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Niall McLaren
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Niall (Jock) McLaren is an Australian psychiatrist, author and theoretician. His work opposes the mainstream view in psychiatry to the extent that he argues modern psychiatry has no scientific basis whatsoever. However, he insists that he is not “anti-psychiatry,” but a committed scientist following his duty of criticizing the prevailing models in his field in order to improve it. He is the author of the books, Humanizing Madness, Humanizing Psychiatry and Humanizing Psychiatrists. Humanizing Madness Humanizing Madness: Psychiatry and the Cognitive Neurosciences was published in 2007 in three parts. Part I: Psychiatry in Crisis: Intellectual Failure in the Science of Mental Disorder The first part is a critical review of the logical status of the theories used in modern psychiatry using the canons of the philosophy of science. Using standard principles, McLaren demonstrates that psychoanalysis, behaviorism and biological psychiatry are not scientific in nature and, moreover, cannot be developed to the point where their epistemological failings can be overcome. They are, he argues, totally flawed and an obstruction to the development of a formal, scientific model of mental disorder. He regards this latter point as important because he believes that mental disorder is a reality and sufferers are denied rational treatment just because academic psychiatry has failed to provide practitioners with a consistent treatment program. He extends this criticism to cover the idea of an eclectic psychiatry and the biopsychosocial model of the late New York psychiatrist, George Engel. He further shows that the dualist model of Karl Popper and John Eccles (“The Self and Its Brain” ISBN 978-3-540-08307-8) is essentially irrational and hence, all substance dualist models must fail. Part II: The Working Mind In the second part of this work, he examines the major theories of mind, functionalism and natural dualism. Functionalism, best exemplified by the work of the philosopher Daniel Dennett, is, he believes, seriously flawed because of Dennett’s adamant stance against the idea of dualism. McLaren argues that Dennett’s opposition to dualism, that it necessarily implies substance dualism, is fallacious. The major problem with naive dualism is that it leads to an infinite regress. Thus, any dualist model which avoids this trap is in a strong position. He then uses the model of natural dualism propounded by the philosopher David Chalmers to show that, in conjunction with the pioneering work of Alan Turing, a dualist model of mind which avoids the errors of substance dualism and the infinite regress is within reach. He develops this model and applies it to major questions in psychiatry in the third and final part of the book. Part III: Toward the Future of Psychiatry The third part of his book is by far the most accessible for those not philosophically versed. Personality Disorder He begins with defining personality as "the distinguishing, habitual forms of interaction between the individual and her environment in the stable, adult modes of behavior...personality just is a set of rules" and argues that previous methods of defining personality are but mere typologies (i.e., personality as described by behaviorism). Typologies do not describe or determine the roots of personality but merely put personality into groupings which can then predict future actions based on previous actions. From a psychiatry perspective this falls short because the therapist's goal is to modify behavior by reconciling the personality and guiding it. However, the output of personality is not static and can vary depending upon the situation and the largely unconscious rules which guide it. An example in the book reveals "consider Mr. James Smith, a man of normal intellect and no compelling idiosyncrasies, who is sitting quietly on a park bench somewhere. He brings to his bench a personal background, a huge, rich history of events dating almost from the day he was born. His head is full of rules derived from his myriad life experiences, some of which he could tell you but most of which he couldn't. These rules amount to his personality (note I didn't say rules are identical with personality,; a generative mechanism is not the same as its output, of which more later). When something happens near him, his reaction is determined by a high-speed and unreportable interaction between what he sees and his unique set of rules. some of his rules are more or less fixed and won't vary much from one year to the next, but some are more fluid, even a little unpredictable. If, today, a man comes past and asks him for money, Mr. Smith may be inclined to smile indulgently and hand over a few coins. However, another day, he may have had an argument with his wife or his boss and not be feeling so chipper; this time, the same wheedling request may elicit only a snarl to get a haircut and a job. His personality hasn't changed, and the inconsistency doesn't mean he has a personality disorder, he's just being normal. Normality is a huge, multidimensional range and behavior is only disordered at the extremes." Additionally, since personality is guided by rules coded in memory "therefore, anything that interferes with memory can affect the rules we call personality, and anything that affects current computational capacity will affect the application of those rules." Personality disorder is then defined, "if the rules governing a person's life are internally inconsistent, or there are so many of them that he can't reach a decision, or they generate disabling emotions or cause repeated conflict with his neighbors, then we say he has a personality disorder." However, the major problem with personality disorders is that the "distorted rules give rise to the disordered behavior and generates an output state which serves to reinforce the rules. That is, either directly or indirectly, the individual's behavior or emotions are such as to convince him that his beliefs or rules are correct (therefore creating a positive feedback loop of psychopathology, ie a vicious cycle). Of course, he doesn't refer to them as rules; he simply knows what is right." The author lists several examples but one of widespread significance is "I'm stupid, ugly and worthless. I hate myself." which leads to "if my girlfriend looks at another man, she's probably thinking of leaving me."" The author argues that the path of mental wellness should involve replacing destructive rules with more adaptive standards. He contends that in general religion, the Freudian model, relaxation therapy, and many other therapies fall short because they seek to "suppress the output without changing the pathological factors generating the output. Anxiety McLaren's view is that anxiety is "probably the most common single disorder in the world, and that it is directly or indirectly responsible for a very large part of psychopathology." He emphasizes the fact that anxiety is normal and adaptive as all animals above jellyfish have an anxiety response (fight or flight) and "animals that can't respond to threats become breakfast." However, humans are unique by the simple fact that many of our anxieties are simply perceptions of threats such as blood, animals, sickness, and social life ("the most common and disabling phobias relate to social life"). The Yerkes-Dodson Curve is then used to describe the relationship between anxiety and performance, that being an upside down U. This relationship shows that anxiety does increase performance for both simple and difficult tasks to a certain point. However, once a threshold is reached executive and other difficult tasks wane in performance while simple tasks such as fear conditioning, focused attention and flashbulb memory continue to rise. When in this state our memory continually consolidates in an emotionally charged and deleterious manner. Over-arousal also has a tendency to reinforce itself because the perspectives formed when over-aroused are less subject to introspection and rational critique. An example used in the book to demonstrate the impact of modifying our arousal level is; if opiates, benzodiazepines, or alcohol are given to a normal person, his performance deteriorates, however, if given to an over-anxious person his performance improves. This model is then used to describe the various levels of anxiety response and how this relates to phobias ("the truth is, you are not scared of frogs, you are scared of how you will feel if you go near a frog which is a totally different thing"), panic states ("in a panic state, the feared object just is the panic state itself"), and hypochondriacal states ("these people all fear death or disability...therefore they become anxious, which makes their bodies deviate further from normality, which convinces them they are right to worry"). Depression Depression is seen as an expected reaction to persons who have sustained major losses. It is argued that depression is not the opposite of happiness, moreover, it is the absence of happiness ("a depressed mood is not formally a negative thing but is simply the absence of a positive thing, although happiness is so pervasive that we take it for granted"). However, most who present with a new case of depression have not suffered adverse life events. Therefore, he contends that the great majority of these cases of depression are precipitated by anxiety as anxiety is "more common than depression itself...is an intolerable emotion...does not spontaneously remit...acts upon itself in a self-reinforcing way...and is commonly associated with depression." Humanizing Psychiatry Humanizing Psychiatry: the Biocognitive Model (2009) is the second monograph by the Australian psychiatrist, Niall McLaren. This work extends and develops the model of mind outlined in his first work Humanizing Madness, the central part of the book being a molecular resolution of the mind-body problem which leads to a formal, cognitive model of mind (the biocognitive model). This lends itself to a theory of psychiatry in which mental disorder is seen as the outcome of disturbed psychological constructs in the setting of a physically normal brain. This places his work in direct contrast to the mainstream view in modern psychiatry, which is that mental disorder is almost always the product of a primary, genetically-determined brain disease, the “chemical imbalance” hypothesis. Biological psychiatry states that a brain disorder is both necessary and sufficient for any and all mental disorders whereas McLaren’s work states that primary psychological disturbances can and do exist and, as a matter of fact, almost all mental disorder will be shown to be the result of primary psychological problems. Following from this view, he argues that the proper treatment of mental disorder begins with psychotherapy although medication may be necessary to calm a person to the point where he can begin to think rationally about his place in life. A preview is available on google books Part I: Restriction the Scope of Biological Psychiatry The first part of this work criticizes the concept of biological reductionism, the notion that mental disorder can be reduced to a matter of brain disorder and thence treated with drugs as a physical condition, like diabetes or high blood pressure. In particular, he assails the view of the Nobel laureate, Eric Kandel, who has claimed that biology will lead to a renewal of psychiatry and psychoanalysis: “There is no reason to believe Kandel’s claims. His assertion that all properties of mind are brain properties and mental disorder will be solved in the laboratory is pure metaphysics.” Part II: Resolving the Mind-Body Problem for Psychiatry In the second part of his work, McLaren outlines a detailed case for the concept of mind as the product of information processing by the dedicated modules of the brain. Specifically, he shows the point at which mental events impinge upon the physical structure of the brain to cause observable behavior, including speech. This is a two-way process: in the brain’s normal state of function, informational states control the brain states such that decisions can be made and sent to the effector organs to ensure the individual’s survival, but when the brain is compromised (by injury, infection, drugs, early dementia, tiredness or, crucially, over-arousal), then the output is also affected. Part III: Applying the Biocognitive Model to Psychiatry The third and final part of the book tests this model against some major problems in psychiatric theorizing. These include the concept of a human nature which, he says, is essentially our common heritage as “higher primate nature.” The cognitive system has two parts, the innate cognitive system which derives from our forebears, and an adaptive system which is recent in evolutionary terms. The innate system is more or less coterminous with the older concept of human nature, and is of major significance in psychiatry as it drives a great deal of the less rational side of human behavior. Interestingly, the notion of a human nature leads to a naturalistic morality, which has always been a major complaint against non-religious models of mind: “If we take God out of the equation, where does that leave morality?” McLaren’s answer to this question is surprising and sympathetic: we can be moral agents without being compelled by higher authorities. Similarly, personality is shown to be the sum total of the rules governing observable behavior which distinguish the individual from others in that society. This is a dimensional model of personality, meaning the DSM-IV concept of categories of personality disorder lacks any support. Finally, he analyzes the notion of language in terms of this cognitive model and shows how language is essentially the communication of mental states between sapient beings. This is in contrast to traditional philosophical models which looked at language as the vehicle for the communication of truth, whereas a great deal of human speech has nothing to do with truth at all, to the extent of being only about mistruth. He shows how this model can be related to the brain structure according to the work of the Russian neuropsychologist, Aleksandr Luria. This gives a far more complete account of language than has previously been available in medicine. Humanizing Psychiatrists McLaren's third work, Humanizing Psychiatrists, explains the failures of Functionalism and Biological Naturalism. He argues that in their supposedly monist models of mind they both employ a "self" or virtual machine in their explanations, thus making their models dualist (albeit Natural dualism, not to be confused with Cartesian dualism or property dualism). It is important to note that Natural dualism is the philosophical stance that McLaren's Biocognitive Model is based on. Publications * [http://www.psychiatrictimes.com/blog/dsm-5/content/article/10168/1803237 "McLaren N. Temper Tantrums, Mental disorder, and DSM-5: The Case for Caution"] Psychiatric Times. 22 February 2011. * [http://books.google.com/books?idvJ8Wp5gW5lAC&dqhumanizing+madness&printsecfrontcover&sourcebl&otsdxp6Gz-6vM&sigxpZETYOtsRTG08Qmsq7B9W8Hm08&hlen&eiA3_ySurgMKbe8Aa-zontAQ&saX&oibook_result&ctresult&resnum5&ved=0CBcQ6AEwBA#vonepage&q&f=false Humanizing Madness: Psychiatry and the Cognitive Neurosciences] 2007; Ann Arbor, Mi.: Future Psychiatry Press. ISBN 978-1-932690-39-2. * [http://books.google.com/books?idJ3F4WUVlORAC&pgPA170&lpgPA170&dqhumanizing+psychiatry+review++-madness&sourcebl&otsaXe1HlC7HR&sigXIYiaf4XnzyZwWIOjDHS5RGYfFs&hlen&eiSRX4Srf4L5jk8Ab239TzCQ&saX&oibook_result&ctresult&resnum8&ved0CCYQ6AEwBw#vonepage&q&f=false Humanizing Psychiatry: The Biocognitive Model] 2009; Ann Arbor, Mi.: Future Psychiatry Press. ISBN 978-1-61599-011-5. * * * The myth of eclecticism Australasian Psychiatry 1996, Vol. 4, No. 5, Pages 260-261 * * [http://www3.interscience.wiley.com/journal/118892145/abstract?CRETRY1&SRETRY0 Only martyrs need apply: why psychiatrists should avoid isolated practice] Australasian Psychiatry 2003; 11: 456-459. * The biopsychosocial model and scientific fraud. Paper presented to annual congress, RANZCP, Christchurch, May 2004. Revised version: When does self-deception become culpable? * * * * Kandel’s ‘New Science of Mind’ for Psychiatry and the limits to biological reductionism: a critical review. Ethical Human Psychology and Psychiatry 2008; 10: 109-121. * McLaren N. Science and the psychiatric publishing industry Ethical Human Psychology and Psychiatry 2009; 11: 29-37. * [http://web.ebscohost.com/ehost/detail?hid7&sidceff5791-54b1-4f2a-9592-1391914c53e5%40sessionmgr13&vid1&bdataJnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#dbpbh&AN55583483 McLaren N. The DSM-V Project: Bad Science Produces Bad Psychiatry] Ethical Human Psychology and Psychiatry Vol. 12 Issue 3, p189-199. * [http://web.ebscohost.com/ehost/detail?hid7&sid3e3900e5-3090-4d9e-85cf-467001a9f9bd%40sessionmgr10&vid1&bdataJnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#dbpbh&AN54453019 McLaren N. Monist Models of Mind and Biological Psychiatry] Ethical Human Psychology and Psychiatry Vol. 12 Issue 2, p122-133. See Also
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