The fields of neurology and psychology have worked a long time to scientifically identify how the mind works. Unfortunately, much of the “science” of mind has been authoritarian conjecture accepted as fact.
Fortunately, more reasonable heads are prevailing today, which may lead to a complete overhaul of the mental health field in the US over the next decade.
A new model is emerging – centered on evidence and real science rather than on the word of “luminaries” in the field. Perhaps it is time to focus our psychology more on how the mind/brain works than on what is “normal” and “abnormal.”
According to Tom Insel, Director of NIMH,
“NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.”
Personally, I’m not interested in seeing science validate my beliefs, though that often feels pretty good to me. I’m much more interested in those areas where science invalidates my beliefs – unsettling and sometimes painful, yet much more useful, imho.
I’m most interested in scientific discovery that is free of preconceptions, presuppositions, and biases. That’s where the real gold is, and where it appears the NIMH wants to go.
A New Psychology
Instead of pursuing verification of the DSM-5’s vast collection of “disorders”, the NIMH is looking to science to help identify states of mind and how they can “go wrong” – called “dysregulation” – and to empirically identify when systems are functioning properly – if not, why not – starting with some basic building blocks.
The NIMH has identified 23 of the mind’s building blocks in five categories:
- Acute threat – also known as our fear circuitry. Active when we sense danger
- Potential threat – active, not in presence of a threat, but when we know the risk of danger is higher than normal. Associated with a sense of unease or anxiety
- Sustained threat – negative emotional state caused by prolonged exposure to unpleasant conditions. Can cause loss of enjoyment in usually pleasurable activities
- Loss – circuits active during permanent or sustained loss of a loved one, or
emotionally significant objects or situation, such as shelter or status.
- Frustration non-reward – reactions to lack of reward after sustained efforts. Can involve aggressive behavior
- Approach motivation – circuits that control our efforts to obtain a reward, such as sex or food
- Initial responsiveness to reward – feelings of pleasure on obtaining a reward. Involves opioid and endocannabinoid receptors, those activated by morphine and cannabis
- Sustained responsiveness to reward – mechanisms that terminate reward-seeking behavior, such as satiety, the feeling that enough food has been eaten
- Reward learning – processes by which we acquire information to predict rewards and learn to repeat the positive experience
- Habit – repetitive behaviors that, once started, can be done unconsciously. Habits can free up cognitive resources
- Attention – a range of processes that regulate access to awareness and higher
- Perception – the processes that take sensory data and transform it into representations of the environment
- Working memory – the system that can hold and manipulate many items of information on a temporary basis
- Declarative memory – the encoding, storage and retrieval of representations of facts and events on a long-term basis
- Language behavior – systems that allow production and comprehension of words, sentences, and coherent communication
- Cognitive control – systems that modulate the operation of other cognitive and emotional circuits. Can involve inhibition of behavior or selection of best response from competing alternatives
- Attachment – systems for bonding with friends and family. Involves hormones such as oxytocin and vasopressin
- Social communication – processes involved in exchange of socially relevant information, such as speech and body language
- Perception of self – circuits involved in understanding ownership of one’s own body or actions
- Perception of others – processes involved in being aware of and reasoning about other animate entities, such as our “theory of mind” networks, which allow us to understand that other people can have different beliefs to our own
- Arousal – a spectrum of sensitivity to stimuli, from coma and unconsciousness,
through anesthesia and sleep to full consciousness
- Circadian rhythms – self-sustaining oscillations that organize the timing of biological systems
- Sleep-wake cycle – recurring behavioral states that reflect coordinated changes in the brain. Regulated by physiological and circadian processes
- The New Scientist online – “Psychiatry’s scientific reboot gets under way” 07 May 2014 by Clare Wilson.
- NIMH Director’s Blog: Transforming Diagnosis
- Council for Evidence-based Psychiatry
- No More Psychiatric Labels – by Sami Timimi – Asylum Online – An International Magazine for Democratic Psychiatry
- The DSM-5