Wednesday, February 27, 2008

Materialist Metaphysics, Continued

The old DuPont slogan, “Better living through chemistry,” expressed the Twentieth Century’s faith in material progress. At one point, Prozac and other new antidepressant drugs seemed to be the crowning fulfillment of this dream. Why be depressed when you can take this little pill and feel better? I could tell that things were getting a little out of hand when I discovered that my sister was feeding chicken-flavored Prozac to her cats.

Faith that brain chemistry determines our mental experience is being challenged by new research that shows that antidepressants do not have more clinically significant effects than placebos. Both placebos and antidepressants have an effect on the mind. Antidepressants also effect the brain. These new studies show that only the mental effects are significant. Curiously, in both cases, the mental effects are produced by illusions—the illusion that the substance will cure your depression.

Wouldn’t it be wonderful if there were some way to work directly with the mind…. How about, “Better living through view, meditation, and conduct.”


David Whitehorn said...

Your call for a way to address depression by working with mind reminded me of the emergence over the past few years of Mindfulness Based Cognitive Therapy (MBCT) as a treatment for depression. Back in the 1980s, large scale clinical trials from NIH reported that cognitive behavioural therapy (CBT) was equally effective when compared with antidepressants (those available at the time) in treating mild and moderate depression.
CBT involves helping people become aware of their thoughts, particularly the negative habitual patterns that are commonly experienced in depression (I’m a bad person; there’s no hope; etc). Some people have suggested that the active element of CBT is the ‘meta-cognition’, the awareness of the thoughts itself.
In the late 1990s, Dr. Zindel Segal, a leading CBT expert from U. Toronto, with some colleagues in UK, got interested in Buddhist mindfulness practice. They wanted to integrate it with CBT. They consulted Jon Kabat-Zinn who advised them to become mindfulness meditation practitioners themselves before trying to apply mindfulness to CBT. They did and MBCT is the result.
From a clinical point of view MBCT seems to be useful particularly for preventing relapse in people who have already had an episode of depression. Of course, not everyone has the interest or ability to work directly with their own thoughts, their own mind. It is particularly difficult to do so in the midst of a fully developed depression. So MBCT is not a cure for all depression, but it does seem to be a significant step in the direction you have suggested.

Anonymous said...

Though I agree that these new studies regarding SSRI antidepressants to be thought provoking, I am disappointed in your oversimplification of the issues your post is addressing. Clinical depression and mental illness is not something that is always best treated with meditation, view, or conduct, anymore than cancer, broken bones or diabetes. I've come across many practitioners in the Shambhala Community, outside of the Buddhist world, and myself included who have benefitted greatly from these medications. Especially in instances where therapy and meditation have not proven fruitful, I think to minimize the suffering of others by trivializing their treatment to a 'happy pill' (Which these medications are certainly not) only promotes suffering by making people feel guilty for seeking help when they desperately need it.

Chris Gherardi -