File spoon-archives/bhaskar.archive/bhaskar_2003/bhaskar.0312, message 275


Date: Thu, 18 Dec 2003 19:49:20 -0600
Subject: Re: BHA: Voloshinov etc




GŁnter Minnerup wrote:
> 
> 
> Not sure about that: is it possible to think about anything seriously without having a "working hypothesis" > as to generative mechanisms? My own hunch is that "mental illness" is a way of dealing with experiences, and > that chemical reactions in the brain are symptoms rather than causes,

This is inexact. No one says that  chemical reactions are _causes_ of
mental illness. Obviously, the causes are those 'events' that trigger
the neurological events. But those events are _symptoms_ either. I don't
experience my neurological events (which aren't reducible to merely
"chemical" events themselves); I experience (for example) the inability
to pick up the phone to make a phone call I have promised to make, or
the inability to stay asleep.

Depression (whatever complex that label covers) causes the destruction
of cells in the hippocampus. It has been recently discovered that
anti-depressants prevent that loss of neurons. There is some evidence
(but this is not decided yet I believe) that anti-depressants can
trigger generation of new cells in the hippocampus. The symptom of that
cell loss is defective memory. I have intermittent difficulty in
retrieving proper names. A year or two ago I was writing a post and
wanted to refer to Edmund Burke. I had to grab an anthology off the
shelf to get the name. Half an hour ago I couldn't remember Somoza's
name -- it came to me after I had paced around awhile and carried out a
couple other tasks. It seems like at least once a day or so I'll have
that kind of trouble with some proper name

> and chemical countermeasures therefore tinker with symptoms.

That's ambiguous in the case of the damage to the hippocampus that ADs
can prevent. (This of course tells us nothing about what causes the
depression, or by what route it kills hippocampus cells.)

> That is useful in itself, of course, as is paracetamol, 
> but if my hunch is correct an actual "cure" can only be 
> effected by some kind of social intervention (including 
> but not confined to "talking cures"). 

Many of the people I know who suffer from schizophrenia, schizoid
affective or bipolar disorder, or depression would be enormously helped
and at least a third of their symptoms brought under control simply by
raising their income by about $15K a year. That also would be (mostly)
treatment of symptoms, but if the pain one suffers is reduced
dramatically, who cares about the label applied to it. A couple of them
would have their symptoms relieved by a better public transportation
system.

Crutches don't "cure" anything, but I would have had a hell of a time
the first six weeks after I broke a hip and had it replaced were it not
for crutches. Symptomatic relief should be given more credit that merely
saying it is "useful in itself." My hunch is that there will _never_ be
a cure for some kinds of mental illness, but through both social change
and therapeutic intervention of various kinds they can be made easier to
bear. There may never be a cure for all types of cancer either, or for
all cases of diabetes. Some illnesses are "caused" by improved
sanitation: People don't catch them during childhood when they are
harmless. Zanaflex controls the extraordinary variety of migraine I
suffer from. No one knows how, and it doesn't cure it by any means. I
need to take 4 tablets a day. If I mess up and only take three, I'll be
awakened the next morning by what I call a shadow headache, which
disappears when I have some coffee or (at worse) a couple Migrin
tablets. (Those shadow headaches are a good thing: they remind me that
the monster is still there ready to leap.) Many things can only be
controlled, ameliorated, not "cured." And that will probably be the case
more or less permanently.

> Whatever is problematic about Freudianism, does a 
> rejection of its explanatory model as strong as yours 
>not also imply a rejection of the broader hypothesis 
> that "mental illness" is a reaction to the 
> environment rather than an innate physical malfunction?

I don't think a rejection of Freudianism implies anything about mental
illness (other than that witchcraft is not a very  effective treatment
of it). We of course _know_ that some mental ailments are caused by
damage to the brain. Consider the man who thought his wife was a hat or
the artist who ceased to be able to either see _or even imagine_ color.
When he thought of a tomato, he thought of something a dullish gray.

Probably the fundamental cause of most cases of depression is some form
of PTSD -- child abuse (physical, mental, or sexual), spousal abuse,
infantry combat. And just last week I read some research suggesting that
a single traumatic event, like an auto accident, might have done it. And
on xmas eve, 1936, at the age of six, I was in an extremely serious auto
accident. Could be? "Mental events" have a physical impact on the brain.
After the cause of the mental event (the trauma, the miserable social
condition, etc.) goes away the damage to the brain usually remains. If
therapy or social changes (or meds) either 'repair' or control the
effects of that damage, they do so by making a physical change of some
sort in the brain. I doubt that (either in origin or 'cure'/control) the
exact mixture of social/physical causes will ever be worked out.

Physical brain functions are the mode of existence of mental illness,
mental health, etc. etc. Hence to refer to them as either cause or
effect is misleading. (Just as it is misleading to speak of imperialism
as "caused" by capitalism: it is the mode of existence of capitalism.)

Keep the X in Xmas,

Carrol

> 
> Regards,
> GŁnter
> 
> --
> GŁnter Minnerup
> School of History
> University of New South Wales
> Sydney NSW 2052
> Tel. (+61 2) 9385 3668 (work)
> Tel. (+61 2) 9398 3646 (home)
> mailto:g.minnerup-AT-unsw.edu.au
> 
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