Biology Is More Than The Body
Michael Karson is a professor in the Graduate School of Professional Psychology. He has taught at the University of Denver since 2003. Before entering academia, Karson practiced clinical and forensic psychology for 25 years. Since 1997 he has authored five books and he publises the blog Feeling Our Way.
Contemporary psychology is under the sway of brain science, and the effects are not good. Yes, there are some mental illnesses whose linkage to brain defects was once ignored, including schizophrenia and autism, and it’s a good thing that these are now recognized as brain diseases and not as parenting outcomes. But the current trend is to link all bad behavior to the brain. When the addicted, the arrogant, the anxious, and the alienated—annoying people—are confronted with their annoying behavior, organized psychology is in league with psychiatry on the issue of alleviating them from responsibility by framing their behavior as a problem with the brain. We are expected not just to be understanding when they tell us the name of the disorder they have been found to have, we are expected to stop being annoyed.
There’s a pretty well-known book called The Gift of Fear, about listening to our fears to know when we’re in danger. I blogged about the gift of anger, here. There’s also a gift of annoyance. Other things being equal, you can often tell when an ill person is succumbing to disease and when he or she is capitalizing on a disease by the annoyance you feel. This was beautifully depicted in The Good Wife by Michael J. Fox’s portrayal of a cutthroat lawyer with tardive dyskinesia. Even when he is near death and in a wheelchair, the other lawyers roll their eyes at his appeals for sympathy in court. You sense the distinction your annoyance makes when you respond differently to elderly and inattentive drivers (and no, the latter are not “addicted” to their phones, although don’t be surprised when Big Pharm puts out a drug for their condition).
It’s all about money and blame. In Psychiatry Under the Influence, Whitaker and Cosgrove explain how the licensure of psychologists to practice psychotherapy independently left psychiatrists vulnerable to being undersold. They responded by crawling into bed with Big Pharm and medicalizing unwanted behavior and emotions. That’s when the DSM gave up “reactions” and created “disorders.” Since then, every annoying person has the brain to blame, and we are told repeatedly that to be annoyed by a behavior is callous once it is labeled as borderline or as anxiety or as depression. The bigger problem is the difficulty in finding a way to view behavior through a psychological lens without blame. When the world feels like a courtroom, it can seem as if the only two outcomes are guilty or not guilty. But we don’t have to accept the premise that the world is a courtroom.
I wonder how biological our current medicalization of behavioral and emotional problems really is. In The Extended Phenotype, Dawkins argued persuasively that it is important for biologists to keep in mind that the only thing genes do is to synthesize proteins; everything else is interactional with the environment. If you want to understand natural selection, then, you have to acknowledge that it operates not just directly on what genes do, and not only on the bodies that genes make (with ingredients from the environment), but also on the behavior of organisms. The genes that make beavers that make dams are selected by the success of the dams that are made. The dam and its reservoir, often covering acres of land, are as much a phenotypic expression of genes as are eye color and whether your earlobes are attached. Especially important to the question of psychological functioning are phenotypic expressions that affect other organisms. On an interspecies level, the cuckoo is Dawkins prime example. They lay their eggs in the nests of other birds that mistake the chicks for their own. They are not evil birds; they’re just capitalizing on the feeding behavior of other birds. Within our species, genes that make humans that can collaborate are selected by natural consequences when collaborators get things done, and genes that make humans that can take advantage of the collaborative nature of most other humans are selected by the extra resources they garner for their hosts.
My point is that even a purely biological view of a person would not frame behavior and emotion by looking only, or even primarily, at the brain. This framing is useful up to a point when the brain is defective (or when you are selling a product that claims to affect the brain). It’s useful only up to a point because interventions will still need to take a broader focus. A similar thing happens when a child smells and it is discovered that the reason he isn’t washing properly is that a hairline fracture makes it too painful to reach certain areas. The diagnosis of a fracture doesn’t mean that we have to tolerate the odor. It means that the intervention strategy will be different—skills training rather than exploration of the function of annoying others. (But don’t be shocked if one day he seeks to be pampered not by charming other people but by allowing himself to smell.)
Behaviorism teaches us to examine the immediate environment of any behavior to understand the phenotype it expresses. Systems theory teaches us to focus especially on the humans in that environment and to expand the relevant immediate environment to a communicative network. A real biologist, as opposed to an elixir huckster, would explore the effects of problematic behaviors on other people, rather than focusing on the brain. To limit psychology, even biological psychology, only to the body of the organism without considering its effect on other organisms is cuckoo.