Academic journal article Ethical Human Psychology and Psychiatry

Kandel's "New Science of Mind" for Psychiatry and the Limits to Reductionism: A Critical Review

Academic journal article Ethical Human Psychology and Psychiatry

Kandel's "New Science of Mind" for Psychiatry and the Limits to Reductionism: A Critical Review

Article excerpt

If the first half of the 20th century was the golden age of physics and the second half, from the elucidation of DNA in 1953 to the description of the human genome, was dominated by molecular biology, many people believe that the most exciting progress in the 21st century will be directed toward a rational account of the ultimate scientific mystery, the human mind (Carr, 2006). From the psychiatric point of view, this will not come too soon: by one measure on intellectual achievement, the Nobel Prize for physiology and medicine, modern psychiatry has made little impression. Even though mental health is the most important single cause of morbidity and secondary mortality in the world, there have been only two awards directed toward matters of psychiatry since they were instituted in 1901. Thus, when the author of a book titled Psychiatry, Psychoanalysis and the New Biology of Mind (Kandel, 2005) is billed as "the first American psychiatrist ever to have won the Nobel Prize in physiology or medicine and only the second psychiatrist to have done so in the prize's 102 year history," psychiatrists may at last feel they are coming out of the shadows.

In this article, I look at one author's concept of a single idea in psychiatry. However, the idea dominates modern psychiatry, and the writer is extremely influential. The author, Eric Kandel, offers the view that "radical reductionism" will convert psychiatry and psychoanalysis into genuinely scientific fields. I argue instead that reductionism is a restricted model of science that can never account for the entirety of human behavior.

PSYCHIATRY AND THE PRIZEWINNERS

The first psychiatric Nobel award was in 1927 when the Austrian neuropsychiatrist Julius Wagner-Jauregg was named for his discovery of the effects of malaria-induced fevers on the progression of tertiary syphilis, or general paresis of the insane. He had published his results in 1917, but his interest in the use of artificial fevers in treating psychosis dated from at least 1887, when he was attached to the university clinic in Vienna. He also worked on treating thyroid diseases and cretinism with iodine, but this was long before modern biochemistry made accurate measurements of hormones possible. His conviction that fevers could improve psychotic states was fanciful if not dangerous. His major discovery was fortuitous and is of no interest to psychiatry today.

The next mention was in 1949 when Antonio Egas Moniz (1874-1955) was jointly honored for his work in psychosurgery. Egas Moniz was a Portuguese professor of neuro-surgery who, remarkably, also sat in parliament and, as foreign minister, led his country's delegation to the Versailles conference in 1919. In the mid-1920s, after serving as ambassador to Spain, he returned to medicine and adapted the new techniques of contrast angiography to the brain, quickly gaining an international reputation. In 1935, he attended a conference in London at which two researchers showed how cutting certain frontal tracts in chimpanzees' brains resulted in increased tractability. Intrigued, he decided to apply this to mental patients. The results of the initial series of 20 patients were considered encouraging, and the procedure was widely copied. For example, in England and Wales, more than 10,000 leucotomies were performed between 1942 and 1954. The figure was much higher in the United States, but, with the advent of powerful tranquillizing drugs, people lost interest in psychosurgery, and it soon fell into disrepute (which probably would have happened anyway). Egas Moniz was not a psychiatrist: He was a neurosurgeon who applied his techniques to a psychiatric population. A reviewer at the official Web site of the Nobel Prize stated, "I think there is no doubt that Moniz deserved the Nobel Prize" (Jansson, 1998), but these days, few psychiatrists would agree.

By modern standards, the work that led to these prizes would not meet the most elementary standards of what constitutes reasoned research, let alone ethical conduct. …

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