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Book Forum: Models of the Mind   |    
Brain Dynamics and Mental Disorders: Project for a Scientific Psychiatry
DAVID V. FORREST, M.D.
Am J Psychiatry 2005;162:1396-1397. doi:10.1176/appi.ajp.162.7.1396
View Author and Article Information
New York, N.Y.

By Avi Peled, M.D. Tel Aviv, Israel, Yozmot Heiliger Publishers, 2004, 121 pp., $24.00 (paper).

Toward the end of the 1980s neural network theories of connectionism became sufficiently current that we began to feel that, yes, for the first time we could see how the brain might self-organize and generate mental experience. This brief book reviews the recent progress in this newly dominant way of thinking about the logical-computational basis of brain function and proposes a framework for conceptualizing psychopathology. Readers who find the author’s clear exposition a bit spare might wish to consult some of his most heavily relied upon sources, such as Hebb, Hopfield, Rumelhart and McClelland, Hoffman, Goldman-Rakic, Tononi, Edelman, and Mesulam, especially if such terms as "Hebbian plasticity," "Hopfield nets," "parallel distributed processing," "pathological foci," "reverberating network feedback," "reentry," "neural Darwinism," and "heteromodality" are not words found lying about their households.

The subtitle echoes Freud’s "Project for a Scientific Psychology" (1) and attempts to continue his abandoned, premature effort to explain neuronal roots of mind. Mental functions can now be viewed as emergent properties of complex brain organization, and mental disorders can be seen as perturbations of this organization. For example, Peled sees dysthymia as "recurrent deoptimization shifts of the transmodal levels accompanied by constraint frustration" (p. 100), bipolar mood swings as an "oscillatory dynamic of optimizations and deoptimizations" (p. 72), psychosis as "connectivity breakdown of the dynamic core" (p. 72), anxious loss of control as "destabilization of the higher level transmodal brain systems relevant to conscious awareness" (p. 73), and transference as "activation of the attractor systems which represent the person from the past" (p. 75). He does not address character types, which I believe can be modeled plausibly by tweaking neural network elements.

Peled provides illustrative cases for his system of psychiatric brain profiling in which both "external and internal perturbators affect the system development and organization" (p. 93). For external perturbators he favors the Holmes-Rahe Social Adjustment Scale (p. 94), which ranges from minor violations of the law and Christmas to divorce and death of spouse. Internal perturbators include metabolic, medication, and intracranial pathological effects. Peled says his Psychiatric Brain Profile is less stigmatizing and categorical and has more "degrees of freedom" than DSM and yet is more constrained by neuroscience than psychoanalytic conceptualizations that "have unlimited degrees of freedom allowing for all concepts to describe all occurrences and thus are operationally meaningless" (p. 95). Many of Peled’s sources as well as his subtitle, however, are conceptually derived from psychoanalysis.

The book concludes with ideas about future directions for psychiatry. Testable hypotheses must move from a linear two-factor model of cause and effect to a three-level model of lower-level multiple biological factors, an intermediate-level system organization, and higher-level system functions and emergent functions. Means to detect perturbations of brain organization must be developed. Synaptogenic control should include neurogenesis. Direct pacemaker control could include transcranial magnetic stimulation coupled with EEG as well as imaging and deep brain stimulation. Experience control should include virtual reality technology, which Peled believes has potential to correct specific brain cognitive deficiencies, even delusions (for example, by showing patients with delusions of persecution by the FBI a warm and caring FBI headquarters).

If the brain were a corporate office, our present state of functional imaging would put us in the position of the superintendent in the basement who can monitor departments’ use of electrical power and tell who is burning the midnight oil. Peled seems to be proposing that psychiatrists assume the role of a corporate information technology manager who knows the information storage and transmission requirements of each department as well as the volume and destinations of its e-mail and who addresses bugs, overloads, crashes, and viruses that arise in the system. In a continuation of the metaphor, psychoanalysis would be a little like entering the play sphere of the office party to observe the employees’ interactions, or perhaps taking the chief executive officer’s secretary to lunch to hear gossip about office politics. We still do not know how to read the e-mail and must infer how the corporation does its business, decides its priorities and strategies, innovates, integrates its employees’ expertise, and sets departmental budgets.

Freud S: Project for a scientific psychology (1950 [1887–1902]), in Complete Psychological Works, standard ed, vol 1. London, Hogarth Press, 1966, pp 295–397
 
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References

Freud S: Project for a scientific psychology (1950 [1887–1902]), in Complete Psychological Works, standard ed, vol 1. London, Hogarth Press, 1966, pp 295–397
 
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