{"id":62,"date":"2015-04-02T15:47:00","date_gmt":"2015-04-02T14:47:00","guid":{"rendered":""},"modified":"2017-06-05T17:11:50","modified_gmt":"2017-06-05T16:11:50","slug":"me-my-brain-and-baked-beans","status":"publish","type":"post","link":"https:\/\/blogs.canterbury.ac.uk\/discursive\/me-my-brain-and-baked-beans\/","title":{"rendered":"Me, my brain and baked beans"},"content":{"rendered":"

Today, in the first in an occasional series of longer form pieces, Peter Kinderman<\/a> reflects on the interaction between his genetic inheritance and his personal experience, and considers what they mean for his own mental health. <\/i><\/p>\n

My wife once came with me on a Saturday morning visit to a psychiatric hospital. I was collecting data for my PhD, and she met me in the car park of a large psychiatric hospital after I\u2019d conducted my interviews.\u00a0 As I drove away, she stroked the back of my hand and suggested that I could relax my knuckle-whitening grip on the steering wheel. I really didn\u2019t like leaving the residents behind. I wanted to rescue them.<\/p>\n

In mental health, resolving the relative contributions of our biology and genetics and how these interact with social and environmental factors (our parenting, peer-relationships, learning, and experiences of both abuse and nurturing) is more than an intellectual puzzle. I\u2019m occasionally annoyed by what appears to be a rather simplistic suggestion that, if there\u2019s a biological, even heritable, element, to a psychological phenomenon, then we\u2019re inevitably discussing an illness, a disease. Of course there are biological elements in every behaviour, thought emotion, or trait, since they all involve our brains. We don\u2019t, despite the jokes, think using any other organ and we do, despite the jokes, always use our brain when we\u2019re thinking. But our attitudes to these issues also have direct personal implications. As a mental health professional, as a some-time user of mental health services and (like most of us) as someone with family members with more serious mental health problems, it\u2019s certainly personal for me.<\/p>\n

I\u2019ve spent much of my professional life studying psychological aspects of mental health problems. Inevitably, this has also meant discussing the role of biology. I hope I\u2019ve made some progress in understanding these issues, in working out how the two relate to each other<\/a>, and the implications for services<\/a>. That\u2019s my academic day-job. But it\u2019s not just academic for me. I\u2019m probably not untypical of most people reading this; I can see clear examples of how my experiences may have affected my own mental health, but I can also see reasons to suspect biological, heritable, traits. As in all aspects of human behaviour, both nature and nurture are involved and they have been intimately entwined in a complex interactive dance<\/a> throughout my life.<\/p>\n

I need to be cautious, because I don’t want to say anything that will irritate my siblings, but I do think there were oddities in my upbringing. My parents had very strong religious beliefs, and I think it\u2019s fair to say that, in addition, there was a degree of emotional repression. Our family relationships were somewhat complicated. Just one example: my parents\u2019 belief system included the need to love God more than anything or anyone else, including one\u2019s children. So, after my mother\u2019s death, we discovered that, when she had confessed to a religious mentor that she was in danger of loving her children more than God, there was a subsequent process of re-adjustment. She was encouraged to practice loving her children less. My parents rejected the material world as merely a stepping-stone on the way to heaven (or hell) and paid little attention to worldly pursuits. I remember opening a letter from Cambridge University confirming an offer of a place as an undergraduate. I told my mother, whose reply was; \u2018Very nice dear, now, do you want baked beans on toast for breakfast?\u2019 Pride was a very worldly emotion. I guess that experiences like that must have had an effect on me and on my siblings.<\/p>\n

So much for my upbringing. But like all of us, I was also born with a particular brain. I\u2019ve been educated to observe signs of neurological as well as psychological functioning (if those two concepts can be separated). And one of my close relatives has had major mental health problems throughout his (and therefore my) life. So it\u2019s intriguing to observe similarities between us and speculate on their origin. Do we behave similarly because of our shared upbringing, our shared genetic heritage or (of course) both?<\/p>\n

A phenotype<\/h2>\n

So I am emotionally labile. My self-esteem and emotions are very fragile and very much dependent on what I imagine other people are thinking. Or, at least, I think I am; my observations of my own behaviour are themselves subjective, and it\u2019s possible that others do these things as much as I do. I frighten myself (given my relative\u2019s experiences) by fantasising about winning Nobel Prizes, winning Pulitzer prizes, being elected to this and that, being awarded knighthoods. And that is<\/i> frightening because I\u2019ve seen self-referent fantasies ruin other people\u2019s lives. My selective attention is terrible and I find it difficult to avoid distractions. Those who know me well will know that I work with the BBC rolling news constantly running in the background, and I frequently play games while on the phone. I appear to have problems with face-recognition; I find it almost impossible even to recognise the faces of people whom I know well. And when in conversation with people (in what seems to me to be a potentially related phenomenon), I find it difficult maintain eye-contact, and look to the side to line-up images in the distance. And, perhaps most saliently, I lurch forwards and jump to conclusions in my mental logic. So, if you give me the sequence \u2018A, B, C\u2026\u2019 and ask me to complete the sequence, I\u2019ll say Z. Maybe that\u2019s a bit of a joke (a pun on \u2018complete\u2019), and it\u2019s unequivocally good for me in my academic career. A creative professor is a good professor. I also and simultaneously make abstract and surreal connections. It\u2019s a recognised part of my teaching style – I\u2019ll veer off on a tangent. Again, perhaps useful in an academic and possibly engaging or at least entertaining for students (if they can keep up\u2026). But jumping to conclusions<\/a>, tangential connectivity<\/a> and abstract, \u2018clang<\/a>\u2019 associations all have very interesting connotations in the field of mental health.<\/p>\n

So I am very interested, and I hope I\u2019m open-minded, about what it is, if anything, that we inherit. How do I differ from other people? What proportion of the variance in these traits can be accounted for by genetic differences? What proportion of the variance in these traits comes from being brought up by repressed religious extremists? What proportion comes from being reinforced, through my childhood, for being academic? Which elements of my upbringing were different other people\u2019s anyway?<\/p>\n

Gene x environment interactions<\/h2>\n

My tentative conclusions, as of today, are these: First, my childhood had many oddities and peculiarities that would capture the attention of any competent psychotherapist. Second, I believe that my professional eye has identified interesting phenotypes<\/a> in my close family that reflect potentially heritable traits. Third, these traits may well put me at risk of many emotional problems. Incidentally, they may well also make me absolute hell to live with, and I must give credit to those who have given that a go. Fourth, the interactions of these heritable and environmental factors in my development have also created a person \u2013 me \u2013 that I value and respect. That\u2019s a very odd, solipsistic, thing to say, but it\u2019s important.<\/p>\n

Which leads to my fifth and most important conclusion. For some people, such as for my relatives, these interactions cause problems. For others, like me, a presumably very similar pattern of interactions has observable similarities but different outcomes. Of course we need to consider the contribution of biological as well as environmental factors in our psychological makeup. I think it\u2019s perfectly possible to be intelligent and open-minded about the contribution of genetic and environmental factors in our mental health. We can intelligently and respectfully discuss how experiences and heritable traits can interact to produce the wonderful variety of human experience. This, I think, is a much more accurate and helpful way to conceptualise what\u2019s going on than to say that some of us \u2013 but only some of us – have \u2018mental illnesses\u2019. Labels such as \u2018schizophrenia\u2019 not only suffer from the validity problems that we\u2019ve discussed elsewhere<\/a>, but also obfuscate these important considerations. I don’t think it\u2019s helpful to consider how I have managed to avoid developing \u2018schizophrenia\u2019, or whether I have \u2018attenuated psychosis syndrome\u2019. To do that, to reduce these discussions to binary considerations of the presence or absence of disorders, necessarily constrains the scientific debate. \u00a0It can also sometimes have frightening consequences in the real world. When I\u2019ve mentioned some of these issues before in less public settings, friends and colleagues have often told me that I\u2019m being brave, and that it\u2019s a potentially risky topic of conversation. So why might that be?<\/p>\n

The eradication of undesirable genetic traits<\/h2>\n

Part of the reason that people might be reluctant to talk about such issues is that we have a very poor track record in this area. This is a difficult topic, but I think it is important to remember the infamous 1933 Nazi Law for the Prevention of Genetically Diseased Offspring<\/a> (Gesetz zur Verh\u00fctung erbkranken Nachwuchses). Arguments of genetic science<\/a> not only led to the drafting of this law (which permitted the compulsory sterilisation of any citizens who were judged to possess a \u2018genetic disorder\u2019 which could be passed onto their children) but indeed led German-American psychiatrist Franz Kallmann<\/a> to argue that such a policy of sterilisation should be extended to the relatives of people with mental health problems (in order to eradicate the genes supposedly responsible). The notorious Action T4<\/a> \u2018eradication\u2019 programme was the logical extension of these policies.<\/p>\n

\"On<\/a>
On the left, the Reich Law Gazette on 25 July 1933: Law for the Prevention
of Genetically Diseased Offspring; on the right, Adolf Hitler\u2019s order
for the Action T4 programme.<\/figcaption><\/figure>\n

Of course, a focus on biological aspects of mental health problems is not in any sense necessarily synonymous with fascism. But for many of us, there are echoes of blame, of stigma, when we identify the pathology within the genetic substrate of the person. I\u2019m reminded of Eric Pickles\u2019 notorious throw-away comment to a voter campaigning about the abuse she\u2019d experienced that she should ‘adjust her medication<\/a>‘. If the pathology lies in the person, and particularly if it is a biological problem, we can dismiss any further troubling considerations.<\/p>\n

So one way to understand these kinds of experiences is to diagnose some form of subclinical syndrome; perhaps attenuated psychosis<\/a>. If the Nazis had won the Second World War, I would have been castrated as a first-degree relative of a \u2018schizophrenic\u2019. Disease-model, eugenic, thinking is a direct threat to me personally, especially given the recent rise of far-right parties in Europe. I am interested in whether the traits that make me a good professor may also be related to the traits I listed earlier, and on their impact on my emotions. I am interested in whether they may have emerged from a similar mix of genes and environment that led my relative to experience psychosis. I am very interested in the practical implications; I have always, for example, avoided certain classes of street drugs. It is absolutely possible to discuss gene \u00d7 environment interactions, but \u2013 please \u2013 don’t use the \u2018disease-model\u2019 as a framework.<\/p>\n

Acknowledgement<\/h3>\n

Thanks to Anne Cooke for helpful comments and advice on earlier drafts.<\/em><\/p>\n

About the author<\/h3>\n

Peter Kinderman is Professor of Clinical Psychology at the University of Liverpool. You can follow him on Twitter here<\/a>. A shorter version<\/a> of this piece originally appeared on The Conversation UK.<\/i><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

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