Tuesday, July 28, 2015

Liberating brains from bodies by capturing them with brainets?

by Karen Rommelfanger

Miguel Nicolelis is dedicated to liberating the human brain from the physical constraints of a body.

Recently, brain-machine interface engineer extraordinaire Miguel Nicolelis connected nonhuman animal brains in a modern-day mind meld called the brainet. For those who don't already know him, Nicolelis is an innovator, dedicated to pushing the limits of what is possible with neurotechnology, and a media darling to boot.

One focus of Nicolelis' work has been developing neural prostheses whose function is mediated through wired or wirelessly transmitted electrical activity from arrays of electrodes implanted on the surfaces of nonhuman animal brains. One well-known experiment from the Nicolelis lab involved monkeys that learned to feed themselves a marshmallow  or even operate a robot on a treadmill via direct connection electrodes implanted in their brains and a prosthetic arm. For extra flash, Nicolelis had a 12-lb monkey (based out of a Duke laboratory) operate a 200-lb robot on a treadmill in Tokyo by transmitting its brain activity through an Internet connection. In this same 2013 interview he waxes philosophical, “Our sense of self does not end at end of the cells of our bodies, but it ends at the last layer of the electrons of the tool that we’re commanding with our brains.”

His work has intended applications for humans. One recent media stunt involved a "Mind-controlled robotic exoskeleton"  donned by an individual who was paralyzed from the trunk down. 29-year-old Juliano Pinto kicked off the first ball at the World Cup in 2014 through an electrode studded cap on his head that transmitted recorded electrical activity from his brain to a robotic suit. Hailing from

Tuesday, July 21, 2015

Bring back the asylum: A critical analysis of the call for a “return to ‘modern’ institutionalization methods”

By Cassandra Evans

Cassandra Evans is a Ph.D. student in Disability Studies at Stony Brook University. She studies mental disabilities and ethics surrounding treatment, services, and access for individuals with mental disabilities. She is currently examining the history of institutions in Suffolk County, Long Island (New York) and what shape the “way forward” from institutionalization will take in the new millennium.

This post is a shorter version of a talk Cassandra gave at the Society for Disability Studies’ national conference in Atlanta, Georgia, June 11, 2015.

In early June, 2015, I visited Pilgrim Psychiatric Center in Brentwood, New York, (Suffolk County, Long Island). As I drove onto the Pilgrim campus, I felt as if I could be entering any of the other scores of institutions around the country—the pictures I’ve seen all look so similar and convey the same eeriness: high rise brick buildings with plain numbers on them, grass growing up all around, broken and barred windows, some areas with trash heaps on the grounds and graffiti on the walls. The names were different, but during their official operations, the treatments and results were similar—many individuals stayed longer than they ever wanted, many died and few were “cured.”

This photo shows a brick high-rise institutional building with a 
gravel road leading away from its parking lot, green grass and 
fresh tire tracks nearby.  Toward the front of the building several 
cars are parked outside the front of the building at the bottom 
floor of this 10- or 12-story, double-winged ward.  “Building 82” 
at Pilgrim Psychiatric Center in Brentwood, New York, is still 
home to many individuals with psychiatric disabilities.  Though 
three out of four institutions in Suffolk County, Long Island were 
closed and their residents deinstitutionalized, others with more 
severe  disabilities or who were more geriatric ended up here.

Photo by Cassandra Evans
While there, I saw pictures and news clippings in the museum that demonstrated how, in the era when institutions were being built and filled—toward the late 1800s and early 1900s until about the 1950s, consensus was that these facilities and the treatments inside of them were “state-of-the-art.” Text describing the 1938 LIFE Eisenstaedt photo essay noted that the pictures are “showing the dark world of the insane and what scientists are doing to lead them back to the light of reason” (Long Island Psychiatric Museum, 2015). While that rhetoric was common then, I wonder if it is similar ableist thinking, this need to normalize that still prevails today, driving new calls to “bring back the asylum.”

It was a recent ethical argument on this topic in the Journal of American Medical Association (JAMA) that prompted me to visit the Long Island Psychiatric Museum. This article, “Improving long-term psychiatric care: bring back the asylum,” by Sisti, Segal and Emanuel (2015) made major waves in both academic and lay literature. In it, the authors argue that because of “transinstitutionalization”—the failure of deinstitutionalization to guarantee appropriate placements for former residents of these homes—the “way forward” for severe psychiatric patients is a return back to the asylum (Sisti et al, 2015).

Tuesday, July 14, 2015

The power of a name: Controversies and changes in defining mental illness

by Carlie Hoffman

The purposes of naming are to help categorize the world in which we live and to aid in grouping similar things together. However, who decides which name is the correct one? Is a child who often cannot pay attention to his classwork “absent-minded,” or experiencing attention deficit hyperactivity disorder? Is a person whose moods often swing from one extreme to the other simply “moody,” or living with bipolar disorder? Naming a lived experience a “mental illness” has the ability to change the social realities of those who receive the diagnosis, altering not only self-perception, but also influencing the perceptions and triggering the biases of others— often in a detrimental manner. So, who has the power to determine how such a label is assigned, and what happens if someone is given the wrong one?

The power affiliated with naming has caused the diagnosis of mental disorders to be fraught with controversy. Mental illnesses are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), which has been deemed the “bible” of mental health. According to Dr. Thomas Insel, the director of the National Institutes for Mental Health (NIMH), the goals of the DSM are to create a common language for describing mental illness, and to ensure that mental health care providers use the same terms in the same ways. Thus, when patients visit a psychiatrist in search of a name that will define the symptoms they are experiencing, this name is assigned with the aid of the DSM.

One controversy affecting the diagnosis of mental disorders is the growing concern with medicalization of the “normal” human experience. Medicalization is the process of defining select human experiences or conditions, typically ones that were once considered normal, as medical conditions that warrant professional medical attention. Some level critiques against medicalization, particularly the medicalization of experiences associated with cognitive and emotional function, suggesting it can lead to over-diagnosis of mental disorders as individuals cope with stressors in a typical fashion [5, 11, 13]. A series of controversial changes made to the newest edition of the DSM, DSM-5, have provided a foothold for those concerned with medicalization. The addition of premenstrual dysphoric disorder and the elimination of the bereavement exclusion from the criteria for major depressive disorder have increased the apprehension that typical premenstrual mood and behavioral changes, and the normal grieving process could be classified as mental disorders [7, 13, 14].

Tuesday, July 7, 2015

Charles Bonnet syndrome, musical ears, and normal hallucinations

by Jonah Queen

In a previous post on this blog, I wrote about the Mad Pride movement, which advocates for the rights of, and the end of stigma against, those diagnosed with psychiatric disorders. I discussed how the lack of a clear distinction between “normal” and “abnormal” psychology even leads some activists to think of these conditions as extreme emotional or sensory experiences rather than illnesses. Mad pride advocates see a trend of increasing medicalization within psychiatry, arguing that feelings and behaviors are too readily classified as pathological. But this concern with over-medicalization is not unique to the Mad Pride movement. It is expressed by a wide range of individuals, including those within the mental health establishment. But there is one area where the field of mental health seems to be moving in the opposite direction: hallucinations. DSM-5, which has been criticized for overly broad definitions of psychiatric disorders, is restricting the diagnostic criteria for schizophrenia, making it so that hearing voices (with no additional symptoms) is no longer sufficient for a diagnosis.

The cover of the report in which Charles Bonnet first described the condition which would be named after him (from demneuropsy.com.br)

This change is due to current research that shows hallucinations are not always a sign of psychosis and are also surprisingly common (according to some sources, ten percent of the population occasionally hears voices). Doctors, researchers, and patient advocacy groups are working to spread this knowledge and to overcome the belief among the general population that experiencing hallucinations makes someone “crazy.”

A hallucination is defined as a perceptual experience that does not come from an external source. They can be caused by a variety of disorders (whether psychiatric, neurological, or somatic) and can occur in healthy individuals in response to psychotropic drugs (like hallucinogens such as LSD and psilocybin) or stress (including sleep deprivation). But there are many other common phenomena that can also be described as hallucinations, though they might not be thought of as such due to their mundane and unobtrusive nature. These include experiences that many of us have had, such as hearing your name being called, hearing a phone ringing, or feeling your cellphone vibrating in your pocket, even though none of those things are actually occurring. Sometimes these experiences can be caused by our brains misinterpreting real sounds. Hearing a “phantom” phone ring can happen in response to faint background noise in a frequency similar to that of the ring, since it is a sound many of us are (even unconsciously) always listening for.