This week’s issue of JAMA is dedicated to recent research in various areas of psychiatry. An accompanying editorial lauds the arrival of “the decade of psychiatric disorders”, when “insights gained from genetics and neuroscience would . . . reconceptualize disorders of the mind as disorders of the brain and thereby transform the practice of psychiatry.”
This makes me nervous. I had the same feeling of unease when I read Tom Wolfe’s essay, “Sorry, But Your Soul Just Died”. In that piece, Wolfe chronicled the work of Edward O. Wilson and the school of sociobiology, claiming that it would be proven that everything we think, do, and will choose to do comes down to chemical pre-programming beyond our control.
I get nervous because I feel that experience has a major effect on our lives and our behavior, and that care of the mind should never be reduced to treatment of the brain. I fear the explosion of chemical agents that will be foisted on people with real existential issues that they grapple with on a daily basis.
A wonderful example of the wisdom of experience comes from Elaine M. Brody, a renowned gerontologist and elder, who recalled her perspective on personal aging in a speech to the Gerontological Society of America in 2008 (recently printed in essay form in The Gerontologist).
Brody is now living in a “retirement community” and shares fascinating memories and insights on life among the very old. A sample: “My favorite example of continuity of personality is my own mother. She was a dedicated world-class worrier all her life. A bad back hospitalized her when she was well into her 80s.” She told her grandson that the doctor had prescribed Valium, but that she didn’t take it. Her explanation: “If I take Valium, I can’t worry.”
Here’s another: “The struggle for control between the elderly parent and middle-aged child is similar to the adolescent struggle. Yet . . . a parent’s dependency is different because it presages more dependence rather than independence as with the adolescent. When a group of my friends were discussing dependence/independence problems, one said plaintively, ‘When did we become afraid of our children?’ That question was greeted with a burst of understanding laughter.”