When it comes to such complex mental disorders as the schizophrenias, I wonder if genes actually have a much less prominent role in the involved biology than we have been led to believe. The more I have learned about genetics, epigenetics, proteomics, and developmental psychobiology the more I have begun to question the hegemony of gene-dominated theories in the field of psychiatric neuroscience. Genes are significantly regulated by the social/relational/psychological environment. As an immediate proof of this (and one that is quite relevant to my views about mental illness), Robert Sapolsky (2005), professor of biology and neurology at Stanford University, suggests the following (rather sadistic) experiment:
“Take a few minutes to relax right now...Feel those muscles relax, feel the tension drain from your face, feel your heart begin to beat more slowly. Now...think the following thought:
You know, someday that heart is going to stop beating...Really think about that fact, think about how every heartbeat is counting down toward that final one. Think about how the flow of blood will come to a standstill, how your brain will shut down for lack of oxygen...”
Sapolsky reports on his own reaction to this exercise: racing heart, panic, tightening of muscles, etc. In short, all you need to do is think a thought (particularly a survival related thought) and you can alter the functioning of virtually every cell in your body. Sapolsky emphasizes that one of the most important concepts in biology is that you can not really ever state what the effect is of a particular gene, or the effect of a particular environment, only how a particular gene and environment interact.
Walter Freeman, Pofessor at the University of California at Berkeley prominent neuroscientist, has authored many volumes on brain science, including Neurodynamics: An Exploration in Mesoscopic Brain Dynamics. In his relatively recent volume How Brains Make Up Their Minds published by Columbia University Press, Freeman (2000) explores the difficult question of free will and intentionality from a neuroscience perspective. I believe this has great relevance for the human condition and human behavior in general, but for our understanding of mental illness in particular. Freeman asks the question: Who is really in charge of yourself, your genes, brain or you? He points out that beyond the doctrines of genetic (nature) or environmental (nurture) determinism, which lie at the heart of the nature-nurture debate, is the person’s own contribution to choices, decisions, circumstances, etc. Viktor Frankl, psychiatrist-logotherapist, has made this a cornerstone of his psychotherapeutic approach to the human condition (see his excellent volume Man’s Search for Ultimate Meaning published in 2000 by Perseus of Cambridge, Massachusetts). Freeman is committed to a point of view in which the power to choose is an essential and unalienable property of human beings. Freeman (2000) noted:
“What is at issue is the nature of self-determinism. The problem boils down to the questions of how and in what sense brains, with their cells, the neurons, can create actions and thoughts, which we experience as our minds and ourselves, and whether and how our experiences can change or influence our brains and their neurons. What does it mean to say that one causes the other?” (p. 3).
Freeman goes to great lengths to explain the neural processes through which goals emerge within brains and find expression in goal-directed actions.
Merzenich and deCharms (1996) pointed out that functional activity and plasticity are inseparable. Sounding more like neurophilosophers than the basic neuroscience researchers that they are, noted:
“We believe that mind is the product of an environment expressed in the nervous system and manifested by it through actions; it is a circular and relational interaction among an incoming world, an experiential context, and outgoing activity. To a large extent we choose what we will experience, then we choose the details that we will pay attention to, then we choose how we will react based on our expectations, plans, and feelings, and then we choose what we will do as a result. This element of choice and the relational nature of awareness in general have almost never been considered in neurophysiological experiments. We realize now that experience coupled with attention leads to physical change in the structure and future functioning of the nervous system. This leaves us with a clear physiological fact, a fact that is really just a mechanistic confirmation of what we already know experimentally: moment by moment we choose and sculpt how our ever-changing minds will work, we choose who we will be the next moment in a very real sense, and these choices are left embossed in physical form on our material selves” (p.76).
Brian Koehler PhD
New York University