August 22, 2013
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In desperate need of a cognitive scientist
JDB 2456527 PDT 10:52.
A review of Listening to Prozac by Peter D. Kramer.
This was a book with great potential, but it failed to live up to most of that potential. The fundamental idea is a profound one that I wish more people would think about: What does cognitive science say about human nature?
The problem is that Kramer is not a cognitive scientist, he is a practicing psychiatrist. All of his understanding of the brain and mind is filtered through that lens; he spends most of the book explaining particular case studies in minute—sometimes excruciating—detail.
I had expected the title, Listening to Prozac, would be merely metonymous for psychopharmacology in general, or at least SSRI antidepressants in general; but in fact Kramer spends most of the book singing the praises of Prozac in particular, lending the entire book a strange parochial feeling—we are trying to assess the totality of human nature based on experiences with a single medication?
Kramer obviously struggles with the mind-body problem (as do we all I suppose); when he sees a drug affecting someone’s behavior or personality, he suffers a kind of crisis of faith: If our minds can be affected by chemicals, how are they really minds? Are we just chemical automatons?
No, I say; that is what everyone gets wrong about cognitive science. The Basic Fact does not say that our minds are false; it does not say that our lives are meaningless; it does not say that we are automatons. The Basic Fact of Cognitive Science says that we are our brains, that everything we are—the things we really are, our thoughts, our feelings, our desires, our hopes, our fears—is made by our brains. The rainbow unweaved is still a rainbow.
Likewise, when he sees a homologue between humans and other animals, he fears that it reduces people to animals—instead of considering the possibility that it elevates animals to people. When he learns that rats and monkeys show the same behaviors and neurotransmitters we do under stress, depression, and loneliness, instead of realizing that this means they feel what we do, he instead tries to understand how it can be that human thoughts and feelings aren’t real because they are made of animal parts.
That is the message that I get from listening to Prozac, and it is the message we should have gotten from Listening to Prozac. Altering the chemistry of our brains can alter our conscious experiences? Of course it can, for it is the chemistry of our brains that makes our conscious experiences! This fact should be no more surprising to us than the fact that running a magnet over your hard drive can erase your files, or the fact that smacking the side of an old UHF TV can sometimes clear the picture.
Indeed, the crudeness of medication shouldn’t surprise us either; the numerous side effects, risks, and unpredictable results are exactly what you’d expect from running a magnet along a hard drive or smacking a UHF TV. You’re trying to resolve a complex, subtle software problem with a brute-force hardware solution.
By comparison, the crudeness of psychotherapy is much more disappointing. It’s obvious that it should be the right kind of solution—you fix software problems with software solutions—but we know so little about the underlying function of the human brain that we can’t make it work. I guess we’re better than cats walking across the keyboard, but we’re something like EECS 101 students who keep forgetting to close their parentheses.
It’s also possible that some more conventionally medical solution would be effective, but even then it won’t be so “conventional”; we’re talking about nanobots that deliver precision doses of serotonin reuptake inhibitor to particular nuclei in the amygdala. To use another machine analogy, filling your whole system with Prozac to treat depression is like fixing an oil leak by covering your car in oil.
Indeed, if there is anything surprising about our current psychiatric medicines, it is that they work at all; they are so hopelessly crude that the only way they could possibly be working is if the brain is already equipped with extremely powerful self-repair mechanisms that only need a nudge in the right direction. Further support for this view comes from the fact that electroconvulsive therapy sometimes works; it’s the neurological equivalent of when a tech support intern tells you, “Have you tried turning it off and turning it back on?”
While the issues it raises are very compelling, I can’t really recommend reading this book; Kramer’s handling of these deep questions is just too haphazard.
