Friday, January 25, 2013

Gun Issues: Sometimes Global Suggestions are just too Simple to be a Solution


By Gary Berg-Cross

Martin Seligman, former president of the American Psychological Association, wrote in the Washington Post, recently on the gun problem and mental health. The general idea is that better “mental health services” would help prevent “mass shootings.  Building better facilities for the mentally ill and being more proactive about putting dangerous people in them seems a reasonable precaution given the abundance of weapons in these United States.  But can we identify such dangerous people?

Seligman is not so sure that we should head off in that direction without some thought.  For one thing it is a seductive, mass effort that could deflects us from “other actions that would save lives." That is it may serve as Seligman put it to "compound our national reluctance to face facts about what can and cannot be changed."

And then there is the problem of the maturity of understanding the concept of mental health and illness (MI)  itself along with treatment. Seligman and others are disappointed with things like drug therapy which has been a 25 year effort at billions dollars costs. It’s a seductive model based in part of the idea of brain chemistry and balance.  Powerful model, but perhaps only part of the picture.  Magic bullet meds offers little current promise to confidently mitigate violence in the mentally ill.

Part of the problem is as developmental psychologist Jerome Kagan put it an article called “The Ghost in the Lab”  is that there have been too many clinical psychology misadventures in understanding what we broadly call Mental Illness (MI).Sure the Diagnostic and Statistical Manual of Mental Disorders ( DSM) provides Torah-like guidance on allowable categories for mental illness. But these psychiatry-based categories are rather superficially (faith?) based and are indeed the only disease categories in all of medicine that do not take etiology (development) or cause into account. Basing disease category diagnosis only on symptoms is a no-no to a developmentist. Kagan points out that this would never occur in mature health fields like cancer or cardiology or immunology, where you always diagnose on the basis of the cause as well as symptoms.

If we are really serious about making progress on MI we need to collect psychological and biological evidence, not just reports of symptoms. And indeed there is growing evidence (Drs. Paul McHugh and Phillip Slavney in "The Perspectives of Psychiatry.") that there are several causes for major depressive disorder. In other words something we call by one name is more like a family of 5- 6 different diseases with 5-6 different causes:

“origins in brain disease (e.g., autism, schizophrenia); temperamental biases for anxiety and depression (e.g., phobias, depression, obsessive-compulsive disorder); temperamental biases that make it difficult to regulate impulsive behavior (e.g., ADHD, conduct disorder); or distressful life encounters (e.g., grief, adjustment disorders).” (from APA Monitor)

One single "family" or method cannot explain all mental distress and simple programs based on these might be expensive and counterproductive without the proper science.


Guns and MI :

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