The Intercollegiate Student Magazine

Reaching the Bounds of Psychology

digital art of human brain sprouting from plants

“The separation of psychology from the premises of biology is purely artificial, because the human psyche lives in indissoluble union with the body.”

—Carl Jung

“There is no scientific study more vital to man than the study of his own brain. Our entire view of the universe depends on it.”

—Francis Crick

While psychology is still a budding seed, it isn’t hard to imagine it firmly planting itself in the garden of hard sciences. As with most sciences before it, psychology can and must transition from the realm of conjecture to the realm of calculation. In the seventeenth and eighteenth centuries, for example, the biology of life was explained through vitalism—the idea that all living things had a non-physical force infusing them with life. Through skeptical scientific reasoning and improvements in technology, we now know that biological life is easily explicable through predictable chemical and physical systems. Biology, just like all other sciences, is an emergent property of lower levels of organization—in this case, chemistry and physics. When stumbling across an apparent mystery, we’ve consistently found answers in the lower levels of science that the field in question emerges from. Psychology is no different; it is simply an emergent property of the biology of the brain. We have every reason to believe that all emotions, thoughts, sensations, and behaviors are the direct result of electrical and chemical processes in the brain as time after time that’s what the science points to. There is no reason to think anything spooky is going on. With this in mind, we need not treat psychology with kid gloves any longer. We must treat it with the same skeptical rigor that we inflict upon all other hard sciences and forge an intimate connection between it and the biology of the brain if we are to maximize its ability to improve well-being.

“Awareness is the first step to change,” and part of the necessary perspective shift in psychology requires first finding the current faults in the field. The most glaring of these faults lies in the replication crisis. Throughout the field, researchers have been unable to replicate a highly concerning number of experiments. In particular, the Open Science Collaboration (2015) conducted replications of 100 studies published in top psychology journals and failed at replicating close to 60% of the experiments. In science, replication is king. It helps increase sample size, remove experimenter bias or error, and uncover confounding variation among populations. Failure to replicate an experiment casts serious doubts on the veracity of its results. The fact that such a large number of studies within psychology are irreplicable illustrates a severe lack of fidelity in the experimental methodology within the field. If meaningful contributions to mental well-being are to be made, a substantial reassessment of psychological research is imperative so that viable and justifiable conclusions can be consistently produced.

At its core, the failure of psychology clinically is a product of our lack of biological underpinnings for many disorders. The cause of schizophrenia, for example, is largely unknown. Sure, we suspect it has something to do with dysregulation of the dopamine system, but about one-third of schizophrenic patients don’t respond to dopamine antagonists. Some researchers even argue pathways using glutamate or serotonin may also be involved. Even if dysfunctional dopamine pathways are the culprit, that’s still a vast network of neurons with many different functions; and, attempts to pinpoint the exact cause of such a dysfunction has yet to produce conclusive evidence. Currently, most psychiatrists and researchers just give the safe, all-encompassing answer of it being “Some combination of genetic and environmental factors.” Anyone who’s spent a nonzero amount of time studying biology knows that almost everything can be explained through the interplay between genes and environment. This isn’t to say that’s not the best answer we have at the moment—it likely is—but it expresses just how far psychology has to go. Yes, psychology can certainly function without strong knowledge of its underlying neurobiological mechanisms, but such ignorance is a huge opportunity cost for clinical treatments, especially psychotropic drugs.

Much of the lack of depth in psychology comes down to the methodologies used to discover the causes of these disorders. One of the most prominent, and dubious, research tools is the pharmacocentric model in which researchers attempt to find the etiology of disorders using drugs with known mechanisms of action. For instance, a dopamine agonist—a compound that mimics the action of dopamine—may be shown to induce psychosis, while a dopamine antagonist, which blocks dopamine receptors, reduces psychotic symptoms. In such a case, one might conclude excess dopamine is the cause of a disease like schizophrenia. Clearly though, merely treating or reproducing symptoms is not strong evidence for a disorder’s ultimate cause. If someone with a broken leg were to take prescription painkillers to alleviate their pain, one would not be so quick to assume their pain was caused by a hydrocodone deficiency. Using drugs to indicate avenues of exploration in research is certainly a viable strategy, but neuroscience research is still in its infancy and has some ways to go before it produces a reasonable understanding of most psychiatric disorders.

The symptom-based approach that permeates clinical research unsurprisingly afflicts psychiatric practice. It is standard protocol for psychiatric disorders to be defined by categories of symptoms, which is rarely the case in medicine. Defining something like bipolar I disorder as alternating manic and depressive episodes is equally as unhelpful as defining the flu as a combination of chills, fever, and fatigue. Symptoms can absolutely point you in the right direction to determine what’s going on with a patient, but with so many diseases causing similar symptoms, it’s often impossible to identify a disease based on symptoms alone. Conversely, a different set of symptoms may have similar causes—recent findings suggest that the CACNA1C gene is a risk factor among schizophrenia, autism, bipolar disorder, ADHD, and depression, which are commonly thought of as distinct, unrelated conditions. Even though it may turn out that there is a notable difference between these disorders biologically, a strong biological understanding would likely completely reshuffle our deck of diagnostic cards, if not reveal that we’ve been unwittingly playing chess this whole time. It’s not hard to imagine a scenario in which major depressive disorder in two patients has such starkly different neurological causes that they should be thought as if they have separate conditions. Or that the cause of two personality disorders is so similar that they should be treated as one. Undoubtedly, if we expect to effectively remedy psychiatric conditions, we must understand their underlying causes.

Beyond simply a lack of scientific rigor, pharmacocentric and symptom-based models of psychology present serious roadblocks for the field and even harm to patients. For one, they present a huge opportunity cost. A failure to take an etiology-based approach means leaving numerous, viable treatment options off the table simply because we don’t understand the origins of these diseases. More importantly, it results in the over-prescription of psychopharmaceuticals. Particularly noteworthy is the fact that it’s not uncommon for people to be prescribed multiple psychiatric drugs. In these “prescribing cascades,” patients are given a drug to treat their original symptoms only to require another drug to tame the side effects of the original. The side effects of these drugs may even be misdiagnosed as symptoms of other psychiatric disorders, resulting in more prescriptions. In some cases, this cycle has continued until patients were on ten different drugs all with the purpose of treating one disease—or rather a set of symptoms. Although we know the basic mechanism of action for a lot of these drugs, we have fairly little knowledge on their lasting and unpredicted effects. For example, Adderall, a drug used to treat ADHD, is an amphetamine that increases concentrations of dopamine in the brain. However, it’s been recently hypothesized that this surge of dopamine results in a pruning of dopamine receptors in an attempt to balance out the overload of dopamine. When the drug wears off, the decrease in dopamine receptors can create a litany of side effects like depression, fatigue, and irritability. 

A barrage of drugs in an effort to treat psychiatric disorders is a rather dangerous symptom of the failure to underpin many conditions with neuroscience, and more importantly, it is not a tenable solution. One would not entrust a mechanic, totally ignorant of engine components and physics, to fix their sputtering car with a toolbox full of screwdrivers. Likewise, we cannot expect to safely and effectively use biological means to influence psychology when our biological understanding of the mind is limited. Luckily, we don’t have a toolbox with one tool. We have other outlets to positively influence human experience and behavior–treatments like cognitive-behavioral therapy, acceptance and commitment therapy, differential reinforcement, and meditation have shown great promise for a plethora of disorders and maladaptive behaviors. Surely, as we understand how these therapies impact the brain to produce their effects, their versatility and efficacy are bound to improve in ways that we cannot foresee. Moreover, we can rest assured that employing these techniques will likely have few lasting physiological side effects, so until neuroscience research matures to the level at which we’re attempting to practice clinical psychology, the prescription of drugs in cases where they aren’t highly necessary seems dangerously irresponsible, especially if alternative treatment options are available.

This is not to say psychology has done more harm than good in the world. The conversations being had and the research being performed are crucial for developing a science of the mind directed toward bettering people’s lives, and in many instances, psychology has already vastly improved well-being. In fact, the failures of psychology may just be part of the natural progression of the field from a soft, social science to hard science. Yet, in order for this progression to continue in a positive direction, we must recognize that we’re barely past the base of the mountain and have no idea what’s waiting at the top. We need to strap up our boots and trek on, potentially scrapping everything we thought we knew along the way. The human mind is awfully complex—it would be absurd to think we’d get everything right on the first try. But, we need to be right more often than we’re wrong, and we need to be right in such a way that uncovers our next step forward. The findings of science continue to evolve, but its methodologies are tried and true. Psychology is no exception to this rigor, and it’s of the utmost importance as the mind is ultimately all we have. Every experience we have is colored by our mental states, and a complete understanding of the human psyche is vital to painting those experiences as vividly and as beautifully as we can.

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