Robert Berezin
Medscape.com
Originally posted March 16, 2018
Neuroscience surprisingly teaches us that not only is psychotherapy purely biological, but it is the only real biological treatment. It addresses the brain in the way it actually develops, matures, and operates. It follows the principles of evolutionary adaptation. It is consonant with genetics. And it specifically heals the problematic adaptations of the brain in precisely the ways that they evolved in the first place. Psychotherapy deactivates maladaptive brain mappings and fosters new and constructive pathways. Let me explain.
The operations of the brain are purely biological. The brain maps our experiences and memories through the linking of trillions of neuronal connections. These interconnected webs create larger circuits that map all throughout the architecture of the cortex. This generates high-level symbolic neuronal maps that take form as images in our consciousness. The play of consciousness is the highest level of symbolic form. It is a living theater of "image-ination," a representational world that consists of a cast of characters who relate together by feeling as well as scenarios, plots, set designs, and landscape.
As we adapt to our environment, the brain maps our emotional experience through cortical memory. This starts very early in life. If a baby is startled by a loud noise, his arms and legs will flail. His heart pumps adrenaline, and he cries. This "startle" maps a fight-or-flight response in his cortex, which is mapped through serotonin and cortisol. The baby is restored by his mother's holding. Her responsive repair once again re-establishes and maintains his well-being, which is mapped through oxytocin. These ongoing formative experiences of life are mapped into memory in precisely these two basic ways.
The article is here.
Showing posts with label Biological Model. Show all posts
Showing posts with label Biological Model. Show all posts
Monday, April 16, 2018
Saturday, June 13, 2015
Biological Biases Can Be Detrimental to Effective Treatment
By John Gavazzi
Originally published in The Pennsylvania Psychologist
During workshops on ethical decision-making, I typically take time to highlight cognitive and emotional factors that adversely affect clinical judgment and impede high quality psychotherapy. In terms of cognitive heuristics that hamper effective treatment, the list includes the Fundamental Attribution Error, Trait Negativity Bias, the Availability Heuristic, and the Dunning-Krueger Effect. Emotionally, a psychologist’s fear, anxiety, or disgust (also known as countertransference) can obstruct competent clinical judgment. A PowerPoint presentation providing more details on these topics is on my SlideShare account found here.
Research from cognitive science and moral psychology demonstrates many of these heuristics and emotional reactions are automatic, intuitive, and unconscious. The cognitive heuristics and emotional responses are shortcuts intended to evaluate and respond to environmental demands quickly and efficiently, which is not always conducive for optimal clinical judgment and ethical decision-making. For better or worse, these cognitive and affective strategies are part of what makes us human. It is incumbent upon psychologists to be aware of these limitations and work hard to remediate them in our professional roles.
Recent research by Lebowitz and Ahn (2014) provides insight into another cognitive bias that leads to potentially detrimental emotional responses. Their research illustrates how a clinician’s perception as to the causes of mental health problems can undesirably influence his or her perceptions of patients. The authors chose to investigate clinicians’ perceptions of patients when using a biological model of mental disorders. The biological model supports the belief that genetics play an important role in the creation of mental distress; that central nervous system dysfunction is the most important component of the mental health disorder; and, because of these biological origins, a patient’s thoughts and behaviors are largely outside of the patient’s control.
The entire article is here.
Originally published in The Pennsylvania Psychologist
During workshops on ethical decision-making, I typically take time to highlight cognitive and emotional factors that adversely affect clinical judgment and impede high quality psychotherapy. In terms of cognitive heuristics that hamper effective treatment, the list includes the Fundamental Attribution Error, Trait Negativity Bias, the Availability Heuristic, and the Dunning-Krueger Effect. Emotionally, a psychologist’s fear, anxiety, or disgust (also known as countertransference) can obstruct competent clinical judgment. A PowerPoint presentation providing more details on these topics is on my SlideShare account found here.
Research from cognitive science and moral psychology demonstrates many of these heuristics and emotional reactions are automatic, intuitive, and unconscious. The cognitive heuristics and emotional responses are shortcuts intended to evaluate and respond to environmental demands quickly and efficiently, which is not always conducive for optimal clinical judgment and ethical decision-making. For better or worse, these cognitive and affective strategies are part of what makes us human. It is incumbent upon psychologists to be aware of these limitations and work hard to remediate them in our professional roles.
Recent research by Lebowitz and Ahn (2014) provides insight into another cognitive bias that leads to potentially detrimental emotional responses. Their research illustrates how a clinician’s perception as to the causes of mental health problems can undesirably influence his or her perceptions of patients. The authors chose to investigate clinicians’ perceptions of patients when using a biological model of mental disorders. The biological model supports the belief that genetics play an important role in the creation of mental distress; that central nervous system dysfunction is the most important component of the mental health disorder; and, because of these biological origins, a patient’s thoughts and behaviors are largely outside of the patient’s control.
The entire article is here.
Tuesday, January 6, 2015
Current practices in reporting on behavioural genetics can mislead the public
Science Daily
Originally published December 2, 2014
Summary:
“Media reports about behavioural genetics unintentionally induce unfounded beliefs, therefore going against the educational purpose of scientific reporting,” writes a researcher following his study of 1,500 Americans. Public misunderstanding is not the only thing to blame for this misinterpretation. “Generally, science reporters’ first goal is to inform the public about scientific developments. However, this practice is not disinterested; some news is purposely written in a manner intended to catch the public’s attention with startling results in order to increase or to maintain market shares," the researcher explained.
The entire article is here.
Originally published December 2, 2014
Summary:
“Media reports about behavioural genetics unintentionally induce unfounded beliefs, therefore going against the educational purpose of scientific reporting,” writes a researcher following his study of 1,500 Americans. Public misunderstanding is not the only thing to blame for this misinterpretation. “Generally, science reporters’ first goal is to inform the public about scientific developments. However, this practice is not disinterested; some news is purposely written in a manner intended to catch the public’s attention with startling results in order to increase or to maintain market shares," the researcher explained.
The entire article is here.
Thursday, December 25, 2014
Effects of biological explanations for mental disorders on clinicians’ empathy
By Matthew S. Lebowitz and Woo-kyoung Ahn
Effects of biological explanations for mental disorders on clinicians’ empathy
PNAS 2014 : 1414058111v1-201414058
Abstract
Mental disorders are increasingly understood in terms of biological mechanisms. We examined how such biological explanations of patients’ symptoms would affect mental health clinicians’ empathy—a crucial component of the relationship between treatment-providers and patients—as well as their clinical judgments and recommendations. In a series of studies, US clinicians read descriptions of potential patients whose symptoms were explained using either biological or psychosocial information. Biological explanations have been thought to make patients appear less accountable for their disorders, which could increase clinicians’ empathy. To the contrary, biological explanations evoked significantly less empathy. These results are consistent with other research and theory that has suggested that biological accounts of psychopathology can exacerbate perceptions of patients as abnormal, distinct from the rest of the population, meriting social exclusion, and even less than fully human. Although the ongoing shift toward biomedical conceptualizations has many benefits, our results reveal unintended negative consequences.
Significance
Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.
The entire article is here.
Effects of biological explanations for mental disorders on clinicians’ empathy
PNAS 2014 : 1414058111v1-201414058
Abstract
Mental disorders are increasingly understood in terms of biological mechanisms. We examined how such biological explanations of patients’ symptoms would affect mental health clinicians’ empathy—a crucial component of the relationship between treatment-providers and patients—as well as their clinical judgments and recommendations. In a series of studies, US clinicians read descriptions of potential patients whose symptoms were explained using either biological or psychosocial information. Biological explanations have been thought to make patients appear less accountable for their disorders, which could increase clinicians’ empathy. To the contrary, biological explanations evoked significantly less empathy. These results are consistent with other research and theory that has suggested that biological accounts of psychopathology can exacerbate perceptions of patients as abnormal, distinct from the rest of the population, meriting social exclusion, and even less than fully human. Although the ongoing shift toward biomedical conceptualizations has many benefits, our results reveal unintended negative consequences.
Significance
Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.
The entire article is here.
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