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Tuesday, 20 December 2011


I admit I am way in over my head here but it is something that is coming up more and more.  So here's my cockamamie theory.

Mental illness has been all about the "mind" and Freud and his psycho-balderdash but we are now discovering that it is more and more about the brain, the physical entity.  Recent work done by clever clinicians in different "mental illness" fields (and some in the same fields coming to the same conclusion from different angles) seems to show that a physical malfunction in the brain can explain a variety of different disorders.

"At present, nearly all of the therapeutic approaches for treating eating disorders have been borrowed from the treatment of other disorders. In addition to factors noted above, a major impediment to developing novel treatments for eating disorders is the lack of a clear understanding of their underlying pathophysiology. Although pathophysiology has been fundamental to the science of cancer, heart disease, and endocrine disorders, the science of mental illness has largely been preoccupied with diagnosis, the development of theories based on observations of behavior, and the promotion of treatments suggested by case reports. This picture is changing with the increasing recognition that mental illnesses are brain disorders (Insel & Quirion, 2005). Unlike neurological disorders with focal lesions, mental disorders appear to involve abnormal activity in brain systems. One implication of this recognition of mental disorders as brain disorders is that the pathophysiology of mental illnesses, including eating disorders, can be approached with the tools of modern neuroscience as well as the behavioral and observational tools of psychology." ( - for full article)

Bring on Cool Brain Guy....

So I get all that.  I understand it is time to move away from the flim flammery of whether you fancy your father and/or are feeling upset because you were born without a penis (Huh??).  What I think we are missing here is using the whole body, including the brain, for diagnostic and treatment purposes.

When treating an eating disorder, refeeding the body and brain to a healthy weight is the first step on the road to recovery.  It is about food, not feelings.  However, other "mental illnesses" also result in a serious lack of care for physical wellbeing. I am not talking only about deliberate self harm here, in the form of cutting or drugs or somesuch.  I am also talking about neglecting to eat properly, wash, general cleanliness or, at the other end of the spectrum, overwashing and obsessiveness about cleanliness.  Surely, all mental health patients should be helped with their PHYSICAL wellbeing too?

What I am saying (waffling?) or rather asking; Is it time to stop treating the brain as an entirely separate entity from the body and start treating the body as a whole?  

1 comment:

  1. Aaactually (this is the part where I plug my theoretical approach :P ) CBT doesn't treat them as separate. An integral part of the theory is that thoughts and behaviour can affect physical health and vice versa, and that all aspects of the problem have to be tackled for the person to recover. It might lead with the cognitive and behavioural because those are more easily influenced to begin with (for example, if emetophobic like myself you can't just order yourself to stop feeling sick, but you can do relaxation techniques and distract yourself from ruminating about it), but both sides are most definitely focused on. CBT wouldn't exist without that idea.

    However, in some other areas of psychiatric treatment this idea has yet to catch on...