Talking to someone convinced mental distress is all biological

Talking to someone convinced it’s all biological
By Ron Unger

Many people are still convinced that the “scientific” understanding is that if a person is diagnosed with a “mental illness” such as “schizophrenia” then this means they have a genetically determined brain dysfunction that has nothing to do with what happened to the person. Of course, such a view is really about as scientific as the flat earth theory!

If you are trying to communicate with such a person, on bit of suggested reading might be the article described below:

“Childhood trauma and psychosis: Evidence, pathways, and implications”, W Larkin, J Read. J Postgrad Med [serial online] 2008 [cited 2008 Nov 2];54:287-93.

Description of the article:

There is currently a growing body of research examining environmental factors in the etiology of psychosis. Much recent interest has focused on the relationship between childhood trauma and the risk of developing psychotic experiences later in life. Numerous studies of psychiatric patients where the majority are diagnosed psychotic indicate that the prevalence of traumatic experiences in this group is high. This body of research now includes many large-scale population-based studies controlling for possible mediating variables, which together provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Several psychological and biological models have been proposed which offer credible accounts of the processes by which trauma may increase risk of psychotic experience. Clinically it is imperative to routinely inquire about traumatic experiences, to respond appropriately and to offer psychosocial treatments to those who report traumatic life events in the context of psychotic experiences.

If the person you are trying to communicate with still denies a possible role of trauma after reading that article, unless he or she comes up with a good point by point refutation of the article, I would get more curious about what are the advantages to the person to believe that trauma has no connection to psychosis and schizophrenia. Because mental health professionals and others who belief themselves “experts” are really no different from people who get called clients in one respect: both groups often believe things for emotional reasons rather than due to real evidence or logic.

Of course, the person you are talking to might just maintain that there is a huge pile of evidence pointing to the existence of brain dysfunction in people who have been diagnosed with schizophrenia – certainly there is evidence of brains operating differently when people are psychotic, but then again, so is there evidence in the cases of people who have been traumatized in general. And there is evidence that at least very frequently, the brains of people with schizophrenia have many structural differences from the average person – but then again, the same turns out to be true for people who have been traumatized, and many of the brain differences show to be the same for both groups.

As for whether or not people end up labeled with schizophrenia due to genetic differences – I think we could really waste our time trying to argue that there is no such thing as a person who is more genetically vulnerable to schizophrenia than another person. More likely, some people are genetically more vulnerable, just as it is also likely that some people are more genetically vulnerable to get PTSD and studies exist that at least suggest this. But that doesn’t mean that we know that just because a person fits the diagnostic criteria for PTSD or schizophrenia, that this person has any genetic vulnerability. It could be that life events and trauma hit that person hard enough, for a variety of reasons, to cause the disorder even though the person had no greater than average vulnerability. One thing that doesn’t exist is any evidence to show that there exists a sub-population that is invulnerable to schizophrenia, or to PTSD.

Anyway, I hope this information and these arguments are helpful to any of you who have to communicate with people who are still believers in the exclusively biological theories about mental health difficulties.

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