In a review of the concepts behind "behavioural genetics," and without obviously trying, Evan Charney of Duke University, North Carolina, made the whole field look foolish [1] . Now this is important because researchers from a dozen or more disciplines are beavering away at finding "the genetic basis of behaviour." These include psychology and psychiatry, of course, but also education, sociology, political science, economics, and business (you may wonder about business but if they could find a gene for shopping, they're made). He concluded:
It is a continuing goal of behavior geneticists to establish a firm connection between genetics and much of human behavior. But their current methods and underlying assumptions are so deeply flawed as to raise more questions than answers [1, p7].
Years ago, the neurophysiologist, Eric Kandel, who gained the Nobel Prize for his work on the cellular basis of memory in sea slugs, said that wearing a bow tie is genetically determined, but even that would not be the silliest claim I've heard. Charney found that one single gene implicated in voting patterns had also been "found" to be causally important in "... over one hundred different behaviors including agreeableness, alcoholism, anorexia nervosa, behavior in romantic relationships, bipolar disorder, creative dance performance, depression, gambling, gang membership, intelligence, job satisfaction, obesity, optimism, persistence, premature ejaculation, schizophrenia, seasonal affective disorder, self-esteem, sexual novelty, shyness, and utilitarian moral judgments" [1, p3]. That's quite a haul; one wonders what the rest of the genome does.
My interest is in Charney's comment: "It is a continuing goal of behavior geneticists to establish a firm connection between genetics and much of human behavior." Fine, that's interesting. Lots of research money and lots of PhDs in that program but ... Why? Why, when human behaviour is infinite, would anybody want to find a genetic "cause" for dancing? There are only about 22,000 genes, half of which control the physical structure of the brain, so obviously there can't be a single cause for each and every individual behaviour. Where then is the theory that predicts that genes can control behaviour, that life experiences don't count? Well of course there isn't one, it doesn't exist. As an example, let's look for the "swimming gene."
It used to be the case, and may still be, that most children born in the UK couldn't swim. At the same time, it was the case and still is, that practically all children born in Australia and New Zealand could swim. Does that say the Poms are genetically deficient? In fact, it's got nothing to do with genes. Humans can swim because we've got a sort of tubular trunk with a limb at each corner to act as a paddle, and our Specific Gravity is 0.98. That means that when we fall in water, we will normally float to the surface. It's then just a matter of kicking and paddling and hey presto, swimming. If our SG were 1.02, say from slightly denser bones, we'd sink and very few people would ever learn to swim. So there isn't a swimming gene, nor a dancing gene, or voting or bow ties or any of the other nonsense that academics dream up.
The whole thing is bizarre, the psychiatric genomics industry is huge and consumes enormous amounts of research money, time and attention, all on the basis of no theory and no results. I'm distinguishing between medical genomics, which searches for genetic factors in disease such as breast cancers, or looks for immune treatments for various degenerative conditions, etc. That's completely different: they have a theory and they are starting to produce results (earlier this year, the enormous drug company Pfizer paid US$43billion for Seagen, a company that works on specific immune treatments for cancers that will target the malignant cells while having no effect on normal tissues; that would be a vast improvement over surgery, chemo- and radiotherapy; last week, Pfizer spent US$11bln on another company working on immune blockers for migraine. This is big, big money because they see it as the future).
Compare that with a comment by psychiatric geneticist Matthew Keller, who asked, “How on Earth could we have spent 20 years and hundreds of millions of dollars studying pure noise?” That's an important question: if researchers are chasing the ends of genetic rainbows, they're not looking at the effects of things like poverty on adult mental state, or childhood physical or sexual abuse, parental separation, over-strict or over-lax parenting, school bullying, and so on. I suggest the answer to Keller's question is fairly simple: Nobody's interested, because they haven't worked out how to monetise it, as they say.
Drug companies aren't interested in social research because there's no prospect of a return for them on any investment, let alone a profit. Governments certainly aren't interested because they don't want anybody pointing fingers at their neoliberal policies, because that would mean spending more on society and less on themselves and their wealthy friends. Does anybody seriously think that politicians like Donald Trump, Boris Johnson or Scott Morrison had the slightest interest in the problems of poor children of broken families in deprived areas being bullied at school? (Morrison belonged to a "prosperity gospel" church, which believes that if you're poor, it's because you haven't prayed hard enough and put enough in the collection plate). And the researchers themselves aren't interested because their concept of a "science of human behaviour" doesn't allow for things like feelings, beliefs, hopes, regrets and so on. But this is a doctrine, an ideology of the same form as prosperity gospel, not a carefully argued position.
But the important point behind all this is that the academic and research industry in modern psychiatry resolutely refuses to consider the possibility that there may be something wrong with their model. The importance of a model is that it tells you what's important and what's "just noise." Look at this example:
A 32yo man with no previous history of mental trouble is taken to the emergency department after a botched attempt to harm himself at work. He had just been dismissed because he smelled of alcohol. When seen, he was intensely agitated, weepy and disorganised. He said he was injured at work months before and was in a lot of pain but the insurers were disputing his claim. As a result, he had been drinking more and was irritable at home. He had lost his sexual interest, which his wife interpreted as him having an affair, and was threatening to leave. Her parting words that morning were "You'll never see your children again," which led him to have a few beers so he could calm down and cope with work. At interview, he had many classic symptoms of depression and expressed vague suicidal ideas.
This is a very typical case. The standard response is to put the man on large doses of drugs, antidepressants, an antipsychotic to sleep, and something for the side effects, etc. When that doesn't work, he is booked for ECT. If he objects, he is detained and gets it anyway. Meantime, his wife applies for custody of the children on the basis he is a certified mental patient and is therefore a danger to them.
The reasoning behind this "management" is that his mental disorder is a genetically-determined disturbance of brain function. Granted, his "life events" of injury, pain, financial and marital problems and so on, may have had something to do with tipping him over the edge but his "depressive diathesis" (a bit of jargon which means innate tendency to some disease or other) is all that counts. Fix that and his mood will improve. The model says that when his mood improves with the drugs, he will be able to sort out all the other things with maybe a bit of help from the social work department. But psychiatry itself has no interest in such things, because its model says they are irrelevant. All that counts is the genes, the rest is of nuisance value.
But for the patient, being a good worker, parent and provider was terribly important in his life. His early life was dreadful and it was only when he beame physically strong enough to handle a day's heavy work that he came into his own. The thought of losing his physical strength and therefore his ability to work and support his family terrified him, kept him awake at night and led him to alcohol. One thing leads to another, and another, until the machine finally breaks down.
Could the drugs help? Well, the first effect they had was to make him too groggy to drive his machines, so there was no prospect of a return to work. Second thing, they caused intense agitation and irritability (known as akathisia); third, they killed the last of his sexual interest, which frightened him even more; and finally, they didn't work. The correct management is: Get him settled in the short term so that he can sleep; explain to his wife the effects of pain and anxiety and depression on sexual function (as it emerged, she was seriously insecure herself); deal with the pain; sort out the insurance claim; finally, find a new career with some training that meant he could give up the heavy work and rely on his brains, not brawn.
To my simple mind, all of this is absolutely elementary. Humans are more than the sum total of their genes, but the modern concept of science can't cope with that: if it can't be measured, it doesn't exist. Psychiatry itself, which wants to be seen as "scientific," is a case of "If your only tool is a hammer, then every job looks as though it needs a nail." In psychiatry, if your only concept, your only model, of what could go wrong is the genes, then that's what you see: everything needs a "gene corrective" to fix it. It all goes back to the model.
Your model of mental disorder tells you what to do, but the critical and almost entirely unrecognised problem with models is that they also tell you what to see. If your model of mental disorder doesn't have a place for life events, then you won't see them, won't be listening when the person wants to talk about them. Why does psychiatry believe this? Because this is exactly what the modern idea of science says. In a review entitled Genetic Approaches to Understanding Psychiatric Disease, a senior researcher said:
Human genetic studies have been the driving force in bringing to light the underlying biology of psychiatric conditions. As these studies fill in the gaps in our knowledge of the mechanisms at play, we will be better equipped to design therapies in rational and targeted ways, or repurpose existing therapies in previously unanticipated ways [2].
The journal is published by The American Society for Experimental NeuroTherapeutics, Inc.. The claims are absolute rubbish. There are so many things wrong with this paper that it's hard to know where to start: psychiatric disease? What's that, if not a physical thing? Understanding? Don't you mean propaganda? That's two deceptions in the title.
The so-called driving force in psychiatry has been the drugs, specifically arguing that because the drugs have a particular effect, then the "disease" they are treating must have been caused by the opposite effect. If the drugs block the effect of a particular neurotransmitter, then the cause of the disease must have been an excess. This is called argumentum ex iuvantibus, meaning arguing backwards from the benefit. It is the weakest possible arguement in science just because it fools you into thinking that your model is correct. Sometimes it is, but mostly it isn't. If it doesn't work, what then? Well, they immediately think they need more of the same. This was the justification for blood-letting, the old "treatment" that said if a person is sick, he has too much hot blood in him so the correct treatment was to cool him by draining a lot of his "hot blood." If he didn't get better, then he needed to lose more blood, and more, until he snuffed it, as happened to George Washington (he had malaria). Then they said "Oh well, we tried everything but he must have had a very severe case." It wasn't a matter of "Maybe our model of disease is wrong," it was "We're right but the patient didn't cooperate."
So when the patient says "I've hurt my back, I've lost my job, my wife is threatening to leave and I can't handle it," the psychiatrist smiles knowingly and says "That's your defective genes talking. Take these and come back in a month." And nothing gets better. But that doesn't deter the committed biological psychiatrist. The response is "More of the same. More drugs, more ECT, more and more," until the patient simply sits there dribbling and twitching passively. Then the psychiatrist is happy that, yes, he just nailed another case of genetic mental disease.
1. Charney E (2017). Genes, behavior, and behavior genetics. WIREs Cogn Sci, 8:e1405. doi: 10.1002/wcs.1405.
2. Michaelson JJ (2017). Genetic Approaches to Understanding Psychiatric Disease. Neurotherapeutics. Online publication June 12th, 2017. doi:10.1007/s13311-017-0551-x