Book (In Progress)
Old Ghosts and New Machines: Mental Health and the Neuro Revolution
In a conference room so overflowing with attendees that the doors are guarded by Fire Marshalls, National Institutes of Mental Health Director Tom Insel addresses a crowd at the 2014 Annual Meeting of the American Psychiatric Association. Over the course of an hour, Insel presents slide after slide of data showing that psychiatry, unlike every other field in medicine, has been unable to improve patient outcomes. Insel is exasperated when discussing the current state of psychiatry, imploring the audience to demand better from the field. After demonstrating the failings of psychiatry, he argues that it is finally time to start viewing mental illnesses as "brain disorders" and that the "path to better health care goes through science.” Insel proudly contrasts his push towards brain science with previous NIMH directors, who prioritized poverty reduction. Insel declares, "poverty is important.... but we need neurobiology."
The influence of neurobiology – the connection between human behavior and the cells and structures of the brain – is unquestionable. Neurobiology receives substantial public funding, informs major social institutions, and is shaping both public debates and social policies. Neurobiology is also altering core aspects of human experience and is increasingly leveraged to explain social problems.
Neurobiology is dramatically influencing mental health institutions, concepts, and practices. Brain research is being used to “transform” the diagnosis of mental disorders. Brain science is also shaping the treatment of mental disorders, legitimating medical interventions that directly intervene on the brain and, for some mental disorders, justifying treatment prior to the emergence of symptoms.
Understanding the ramifications of brain science is crucial in the context of this neuro-revolution.
My book examines the influence of brain science on mental illness. I draw on 17 months of ethnographic observation at a well-regarded neurobiological research laboratory, observations of professional meetings, and in-depth interviews with 78 mental health professionals. I investigate brain research and mental illness in relation to causality, reductionism, and the legitimation of new treatments. My book also provides an analysis of how the brain is employed to explain social problems, while detailing the potential for multi-dimensional approaches.