Mental Health and the Brain: Working Group, Feb 16

Mental Health and the Brain Working Group:

Thoughts welcomed in the on-line forum below.

Summary

The first meeting began with introductions and brief discussions of participants’ interests. Present were post-bacs, an undergraduate chem/bio major, alum working with the TBI population, professors in biology, a counselor, a former psychologist/now teacher, adolsecent counselor, and a social worker involved in mental health policy. Interests expressed included: the application of brain research to mental health, mental health parity and policy, improving/re-defining the relationship between “patient” and “clinician”, group therapies, consciousness & the self, how different therapy approaches can best be combined to suit individual needs, and the education of mental health practitioners.

Research on the brain

Many mental health “consumers” are quite capable of understanding and indeed eager to learn about research on the brain. Knowing something about themselves in biological terms can be comforting and help a person create a sense of self or “story” about themselves, as well as reduce the stigma of “mental illness”. Also, it may be helpful to teach kids something about the brain and how it works to help them learn about themselves and about others.

The use of the term “brain”, though, can lead many people to think only in terms of internal/inherent characteristics and to ignore the influence of one’s environment, history, and culture. Mental health consumers should not be asked, “What’s wrong with you?” but instead be asked to consider, “What’s happened to you?” An effort should be made to expand the understanding of “the brain” not as a seat for internal, unchanging aspects of a person, but as something always changing and being influenced from both within and by the environment/culture.

Researchers and anyone interested in mental health and the brain may do well to make fewer assumptions about what one is looking for in the brain, and instead allow inquiry to be guided by observations of the brain. Brain research has been guided by schemas set up based on external observations, which while important, leaves out a person’s internal experience. For example, autistics have been described as being somehow socially impaired. However, this may not actually reflect what is going on “in the inside”. Brain research has shown autistics to have problems integrating sensory information, which may only become apparent in social situations and as such be misattributed to some deficit in social learning abilities.

Categories and “from the inside”

The categories and labels used in the psychiatric community (schizophrenia, bulimia, borderline personality, etc.) seem to become less distinct when one compares the internal experiences in these phenomena. Attention should be paid to the experience “from the inside” because it provides valuable information not evident from observations made from those “on the outside” (doctors, psychologists, family, peers, etc.) which has in the past been largely ignored. A fundamental commonality among mental health disorders may be a conflict between one’s intrapersonal understanding—sense of self or story of oneself—and interpersonal understandings—cultural understandings or group stories. One participant suggested that a good pedagogical approach to preparing mental health workers might be a course which reads solely memoirs, emphasizing internal experiences. Understanding internal experiences is valuable and evident by the fact that “peer specialists” (those who’ve dealt with mental illness) are proving to be a common and helpful source of support for those experiencing mental health issues.

Practical issues

How to get more information not only to consumers and clinicians but also to politicians, those influential in policy decisions?

Books referenced during the discussion

Look Me in the Eye: My Life with Asperger's by John Elder Robison
Running With Scissors: A Memoir by Augusten Burroughs
The Center Cannot Hold: My Journey Through Madness by Elyn Saks
Get Me Out of Here: My Recovery from Borderline Personality Disorder by Rachel Reiland
My Lobotomy by Howard Dully and Charles Fleming