Is it all in the brain? An inclusive approach to mental health

For many years, the prevailing view among both cognitive scientists and philosophers has been that the brain is sufficient for cognition, and that once we discover its secrets, we will be able to unravel the mysteries of the mind. Recently however, a growing number of thinkers have begun to challenge this prevailing view that mentality is a purely neural phenomenon. They emphasize, instead, that we are conscious in and through our living bodies. Mentality is not something that happens passively within our brains, but something that we do through dynamic bodily engagement with our surroundings. This shift in perspective has incredibly important implications for the way we treat mental health – and schizophrenia in particular.

In much of the Western world, and particularly in the United States, drugs are a primary mode of treatment for psychological disorders. This reflects the common assumption that mental illness results from faulty brain chemistry. Although it would be difficult to deny that medication can play an important role in treatment, this drug-based approach faces three major limitations:

1. It is doubtful whether disorders such as schizophrenia are caused by anything neurological (in the straightforward way that heart attacks are caused by arterial blockage). Indeed, many mental, emotional, and behavioural problems do not have clear-cut genetic or chemical causes, but instead result partly from difficult human experiences, stressful events, or other problems in their personal life. When minds “go wrong” it is not simply a matter of mechanical breakdown, and “fixing” neural wiring will not be sufficient to address the underlying causes of disorder.

2. There is evidence that antipsychotic medications are not sufficiently effective in managing the debilitating symptoms of schizophrenia, such as delusions and hallucinations. Many patients on medication continue to experience psychotic symptoms throughout their lifetimes. In addition, there is a worry that anti-psychotic drugs may cause negative side effects, such as apathy, muscle stiffness, weight gain, and tremors.

3. By focusing on just one organ of the body (i.e. the brain), drug-centred approaches overlook the role of bodily processes more broadly construed. Once we acknowledge that consciousness and cognition are fully embodied, this pushes us to move beyond narrowly defined, brain-based methods and to seek treatments that transform a subject’s overall neurobiological dynamics.

What can be done?

Interventions that target the subject’s whole body, and not just the brain, include yoga, dance-movement therapy, and music therapy – all of which have proven to help schizophrenic subjects re-inhabit their bodies and regain a coherent sense of self.

There is strong evidence that yoga therapy can reduce psychotic symptoms and improve the quality of life of adults with schizophrenia. Through the repeated execution of sequenced movements and postures, as well as enhanced sensory self-awareness, subjects are able to forge more of a felt connection with their bodies and also begin to feel more “at home” in their surroundings. Breathing exercises and meditation can help to make the make body feel more familiar, increase sensitivity to subtle bodily sensations, and minimize feelings of bodily alienation and hallucinations that are commonly found in schizophrenia.

Like yoga, dance/movement therapy centres on the use of movement to foster the integration of bodily sensations and emotions. Through exercises that aim to increase bodily self-awareness (such as sequential warm-ups, patting one’s own body, defining its outer limits, grounding, and reflecting on the movements of others), a sense of self is promoted. In addition, it provides opportunities for increased emotional expression and the controlled, cathartic release of emotions of joy, sorrow, rage, or frustration.

Last, but not least, music therapy may have great potential for treating schizophrenia. Subjects can be invited to play or sing, whether through improvisation or the reproduction of songs, or simply listen to recorded or live music. Like dance, music provides subjects with a nonverbal means of expression and can serve as a powerful therapeutic medium for those who are unable or too disturbed to rely on words. Improvising, playing, composing, and listening to music all are thoroughly embodied processes that address symptoms from the bottom-up, by engaging emotions and bodily feelings.

By tackling mental issues with this ‘bottom-up’ method, we are able to bring about changes in higher-level cognition and interpersonal functioning – by evoking emotion and tapping into bodily feelings. Such therapies have a fantastic potential to make subjects more attuned and sensitive to their surroundings, and to foster emotional resonance with others.

It is true that such treatments may take longer, and be more expensive than medication. However, such interventions may be our best hope for bringing about lasting improvements – focusing on the person as a whole, to treat a problem as a whole.

Featured Image Credit: “Contemporary Dance at its Finest,” by Nazareth College from Rochester, NY, USA – Bend and Snap Uploaded by Ekabhishek. CC BY 2.0 via Wikimedia Commons.