Preliminary Treatment Implications

Since all psychiatric disorders reflect disturbances in communications, and both the brain and body devote much metabolic action to mediating social behaviors (aberrant features of which correlate with psychiatric illness), the study of communicational sociophysiology will foster more illuminating across-species comparisons. Such studies will generate robust evolutionary inferences, particularly on the operation of conserved versus emergent features of brain-behavioral systems in specific clinical problems.

All psychiatric treatments hinge on communication. Of course, this is the prime métier of psychotherapy, but psychopharmacology also requires effective communication in that patients must disclose syndromic phenomena and physicians must elicit cooperation via informed consent. In addition, pharmacological agents impact communicational propensity states, functions, and attributes. Also, akin to psychotherapy, placebo effects represent the benefits of interpersonal communication and cultural expectation: The patient expecting to be helped feels helped and indeed often is, for reasons other than the intended effects of the agent in question (Brown, 1998).

Scott (1989) has suggested that conspecifics regulate each other in that physiology can be affected more or less directly by factors in the ecosystem and in social systems. An individual's behavior can also affect a social system or ecosystem, but effects are usually much more evident in the reverse direction, from the higher levels down. Com-municational behaviors grounded in the body influence the bodies of other conspecifics, for example, the stress-producing effects of a hostile put-down on the one hand, or the restorative effects of a mother on a distressed child on the other. Hofer (1984) working with rat pups and their mothers noted that the mother regulates infant homeostasis. Both Harlow (McKinney, 1988) and Bowlby (1988) documented the importance of attachment for primate infants. The salutary effects of people on one another extends well beyond childhood; attachment enhances health and reduces effects of stressors throughout life (Wolf and Bruhn, 1993).

MacLean (1990) also documents how the cortex itself may have arisen and increased its size as a neuroendocrine communicational device because its oldest component—the thalamocingulate gyrus—mediated the mother-offspring distress call that emerged at some indeterminate point around the reptilian-mammalian transition. D.R. Wilson (2002) emphasizes how the molecules that enhance bonding, and indeed all neurotransmission, originated in deep time and persist into the present with phylogenetic lineages of revealingly specific derivation. Via chemicals of parenting and motherhood such as oxytocin and arginine-vasopressin, babies express themselves exquisitely to elicit parental attention and attachment (Hrdy, 1999; Harris, 1995; Siegel, 1999). Panksepp (1998) considers the operation of these neurochemical systems in his emotion studies of nonprimate mammals, showing them to work in more primitive brain regions (and to have arisen earlier) than many human researchers assume.

Humans continue the capacity for eliciting help into adult life, indeed lifelong, and in many forms; they likely accomplish this by neoteny, that is, the retention of youthful traits into maturity. Part of this involves humor, as expressed in playful communications, such as comedy. Panksepp and Burgdorf (2000) highlighted that play too represents an ancient system among the emotions; for instance, even rat pups not only play but when vigorously touched (tickled) they utter ultrasonic "laughter." Indeed, Panksepp (1998) also suggests that, in part, attention deficit and hyperactivity disorder is not so much a disease as a strategy for learning via increased play. That it seems a disorder may stem from strictures on activity in present-day educational settings.

Humans expect to help as well as to be helped. Hrdy (1999) describes allomothers, mother-aides, or substitutes, who help care for infants or who adopt them, a role that exists throughout primates. In humans, help is sought and proffered throughout the life span. Beyond motherhood and parenthood, humans institutionalize helping other conspecifics in the form of education, medical care, retail services, and innumerable other service professions and roles—positions that are occupied less formally and extensively in other species.

Using controlled methods, researchers have extensively investigated psychotherapy over the last half of the 20th century (Wampold, 2001). Results document effectiveness with benefits that stem from general communication operating across various forms of treatment—psychodynamic, cognitive-behavioral, interpersonal, and many others. This suggests that each type of therapy reflects the ally-seeking capacity that humans possess to a high degree, seemingly from their relatively large cerebral cortex. Such capacities need to be considered during psychopharmacology treatment too, of course. Drugs impact brain systems that are essential to the production of communicational attributes and propensity states; but they (and surgery as well) can also promote placebo effects that may also reflect affiliation-seeking processes. Placebo means "to please," so the very word emphasizes positive components of the clinical relationship.

Circuits connecting frontal lobes to subcortical systems critically function to organize, plan, display empathy, maintain relatively steady mood and concentration, and respond appropriately to social cues (Mega and Cummings, 2001). More posterior structures decode faces and organize the person in space using primary senses singly and in combination, creating gestalts and allowing written language use. Luria (1972) presented the illuminating case study of a war veteran brain-damaged in the posterior cortical areas; he had great difficulty in the language decoding tasks involved in writing his story as Luria requested, but he persisted and succeeded. The patient's intact frontal lobes determined his energetic and resourceful completion of the task over many years that resulted from the therapeutic instruction and later appreciation of the accomplishment, including how Luria supported him and later arranged for publication.

Story use summarizes how human cortical functions shape communication. People avidly tell and listen to stories using verbal language, and they shape their lives according to stories learned when young that then modify as life goes on. Encompassing ones can be restated as cultural mores, belief systems, national or ethnic customs, as well as legal, political and religious systems. They modify ancient communicational propensity states that provide impetus and meaning. But the motivating urges stemming from deep time become triggered according to personal and interactive story lines that typify recently evolved levels. The individual typically assesses his or her attributes, circumstances, and ambitions in adolescence and adulthood and comes up with an individual story line that is then lived out, with modifications and adjustments, but with the story realized in dramatic and verbal forms (Donald, 1991). Alpha and audience commu-nicational propensity states promote story using in a variety of ways; for example, people choose to become audiences at concerts, political rallies, lectures, or poetry readings. Complex negotiations with variations on rival story lines allows conflict resolution between warring parties, transforming action-focused combat, for instance, to more optimal outcomes that work according to mutually constructed and consensually agreed-on plans. In this way primitive communicational propensities may be overcome as human allies communicate via their complex system of language interaction.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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