A disease of the brain, but not of the mind?

Besides the NBC evening news, the only show I regularly watch on television is “Sixty Minutes,” and I try not to miss it each Sunday. Last night’s episode (consisting, as usual, of three disparate segments) was good, but there was one thing that I’d like to nitpick. (At least I’m not saying that “I don’t mean to nitpick, but. . .”).

The best segment, I thought, was one on schizophrenia, describing its symptoms, giving some distressing interviews with sufferers, and showing how many prisons have now become a repository for the mental ill. Cook County jail (here in Chicago), for instance, was described as “the largest mental institution in the United States.”

In much of the 13-minute piece, which you can watch free here, Steve Croft interviews Dr. E. Fuller Torrey, perhaps the country’s reigning expert on schizophrenia. its etiology, and its relation to crime. It’s heartening to see how hard Torrey fights to show that crimes committed by many of these people, including some recent and horrific massacres, is not their ‘free choice’ but the result of their disease.

I highly recommend watching it, if for no other reason than to hear some schizophrenics describe, with great lucidity, the horrors of their malady and the persistent voices in their heads that tell them to kill not only themselves, but others.

My quibble occurs during the discussion between 3:45 and 4:01, when Kroft is interviewing Dr. Jeffrey Lieberman, another schizophrenia expert and the president of the American Psychiatric Association, who shows Kroft a scan of a “normal” brain and a “schizophrenic” brain. As you can see below, there’s a dramatic difference. Of course, the brain abnormalities might be the consequence rather than the cause of schizophrenia, an issue that’s ignored.

_________

UPDATE: A neurologist, Ian Belson, has said in a comment below that these are both images of the normal brain taken at different levels. If that’s the case, CBS has made a serious error.  Belson’s comment:

As a neurologist who looks at MRIs daily I just thought you should know that your pictures are two images of the normal brain that were taken at two different levels. The structural differences between a schizophrenic and a normal brai are usually much too subtle to be seen on a routine MRI.

_________

“Normal brain” (screenshot from the show):

Picture 3

Brain of schizophrenic; arrows show abnormalities supposedly associated with the disease:

Picture 2

After seeing this, the pair have this exchange:

Kroft: This is really a disease of the brain, and not a disease of the mind.
Lieberman: Absolutely.

That’s not good; for the mind is, as Pinker says, “what the brain does.” In the case of schizophrenia, if there is a genetically (or environmentally) based pathology of the brain, it also causes a pathology of the mind: racing thoughts, voices in the head, and desires to harm.  So it’s a disease of both the brain and the mind. Television shouldn’t perpetuate this duality.

But, as I said, this is a quibble, and I think the show did a service by getting people used to the fact that criminal behavior may not be a choice. As you know, I don’t think any criminal behavior is a “choice.” In some sense, all criminals have brain diseases, and that needs to be taken into account by the judicial system.

87 Comments

  1. Cara
    Posted October 1, 2013 at 4:28 am | Permalink

    Subscribe.

  2. Posted October 1, 2013 at 4:32 am | Permalink

    “In some sense, all criminals have brain diseases, and that needs to be taken into account by the judicial system”

    Wow! I’m interested in more insight. Perhaps the definition of criminal would help me?

    The boy stealing from the corner shop, maybe dared to do so by his friends? Sales reps fiddling their expenses, just a bit?

    • Posted October 1, 2013 at 4:40 am | Permalink

      My point is that no behavior is a “free choice” in the sense that it is independent of one’s genes and environment. In fact, I think that all “choices” are deterministic products of one’s genes and environment,which completely dictate what we will do. That means that while we are responsible for our acts, and that needs to be dealt with by society, we are not MORALLY responsible.

      I’ve talked at length on this site on the implications for the criminal justice system and won’t reiterate those here. Just search for “free will” on the site.

      • Romuald.
        Posted October 1, 2013 at 7:03 am | Permalink

        I’ll play the devil’s advocate now(as often) : even if what you say is true, it shall not be said. Because it will push people towards excuses.

        “I’m tempted to drive beyond the speed limits, but the fear of radars stops me”.
        “It’s not my fault!!!”.

        I mean, most people want to do forbidden things, and the fear of consequences is a deterrent in many case. consequences may be legal, or divine(for those who believe, like my wife), or lost friendship, or whatever.

        I’m undecided on the topic of existance of free will. But, even if free will does not exist, it is a useful illusion, as it gives a sense of responsability to people.

        • jay
          Posted October 1, 2013 at 12:14 pm | Permalink

          Modifying our behavior to avoid bad consequences is a perfectly normal function of mind, both human and animal.

          • Charles Sullivan
            Posted October 2, 2013 at 2:29 am | Permalink

            What does it mean to be responsible for your actions but not morally responsible for your actions?

            If all we mean is “these actions emanated from my body” then so what? It’s like being responsible for having the hiccups.

            How can you be responsible (without completely obliterating the meaning of the concept of responsibility) if you can’t decide how to act?

            If you’re a puppet on a string, whence responsibility of any sort?

            I would suggest that talking of responsibility that’s not moral responsibility is either trivial or meaningless.

  3. Jesper Both Pedersen
    Posted October 1, 2013 at 4:43 am | Permalink

    I think I’m one of those people that will never fully grasp the subtle distinction between mind and brain.

    The brain and the mind are one and the same… or am I missing something?

    • Posted October 1, 2013 at 4:57 am | Permalink

      Well, a popular analogy is with computers: software (mind) running on hardware (brain). But like many analogies it’s flawed as mind and brain are really the same wetware: mind is more than neurochemical activity in the brain (which by itself would be close to the software analogy) as the “wiring” of the brain changes over time with experience and learning. (A hasty and imprecise description, but I hope the gist is clear.)

      /@

      • BradW
        Posted October 1, 2013 at 5:03 am | Permalink

        Can one have “mind” w/o having “neurochemical/bioelectrical activity in the “brain”?

        • Posted October 1, 2013 at 5:09 am | Permalink

          Possibly, but we haven’t seen one.

          On the other hand, it seems unlikely that we can have a mind without some kind of material substrate. That way lies supernaturalism… 

          /@

    • Posted October 1, 2013 at 5:03 am | Permalink

      You could talk about a brain and wish to only talk about its physical existence. On the other hand, when we speak about our mind, that can imply some possible intention. “Brain your own business” or “That escapes my brain” are not sayings we use… So there a semantic difference, namely what aspect of ourselves we wish to speak about in context.

      • Posted October 1, 2013 at 5:10 am | Permalink

        But when you’ve been knocked unconscious you might say that you’ve been brained… (when you can say anything again).

        /@

        • Posted October 1, 2013 at 5:22 am | Permalink

          Ah, I haven’t had the opportunity. Yet!

          I am sure there is the correct distinction between mind and brain on this website somewhere. But in the meantime, I’ll have a go: What we perceive to be our minds is dependent on us having our brains. However, the existence of a brain does not necessarily have a perception of mind as a consequence, depending on whether or not that brain is attached to a function support system, and dependent on the development on the whole entity.

          And now my mind hurts…

      • Jesper Both Pedersen
        Posted October 1, 2013 at 5:14 am | Permalink

        But surely the mind isn’t independent of the brain and not the other way around?

        A mind is a human construct that has no matter or physical properties while the brain is real regardless of human ideas about the mind.

        In short I think this double-whammy definition of the brain as something dualistic mainly serves to confuse and blur the defintions.

        The mind is an idea, the brain is matter.

        Does that make sense? 🙂

        • Posted October 1, 2013 at 5:44 am | Permalink

          “…A mind is a human construct that has no matter or physical properties while the brain is real regardless of human ideas about the mind. … The mind is an idea, the brain is a matter. …”

          Any thought must be represented in the physical world somehow, or it would not exist. I think you agree on this one, it just didn’t come out this way in your comment.

          We are all bound to trip over imprecisions with these distinctions. Je pense.

          • Jesper Both Pedersen
            Posted October 1, 2013 at 5:59 am | Permalink

            Any thought must be represented in the physical world somehow, or it would not exist. I think you agree on this one, it just didn’t come out this way in your comment.

            I do agree, but I’m still somewhat puzzled by the duality of the matter. A thought is a chemical reaction in the brain that may or may not influence behaviour, and I fail to see a thought as a product of the mind. It’s a product of the brain.

            • Posted October 1, 2013 at 6:28 am | Permalink

              “… A thought is a chemical reaction in the brain that may or may not influence behaviour,…”

              I must ask myself: How could a thought that has arisen not be an influence on the behaviour that is about to take place? (Whether that be in excitation or inhibition of any further thought activity.)

              I don’t know if you are a layperson like me… I find that the more I try to articulate about subjects that are not my field, the more I get into minefields of imprecisions.

              As regards the distinction between mind and brain, you are right, just do away with it. Take it off your brain! 🙂

              • Jesper Both Pedersen
                Posted October 1, 2013 at 6:34 am | Permalink

                LOL.

                No I’m a layperson just like you, I’m just looking for a bit of clarity. I blame my brain. 🙂

                I must ask myself: How could a thought that has arisen not be an influence on the behaviour that is about to take place? (Whether that be in excitation or inhibition of any further thought activity.)

                Well, speaking from my own experience I have several ideas on a daily basis that I never act upon or even consider acting upon. I just enjoy thinking about them.

                Some call it daydreaming, I call it therapy. 😉

      • Reginald Selkirk
        Posted October 1, 2013 at 6:44 am | Permalink

        “Brain your own business” or “That escapes my brain” are not sayings we use…

        Ah yes, the argument from an impoverished vocabulary.

        The first term clearly uses a different definition of “mind” than is being discussed here. “Tend your own business” would be much moar appropriate than “brain your own business.”

    • Diana MacPherson
      Posted October 1, 2013 at 5:42 am | Permalink

      I like Steven Pinker’s definition that Jerry quoted which to me is like seeing the brain as the noun and the mind as the verb.

      For the most part though, I’m with you and just see the two as one in the same (because for the most part they really act as one agent). Unfortunately, we’re saddled with dualistic language so it gets muddy sometimes.

      • Jesper Both Pedersen
        Posted October 1, 2013 at 6:04 am | Permalink

        I don’t know if it’s basically just semantics, but we have the same issue in danish where the mind is supposed to be something extra in addition to the brain.

        I’ve never really understood that meaning of the word “mind”.

        • Diana MacPherson
          Posted October 1, 2013 at 6:10 am | Permalink

          I blame dualism. It’s permeated language because that’s how we saw things or at least the idea of a separation of mind and brain in a sort of soul and body way is embedded in language and now that we think differently (ha a bit of a clumsy, accidental pun) it’s cumbersome to express this.

          • Jesper Both Pedersen
            Posted October 1, 2013 at 6:28 am | Permalink

            I think Ant is on to something in one his replies above.

            The mind is often perceived as something that adds an extra layer to the brain, and this perception often leads to supernaturalistic ideas.

            • Posted October 1, 2013 at 6:49 am | Permalink

              You made me think, rather than reaching for a technology analogy (a “technalogy”?), better to think in terms of biology?

              Breathing : lungs :: thinking : brain.

              What is the respiratory equivalent of “mind”?

              /@

              • Jesper Both Pedersen
                Posted October 1, 2013 at 6:53 am | Permalink

                Good question. Any bids anyone?

              • brandon
                Posted October 1, 2013 at 8:46 am | Permalink

                I’ll give it a shot… “breath” maybe?

                Breathing and thinking are what the organs do, breath and mind are what they produce?

                I am not speaking from any sort of authority on the matter, just an interested lay-person.

              • Diana MacPherson
                Posted October 1, 2013 at 10:47 am | Permalink

                Well the mind minds of course 🙂

    • Posted October 1, 2013 at 9:17 am | Permalink

      The brain is a thing, minds are processes: “brains mind” – like intenstines digest, etc.

      • Jesper Both Pedersen
        Posted October 1, 2013 at 9:28 am | Permalink

        What does a mind consist of that is not a part of the brains processes?

        • Posted October 2, 2013 at 9:31 am | Permalink

          Nothing, but the point is that one can draw a somewhat important category (thing vs. process) distinction, just as one can with any organ. I used to think that this distinction (which is sort of like the distinction between anatomy and physiology) could ground a distinction between a field which treats structural abnormalities vs. one which treats process ones. However, since the process results in new structure, the dicotomy is false.

    • Brygida Berse
      Posted October 1, 2013 at 12:27 pm | Permalink

      The brain and the mind are one and the same… or am I missing something?

      The mind (a process) is a function of the brain (an anatomical structure), but not the only one, so the two are not one and the same. There are other functions of the brain, for example body temperature control, that are independent of – and not even perceived by – our conscious “mind”.

      • Jesper Both Pedersen
        Posted October 1, 2013 at 12:51 pm | Permalink

        So the mind is simply the chemical processes of the brain?

        How do we decide what brain processes are a part of the mind?

        • Brygida Berse
          Posted October 1, 2013 at 1:24 pm | Permalink

          Wikipedia defines the mind as “the set of cognitive faculties that enables consciousness, perception, thinking, judgement, and memory”. If you agree with this definition, then yes, this set of cognitive faculties is a function of the brain and depends on chemical (biological) processes in the brain. Which specific processes are responsible for which aspects of the mind and the exact mechanisms by which they work is the subject of neuroscience; so far our understanding of it is rather rudimentary. But we do know that manipulating brain structure or chemistry (for example, surgically or pharmacologically) can alter the mind.

          • Jesper Both Pedersen
            Posted October 1, 2013 at 1:38 pm | Permalink

            I can almost dig it.

            I still think it’s just a human construct that tries to describe processes in the brain, though.

            • Brygida Berse
              Posted October 1, 2013 at 1:57 pm | Permalink

              I still think it’s just a human construct that tries to describe processes in the brain, though.

              That something can be described by “a human contruct” (i.e. an intelectual concept) doesn’t mean that it is not real or that it is supernatural. In that sense the distiction between brain and mind is not different than any distinction between an anatomical structure and the corresponding physiological function. The circulatory system is distinct from blood circulation and the kidney is distinct from filtration. It is unfortunate that the brain-mind distinction is confusing to people prone to supernatural thinking, but we should explain this concept and and not abolish it.

              • Jesper Both Pedersen
                Posted October 1, 2013 at 2:09 pm | Permalink

                That something can be described by “a human contruct” (i.e. an intelectual concept) doesn’t mean that it is not real or that it is supernatural.

                My point isn’t that the processes aren’t real. My point is that the processes we call mind is simply a product of a functioning brain.

              • Brygida Berse
                Posted October 1, 2013 at 2:29 pm | Permalink

                My point isn’t that the processes aren’t real. My point is that the processes we call mind is simply a product of a functioning brain.

                Absolutely correct. But being a product means that these processes are not “one and the same” with the structure that runs them. Also, they are not the only product of the brain. So even if we understand this close relationship, it is still useful to have two words: “mind” (cognition) and “brain” (a body part).

              • Jesper Both Pedersen
                Posted October 1, 2013 at 2:42 pm | Permalink

                I think we’re close now.

                What I mean by “the one and the same” is that the mind is the brain. A brain can exist without a mind, but as far as we know a mind cannot exist without a brain.

                My small quibble with the wikipedia definition of mind is that consciousness is a somewhat blurry concept.

            • Diana MacPherson
              Posted October 1, 2013 at 2:51 pm | Permalink

              Just do like I do and think of it all as brain. It may not be super accurate but it’s more accurate than dualism. 🙂

              • Jesper Both Pedersen
                Posted October 1, 2013 at 2:55 pm | Permalink

                Hehe…Good advice, and will do.

                I’m just a bit curious about this whole mind business. 🙂

  4. joao romulo baptista e costa
    Posted October 1, 2013 at 4:57 am | Permalink

    The brian images are upsidedown.

    Enviado via iPhone

    • Posted October 1, 2013 at 5:11 am | Permalink

      Turn your iPhone through 180° … 

      /@

    • Posted October 1, 2013 at 5:17 am | Permalink

      The cuts aren’t exactly at the same level either, but who’s counting? I understand the quibble, but the mind/brain distinction will remain a practical one for the foreseeable future and I think that is the sense of the distinction used in the interview. I think we’re stuck with it for the duration, actually. For example, CBT will remain effective monotherapy for anxiety disorders, but not for schizophrenia. This does not negate psycho-physical identity.

  5. BradW
    Posted October 1, 2013 at 4:58 am | Permalink

    I agree with Jesper:

    Why do professionals in the brain/psychiatric/psychology field continue to perpetuate this duality?

    Nature vs. Nurture is a different subject.

    • rickflick
      Posted October 1, 2013 at 5:37 am | Permalink

      It is illuminating, I think, to compare with the long-running controversy among cardiologists about the stuff of the heart and its undeniable circulation. Materialism is still a long way from unmasking that Cartesian delusion.

    • Diana MacPherson
      Posted October 1, 2013 at 5:44 am | Permalink

      Also, I think, as I said above in my reply to Jesper, that our dualistic language gets in the way. In this example Jerry has provided though, this is not the case because the speakers made a conscious decision to differentiate mind from brain.

  6. teacupoftheapocalypse
    Posted October 1, 2013 at 5:13 am | Permalink

    sub

  7. Barry Lyons
    Posted October 1, 2013 at 5:38 am | Permalink

    I wonder what Thomas Szasz would have made of the “60 Minutes” segment. I think I know what he might have said.

    I love this collection of comments. A description of the video: “Psychiatrists openly admitting at the 2006 APA convention that they have no scientific tests to prove mental disorders are illness or disease, and that psychiatric drugs do not cure anyone”:

    But this classic essay by L.J. Davis on the previous edition of the DSM is a laugh-out-loud classic:

    http://harpers.org/archive/1997/02/the-encyclopedia-of-insanity/

    • Jamie
      Posted October 1, 2013 at 8:31 am | Permalink

      Back in the ’70s I was diagnosed schizophrenic and I and my family were told I was “very sick” and would be for the rest of my life. Fortunately I had read a bit a Szasz and so I had a different idea. I was definitely having difficulty functioning, but I found other ways to explain this (other than the unhelpful “brain disease” and “genetic disease” notions) and with the support of my family, abandoned the system’s drugs and dismal prognosis and have, after clawing my way out of my difficulties with much anguish and many tears, led a normal life free of psychiatry and all its trappings for 40 years.

      BTW: that diagnosis was based on a bit of conversation with a therapist and the therapist’s observation of my behavior (or what the therapist was told about my behavior), not on an MRI, or a blood test or urinalysis or any other physical test, so perhaps I did not have the disease I was assigned. But then, I don’t believe an MRI is a standard element of diagnosis today. One has to wonder, when they hold up the MRI as proof of the underlying brain condition, why it is not used to diagnose. And given my experience, if I was “mis-diagnosed”, I have to wonder how many other people are shuffling about on locked wards or gulping their daily meds without actually having the condition. And then one has to wonder, if some people don’t have the condition, why are they mis-diagnosed (why does their behavior mimic the condition closely enough to fool the doctors?) Or one can conclude that I really did have the condition and was not mis-diagnosed. In which case one has to wonder why I returned to full function without drugs but others cannot do this but take drugs for years and years and have “breaks” and go into hospital when they “go off their meds”. There may be satisfying answers to these questions within the disease model, but if there are we don’t yet have them. On the other hand, the disease model may be leading us to no answers at all. As Szasz once wrote, before spirochetes were known, syphilis was a ‘mental disease”, after, it was just syphilis, a physical disease with a known etiology. When we know enough about the brain, there won’t be any “mental diseases”.

      My own view, from my own experience and in conversation with hundreds of other psychiatry survivors, is decidedly materialistic. I am convinced that all behavior is rooted in physical causation in the brain, but that the brain is very plastic and shapes and reshapes itself much more quickly than we generally realize (you can change your brain state by drinking a cup of coffee, or merely by relaxing in an easy chair). Brains cause thoughts and behaviors, but our thoughts and behaviors also affect our brains. I don’t think that’s controversial, but I think psychiatry does not grasp the full significance of this and seeks to impose certain brain states from the outside with drugs. Their brute force approach is clumsy and off target. Since there are very few untreated schizophrenics, the MRI artifacts being pointed to could quite possibly be caused by the drugs these patients are given (or be the result of boring tedious lives, or have some other cause). I would like to see the longitudinal study showing the series of brain scans from first presentation of symptoms through treatment with proper controls, to see the scans correlated to behavior, and to see the comparison of normal brains on psychiatric drugs, before I felt comfortable interpreting these scans as Dr. Torrey does.

      All of this is rather off topic, so forgive me for indulging myself. Back to the point, I agree with Jerry that scrubbing the “free will” meme from the discussion can only be helpful, but with two caveats. 1) The public generally is terrified of mental illness and the mentally ill. Reinforcing the stereotype that schizophrenics are the criminally insane is not going to help. The last time I looked (about 25 years ago), “mentally ill” people and schizophrenics in particular, were statistically less violent than the general population. I doubt those statistics have changed since then. Highlighting extreme cases of violent behavior associated with schizophrenia just bolsters people’s fear and hopelessness about the condition. 2) Suggesting that the mentally ill are not responsible (had no free will) plays into a very unpleasant paternalism rife in psychiatry. Unless it is asserted very forcefully that the mentally ill have no free will because free will doesn’t exist and no one else has it either, the general public will simply take it to be a distinction between themselves and the mentally ill. A false distinction that reinforces all the worst stereotypes of the so-called mentally ill, that they have no control of themselves or their behavior. This is already a primary element in the psychiatric description of mental illnesses. Mentally ill people are, by definition, those who have no control of their own behavior and must be helped to bring their behavior into socially acceptable alignment.

      I have no problem with the idea of developing technologies to assist people to modify their own behaviors, but we also need to continue work from the other end to enlarge what is deemed socially acceptable. Homosexuality, for instance, is no longer a mental disease and perhaps we will someday reach that enlightened state where we can say that it is socially acceptable for stressed people to break down and have a good cry or tantrum in public without rushing them off to hospital in alarm and labeling them mentally defective. Once we get there, we may find it reasonable to design our lives and our environments, our workplaces and our cities, in a manner that doesn’t induce so much stress in the first place. We may find more value in cooperation and less in cutthroat competition. We may choose to encourage kindness and acceptance instead of demanding conformity and obedience. We may discover our compassion and humanity and build our social structures and institutions based on that, instead of on wealth and power, racism and greed. But don’t listen to me, I’m just a schizophrenic crazy guy with no free will who can never fulfill my potential…

      • darrelle
        Posted October 1, 2013 at 9:17 am | Permalink

        Thanks for sharing. Good comment.

      • Posted October 1, 2013 at 9:19 am | Permalink

        In case it isn’t clear – Szasz is not a dualist – I thought so at first, but he’s actually an eliminative materialist, last I checked anyway.

      • Richard Olson
        Posted October 1, 2013 at 9:43 am | Permalink

        The departure point from which the quest for understanding originates is so important, as is mindfulness of the distinction between belief and actual knowledge. References regarding changes in comprehension of (among others) schizophrenia, homosexuality, and syphilis remind me of a previous near-universal human misapprehension underlying opposition to an invention credited to Ben Franklin that shared similar roots:

        ‘ Three years later, John Adams, speaking of a conversation with Arbuthnot, a Boston physician, says: “He began to prate upon the presumption of philosophy in erecting iron rods to draw the lightning from the clouds. He railed and foamed against the points and the presumption that erected them. He talked of presuming upon God, as Peter attempted to walk upon the water, and of attempting to control the artillery of heaven.’

        Stigma resulting from sheer ignorance is so expensive to humanity.

  8. Don
    Posted October 1, 2013 at 5:40 am | Permalink

    I hope, Jerry, that as a fan of the program you wrote to Steve Croft to apprise him of your quibble. When the opportunity arises, little education is usually a good thing.

    • Posted October 1, 2013 at 5:47 am | Permalink

      I would but I can’t find any contact information for him. By the way, the name is spelled with a “K”; I, too, assumed “Croft” before I looked it up.

  9. Diana MacPherson
    Posted October 1, 2013 at 5:50 am | Permalink

    I look forward to watching this (stupid, busy day) as I’ve found mental illness in general and schizophrenia in particular such a tragic illness to suffer from. I’ve met or known many schizophrenics in my time and many had great potential and were extremely smart but their illness prevented them from realizing their potential. It’s truly heart breaking.

    The latest person I know with the disease is the brother of one of the kindest girls I know. We went to high school together and she had a very difficult home life. Her little brother was the sweetest and smartest little boy. He developed schizophrenia in early adulthood and my friend now raises his son as he was unable to do so. His son is a spitting image of him and is equally bright. The question now looms if this sweet boy will also develop this terrible disease.

    • threeflangedjavis
      Posted October 1, 2013 at 7:10 am | Permalink

      I do recall reading somewhere that schizophrenia is thought to be a side-effect of one of the adaptions that separates us from our primate ancestors. Apparently there is a linkage between the disease and genes which give us such an advantage over other primates. It was proposed that the increased mental capacity came at the cost of potential for mental illness. Maybe there is some truth to the idea that schizophrenics tend to be of above average intelligence.

    • ladyatheist
      Posted October 1, 2013 at 8:47 am | Permalink

      The odds are about 1 in 10, so it’s not inevitable!

  10. Posted October 1, 2013 at 6:02 am | Permalink

    For purposes of pragmatic conceptualization, the brain is jelly and the mind is “manifest” jelly. I tend to visualize schizophrenia as a lack of cohesion without a reliable default screen. Working with Cluster A types in community mental health makes one realize that reality testing is one of the most difficult forms of therapy. Anything approaching a neurotypical range of experience in these cases is dependent on med-compliance combined with long-term behavior management while differentiating delusions from hallucinations.

  11. Posted October 1, 2013 at 6:02 am | Permalink

    This is fascinating. I don’t put much “truth” stock in TV dramas, but I’ve done quite a bit of reading on this issue because of several episodes of “Law & Order: SVU” (don’t laugh) that directly tackle this issue of “free will” (in the loosest, layperson term) vs. brain abnormality or disease. I don’t know what the right answer is, if there is one, but I do know that the legal system has a horrendous history of not keeping pace with modern science and medical research.

  12. imil42
    Posted October 1, 2013 at 6:09 am | Permalink

    I guess they could have meant “disease of the brain, NOT ONLY of the mind”.

    Some people think that schizophrenia and paranoia are just “faulty logic” or something like that and they may be cured by proper education, or punishment, or whatever. Most likely, Kroft and Lieberman addressed this misconception.

    • eric
      Posted October 1, 2013 at 8:40 am | Permalink

      Yes, like you I’d be fairly generous in interpreting that one line. Most likely, Kroft and Lieberman were trying to say that it’s a disease arising from a physical abnormality, not a normal brain.

      I also think they probably said it in order to increase listener empathy. Mental illness has a pretty big social stigma to begin with; its probably a good idea to reinforce the fact that the victim has a biological malfunction (i.e., in many ways, can’t help the way they act) every chance we get.

    • ladyatheist
      Posted October 1, 2013 at 8:49 am | Permalink

      Not to mention, scientologists have demonized the psychiatric profession and their tactics were subversive — many complaints against psychiatry and medication seem to be neutral but in fact are sourced by scientologists, at least in the past

  13. James Rednour
    Posted October 1, 2013 at 6:13 am | Permalink

    I see Jesus in the normal brain which goes to show that schizophrenia is caused by demon possession.

    /snark

    • Diana MacPherson
      Posted October 1, 2013 at 6:15 am | Permalink

      It looked like a happy guy saying, “wheee!” to me. 🙂

    • D'oh
      Posted October 1, 2013 at 6:43 am | Permalink

      Jesus in clown shoes no less.

    • Reginald Selkirk
      Posted October 1, 2013 at 6:46 am | Permalink

      Look again. That’s not Jesus, it’s a frog.

  14. Ian Belson
    Posted October 1, 2013 at 6:46 am | Permalink

    As a neurologist who looks at MRIs daily I just thought you should know that your pictures are two images of the normal brain that were taken at two different levels. The structural differences between a schizophrenic and a normal brai are usually much too subtle to be seen on a routine MRI.

    • Posted October 1, 2013 at 6:51 am | Permalink

      Well, that’s bizarre. If you watch the segment, and there’s an addendum at the site that they didn’t air, they clearly state that these are two different brains. I’ll put your statement above, and it’s a serious one that should be conveyed to CBS.

      • Posted October 1, 2013 at 8:59 am | Permalink

        Not a neurologist, but have examined scans of a person with dementia – looked into the process of scanning and interpreting MRIs. Not an expert by any means, but it does seem that there is a lot of variation between subjects – and variation within the same subject as they age… that’s a real biggie.

        I nearly freaked out at the size of those vacuoles in the person with advanced dementia, looked like an empty walnut — until I figured out this is what most 92-year-old brains look like (correct me if I’m wrong). As we age (or get our faces punched by Muhammad Ali), those spaces get bigger. I’d be hard pressed to look at a vertical series of scans – entire brains of people – and actually pick out the pathology, given the subjects age. At the same time, it is pretty easy for me to tell, non-expert that I am, that the pics are merely of two vertical levels. – probably of different brains.

        I don’t think Ian Belson was implying they are both the same individual – but these pics are clearly at two different vertical levels. (which greatly affects what you see re: the size of those spaces).

      • Posted October 1, 2013 at 12:00 pm | Permalink

        Yeah, they may be two different brains, but they both look normal. The second one is at a lower (inferior) level, where the ventricles are bigger. Part of the problem may be that a psychiatrist is trying to interpret an MRI. Also, they may have been cutting corners for good TV. Either way, the end result is bad (and misleading) journalism.

        • Posted October 1, 2013 at 3:28 pm | Permalink

          La muneca. For demonstration purposes, I’d guess, though still misleading.

          • Posted October 1, 2013 at 4:04 pm | Permalink

            I was wondering how long it would take before I saw “la muneca.” You’re the first. Congrats! You win all the prizes (there are no prizes).

    • Jamie
      Posted October 1, 2013 at 8:41 am | Permalink

      Thanks for that. I just posted above an overlong essay with my view as a card carrying schizophrenic that this is basically psychiatric PR hype, not science. Nice to have the confirmation.

  15. Posted October 1, 2013 at 7:24 am | Permalink

    Isn’t this like saying that asthma is a disease of the lungs not a breathing problem?

    Same church, different pew.

  16. Gerardo F Zambito Brondo
    Posted October 1, 2013 at 7:29 am | Permalink

    I hated the “This is really a disease of the brain, and not a disease of the mind.”

    Without a brain, there is no mind.

    Oh, and by the way, the images of MRI used to illustrate the changes are upside down and the “dramatic difference” on the scans is due to the fact that the slices do not correspond to the same area, that is, they are from different parts of the brain. There are studies that have shown a reduction in grey and white matter with an enlarged ventricular volume in patients with schizophrenia (http://apt.rcpsych.org/content/11/3/195.full.pdf )
    (http://cercor.oxfordjournals.org/content/12/12/1331.full.pdf).

  17. Mark
    Posted October 1, 2013 at 8:48 am | Permalink

    “Hearing voices” is an excuse for bad behavior, and people who participate in it know the difference between right and wrong. They know they are killing people, and they know it’s wrong. Just because one “hears voices” doesn’t mean they must do what the voices say.

    Regardless, most, if not all the latest mass murders were known nuts who should have already been locked-up. It’s a very simple solution to a problem that should never be allowed to happen.

    • ladyatheist
      Posted October 1, 2013 at 8:59 am | Permalink

      Involuntary commitment requires documentation that they are an imminent threat to themselves or others. It’s a difficult process by design, because you’re depriving someone of their freedom. Merely hearing voices is not enough.

      • Mark
        Posted October 1, 2013 at 9:26 am | Permalink

        Actually, I didn’t specify “hearing voices” was sufficient for “involuntary commitment” – but it should be. If someone is truly “hearing voices,” then they are already deprived of their “freedom.”

        • John Scanlon, FCD
          Posted October 2, 2013 at 6:56 am | Permalink

          It’s not hearing voices that makes you nuts (to lapse into the colloquial), it’s doing what they tell you.

          • Mark
            Posted October 2, 2013 at 11:15 am | Permalink

            “Just because one “hears voices” doesn’t mean they must do what the voices say.”

  18. ladyatheist
    Posted October 1, 2013 at 8:57 am | Permalink

    Yes, many schizophrenics wind up in jail, but they are not necessarily all violent. That’s a myth. The ones who wind up in jail may be self-medicating with illegal drugs, stealing to eat, trespassing as homeless “vagrants,” etc. They aren’t all hearing voices tell them to kill.

    Now Abraham, who heard God tell him to kill Isaac, there’s a schizophrenic if ever there was one!

  19. sambricky2013
    Posted October 1, 2013 at 9:22 am | Permalink

    I swear that’s Jesus in the normal brain scan. That just does not make sense.

  20. Timothy Hughbanks
    Posted October 1, 2013 at 1:27 pm | Permalink

    As you know, I don’t think any criminal behavior is a “choice.” In some sense, all criminals have brain diseases,…

    I think in some cases, i.e., for some laws, the people who wrote the laws are the ones with brain diseases.

  21. Posted October 1, 2013 at 1:58 pm | Permalink

    I watched on Sunday too (one of the few shows I try to watch regularly, but I doubt others share my other Sunday night show — Squidbillies), and that line stood out to me as well, although I enjoyed the segment as a whole.

    It also bothered me in the segment with Bill O’Reilly that the interviewer said “you believe the holy spirit inspires you to write?” — I’m paraphrasing.

    I wish she would have started with “you believe there’s a holy ghost?” I didn’t like implicit in her question was the existence of a holy spirit was taken as a given.

  22. Lowen Gartner
    Posted October 1, 2013 at 7:24 pm | Permalink

    So is religion then a disease of the brain rather than a disease of the mind?


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