Rants & Reasons

In the Times Literary Supplement, Jerome Burne reviews Irving Kirsch’s book The Emperor’s New Drugs, in which Kirsch argues that anti-depressant drugs—SSRIs like Prozac, Seroxat and Lustral—are no better than placebos.  The evidence for his claim is impressive and it does not surprise me that the pharmaceutical industry has made billions of dollars by suppressing evidence.

What is bothersome about Burne’s review is his utterly misleading use of 20th Century philosophy of mind to make his case.

His review is subtitled: “A debate on Cartesian dualism has led to radically differing approaches to the treatment of depression”. The introduction of the article suggests that opposition to Descartes’ claim that the mind (or soul) is a non-physical substance led to the assumption that brain functions are nothing but chemical reactions that can be controlled through drug intervention—an approach that is now proving to be ineffective.

Sixty years ago, the philosopher Gilbert Ryle published his famous attack on Cartesian dualism, The Concept of Mind, which claimed to find a logical flaw in the popular notion that mental life has a parallel but separate existence from the physical body. Among other effects it provided sophisticated support for the psychological behaviourists, then in the ascendant, who asserted that since we could not objectively observe mental activity it was not really a fit subject for scientific investigation.

Nowhere was the notion of banning mental states taken up more enthusiastically than by the emerging discipline of neuropsychiatry. If consciousness and all its manifestations were “merely” the firing of neurons and the release of chemicals in the brain, what need was there to focus on mental states? Once the physical brain was right, the rest would follow.

It was an approach that has spawned a vast pharmaceutical industry to treat any pathological psychological state – anxiety, shyness, depression, psychosis – with a variety of pills.

The clear implication of the article is that we should return to a dualistic conception of the mind that treats the mind as independent of physical states.

But this is just silly. Ryle rightly criticized the Cartesian picture of the mind as assuming a “ghost in the machine”—a weird supernatural entity that somehow issues in experience and rationality. Ryle’s criticism of Descartes was surely apt.

However, Ryle’s solution to uncovering the nature of the mind, behaviorism, was rejected by cognitive science decades ago and few researchers think that we can understand the mind by ignoring mental activity. I doubt that behaviorism had much impact on the development of pharmaceutical interventions.

Furthermore, the fact that we haven’t yet discovered the complex brain functions that cause psychosis or depression does not entail that the mind must be non-physical. The failure of drug interventions simply shows that the brain is more complex than many researchers had thought and mental illness is unlikely to be cured by a pill.