Brainy Kids:Mental Health, Social Care,

and the Circulation of Neurologic Knowledge

‘Monitoring Parents’ Conference, 14th September 2011

Dr Martyn Pickersgill

Wellcome Trust Senior Research FellowCentre for Population Health Sciences

University of Edinburgh

martyn.pickersgill@ed.ac.uk

Overview

• Background

• The Social Life of the Brain

• Health, Illness and the Neurological

• The Brain in Professional Practice

• Narratives of Resistance

• Final Reflections

Background

• ‘Neuroscience, Clinical Practice, and the (Re)Construction of Personality Disorder’ (ESRC)

• ‘Constituting Neurologic Subjects: Neuroscience, Identity and Society After the ‘Decade of the Brain’’ (ESRC)

• ‘Translating the Brain: A Sociology of Neuroscience and Everyday Life’ (Newby Trust)

• ‘Access Denied: The Roles of Clinical Knowledge and Moral Discourse in Mediating Access to Psychological Therapies’ (Wellcome Trust)

• Documentary analysis; focus groups; interviews; (participant) observation.

• Educational neuroscience is a small but growing area of research

• Increased policy and practice emphasis in education and social care on cognitive development and decline

• Brain plasticity is “one of the most extraordinary discoveries of the twentieth century” (Norman Doidge, 2007)

• Over 17.5 million brain training games have been sold by Nintendo

• Plasticity enrolled not just to support increased surveillance, but wider social policy (e.g. around poverty)

The Social Life of the Brain

• Neuroscience is an increasingly prominent aspect of ‘technosomatic’ psychiatry

• Current classification schemes (the DSM) helped in the standardisation of subjects for (neuro)biological research; in turn, these studies helped to authorise the categories themselves (e.g. ADHD, autism)

• Neuroscience is central to the logics of psychopharmaceuticalisation

• But neuroscientists themselves are not necessarily ‘reductionist’

• The perceived implications of neuroscience for psychotherapy are far from straightforward

The Social Life of the Brain

• “there can be a shift in the brain” (F1, epilepsy group 2)

• “part of my brain had got worse” (F3, epilepsy group 2)

• “I’m interested in the change, because I never noticed the change really” (F1, dementia group)

• “there’s something hormonal” (F1, epilepsy group 1)

• “your brain can be retrained. I mean to me it’s blatantly obvious” (M3, head injury group 2)

• Such narratives can be read against broader cultural tropes wherein the brain is actively positioned by mental health service users as the locus of their pathology

• though national cultures may mediate this relationship

Health, Illness and the Neurological

• Changes in the brain are a taken-for granted aspect of life

• Experiential knowledge is formed from the embodied experiences of illness

• Such knowledge melds with and is legitimatised by information from everyday life, such as television programmes and encounters with health professionals

• This is grounded in a centuries-old culturally-embedded assumption that the brain is an object of import

Health, Illness and the Neurological

• “talk about exercising your brain is a bit of a theme at the moment” (F1, teachers group)

• “an NHS seminar […] that showed us pictures of a normal brain and then a brain of a child who had been traumatised and neglected, and there were all these gaps in the kind of transmission, neuro, whatever, neurotransmitters I’m trying to say, and the neuro-pathways” (F2, foster care professionals group)

• “it kind of explains things a bit better” (F1, foster care professionals group)

• “you can re-forge links and re-process trauma” (F3, counsellors group)

The Brain in Professional Practice

The Brain in Professional Practice

• The embedding of neurologic discourse within popular entertainments does not necessarily trivialise it

• Images may not be understood, but they have a compelling rhetorical force

• The ideas conveyed interact with professional concepts and practice, justifying current modes and enjoining new ventures and concerns

• Epistemological claims of lower status work may be buttressed by neurobiological framings

Narratives of Resistance

• Neuroscience ideas only “loosely” inform practice (M2, foster care professionals group)

• “people will go away all enthused for a couple of weeks and do things, and then forget about it.” (M2, teachers group)

• “it’s not the whole story” (F3, counselors group)

• “[T]he most useful thing to do is that we spend most of our time supporting carers or working with teachers. Rather than having debates about neuroscience.” (M2, foster care professionals group)

• Such comments resonate with even the discourse of psychiatrists (and, to an extent, neuroscientists)

Narratives of Resistance

• To frame the role of neurologic discourse within the professions as a ‘neurobiological turn’ is perhaps a step too far

• The exigencies of everyday work and the distance between the professions and academia both play a part here

• ‘Professional resistance’ may simply be a lack of time and interest

• If neuroscience does not resonate with the experiential knowledge of professionals, it will be ignored

Final Reflections

• New ideas about the brain only make sense within the context of everyday life

• “Extraordinary” to researchers, neuroscientific ideas about the brain are ‘common sense’ to many participants

• Acceptance of new facts about the brain occurs as a consequence of their resonance with experiential knowledge

• The ‘promise’ of neuroscience is important, but is carefully managed, often resisted or simply ignored

• Images are compelling but their legitimization itself comes from the everyday in a process of co-production

• Ideas about plasticity are not likely to propel new regimes of self-surveillance; rather they are a window through which to view the means by which individuals ascribe relevance to ‘new’ knowledge