David Brooks: Not Beyond Neuroscience Denial
Related: The Failure of Mysterian Complaints about Neuroesthetics, Naive Philosophical “Criticism” of Reductionism in Science
Through the shining light of rational science, most reasonable people have stopped attributing epidemics of infectious diseases and natural disasters to deities or demons. Instead, they have come to accept the scientific reality of disease-causing microorganisms and natural processes such as earthquakes and tropical cyclogenesis. Again and again, scientific explanations have replaced alleged mystical or religious claims in fields as diverse as cosmology, astronomy, geology and biology. Although mysterian beliefs about the world has largely cracked under the evidence and retreated from the natural sciences, some people still cling to the misguided notion that the human mind exists independent of and above-and-beyond the brain. These individuals, called mysterians, often come in one of two flavors. The religious flavors rejects mind-brain physicalism because if it was true, that would mean the end of both souls and deities (as they are considered brainless minds). The secular, non-religious flavor rejects mind-brain physicalism because if it was true, they (falsely) believe that it would mean end of moral responsibility, human appreciation of art and beauty, freedom and equality.
Although careful not to go into details about neuroscientific research, journalist and social commentator David Brooks made a similarly unpersuasive case against mind-brain physicalism in his op-ed column called Beyond the Brain. It starts with a straw man of neuroscientific research, claiming that neuroscientists consider it a theory of everything and that humans are viewed as nothing but neurons. It continues to list some important limitations and current neuroscientific research. It finishes off by drawing the unjustified and preposterous inference that these limitations imply that the mind is not the brain.
Scattered through the article are a couple classic anti-psychiatry and neuroscience denialist talking-points, such as the rejection of mind-brain physicalism and the claim that addiction is not a brain disease.
Neuroscience is not a theory of everything
Brooks cannot even get past the first paragraph without making a straw man assertion about neuroscience.
It’s a pattern as old as time. Somebody makes an important scientific breakthrough, which explains a piece of the world. But then people get caught up in the excitement of this breakthrough and try to use it to explain everything. This is what’s happening right now with neuroscience.
Neuroscience is used to explain everything? Show me a peer-reviewed scientific paper published in a reputable journal that claims that neuroscience explains the phases of Venus, nuclear fusion, the nature of dark matter, trade winds, earthquakes, the four color problem, the fact that cytochrome c is evolutionarily well-conserved or the Belousov-Zhabotinsky reaction. I doubt that Brooks can actually do this if he tries. In other words, the goal of neuroscience is not to be a theory of everything. I have the creeping suspicion that the real problem for Brooks is that neuroscience is beginning to explain those features for which he prefers a mysterian account.
Personal anecdotes and another straw man
From personal experience, I can tell you that you get captivated by it and sometimes go off to extremes, as if understanding the brain is the solution to understanding all thought and behavior. This is happening at two levels.
Arguing from personal experience about a well-established scientific field for which one has little or no theoretical and practical experience is perhaps the weakest kind of evidence, just slightly above a mere assertion. Brooks is claiming that modern neuroscience has gone to extremes, yet he provides no actual evidence for this.
Indeed, modern neuroscience does not claim that understanding the brain is the solution to understanding all thought and behavior. In reality, neuroscience claims that understanding the brain is an integral and indispensable tool for understanding thoughts and behaviors. That does not equal a rejection of the fact that other factors (such as biological factors besides the brain as well as environment) also contribute to cognition and behavior. The interaction between biological, psychological and environmental/social factors is evident from brain development and learning to the origin of mental conditions.
So what two levels are Brooks talking about?
Examples listed by Brooks are not cases of “neuroscience extremism”
Brooks calls the two levels “highbrow” and “lowbrow”. Presumably, he thinks the former is something you would often see talked about in magazines and sensationalist newspapers. The latter may be things he thinks are being seriously discussed in the scientific literature.
In the “lowbrow category”, he includes things like correlations between brain activity and political affiliation, brain scans as lie detectors, and criminal responsibility. However, serious research has been done these issues and they cannot be dismissed out of hand (Greene and Paxton, 2009; Lagleben and Moriarty, 2013; Kanai et al, 2011; Jost and Amodio, 2012; Eastman and Campbell, 2006). Sure, it may be the case that such research turns out to be a dead-end, but that has to be debated and decided in the scientific literature, not by a journalist.
In the highbrow category, he includes the claim that humans are “nothing but neurons”. This is a straw man as groups of neurons can perform tasks and functions that single neurons cannot accomplish on their own (compare superficially to water tension with individual water molecules). The next claim is that neuroscience holds that understanding the brain will allow us to understand behavior and that neuroscience will replace psychology. This repeats the same straw man (i.e. the idea that only the brain is relevant for behavior) that was dealt with above. He also mentions the naturalistic origin of the mind and the position that contra-causal freedom does not exist, which indeed are neuroscientific consensus positions.
Brooks makes a flawed anti-psychiatry assertion regarding addiction
Perhaps one of the most shocking claim made in the article is that this alleged “highbrow extremism” also includes the position that addiction is a brain disease. Since the entire article is an attack on this perceived “extremism”, one can reasonably concludes that Brooks rejects the position that addiction is a brain disease. This is a classic anti-psychiatry trope and can be refuted once we noticed that science has shown both neurological mechanisms and genetic risk factors for substance addiction (see the sixth paragraph here).
This is yet another example among many that a lot of journalists often screw up when talking about science.
Brooks fails to “refute” mainstream neuroscience
So after erecting the straw man of neuroscience extremism, how does Brooks attempt to knock it down? He attempts to do this in two ways: (1) the bare assertion fallacy (asserting, without evidence, that “the mind is not the brain”) and the (2) appeal to ignorance (pointing out that methodological limitations exists). Let us take them on, one by one.
These two forms of extremism are refuted by the same reality. The brain is not the mind.
Not only does Brooks reject neuroscientific consensus, but he also does so without providing a shred of positive evidence for his claim.
It is probably impossible to look at a map of brain activity and predict or even understand the emotions, reactions, hopes and desires of the mind.
It is probably impossible to look at the DNA of living organisms and construct the exact mutation-for-mutation transformation that occurred in all lineages. You might get the most probable transformations or the transformations that predict the evidence with highest probability, but scientists will have a hard time determining the actual sequence of mutations. This, however, is in no way, shape or form an argument against common descent. The fact that we do not know exactly how life evolved from a common ancestor does not mean there is any reasonable uncertainty regarding the question of whether it did. Similarly, the fact that we might not know how the brain cause the mind in every minute detail is not an argument against our knowledge regarding whether it does. Believing that it poses a problem is a classic denialist tactic known as confusing mechanism with fact.
The remainder of the article mentions methodological limitations of current neuroscientific research, such as brain regions having multiple functions, the same behavior can arise from different brain activity etc. but these are additional arguments from ignorance and confuse mechanism with fact. The fact that there exists methodological difficulties with finding out how the brain cause the mind (and behavior) is not an argument concerning the questions of whether the brain cause the mind (and behavior).
The mysterious “they”
Right now we are compelled to rely on different disciplines to try to understand behavior on multiple levels, with inherent tensions between them. Some people want to reduce that ambiguity by making one discipline all-explaining. They want to eliminate the confusing ambiguity of human freedom by reducing everything to material determinism.
When everything else fail, bring up the horrid specters of “reductionism” and “determinism”. As detailed in my post Naive Philosophical “Criticism” of Reductionism in Science, people doing that rarely understand what reductionism or determinism means, let alone how these concepts are applied in the natural sciences. Science uses hierarchical reductionism (understanding something by the way its parts interact) and not greedy reductionism (which misses out on important levels of analysis).
It is also unclear exactly who “they” represent. Journalists writing flawed popular science? Individual neuroscientists? Scientific organizations? The scientific community? Brooks does not say. Guess a story about abuse is more exciting if the bogeymen are left unidentified. He finishes off his article by repeating the assertion that the brain is not the mind (again without providing a shred of evidence).
Conclusion
David Brooks’ attack on neuroscience turns out to be little more than bare assertions, straw men and appeals to ignorance. He confuses the question of finding out how the brain cause the mind and behavior with the question of whether the brain cause the mind and behavior. Especially problematic is the anti-psychiatry claim that addiction is not a brain disease as genetic risk factors and charted neurological mechanisms says otherwise.
References
Eastman, Nigel, & Campbell, Colin. (2006). Neuroscience and legal determination of criminal responsibility. Nat Rev Neurosci, 7(4), 311-318.
Greene, J. D., & Paxton, J. M. (2009). Patterns of neural activity associated with honest and dishonest moral decisions. Proceedings of the National Academy of Sciences, 106(30), 12506-12511.
Jost, J. T., & Amodio, D. M. (2012). Political ideology as motivated social cognition: Behavioral and neuroscientific evidence. Motivation and Emotion, 36(1), 55-64. doi: 10.1007/s11031-011-9260-7
Kanai, R., Feilden, T., Firth, C., & Rees, G. (2011). Political Orientations Are Correlated with Brain Structure in Young Adults. Current biology. 21(8), 677-680.
Langleben D.D., Moriarty J.C. (2013). Using Brain Imaging for Lie Detection: Where Science, Law and Research Policy Collide. Psychol Public Policy Law. 19(2):222-234.
You think addiction is a brain disease? And that I, and most people, can cure a ‘disease’ with thought and will power? I gave up smoking!! You think this view is a science? Really?
My position is that addiction is a brain disease and that modifying psychological factors can help with mental conditions such as addiction.
This, however, does not mean that you can “cure a disease” with “thoughts and will power” in the new age woo sense. I flatly reject such a notion.
If the brain is what is affected by addiction, and if the brain creates your thoughts, why would a brain create thoughts that ‘cure’ addiction, even if it could? Your brain *wants* to keep smoking, even while it wants to quit. Cognitive dissonance at its best.
I am not claiming that “thoughts cure addiction”.
I am saying that psychological interventions, such as cognitive behavioral therapy, can help treat addiction. Such treatments is based on purposefully modifying maladaptive cognition.
Sorry, this was supposed to be a response to Dirk, not Emil. My bad.
No problem. I sometimes get confused by all the comment nesting as well.
In other words, he seems to think you are claiming thoughts can cure addiction. I was saying that the brain wouldn’t even if it could, because it’s addicted. That’s how addiction works.
Thanks for the clarification!
‘Your brain *wants* to keep smoking, even while it wants to quit.’ I can’t quite make up my mind about this statement. It makes my brain hurt a little…
It basically means that: (1) there are neurological mechanism related to addiction that contributes to the continued usage of the drug (e. g. withdrawal) and (2) you consciously know that the drug is harmful to you (and that makes you want to quit, but the neurological mechanisms of addiction is often very strong).
You think that ‘modifying psychological factors’ can cure a disease? I am not sure I understand you. How do you define a disease? What is a psychological factor? How does it cure a brain disease? I am confused by this notion.
I prefer to be pragmatic and define “disease” as “an abnormality in mental or physical health” (the NIMH definition).
Sure, some diseases (by no means all) can be treated by psychological interventions. The easiest examples I can think of is cognitive behavioral therapy for specific phobias. Other treatments require the modification of psychological factors for the treatment to be effective, such as exercise for sever obesity or high blood pressure. While exercise is an environmental factor, getting many of them to a place were they exercises regularly requires modification of psychological factors.
Other diseases, such as cancer and autoimmune disorders cannot be treated by psychological interventions.
You define a phobia as a disease? ‘getting many of them to a place were they exercises regularly requires modification of psychological factors.’ Sorry I may be being stupid here but still not sure I understand you. What is a ‘psychological factor’ and what is the method of the physical change made to the brain? You think some diseases can be cured by ‘wishful thinking’ although not all? Can you give me an example of a psychic cure of a physical illness? Or are these only useful for mental illness?
It is not that I personally define specific phobias as diseases in the above sense. Rather, it represents the mainstream scientific consensus.
A psychological factor is any factor related to cognition: thoughts, feelings, beliefs, emotional history etc.
No, wishful thinking does not cure any disease, whether physical or mental.
“A psychological factor is any factor related to cognition: thoughts, feelings, beliefs, emotional history etc.
No, wishful thinking does not cure any disease, whether physical or mental.”
Are you saying wishful thinking not a thought or feeling or any factor related to cognition? I am even more confused now? I must be missing something… sorry.
What I am saying is that wishful thinking (which is a specific psychological factor) does not cure any diseases at all…
…but the modification of some other psychological factors (in e.g. cognitive behavioral therapy) is therapeutically beneficial for e. g. some mental conditions. The classic example is e. g. hypervigilance in specific phobias.
Sorry – don’t want to take up your time here. Maybe your next blog can provide a deeper explanation of these issues. Thanks.
Emil, you say “but the modification of some other psychological factors (in e.g. cognitive behavioral therapy) is therapeutically beneficial for e. g. some mental conditions. The classic example is e. g. hypervigilance in specific phobias.”
Are not mental conditions actually brain conditions? So what are ‘psychological factors’ that are therapeutic for mental disease but do not cure physical disease? You seem to be saying that there are diseases that are physical which cannot be cured by talk therapy such as CBT. Yes? But can cure mental illness/conditions. Is that saying the brain and the mind are not the same? I thought they were.
Yes, mental conditions are a subset of physical conditions. So in that sense, treatments that work for mental conditions would treat that subset of physical conditions. This, however, is not the same as saying that “wishful thinking” is an effective treatment for anything.
By mistake, I occasionally fall back to the mental/physical dichotomy by without thinking (because it comes so natural). Sorry for the confusion.
So how did I cure my disease of addiction to nicotine. What did my brain do?
I have no idea what the relevant factors was for a specific individual.
In terms on neurological mechanism, nicotine binds to nicotinic acetylcholine receptors and that eventually lead to an increase in dopamine (part of the brain’s reward system). During nicotine withdrawal, the brain attempts to down-regulate the increase in dopamine. The sensitivity of the receptors decrease (regulated by dopamine). To compensate for this, the brain increases the number of receptors. The downstream psychological effect is that the reward system becomes more sensitive.
Once a person gets past the withdrawal phase, avoids the behavioral patterns related to smoking and stays away from it, the addiction can be considered managed. However, there are cases where smokers pick it up again, so more research is probably needed for a fuller answer.
How does the brain start to initiate the withdrawal phase? If it does not want to? Are all addictions never cured… only managed? Interesting to think why.
The down-regulation I discussed occur on a molecular level, so is not a conscious process.
It is very important for the brain to keep neurotransmitter levels within a physiologically optimum range. When something changes these levels so much that they rise or fall outside this range (like the use of a recreational drug), the brain attempts to move them back (an important biological process called homeostasis).
In the case of nicotine, the brain tries to compensate for the large increase in dopamine. It does this by reducing the sensitivity of the receptors that nicotine bind to. This means that the same number of activated receptors does not lead to the same amount of dopamine produced (as a rough analogy, think of reducing the sensitivity of the mouse; the same movement only moves the cursor a tiny bit now instead of normal).
But when the body is not getting nicotine anymore, that means that you now have a normal amount of signaling molecules that can bind receptors, but the receptors have lesser sensitivity. This means that the dopamine production is lower than required for physiologically optimal function of the brain. The brain tries to compensate again by increasing the number of receptors. This crucial chain of molecular events results in the psychological experience of withdrawal.
It seems that the current mainstream view of drug addiction (particularly when it comes to things like cocaine, heroin and so on) is that it is a chronic disease because long-term abuse changes several neurotransmitter systems and brain circuits with the very real potential for relapse even if a person stops.
With that said, all recreational drugs are not equally addictive or equally harmful. Also, the addiction risk and severity of an individual’s addiction depend on many factor, such as genetic risk factors, potential mental illness co-morbidity, social factors such as socioeconomic status, stress, peer-pressure, parenting, life quality, the age at which a person starts using, usage frequency and amount etc.
So it is probably easier to give up a coffee addiction than a heroin addiction. So it may be the case that some forms of addictions can be curable, whereas other severe addictions should be considered chronic diseases were realistic approaches are management, rather than complete cure.
‘It seems that the current mainstream view of drug addiction is that it is a chronic disease because long-term abuse changes several neurotransmitter systems and brain circuits’
This is where you and I part. You are promoting a pseudoscientific belief here. You are actually changing the definition of what is a disease. Of course boxing can be said to change or damage the brain. Is boxing a disease? Is gambling a disease? Sex or internet addiction even? Notice that ‘music addiction’ is not considered an illness as Mozart never ‘suffered’. You are subverting language here whereby ‘deviant’ behaviour becomes a symptom of a disease. See medicalization on wiki. You still ignore how my brain made the choice to stop smoking. You have already stated that some diseases cannot be cured by CBT (thought change and behaviour modification) but that physical diseases cannot be… only mental. You seem to have a dualist view of the mind and brain. It seems you are as confused as I am…
Also perhaps you can point me to the science which states what the optimum dopamine levels are in the brain before it is considered a diseased one. Thanks.
i am neither promoting pseudoscience nor am I changing the definition of a disease. The definition I posted is the definition used by National Institute of Mental Health.
Boxing can damage the brain, and it is that brain damage that is the disease. Problem gambling is also a disease. DSM-5.0 consider it an impulse control disorder. An addiction is not the same as being very interesting in composing or listening to music. All of your alleged counterexamples fail.
The reason that drug addiction is a disease is not because the addicted individual has a deviant behavior, but rather because of the major brain dysfunctions that occur in addition to the behavioral symptoms.
Your personal struggles with nicotine addiction is not relevant to the bigger scientific picture. The fact that some individuals manages to stop smoking with out treatment is no more an argument against the notion that addiction is a disease than the fact that a person who goes on a diet and lose weight reduces the likelihood of a second heart attack is not an argument against a heart attack being a disease.
No one is saying that physical disease are only mental. What I have explained to you, over and over again is that mental conditions are disease of the brain.
The mechanisms of drug abuse and effects of the dopamine neurotransmitter system is quite well known. I have already explained it to you several times, but you can also check DrugFacts: Understanding Drug Abuse and Addiction, Drugs Alter the Brain’s Reward Pathway, Dopamine in drug abuse and addiction: results of imaging studies and treatment implications..
At any rate, It is time that you start addressing my arguments and presenting evidence for your position, instead of merely repeating the asserting that the mainstream disease models are false.
What are your main arguments? You have confused me… can you summarise? I will address.
‘What I have explained to you, over and over again is that mental conditions are disease of the brain.’
All pseudo science is explanation. I am looking for the scientific proof. Define ‘mental condition’ and ‘disease’. If the mental condition is ‘good’ and accepted by society’s norms… music etc.. no problem. Only if the mental condition is deemed ‘bad’ then that deviant person must have a medical disease? A brain or gene disease? This is a religious faith you hold.
I think you are confusing ‘moral’ issues with science. And emphasise that science supports the moral questions/resolutions of society. When it does not. Religions once claimed to resolve the moral issue. Now pseudo scientists claim the same…. Thus does the circle spin….
A disease is simply a condition were some part of the body is in state where it functions in such a way that it interferes with the health and life of an individual (see definition I linked to in the above post). In that sense, the disease concept includes influenza, high blood pressure, chronic pain and various mental conditions. It is not about morality and ethical judgments. The difference between a mental condition and, say, a kidney condition, is that the condition is more strongly related to a specific organ (in this case, the brain and kidney respectively).
The problem with your comparison with music is that “addicted to music” is a popular term without a solid scientific basis. Being “addicted” to music in the popular sense (really liking music and spending a lot of time on music) is not the same as being addicted to e. g. heroin. The problem with heroin addiction is not simply that the person likes heroin a lot, but that the condition has made pathological changes to the brain.
I am getting a little bit tired of your unsupported claims that modern medicine is pseudoscience or a religious belief. It is time that you put forward actual scientific evidence to back up those assertions instead.
I never claimed that modern medicine is a pseudoscience. Like homeopathy and acupuncture, there are aspects of medicine (CAM) that also do not have scientific foundations. I question your assertion that addiction, whether to drugs, sex, the internet etc etc is a disease as you are attempting to broaden the definition of what falls under its remit. It is a function of science to narrow definitions. . I fail to see your logic when you claim that mental conditions are actually physical brain diseases but, unlike true physical illness, can be cured/managed by talk therapy.
Also, you are taking the opposite view to Tom Insel , head of NIMH, who currently claims that there is no evidence of any objective physical brain disorder associated with the ‘invalid’ DSM description of mental conditions. You also disagree with those such as Allen Frances, chair of the DSM-IV, who states that small changes in the definition resulted in huge jump in diagnosis due to cultural forces. As such you are promoting anti-psychiatry and pseudoscience. I am asserting what current psychiatry is stating. If you disagree with this then you have to show the science to support your views.
Emil, you say “A disease is simply a condition were some part of the body is in state where it functions in such a way that it interferes with the health and life of an individual”. With your definition then homosexuality, especially in countries where it carries a harsh penalty, is till a disease. http://www.tandfonline.com/doi/full/10.1080/13674676.2012.762574#.UgCjC21sBvo is a good article to explain cultural influences over the ‘disease’ model of mental conditions. There is also lots of information to be had here http://www.mentalhealth.freeuk.com/article.htm and the psychiatrists involved in the Critical Psychiatry Network in the UK.
You also say.. ‘I am getting a little bit tired of your unsupported claims’. I have asked you to read the wiki entry on ‘medicalisation’. Within the references there is much to support my claims. Did you read?
I am not attempting to broaden the definition of “disease”. I have presented a modern mainstream scientific definition of disease.
The function of science is not to narrow definitions, but to make definitions empirically accurate.
The reason why e. g. cognitive behavioral therapy is an effective treatment for many mental conditions is that they contribute to the same therapeutic changes in brain activity and function as psychiatric medication. As I have explained in an earlier blog post:
So CBT alters cognitive and brain processes in a very similar way to psychiatric medication. However, diseases not related to the brain are obviously not affected by this, for the simple reason that CBT does not affect other organs.
You are misrepresenting Tom Insel. He never states that there is no neurological basis for mental conditions. He is claiming that psychiatric diagnosis are not theory-laden. Steven Novella explains:
In other words, you are confusing a debate about the details of psychiatry with a contrived and non-existing debate about the validity of the entire field. He is not claiming that the DSM is invalid.
You are certainly not presenting current psychiatry and I have done almost nothing but present evidence for my claims. You have presented no evidence.
Homosexuality does not become a disease because some countries punish it. You have to look at the individual. Does romantic and erotic attractions to the same sex interfere with that persons health? The answer is no.
It is true that some cultural influences exists on mental disease concepts, but medical aspects are the most important. Some mental conditions, such as schizophrenia, have the same incidence globally, regardless of culture.
Critical psychiatry is not a form of direct anti-psychiatry, so you are yet again confusing scientific debates about details with non-existent “debates” about the entire field.
You have not provided any evidence for your claim. When you make claims, such as claiming that psychiatry is a religious faith, then the onus is on you to provide the evidence. Pointing to a Wikipedia entry and telling me to read those references is not evidence, because it is not specific for your claims.
You continue to repeat your mindless assertions without providing a shred of evidence and you do not address my arguments.
You are done here.