Subject: RE: BHA: Voloshinov etc
Date: Fri, 19 Dec 2003 11:15:20 -0500
From: "Moodey, Richard W" <MOODEY001-AT-gannon.edu>


Hi Carrol,
 
I'm convinced.
 
Dick



-----Original Message-----
From: Carrol Cox [mailto:cbcox-AT-ilstu.edu]
Sent: Thursday, December 18, 2003 8:49 PM
To: bhaskar-AT-lists.village.Virginia.EDU
Subject: Re: BHA: Voloshinov etc




Günter 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,
> Günter
>
> --
> Günter 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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