Do the ‘evidence-based’ results of brain scanning debunk Freud both scientifically and in the clinic?

by Julia Evans on September 5, 2012

 

My attention was caught this morning by a report by Tom Feilden on the BBC Today programme, titled ‘How neuroscience could help explain human emotions’[i].

‘So what?’, I hear you say.

The reason this debate is important is that the Government, of whatever colour, believes that scientific brain scanning results are completely reliable and they base their clinic, of conditions known as Mental Ill-Health, firmly within this evidence-based, completely reliable and safe clinic, without considering that this constitutes an ethical position.  This position is sold, by its supporters, see below for Professor Leonard Mlodinow and Professor Colin Blakemore, as a certainty.  They, in Tom Feildon’s words, have debunked Freud.

My challenge: How are you going to challenge this status-quo?

It is being driven from within Parliament and included in legislation. This legislation drives how the NHS, and much else in the field of mental health, is allowed to operate.  It is being used against skilled and experienced nurses, therapists of every flavour, ambulance drivers, and so on.  Many of them are loosing their employment through the exact application of this legislation – remember Shylock – within kangaroo trials held outside primary legislative processes.

The arguments as given on the Today programme (see endnote i).

Warning: a full transcription of this programme is not available. All quotes have been noted, at speed, from the sound broadcast by Julia Evans and their total accuracy is not guaranteed. See end-note i for the web-link to the broadcast.

The programme started with a recording of a FMRI [ii] in use with the explanation from an EXPERT, from Cambridge University so she must be right, that she was studying brain images of those classified with bi-polar disorder.  She judges, from this ‘scientific evidence’, that these brains are more stimulated & less able to process information than standard brains. This biological investigation apparently proves that there are physiological correlates, underlying the symptoms of bi-polar disorder. It is alleged this biological ‘Truth’ will be central to treatments of the disorder in the future. Those defined as bi-polar, probably by our old friends NICE clinical guidelines or the DSM classification, will be normalised by the clinical use of direct treatment to the body or more probably brain, given by those with THE Knowledge of how these (sub-standard) brains work.  Similar fantasies led, in the past, to electric shock treatments to the head, for depression and much else and leucotomy, which had the unfortunate side-effect of turning these (sub-standard) human beings into zombies.

A similar point is made in a previous post on August 24th 2011: An historical look at treatments for human conditions of mental distress – are the same parameters still driving treatments? or here

Professor Leonard Mlodinow, California Institute of Techonology then joins in.

Note: Professor Mlodinow Published on April 24th 2012 a book, titled: ‘Sublimal: How your Unconscious Mind rules your behaviour’. So a more cynical commentator than I, might see this broadcast as a useful opportunity for self-publicity.

Professor Mlodinow argues that (quote) ‘invention of FMRI has finally elevated psychology into a proper empirical science. Scientists have suddenly been able to connect behaviour with processes in the brain and this has caused a revolution in our understanding of the unconscious mind.  What this new evidence-based understanding of the unconscious mind means, Mlodinow argues according to the BBC’s science reporter, Tom Feilden, is that there is no hidden meaning or emotional value attached to the subliminal processing that goes on in the brain. We are just complex and wonderful biochemical machines.    That Freud is bunk.  Mlodinow continues: What we have found is that the unconscious mind is not really the way Freud and Jung and people in the 20th century believed who did not have access to these new technologies. In fact, they were not really scientists. They would extrapolate and form ideas from talking to their patients. The unconscious is not hidden from us for emotional or motivational reasons, as Freud thought, and it cannot be revealed through introspection or therapy. The conscious mind does not have access to what is going on.’

JE:  Clearly, the Professor does not feel the need to condescend to actually reading Freud.  If you wish to so do, then in the post The Project for a Scientific Psychology: 23rd & 25th September & 5th October 1895: Sigmund Freud ,also available here , how Freud develops his arguments on this subject is attempted.  It is a project which the French psychoanalyst, Jacques Lacan, developed further throughout his life.  To dismiss Freud’s ideas  as unscientific because they are ‘only’ based in analysis of subject’s words, brings doubt onto the whole ‘scientific’ project as it, too, is only based in words.  Admittedly, the superior words of Experts in the ‘scientific’ study of brain images produced by a machine programmed by a human subject, are defined, tautologically, as more scientific than Freud’s.  So that, apparently makes them completely value-free.  I suspect that Freud would agree with Professor Mlodinow that the unconscious is not accessible to the conscious mind and it cannot be revealed through introspection or therapy.  Well, anyway, I agree with Professor Mlodinow on these points.

The broadcast continued with Professor Rachel Blass, who according to the internet is on the academic staff of both Heythrop College and University College, University of London, rejecting this narrow deterministic account……  (On reflection, she is probably Professor Peter Fonagy’s replacement. Peter Fonagy is well-known to the regx2 circulation group and posts to LacanianWorks.) She is given about two sentences in which to accomplish this.

Professor Colin Blakemore concludes the broadcast.

Note: Professor Blakemore is Professor of Neuroscience at Oxford University. According to his description, on its web-site available here , he is :

– Colin has been actively involved in the public communication of science for more than 30 years. He is a frequent broadcaster on radio and television, has published a number of books about science for a general readership, and he writes for the national and international media. (JE adds: so a useful second income stream.)

– He is an active supporter of several medical charities, and is President of the Motor Neurone Disease Association, Vice-Chairman of SANE and Vice President of the Progressive Supranuclear Palsy Association. He is Chairman of Understanding Animal Research. He is a Commissioner of the UK Drug Policy Commission and has helped to develop new evidence-based methods to define the harm of drugs of potential abuse. [JE adds: so he uses the medical framework when he is involved in these areas of human being-ness.]

– Colin’s research has been concerned with many aspects of vision, the early development of the brain and plasticity of the cerebral cortex. His current interests lie in three areas. First, with Dr Irina Bystron, he is studying the earliest stages of formation of the human cerebral cortex, using immunocytochemical methods and techniques for tracing the outgrowth of axons to examine the proliferation of neural stem cells, the production, migration and differentiation of cortical neurons, as well the formation of connections into and out of the developing cortex. One aim of this research is to define the developmental errors that underlie cognitive disorders, such as autism, dyslexia and schizophrenia. Colin’s second area of current research, together with Drs Kai Thilo and Meng Liang, uses techniques for imaging activity in the living adult human brain to examine the capacity of sensory areas of the cortex to reorganize their activity during selective attention, during the integration of information from different sensory systems and after the onset of blindness. …. [JE adds: so his frame of reference is limited to his interpretation of the human inventions of immunocytochemical methods ( I suggest you look it up on Wikipedia as I have no idea) and imaging activity.  So this is value-free? ]

In the web-site www.newhumanist.org.uk, available here his name is quoted as a ‘Distinguished supporters of the Rationalist Association’. : Current honorary associates are: …, Colin Blakemore. Incidentally Sigmund Freud is also included as a great name from the past….  This is confirmed at the web-site www.philosopedia.org, available here: ‘Rationalist Association: In 1998, the honorary associates were as follows: … Professor Colin Blakemore. … Honorary Associates in 1940: In 1940, the honorary associates listed by Joseph McCabe were as follows: … Dr. Einstein, Dr. Sigmund Freud, … Other honorary associates have included the following: … Ernest Jones,’  [JE adds: So Professor Blakemore’s position is not value-free.  As Professor Rachel Blass notes, he takes the rationalist position.  There is nothing wrong in taking a position except if it is obfuscated as The TRUTH.]

From the BBC web-site ( see endnote i): The Professor of Neuroscience at Oxford University, Colin Blakemore, told him: “Until recently, neuroscience has not been delivering very clear messages about human behaviour. But we’re getting very close to that.” Blakemore said we could soon have “some kind of mechanistic description” of what makes the brain makes humans feel emotions such as love, hate, fear and anger.

From JE’s transcription: ‘Everything we do must be influenced by the state of our minds when we do it – this could include our family background, … , all that is in our heads. I think we have to reflect on that and it does give a different perspective on the nature or the nature of responsibility. Even emotions such as love, hate, fear and anger. There must be some sort of mechanistic description of how the brain works.  After all, if we do not, what other sort of explanation could there be?

JE adds: So Professor Blakemore is accepting payment for proselytising his rationalist position: to find a mechanistic description of how the brain works. In his opinion, there cannot be any other explanation.

Freud, whose aim in Part III of The Project is given as: ‘It must be possible to give a mechanical explanation of what I have termed “secondary processes” based on the effects produced by a group of neurones with a constant cathexis (the ego) upon other neurones with changing cathexes. I shall begin by attempting to give a psychological description of these processes’,

[Quote from ‘Part III, An attempt at an account of normal Ψ-processes’, 5th October 1895, p416 of Marie Bonaparte, Anna Freud, and Ernst Kris, (Eds.), The origins of psycho-analysis: Letters to Wilhelm Fliess, drafts and notes, 1887-1902, (James Strachey, Trans.), London: Imago, 1954: p347-445]

is dismissed.  He has been debunked.

This leads to Experts proclaiming their mastery of every individual’s unique brain’s workings. This leads to their proposing a clinic where these brains are modified by these experts in all human’s brains, so that a unique human BEING works to standard.

And the Government’s ethical response?  The Department of Health gets excited by the cost savings….  No more problems with unmeasurable therapists, etc & it fits into their Library of Standards as given in NICE clinical guidelines, Skills for Health’s competencies, the DoH’s outcome measurement as specified in the outsourcing of all interventions in the field known as Mental Health, the Health Profession Council’s Entry standards, fitness-to-practice standards and ethical standards and I could go on .. and on … and on ….  It is controllable, the DoH asserts.  Even the MPs can easily understand this approach.  It is tangible and sold by the Blakemore’s and Mlodinow’s of this world.  It is seductive.

Is the capacity to argue from principles lost?

Is the recognition of principles which drive these claims lost?

And it matters. The NHS is being evacuated of Talking Therapists who, according to Mlodinow, work unscientifically with the subject’s words. It is impossible to work within the Government’s Happiness Factories (IAPT) if you refuse to comply with its factory production mentality. So I return to my question: What are you prepared to do about this?  Do you feel strongly enough to arrange to meet your MP and explain these issues to them? Do you feel strongly enough to alert colleagues, friends, family, enemies, to what is going on?



[i] BBC Radio 4, Today programme @ approximately 7.30am on Wednesday, 5th September 2012 : Quoted from the BBC web-site

How neuroscience could help explain human emotions

Available here

Developments in imaging technology, genetics, brain chemistry and computing that raise the prospect of genuine breakthroughs across a range of debilitating neurological

The BBC’s science correspondent Tom Feilden asks what neuroscience has to say about what it means to be human.

The Professor of Neuroscience at Oxford University, Colin Blakemore, told him: “Until recently, neuroscience has not been delivering very clear messages about human behaviour. But we’re getting very close to that.”

Blakemore said we could soon have “some kind of mechanistic description” of what makes the brain makes humans feel emotions such as love, hate, fear and anger.

 

At approximately 9.30am on September 5th 2012, philosopher Mary Midgeley is included on the comments in BBC tweets.

 

[ii]   From Wikipedia, the free encyclopedia: available here : Functional magnetic resonance imaging or functional MRI (fMRI) is an MRI procedure that measures brain activity by detecting associated changes in blood flow.[1] The primary form of fMRI uses the blood-oxygen-level-dependent (BOLD) contrast,[2] discovered by Seiji Ogawa. This is a type of specialized brain and body scan used to map neural activity in the brain or spinal cord of humans or animals by imaging the change in blood flow (hemodynamic response) related to energy use by brain cells.[3] Since the early 1990s, fMRI has come to dominate brain mapping research because it does not require people to undergo shots, surgery, or to ingest substances, or be exposed to radiation.[4]

The procedure is similar to MRI but uses the change in magnetization between oxygen-rich and oxygen-poor blood as its basic measure. This measure is frequently corrupted by noise from various sources and hence statistical procedures are used to extract the underlying signal. The resulting brain activation can be presented graphically by color-coding the strength of activation across the brain or the specific region studied. The technique can localize activity to within millimeters but, using standard techniques, no better than within a window of a few seconds.

2 comments

9th September 2012

Hello Julia

You ask: “So I return to my question: What are you prepared to do about this? Do you feel strongly enough to arrange to meet your MP and explain these issues to them? Do you feel strongly enough to alert colleagues, friends, family, enemies, to what is going on? “

I totally see where you’re coming from but I don’t feel as strongly as you evidently do.

I happen to subscribe to the Brain and Mind section of Science Daily, an online resource emanating from somewhere in the US. As far as I can tell, a very large percentage of the ‘science’ stories touted on BBC News generally and the Today programme in particular, to which, like you, I am an avid listener, are lifted directly and often with little further critical appraisal from this source. Occasionally they are developed into features such as the one you heard on fMRI and its so-called findings. Such packages seem more likely to be produced when there are political implications or some ‘celebrity’ is involved [or, as in the case you cite, both].

Skimming some of the original accounts churned out by Science Daily, I am constantly struck by how much of current ‘research’ into ‘mental health’ is driven by the increased availability of scanning equipment, and how much of the ‘research’ produced by such methods seems to be of questionable value, even quite pointless.

Often it’s pointless because the hypothesis being tested is self-evident – except of course to health economists (for whom even ursine sylvan defecation would need to be evidenced in a peer-reviewed journal).

And sometimes it’s pointless in the way the research you cited is pointless – that is to say, because the paradigm within which it is conducted is itself of questionable validity.

Advanced technology such as the MRI scanner, it is not unreasonable to assert, is highly seductive to the sort of mind which is fascinated by the power to quantify phenomena – even private mental events – so that they may be manipulated within any context, but especially economics and politics. And MRI scanners, being capable of generating vast quantities of such data for almost any purpose the Empowered may care to name, are unlikely to be disinvented any time soon.

Those engaging in such reductionism are in my view unlikely ever to realise that there is such a phenomenon as self-deception, still less that they may be its unwilling subjects. Face it, the research paradigm in which they operate, and with it their whole existence, is premised on the denial of unconscious processes. Moreover, the same ‘scientists’ seem incapable of thinking beyond the envelope they have designed for themselves in which the value placed on their research is tainted by the powers that have given rise to it. It would be fascinating, would it not, to subject some of these researchers also to an MRI scan, preferably while they were themselves scanning their research subjects, and perhaps thereby to discover more about the content of minds which probe the content of other minds. [Fascinating, yes, but also dangerously tantamount to therapy and thus completely unscientific, right?]

As you’ll have gathered by now, I regard this particular line of exclusively content-driven scientific enquiry as a royal route to neuronal Nowhere. It’s utterly pointless. Equally pointless, therefore, would be any effort on my part to head these people off at the pass. Indeed I think it more productive to let them discover the impossibility of digitising and bar-coding humanity, and ultimately their own stupidity, in their own good time..

Yes, of course, this view may be seen as defeatist. It’s just that paradigm wars are inherently unwinnable. We can rail all we like against the medical model and its acolytes, and though we may succeed in halting it in its tracks occasionally, we are powerless to vanquish it. I think it better to simply accept that, notwithstanding the haplessness of some of its questings, it will always have a part to play in the story that is the human condition.

best wishes
Bob

by Robert Jenkins on 26/09/2012 at 5:20 pm. Reply #

Reply:

12th September 2012 (revised on 24th September)

Hello Bob,

Thank you for this response which certainly set me thinking. I set it to one-side for a considered response and realise that that is not going to happen any time soon. This autumn I have difficulty emerging….

Points of agreement:
There is no critical engagement with the sources, especially if a ‘celebrity’ is involved.
Research into ‘mental health’ is driven by the need to use, and prove how cost effective, much new technology is.
Much of this research is of questionable value, even quite pointless.
The paradigms, within which the research is conducted, are quite useless.
Scientists are not able to think beyond the envelope within which they cocoon themselves. (Yes, this point is made by Jacques Lacan in Seminar X: The Anxiety or Dread – L’Angoisse: Session of January 16th 1963. Also commented on in The Government as Sadeian experimenter by Julia Evans on August 17th, 2011 http://www.lacanianworks.net/?p=75 )
This particular line of exclusively content-driven scientific enquiry is a royal route to neuronal Nowhere

Points of disagreement
The linking of the utter pointlessness of this research to the pointlessness of any challenge
It is better to allow them to discover their pointlessness for themselves.
Paradigm wars are inherently unwinnable.
Although we may halt the medical model and others in its tracks, we are powerless to vanquish it.

JE comments:
I would like to avoid win-lose wars of who is right! I suspect that we both, as practitioners, practise from a similar position. It seems to me that the battle for resources is being conducted on a competitive battle ground. Thus, the provision of treatments is decided solely on which is the best value for money. There is no scratching the surface to critique the limits of the experimental box where these results are derived. Equally there is no critiquing the frameworks used for evaluation so ‘scientific’ brain scans or the application of 10 sessions of cbt win. My urging engagement is so that politicians, or those who make decisions about what treatments should be available stop swallowing these adverts for funding as THE truth. This research is useless.

I also strongly object to the claim that Freud has been debunked. As originally stated, none of those who make this claim seem to have read Freud. I have started a development timeline of Freud’s struggle to link psychic mechanisms with physical or bodily phenomena. Much of his work holds today, 100 years later. This timeline is available here: The Project for a Scientific Psychology: 23rd & 25th September & 5th October 1895: Sigmund Freud or here http://www.lacanianworks.net/?p=401

Some comments on the points of disagreement:
The linking of the utter pointlessness of this research to the pointlessness of any challenge
There is a zeitgeist of solidity about the way these experts from Cambridge and Oxford University speak. They spout certainties. These certainties are accepted because, in my opinion, the art of political debate has gone missing. No-one dares to bring these gods into question. Well, I dare & what is more I dare to do it within the institution set up for managing conflict of interest – the Houses of Parliament. Maybe I am not heard, and this issue of how money is spent on finding treatments for conditions defined by the Government-supported NICE guidelines as dis-being or substandard health is important enough for the attempt to be made.

It is better to allow them to discover their pointlessness for themselves.
In a therapeutic setting, yes every time. This battle is not going on in such a setting. Politics are being manipulated so that researchers who enjoy playing with expensive machinery, get funded. And counsellors are not now employed within the NHS, but in the Government’s contracted-out Happiness Factories. The attempt to cleanse the NHS of psychotherapists is on-going. They will probably win and replace them with ‘scientific’ solutions as above or drugs. (I recommend the Guardian article: The drugs don’t work: a modern medical scandal | Ben Goldacre, published on Saturday 21st Sep 2012)
Paradigm wars are inherently unwinnable.
Probably, yes and the arguments for and against their position need to be made and loudly. This is not about winning, it is about the practice of talking therapies being wiped out. It is a survival battle. With a practice, let’s call it talking therapy, it is more important that the subject finds it of use than that the paradigm is correct. A practice, whether yours or mine, evolves. In order for a practice to develop, it has to be held in a place, by practitioners, in a network of relationships called supervision, case studies, explorations of tactics and frameworks, and so on. This is very far from arguing over paradigms. By and large, practices do not register on ‘scientific’ measures of evaluation. Does this invalidate practices? is the battle I am engaged in.
Although we may halt the medical model and others in its tracks, we are powerless to vanquish it.
Clearly so as Sigmund Freud was arguing against the medical model, over 100 years ago. My reason for engaging with these arguments is two-fold: 1) So that its limits become recognised. The medical model will not cure all conditions of human distress. 2) So that politicians and civil servants stop treating it as unchallengeable. The only prism through which human suffering can be viewed.

My concern is that when this nonsense is sold as the way forward for clinics of ‘Mental Health’ conditions, and politicians believe them, there are consequences. The talking therapies get wiped out within the NHS and from its contracted-out services on ‘evidence’ such as this. Courses in the humanities, psychotherapy – Roehampton, I think, and so on, get wiped out as funding goes to the certainties of this garbage.

I am so concerned about the domination of this unexamined nonsense within the Department of Health and both Houses of Parliament, that I believe it is worth the risk of engagement with the human beings who inhabit these structures to see if the Government can be persuaded to give up its ambition of protecting all subjects’ health and well-being – see Health Professions Order 2001.

As an example of the gullibility of Parliament, a retired Professor of Economics, became their chief guru for dealing with mental health issues. On his advice, all counselling has been eliminated from the NHS and put in the Government’s contracted-out Happiness Factories or IAPT. He is still at it – see ‘We need a new mindset on mental health’ by Richard Layard, Financial Times, September 11th 2012 (http://www.ft.com/cms/s/0/efb55ada-fb32-11e1-a983-00144feabdc0.html#axzz27aoeRVQE ). There is a new unsubstantiated judgment in every paragraph. Example: ‘Since 2008 the NHS has greatly improved what it offers people with depression and anxiety disorders. Until then little more was available than medication and, occasionally, counselling. Now we have treatments such as cognitive behavioural therapy, usually involving fewer than 16 sessions. Research shows that these lead to 50 per cent recovery rates within four months. In 2004 the National Institute for Health and Clinical excellence determined that these therapies should be offered to all people with depression or anxiety disorders.’
So ‘scientific’ research is swallowed whole and not questioned because it is scientific.
The DoH and the Government believes this ‘scientific’ evidence and think they have got conditions known as Mental Ill-Health solved. It is not challenged.
I maintain that this form of governance, modelled on the Emperor’s New Clothes, has to be challenged. I will not lie down waiting for them to see the error of their ways for themselves. This is a power battle and the ones who are suffering are at the bottom of the pile. Challenging this for me is a no-brainer, for you it is inevitable so why bother? And may be you are correct, and it has to be worth a try.

Thank you once again for engaging with my position.

Julia

by Julia Evans on 26/09/2012 at 5:32 pm. Reply #