So you’ve got the “traditional” psychiatric community on the left that engages, to some degree, in the “talking cure” whereas, on the right you have the neurophysiology that underlies those terms and have a tangible physical existence within the brain. The problem is that gap between the left side and the right side, the concepts, the terminology that explains the lived experience – the phenomenology – on the left and how it is translated into (and how it translates in the other direction) from the phenomenon to the neurophysiology and back. Forget, for a moment, about dopamine and stuff because, bottom line is, I don’t feel dopamine. I feel happy, sad, joyful, sad and so on. Yet we know that the physiology maps to the  phenomenon and vice-versa. (next page)

Dr. Parker looks at this issue in his post “Psychiatric Diagnostic Labels: Functional or Static?” There are those within the psych community and its hierarchy, as Parker notes, that are resisting the changes needed to incorporate the latest research and to “map” that research to the categories. As Doc points out, even with 20 plus years of research and peer reviewed and replicated data, there is still an enormous resistance to incorporating these findings into the DSM. What’s needed, as he points out in his conclusion, is “DSM 5 should include biologically available grids that match with office symptoms and evidence.”

There are three issues that need to be dealt with.

1. There is always a tendency for people and institutions to protect their knowledge and with it, the power that comes from that knowledge. “Truth” has nothing to do with it. So we have the traditional community protecting its power (knowledge).

2. We have the alternate community, represented by Doc Parker and others, who are looking beneath the surface to see, what is it that is REALLY going on here and how can we create treatments that deal with the “problems” as they manifest themselves, not as happiness or sadness, but as changing levels of X which are effected by receptors of Y, and so on. How can we help people by dealing with the physiology of the problem.

3. The problem that is being faced, and that needs to be overcome, is how to take the static nature of the diagnostic labels, as Doc points out in the title of the post, and make them functional. But actually, the problem is bigger than that and was hinted at when Doc used the word “grid.” How can we have a gird that brings together the understandings of “1″ above with the findings of “2″ above?

I believe the answer is something like the following: (see next page)

We need the equivalent of three dimensional chess. The bottom most level is, say, the neurophysiological level. The top most level is sadness, happiness. That middle level acts as the transposition layer between the two. It’s the next evolutionary step in the understanding of how mind/brain translates[,] interact[s]. So Doc Parker suggestion of having that grid in DSM 6 [Editor's note: Parker said DSM 5] and having a more open, fluid system that allows for information to change, dynamically, as new information becomes available, would seem to be a vital step forward. You need to have both the current descriptions of ailments – in words, that is – and physiological description of the same to coexist for a time so that ongoing practice and research can refine it over time and help with [the] missing middle level. But as Doc points out, you must allow for more fluid, more dynamic change to the definition and understanding. You probably need a peer-reviewed psychiatric Wikipedia that can be updated with the latest research at any time.

Print Friendly

Tags: , , ,

  • Dr Charles Parker

    Many thanks for your comprehensive review of my white paper and book, – your insights are very interesting, deeper than I had expected to go, but quite relevant. My whole mission is actually more practical: to simply make our work more effective on an everyday basis all around for patients and docs. It can be simpler, and can be more effective if we simply translate the science into useful, conversational packages.

    Thanks so much! Really interesting post!

    • Jeff

      Doc Parker, what I tried to do, and it seems I probably hit the mark, was to tease out the implications of your post. Keep in mind that my background is philosophy and sociology so that when I read your post I immediately saw this gap between the lived phenomena of depression and the physiology, between the politics and, to a degree, the practical.

      I think the logical progression, which I think the juxtaposition of the categories with the biological grid would help to foster, is an ecology of mind. We’re missing the vocabulary to speak about this ecology. Your idea concerning dynamic categories seems to point the way of making this possible.

  • Gina Pera

    Love that “game board,” Jeff. Didn’t Quark’s bar feature one something like that?

    Huge fan of Dr. Parker’s work here.

    If your readers haven’t already signed up to receive the free PDF, I strongly encourage them to.

    Even when working with the most highly skilled psychiatrists (and let’s face it, they’re in the minority), we must be our own advocates. Keep records. Ask questions. Do research.

    What reader will learn from that free PDF is light-years ahead — and vastly more substantive — than what you will find in any book currently available.


  • Gina Pera

    Do love your new medium, Jeff.

    It feels like I’m reading what you’ve been scribbling while acting like you’re paying attention in some Econ or World History class. lol!

    • Jeff

      I’ve seen that game board in Star Trek episodes. And you are correct about Parker’s work…he is way ahead of the curve. As for the new medium, well, I’ve got a few more tricks up my sleeve and something I’m working on now will knock your socks off. Finally, to some degree, you are reading what I’ve scribbled. I actually wrote this piece in one sitting. It’s practically stream of consciousness.

      • Dr Charles Parker

        Thanks again, gang, for your kind remarks – I confess i am quite taken up with another aspect of the process here, as noted by Gina, those great notes are so evocative. – Feel like I’m with Master with the original conceptualization of new brain/think! Can I just hang out with Gina and Jeff and read the notes?

  • Gina Pera

    Actually, I think it reminded me of the tri-dimensional chess set, which wasn’t in Quark’s, as I recall. Surely didn’t enjoy the fanfare of Dabo, at any rate, especially the Dabo girls.

    Hey, that’s what you need, Jeff. The Phenomenological/Neurological/Transpositionaal/Phantasmagorical Girls. Get crackin’ on those graphics!

  • David A. P.

    I really like the scribbled-notes effect. Made it much easier for me to read all the way through :) .

    • Jeff

      I thought people might like the challenge. ;) But I added the transcription…just in case.

  • Jennifer Koretsky

    Jeff, reading your 3D chess board metaphor felt like reading an analysis of LOST! That’s a good thing! ;-)

    Dr. Parker is a true gem in the AD/HD community. His new eBook is going to help so many patients–and doctors–finally get it right!

    • Jeff

      One of my favorite shows! But any resemblance to the Dharma Initiative is purely coincidental. And I wholeheartedly agree with you concerning Dr. Parker. I think his book has the potential to create a massive paradigm shift in the medical community.

  • Scott Hutson

    Jeff, I also like the 3d chess game and also like that you mentioned Star Trek. Dr. Parker makes it simple enough that even I can understand. As do you and Gina. That doesn’t mean I don’t have to read and re-read before I can grasp what amazing results I see personally from these things. I am slowly learning from the Best 3.

    That’s all for now, just wanted to say thanks!

  • Pingback: Mapping Clinical Manifestations of Psychiatric Disorders to the Underlying Neurophysiological Lattice: Towards a Vocabulary of the Ecology of Mind | Jeff's A.D.D. Mind

  • Pingback: Customized, Personalized Medicine: Dr. Parker’s Methodology for ADHD Treatment | Jeff's A.D.D. Mind

ADHD: Awesome and Deadly

An email from an ADHDer. Subject: Open this email I have ADD and I want to share! Message: Hi Jeff, [...]

What It Feels Like To Have ADHD

ADHD – A Love Story (Part 6)

The Trap is Set

The Wanderer

The Child Within The Man

ADHD – A Love Story (Part 5)

The System Is Blinking Red

ADHD – A Love Story (Part 4)

A Quick Bite

ADHD – A Love Story (Part 3)

Thick As A Brick

How Do You Know If You Have ADHD?

The Warning Signs of ADHD

ADHD – A Love Story (Part 2)

Warning Signs

ADHD – A Love Story (Part 1)

The Ground Shakes

A Cure for ADHD

Satisfaction Guaranteed Or Your Money Back!

The Perfect Month

What A Great Time Of Year

That’s What I Call ADHD-Friendly Software

A recent ADHD newsletter noted that The Brain — a mind mapping software — might be a useful tool for [...]

Life in the Modern Age

Sixteen months ago I moved from the world of entrepreneurship — a portmanteau comprised of the French word entrepreneur, which [...]

E-Card Fun

Some more e-card humor: Expressing Your ADHD Self…Digitally A Few Laughs, Giggles & Groans

While Rome Burns

I’ve started collecting screenshots of online advertising. I’m trying to understand the message. The ad below says that if I’m [...]

Kiss Your Distractions Goodbye

Do one thing at a time

ADHD Does Not Exist

I can’t tell what is more disturbing. A book titled “ADHD Does Not Exist: The Truth About Attention Deficit and [...]