Recommendations for psychotherapists studying neurobiology

Authored by Henry Strick van Linschoten

A difficult subject

Neurobiology, even more than biology in general, has become deeply rooted in a multidisciplinary background. As a result, a full insight and evaluation capability of neurobiological research requires a reasonable command of a number of sub-disciplines, including biology itself, chemistry, biochemistry, physics and computer science. Nevertheless, there are possibilities for an educated professional from a different discipline such as psychology to not only make sense of what is involved in neurobiological research findings, but to do this at a level substantially ahead of journalistic popularisation.

Character of the module’s study material

The neurobiology module contains videos / audios as well as a number of papers with bibliographies. The recorded material is unique and provided by contemporary experts in their field, who give their own point of view, usually about specific topics that they saw fit to highlight. They do not generally try to give systematic overviews of the whole field. For a fuller perspective it is essential to review the literature, guided by the overview and structure provided in the module’s papers.

Auxiliary materials

Other than formal study, going to lectures and viewing television or DVDs, the world-wide web is becoming a major source of knowledge, even at the academic level. Additional materials should be adapted to the optimum learning style of the student. In the field of neurobiology a range of high-quality sources in the form of books and articles is recommended in the bibliographies of the module papers. On the Web, wikipedia is especially good in the fields of biology, neurobiology, chemistry, genetics, evolution theory and computer science.

There is also a large number of videos available on the Web, starting with YouTube, of course of variable quality. A few videos have been recommended in the references of the papers. Out of a number of universities, MIT in Cambridge, MA are offering a substantial part of their courses in biology, neuroscience, neurobiology, cognitive science, anatomy and physiology via the Web for free. A particularly relevant course is Duke University’s online course in Medical Neuroscience. This is an important and valuable source of information that can supplement the module in aspects that are of special interest. A third option is the online neuroscience textbook of the University of Texas.

Studying method

The module papers assume that the reader will read with a computer alongside, ready to look up unexplained new words and concepts. Via search engines and wikipedia there is also a large number of images, important for most people for visualising the location of parts of the nervous system.

Helpful attitudes for study and evaluation

The following may be positions that will help in studying and processing new ideas in neurobiology:

• Assume that mind and body are always acting in parallel. Mind activity always has a counterpart in the body or mind; body or brain activity always has a counterpart in the mind. The mind here encompasses the conscious and the unconscious mind.
• In any relevant psychological or neurobiological manifestations, consider what happened to be part of a system, and try to imagine what the elements and the scope of the system may be. Even a system does not operate in isolation, but has an outside, environment or context. Complex explanations are inherently more likely than simple ones. Causality is almost always multiple. Environment and genes always interact and work together.
• Organisms and non-human or human animals always develop over time. The past influences the present. Always consider a developmental view.
• When the research you read or the conclusions you reach involve causality, consider how this could be used for intervention, prevention or change. An explanation of causality or aetiology rarely produces an automatic answer that can be used for cure or treatment.

The problem of controversies and contradiction

Popular presentations of neurobiological findings almost always overstate the degree of certainty, clarity, simplicity and originality of what they report – if not in the research article itself, then in the reporting of it in the media, in news items on the internet, and in secondary sources, including popular books.

Even top researchers and leading senior professionals, in order to take a topic forwards, may need to emphasise one side in a controversy, or focus on vocally stating a position or one aspect of a complex issue, in order to clarify what they have contributed or found. This also serves the scientific purpose of making it easier for reviewers and critics to know precisely what their position or claim is.

This represents a problem for all students of neurobiology, and especially for mental health professionals who aren’t neurobiology insiders themselves, but who want to apply neurobiological findings to their practice, or need clarity in order to engage constructively with the certainties and convictions of their clients.

Examples

A well-known example is the aetiology of schizophrenia. Setting aside the legitimate questions about its scope, definition, diagnosability, validity and unity or multiplicity as a ‘syndrome’, there are currently a number of aetiological explanations. One is the long-standing dopamine hypothesis, still quoted by some as an example of the achievements of biological psychiatry, This flies in the face of most textbooks now stating that it has been largely abandoned, in line with the conclusion of a recent review (Howes & Kapur, 2009) that the earlier versions of the dopamine hypothesis, especially what they call “Version I”, attributing schizophrenia to an excess of dopamine, has been overtaken by new research. A different view one hears expressed about schizophrenia is that it is most likely or always caused by childhood abuse, often held strongly as a monocausal explanation. The overview article by Howes & Kapur (2009) is an excellent example of moving from a monocausal simple explanation to the complex set of multiple causes that characterises modern neurobiology, pulling together genetic, environmental, dopamine and abuse interpretations, and repays a careful read.

Another good example is the development of thinking about autism. Autism has been recognised for half a century, possibly longer, and Asperger’s also for more than 50 years. Over that period there has been a long list of presumed causes, many of which were stated by reputable professionals as very definitely certainly established.

Suggested causes have been “refrigerator mothers”, genes, childhood abuse, family system dynamics, environmental toxins, neurotransmitter imbalance, vaccination, and pre- and perinatal events. For treatment, psychoanalysis, family therapy, behaviourist methods, diet, special forms of training have all been proposed. And there is also the suggestion that no treatment is necessary, but that “neurodiversity” should be accepted.

Mirror neurons are a third example; different views have been summarised and referenced in the paper ‘The neurobiological basis of human relationships’.

Some questions are how unusual the mirror neurons really are, what exactly their function is, the transferability of monkey research to humans, and, even if certain psychological capacities could be confidently linked with the mirror neurons, what could be done with that knowledge.

Dealing with contradiction

There is not much else that can be done than starting with acceptance. In this field some views are really beyond the pale, but a historical perspective shows that even ideas that were once completely abandoned have made a come-back. A realistic but far from easy approach is trying to hold the strongly expressed and supported single views simultaneously as a set of possible contributory causes. This may make it harder to move from understanding to action, but in the face of the actual certainty of almost all research evidence, of the likelihood of multiple causation, and of a review of the historical ups and downs of different explanations, it seems a well-founded position to take.

As regards the equally important question of responding to clients who have strong monocausal explanations that they believe apply to themselves or to people near to them, it usually is a good tactic anyway to try to advocate a shift from rigidity to flexibility, and to suggest that there is less certainty about their views than they think, and than they believe they can conclude from the reports they read about research “evidence”.

References

Howes, O.D. & Kapur, S. (2009). The dopamine hypothesis of schizophrenia: version III – the final common pathway. Schizophrenia Bulletin 35: 549-562.