Future Prospects

The future of psychiatry lies in our capacity to fathom the true sources of emotional distress in the human brain and in our capacity to prevent and to alleviate such distress with ever more effective interventions. Much of the essential knowledge for future progress is emerging from a detailed understanding of the evolved core emotional systems that evolution provided all mammals as tools for their animate existence. Many animal models are helping us decipher the neuroevolutionary psychobiology of brain emotional systems and the resulting nature of affective experiences. Perhaps the most important understanding at this level is to be achieved in the realm of neuro-chemistries. Those that help us characterize emotional learning processes and other forms of use-dependent brain plasticity allow us a glimpse into how organisms adapt to various environments and how they navigate the world when confronted by specific life challenges.

Studies in humans provide new strategies on how emotional responses can be regulated. Relevant brain systems can be manipulated directly by emerging technologies such as transcranial magnetic stimulation (TMS) and other somatic approaches. We can envision a day when there will be medicinal agents that will facilitate positive forms of use-dependent plasticities in the mental apparatus of the nervous system. However, these approaches will never replace the vast array of traditional human healing skills. In the future, there will probably be neurochemical interventions that are so emotionally specific that we may be amazed how many of them work best in specific socioemotional contexts. As such agents are developed, we may need to better understand the depths of

Textbook of Biological Psychiatry. Edited by Jaak Panksepp Copyright © 2004 by Wiley-Liss, Inc. ISBN: 0-471-43478-7

the human psyche in order to provide optimal assistance for those who desire help with their emotional lives. It is from the combination of approaches that the most effective future tools will emerge. In dealing with the human brain/mind, we must recognize that there is no single path to an adequate understanding of the human mental apparatus. A healthy mind is as integral a part of a healthy body, as the body is an essential substrate for the mind. As Freud put it "The ego is first and foremost a body ego" (Sigmund Freud's essay on "The Ego and the Id" (1923) Standard Edition, Vol. 19, p. 18).

In accepting human complexities, we must increasingly recognize the importance of "meaning" in human lives. While science can give us some assurance about the "truth of fact" it has comparatively little to say about the "truth of meaning." The latter is a creation of how the basic evolved values of our nervous system interact with vast general-purpose cerebral spaces and world events that create mental realities out of human fantasies and imagination. It is only by combining the best of brain/mind science with those aspects of the humanities and social sciences that attempt to deal with human meanings, that adequate frameworks for dealing with human lives can emerge.

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