“The gap between what we know and what we do is unacceptable.” Dr. Thomas Insel

The quote is from this article:

https://www.theatlantic.com/magazine/archive/2017/07/the-smartphone-psychiatrist/528726/

It seems like every shimmering insight into disorders of the mind over the past century has become the subject of intractable controversy. The terminologies ‘brain’ and ‘mind’ are not interchangeable, however, the mind is a composition of certain functionalities of the brain and all of the neural processes than maintain the semblance of ‘mind’, that is why advocates speak of brain disorders when referring to SMI.

DJP has stated before that it looks to the future of neuroscience to civilize the criminal justice system.  It was also stated in a prior blog article that we need not look further than the past, harkening back to the M’Naghten case of 1843 to find a criminal justice system giving proper respect and deference to medical doctors.

The following article “Rethinking Schizophrenia” discusses how the conceptualization of Schizophrenia has been in flux and controversy over the past century.

https://www.researchgate.net/publication/47743031_Rethinking_Schizophrenia

DJP believes that Dr. Insel has been on the right path in exploring sound approaches to research into this complex disorder. However, DJP believes that there is still a critical aspect of Schizophrenia that is still outside the scope of how it is currently conceptualized.  Recently, a post was added to the About Psychosis page that discusses the overlap between Temporal Lobe Epilepsy and Schizophrenia.  We ask, would the Sz-type symptoms that occur in any ictal phase of TLE be construed as psychosocial?  Probably not.  Clearly, some of the symptoms are indicative of disorder of consciousness.  Why then, do strikingly similar symptoms in Schizophrenia continue to be relegated to the psychosocial?  Why does research into this disorder continue to be adversely impacted by fractiousness among credentialed professional in the fields of psychology and psychiatry?

Now, where violence becomes the subject, rationality and logic succumb to cognitive bias with regularity.  DJP has been caught off guard to find some reports where there has even been dissociation of paroxysmal type violent behaviors from Epileptic/seizure disorders.  Where harm was done to another, it was hypothesized that there was some intervening (rationalized) emotion brought about by stressors, which in turn, triggered the violent behaviors, even when there was a patient history of stereotyped violent motor activities.

The clinging to psycho-social constructs of Sz continues to kick off endless iterations of the same stress/trauma theories, which are sometimes masked by dense statistical metrics and scientific jargon. The reader must be astute in deciphering research papers such as these to discern where there is rehash of well-worn theories of stress/trauma/environment.  Sometimes, they erupt and give themselves away in conclusion after drawing the reader in.

It is no wonder that the field of psychiatry is not respected on the level of other specialties of medicine. DJP would prefer that the medical profession get a grip and reign in the practice of psychology (vs. psychiatry, which should not cast aspersion on all psychologists) so that the corrosive influence of troublesome factions does not continue to hold back research and cooperate with the regime of criminalization by its regressive orthodoxies.  The factions need to stake out their territories, be clear where they stand on the controversies, cede to where there is consensus about the unknown, and make peer-review of some of the junk science accessible to the public.  There is a whole lot of ignorance about SMI out here.  Someone has to lead the way into enlightenment.

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