NeuroAnalysis New Edition 2019
A Unifying Theory for the Future of Psychiatry Abraham Peled M.D.
As early as 1990, the year I began my residency, it was clear to me that psychiatry has a descriptive diagnostic system (signs and symptoms) because there is no etiology (known causes) of psychiatric disorders. Even though we were taught that mental disorders are disorders of the brain, this idea is not evident in our conceptualization of mental disorders. Terms like “depression” and “anxiety” are not brain-related, as are “encephalitis” and “CVA,” terms that include the brain in their taxonomy.
Theodor Meynert and Sigmund Freud; Dialog on the future of Psychiatry
In this fiction Theodor Meynert and his student Sigmund Freud are projected in time from the late 1800’s to the present. They are updated with the current state-of-the art sciences of the brain, neurology and psychiatry and they meet in a café in Vienna to discuss the cutting edge of psychiatry circa 2011, and offer a fresh outlook for the future of the field.
Clinical Brain Profiling Theory in a Nutshell
The plasticity theory for psychiatry is rather straightforward. It is based on two assumptions
1) Emergent properties from the brain, and
2) brain network dynamics.
Emergent properties are typically defined by the statement that the “whole is more than the sum
of its parts”. This is true for systems characterized by non-linear interacting elements. The
emergent properties evolving from the complexity of the brain are phenomena such as
consciousness, mood and personality. One neuron, or even a large group of neurons, do not show
characteristics such as consciousness, mood and personality. However the whole brain
integrative activity does. Thus, in disturbances to consciousness, mood and personality, we
assume that whole brain organization will be influenced.
Debra BrandDan Moor drove into the parking lot at University Hospital and pulled into an empty space facing the building. He switched off the engine and sat behind the wheel, staring at the psychiatric wing. Of average height and build, Dan’s sandy colored hair bordered on unruly. He ran his fingers through it now, feelings of anticipation and apprehension making his stomach churn.
Neuroanalytics for Neuromodulation
Neuromodulation is the next big challenge for Psychiatry. Technology of Neuromodulation isadvancing fast and is being tested on patients. However, the challenge of where and when tostimulate reminds us that we have not fully defined the underlying causes of mental disorders.Moreover, the etiology of mental disorders is essentially still lacking. This book was writtenbearing in mind that before advances in Neuromodulation can be achieved, a reasonable theoryfor guiding modulation needs to be formulated. Such a theory should be based on the availableknowledge accumulated in the field of computational neuroscience.
BRAIN DYNAMICS AND MENTAL DISORDERS:
The project for a scientific psychiatry is an ambitious endeavor. It opts to complete Freud’s original effort to explain the physical (neuronal) roots of mental phenomena. Achievements in biological psychiatry reflect the consensus that psychiatric mental disorders are brain disorders. However, we do not have enough knowledge about the exact processes underlying the different mental disturbances. Without understanding of the specific causes for mental disorders, their diagnosis is descriptive and subjective, thus unreliable and deceptive. Two reasons for our shortcomings in this field. Firstly, not enough is known about how the brain works to enable high mental functions. Secondly, there are no good theoretical frameworks or models that can explain the underlying neurological pathology of mental disorders. In 1895, Sigmund Freud attempted to explain mental phenomena and mental disorders based on neurological brain functions. He wrote in his manuscript titled Project for a Scientific Psychology “The intention [of this project] is to furnish a psychology that shall be a natural science” Figure 1. By natural science, Freud meant disciplines like biology and physics that deal with matter by using measurement and experimentation.
Neuroanalytic Manual NM 0.1
Psychiatric diagnosis based on the DSM is descriptive. The DSM is a set of descriptions (signs and symptoms) with a title. For example, if the patient is complaining about sadness, helplessness, insomnia, and lack of motivation he recives the DSM title of “Depression.” Unlike psychiatry, in other fields of medicine the diagnosis is etiological meaning that the name of the disease is the cause of the disease. For example, “Appendicitis” involves a location in the body, the Appendix, part of the intestine, and it is infected, as “itis” indicates. Another example, “Mitral Valve Prolapse” indicates valve insufficient closure, in the heart, again a location in the body and its related pathology. “Depression,” “Anxiety” and all other psychiatric diagnosis are not in any way body-locations or pathologies. This is because the aetiology of mental disorders is simply unknown thus psychiatry is stuck with a descriptive diagnostic approach of the DSM.