Psychiatry on the Couch: Breakthroughs in Brain Research Could Improve Mental Health Care. (Society)

Article excerpt

Two million Americans suffering from mental illnesses are not getting the care they need because the profession of psychiatry itself is in crisis over how to treat its patients, according to Harvard psychiatry professor J. Allan Hobson.

Caregivers are not coordinating with each other, Hobson explains. Some therapists favor "humanistic" talk therapy, but many psychiatrists focus on finding the right drugs and dosages. Meanwhile, neuroscientists who probe the brain's secrets are often ignored by psychiatry. Psychiatry needs to be updated and unified, Hobson contends in a new book, Out of its Mind: Psychiatry in Crisis, co-written by medical writer Jonathan A. Leonard.

"One way this should be done is with a new psychology--a psychology that will harness brain science knowledge to the task of advancing our understanding of the mind," write Hobson and Leonard.

They propose balancing the strengths of psychotherapy, pharmacology, and neuroscience. Therapists, for example, often establish empathy with their patients and have detailed knowledge of the people they treat. Such information is vital to pharma-cologists who need to make their drug therapy as effective as possible. Applying recent advances in brain science, animal behavior, and genetics to the diagnosis and treatment of mental disorders is the important new piece of the puzzle, according to Hobson and Leonard.

"Our current knowledge of the brain is growing fast," they write. "We have learned about brain chemistry and how such chemistry can direct the brain to sleep, dream, and awaken, as well as to experience bizarre effects like irrational panic or hallucinations. And we are learning how certain genes may raise intelligence, for example, or increase vulnerability to alcohol and drugs, or make us prone to schizophrenia, depression, and other mental ills. We have also developed compelling theories about the causes of mental ills, including various anxiety disorders."

We now understand more about how "the mind arises from the brain," and how the brain is divided into specialty compartments to deal with thoughts, movement, sensory information, emotions, and memory. Ongoing research into brain chemistry has boosted knowledge about how psychiatric drugs actually work and how to target their use toward particular diseases and symptoms. …