In Better Living Through Chemistry? Part I, I described the history of Psychiatric diagnostic approaches and the problems arising from a dependence on a symptom based diagnostic system versus a system based on an etiological understanding of dysfunction and disease.
In Better Living Through Chemistry: Part II, I described, using patient examples, how the availability of less toxic medications along with the use of subjective symptoms for diagnosis, led to a reconceptualization of unhappiness as a treatable condition, "Depression." In my examples I tired to offer some admittedly superficial guidelines for differentiating unhappiness from the life altering dysfunctional state known as Depression.
In Better Living Through Chemistry: Part III, I discussed the tendency for Psychiatric diagnoses to metastasize such as to increase the fluidity and diminish the boundaries of Psychiatric diagnosis. As more and more conditions become subsumed under the rubric of an "illness" personal responsibility and agency are diminished.
The psychiatric contribution to the diminution of responsibility and agency is receiving powerful support from legal efforts to use novel theories of the mind superficially based on Neuroscience that aim to diminish legal responsibility and agency. [HT: Dr. Helen]
Steven K. Erickson
University of Missouri School of LawMinnesota Journal of Law, Science & Technology, Vol. 11, 2010
Abstract: Criminal law scholarship has recently become absorbed with the ideas of neuroscience in the emerging field of neurolaw. This mixture of cognitive neuroscience and law suggests that long established conceptions of human agency and responsibility are fundamentally at odds with the findings of science. Using sophisticated technology, cognitive neuroscience claims to be upon the threshold of unraveling the mysteries of the mind by elucidating the mechanical nature of the brain. Despite the limitations of that technology, neurolaw supporters eagerly suggest that those revelations entail that an inevitable and radical overhaul of our criminal justice system is soon at hand. What that enthusiasm hides, however, is a deeper ambition among those who desire an end to distributive punishment based on desert in favor of a prediction model heavily influenced by the behavioral sciences. That model rests squarely on the presumption that science should craft crime policy at the expense of the authority of common intuitions of justice. But that exchange has profound implications for how the law views criminal conduct and responsibility - and how it should be sanctioned under the law. Neurolaw promises a more humane and just criminal justice system, yet there is ample reason to believe otherwise.
The current state of Neuroscience is now being misunderstood and misapplied on regular basis. Though I generally enjoy his writing, David Brooks exhibits the common tendency to overvalue the data now accruing to the very immature science of the mind known as Neuroscience:
In 2001, an Internet search of the phrase “social cognitive neuroscience” yielded 53 hits. Now you get more than a million on Google. Young scholars have been drawn to this field from psychology, economics, political science and beyond in the hopes that by looking into the brain they can help settle some old arguments about how people interact.
These people study the way biology, in the form of genes, influences behavior. But they’re also trying to understand the complementary process of how social behavior changes biology. Matthew Lieberman of U.C.L.A. is doing research into what happens in the brain when people are persuaded by an argument.
...
... consciousness is too slow to see what happens inside, but it is possible to change the lenses through which we unconsciously construe the world.
Since I’m not an academic, I’m free to speculate that this work will someday give us new categories, which will replace misleading categories like ‘emotion’ and ‘reason.’ I suspect that the work will take us beyond the obsession with I.Q. and other conscious capacities and give us a firmer understanding of motivation, equilibrium, sensitivity and other unconscious capacities.
The hard sciences are interpenetrating the social sciences. This isn’t dehumanizing. It shines attention on the things poets have traditionally cared about: the power of human attachments. It may even help policy wonks someday see people as they really are.
My back of the envelop computations suggest that current Neuroscience technology needs to improve by at least 6 orders of magnitude before we can begin to reliably describe behavior at the level of the neuron; even then, there is no certainty that we will have fine enough resolution to tease out the contribution of individual neurons or neural networks to any specific behavior(s). To paraphrase Roger Penrose in The Emperor's New Mind, "the mind is not computable." (Many others disagree, of course, but certainly, for now, the statement is accurate.) We may some day be able to simulate a human mind, perhaps we will one day be able to upload minds into hardware, but we are a long way from that day, our first steps remain quite rudimentary, and extrapolating from the present is almost certainly a category error; ie, its not even wrong.
However, the Neuroscience fallacy, that human behavior will one day (soon) be understood in terms of its underlying neurological components, is doing more than fueling a left wing dream of a "radical overhaul of our criminal justice system." It is also being used as evidence for the Nurture hypothesis, ie that genetics is relatively insignificant and that Culture (Nurture) is primary.
The two opposing views of Neuroscience are already being politicized and resolved selectively. Genetic determinism (Nature) is in conflict with cultural determinism (Nurture) and Neuroscience is being used selectively to support both sides of the debate when it is politically expedient. Both arguments, of course, oversimplify an exceptionally complex topic, but such oversimplification serves the purposes of those who muster the arguments to support their politics.
David Shenk, at the Atlantic, is a strong proponent of the Nurture argument. Note his explanation for his interview request of Keith Jarret:
Keith Jarrett, Part II: The Q&A
DS: Thanks so much for taking the time. My idea for these interviews is to talk to extraordinary achievers about the roots of talent and the process of achievement. In the book, I try to defuse longstanding myths of "giftedness" and innate talent. I start with genetics. It turns out that genes, as you may know, interact with everything around them. They're not blueprints with established plans, but more like switches that get turned on and off all the time. So we need to get past the whole idea of nature versus nurture and instead understand nature as constantly intertwined--
KJ: In other words, those people that think I'm a freak of nature and therefore there's no point to trying are wrong, like I've always said. If they're not going to try to do it, they will never find out if it's possible.
DS: Exactly. We can't know our true potential until we put in an extraordinary amount of effort and time. And a lot of other things have to come together. One has to have the right resources, right motivations, and so on.
This is nonsense; again, it is not even wrong. No amount of practice and dedication would have made me the equal of Derek Jeter on the baseball diamond, and no amount of study and schooling would make someone with an IQ of 85 an adequate Medical Doctor. Shenk never recognizes that immediately after posing that the whole idea of nature versus nurture is passee, he dismisses the "nature" part of the argument, as if the "right resources (and) right motivations" do not themselves result from a complex admixture of both innate and acquired properties.
To understand how this is being misused politically, simply compare this with the evolution in our understanding of homosexuality, and especially the politically inspired determination that it is an inherent, genetic predilection rather than a choice. (For purposes of clarity, those are the two poles of the debate; in reality, object choice, in Psychoanalytic terms, is an extremely complex outcome of constitutional and environmental factors. For rare individuals homosexuality may be a choice but for the vast majority, it is just part of who they are.) Consider OneSTDV's explanation of the current status of homosexuality and the question he raises:
Moral Perspectives: Homosexuality vs. Pedophilia
Since the 1960's, homosexuality has become a somewhat mainstream sexual preference. While it still has some social stigma, it's generally accepted as a common aspect of biology and not that of mental illness or social deviancy. Given the ubiquity of homosexuality and several theories regarding the "gay gene", "gay germ", or even the "ghost twin syndrome", there's a reasonable argument that truly homosexual individuals, like RuPaul and Rosie O'Donnell, didn't choose to be that way. As a result, polite society has embraced homosexuality as different from the normal, but still "normal". [This is an important point of the argument, so if it's not clear, please say so in the comments.]
Yet, if such acceptance is afforded to homosexuality, how can the modern view of pedophilia be justified? Maybe this is a contentious idea, but in my opinion, pedophilia is a biologically based abnormality affecting a surprisingly large number of people (who else watched those Dateline marathons?). The non-violent, non-intrusive pedophile has an inherent desire for underage children. Just like homosexuality, this deviates from the normal sexual preference.
If one considers homosexuality, due to its biological basis, acceptable even though it differs from the norm, then why is attraction to (not assault of) underage children considered so morally abhorrent? The two situations are almost identical scenarios, yet the social framing of them differ widely. Either one must accept both as immoral or accept both as biologically based abnormalities with no moral connotation.
Where I disagree with OneSTDV is the notion that homosexuality must be considered in parallel with pedophilia. Homosexual behavior between consenting adults is, to my mind, none of my business even were I to consider it morally wrong, whereas pedophilia, even when committed by a great "artiste", is a morally reprehensible behavior deserving of the gravest punishment. Yet the underlying argument, that homosexuality, pedophilia, in fact, any aspect of character and behavior is biologically determined, is being used legally to diminish personal responsibility.
The Psychiatric profession had given its imprimatur to the biological determinists in its eagerness to expand the boundaries of Psychiatric diagnosis (requiring Psychiatric treatment and medications.) The problem legally and Psychiatrically is that they are trying to address a question better suited to Philosophy than Science, ie the question of free will. What is missing in all the discussions is the quaint, old fashioned notion of "free will" merely dressed up in modern language and disguised by modern technology. Neuroscience cannot determine whether or not human beings have "free will." Neuroscience does offer support for the notion that we often do not know why we do what we do (ie, much of our own mind remains unconscious) but even if the Pedophile has no control over his desires, he still must be held absolutely accountable for his behavior.
For over a hundred years Psychiatry has been involved in a discussion of the limits of legal responsibility. The McNaughton rule (1843) held that
the jurors ought to be told in all cases that every man is presumed to be sane, and to possess a sufficient degree of reason to be responsible for his crimes, until the contrary be proved to their satisfaction; and that to establish a defence on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know he was doing what was wrong. [Emphasis mine-SW]
Since the McNaughton rule was promulgated, there has been a steady expansion of the concept of legal insanity, such that conditions as varied as PMS and Hyperglycemia (the "twinkie defense") have been used by clever Defense Attorneys to gain a determination of innocence for their clients. The shallow understanding of Neuroscience, with a commensurate distortion of its explanatory power, offers nearly unlimited opportunities for diminishing responsibility, not only in the legal realm but in the public square as well.
The ever expanding realm of Psychiatric illness is working in concert with powerful pharmaceutical, legal, and political interests to diminish the unique personal agency and responsibility of each individual member of our society.
We may yet find ourselves mirroring the old unlamented Soviet diagnostic system, where all unpopular behavior was pathologized; in our case it will be form a desire to "make people better" but the results will be the same.
Once we have controlled speech with our "hate crimes" law, we can begin (continue) to pathologize those who insist on voicing "illegal" speech. Impossible? Ask Mark Steyn and Ezra Levant.
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