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Impulse and Neuroscience

Psychologists sixty, seventy, eighty years ago were describing troubled people as having a reason for their "abnormal" thinking. They called these reasons "defense mechanisms," phobias (fears) or something similar — which suggested rationality however distorted by the individual's perceptions — rationality insofar that the individual has his or her reason for behaving or thinking as they do.

But it may be that the troubled person has a brain dysfunction that involves something without even this level of reason, something that makes old-style therapy impossible. No use talking with them as they lay on your couch and getting them to reason themselves to perfect mental health. Something in their brain physiology is impeding their ability to make necessary connections in meeting whatever is challenging them. In other words, their problem may have a genetic component.

I knew well someone who was brilliant in ways and accomplished in her profession — acting. She was able in conversation. But she had lost the control she needed regarding food: she had an eating disorder. At one point in her life she couldn't simply eat while knowing that she should. But she was sane enough that she wanted to go to a hospital. She dropped to sixty pounds and was finally admitted.

I've modified my view slightly about people resisting impulses, in other words being more in charge of what they do. I read that neuroscientists are aware of a segment of the human brain that is devoted to impulse control. This tells me that if this part of the brain is physically disabled or damaged to some degree a person is going to have a harder time controlling his impulses. The damage might be genetic. Or the damage might be from ingesting chemicals of some kind.

I wanted my friend to master her anxieties and impulses without pills — with discipline. I'm annoyed that when she was in her late teens she conquered a weight problem with prescribed pills. I wonder whether the pills she took could have damaged her. An acquaintance at Berkeley, very balanced, sane, cheerful and happy, ended up in an institution, her brain having been fried by pills her boyfriend gave her. The point I want to make here is two-fold: 1) be concerned about the chemicals that your friend is ingesting and (2) if you have a friend who is psychologically troubled don't assume that she can just reason her way into conquering her challenges. A most-advanced psychotherapy will consider that your friend's problem might have a genetic component and this might involve properly prescribed medication.

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