindergartener with cerebral palsy and a number of "brain damaged" adults intrigued me a lot, particularly in light of the distinction we tend to make between people with "brain damage" and people with "mental health" problems.  The kindergartner is being helped to deal with "educational" inadequacies, with the implication that those are distinct from "brain damage" problems, which are in turn distinct from "mental health" problems.

My sense, of course, is that the three contexts are much more similar than the terms and the ways we use them would suggest.  In my terms, all three have to do with troubling behaviors that reflect distinctive organizations of the brain.  And in all three cases, what one wants to do is produce alterations in the brain that will yield less troubling behavior.  

The point here is not only semantic but also practical. We tend to approach people with "brain damage" differently from how we approach people with "mental health" problems.  Even when the troubling behavior is the same, we think of "brain damage" as something we/they have to live with, or, at best, as something  requiring rehabilitative skill training , whereas we think of "mental health" problems as something to be corrected (by medication, therapy, or otherwise).  It would make more sense, it seems to me, to recognize that in both situations the aim is to alter behavior by altering the brain, and that the brain is most readily altered by exploiting its own corrective capabilities.  

The same holds, it seems to me, for the kindergartner with cerebral palsy, or any kindergartner for that matter.  Here too the aim is to alter behavior by altering the brain, and it is best done by exploiting the brain's own corrective capabilities.  

What does that mean in practice?  Here is where I found Grace's story/experiences particularly compelling.  Rather than waiting for the neurologist's report of what a child with brain damage can/can't be expected to do, Grace suspected that certain things were possible and kept trying out different ways of getting them to happen.  That seems to me a good general procedure for dealing not only with "brain damage," but also with "mental health" problems, and with education in general (to say nothing of child rearing and human intercourse generally).

Several points come out of this for me

  • We all have different brains, and so are in an important sense, all "brain damaged".
  • We all infer, sometimes more correctly/sometimes less so, problems in other brains, and should explore/make use of, rather than deny the validity of, such intuitions.
  • Our brains are most useful to modifications of other peoples' brains when we look for ways to encourage those brains to alter themselves in terms meaningful to themseves, rather than insisting on the incorrectness of particular organizations or the need for particular correct organizations.
  • While there are limitations to what any particular brain can achieve, all brains retain the capacity to usefully alter themselves.   

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