Best 3 quotes of Tom Burns on MyQuotes

Talking about abstract things is important. Having big, wild conversations about concepts like art, music, time travel, and dreams makes it much easier when you’ll eventually need to talk about things like anger, sadness, pain, and love.

The fading relevance of the nature–nurture argument has recently been revived by the rise of evolutionary psychology. A more sophisticated understanding of Darwinian evolution (survival of the fittest) has led to theories about the possible evolutionary value of some psychiatric disorders. A simplistic view would predict that all mental illnesses with a genetic component should lower survival and ought to die out. ‘Inclusive fitness’, however, assesses the evolutionary value of a characteristic not simply on whether it helps that individual to survive but whether it makes it more likely that their offspring will survive. Richard Dawkins’s 1976 book The Selfish Gene gives convincing explanations of the evolutionary advantages of group support and altruism when individuals sacrifice themselves for others. A range of speculative hypotheses have since been proposed for the evolutionary advantage of various behaviour differences and mental illnesses. Many of these draw on ethological games-theory (i.e. the benefits of any behaviour can only be understood in the context of the behaviour of other members of the group). So depression might be seen as a safe response to ‘defeat’ in a hierarchical group because it makes the individual withdraw from conflict while they recover. Mania, conversely, with its expansiveness and increased sexual activity, is proposed as a response to success in a hierarchical tussle promoting the propagation of that individual’s genes. Changes in behaviour that look like depression and hypomania can be clearly seen in primates as they move up and down the pecking order that dominates their lives. The habitual isolation and limited need for social contact of individuals with schizophrenia has been rather imaginatively proposed as adaptive to remote habitats with low food supplies (and also a protection against the risk of infectious diseases and epidemics). Evolutionary psychology will undoubtedly increasingly influence psychiatric thinking – many of our disorders fit poorly into a classical ‘medical model’. Already it has helped establish a less either–or approach to the discussion. It is, however, a highly controversial area – not so much around mental disorders but in relation to social behaviour and particularly to gender specific behaviour. Here it is often interpreted as excusing a very male-orientated, exploitative worldview. Luckily that is someone else’s battle.

Why do families blame themselves? If so many of the family theories have been discredited why spend so much time on the issue here? Family theories in mental illness continue to exercise a remarkably powerful hold over us despite the evidence. And not just in schizophrenia but in depression, anorexia nervosa, personality disorder, drug and alcohol abuse, etc. Parents seem to have an endless capacity to blame themselves for what happens to their children (and perhaps children to blame their parents). This is probably because we need to believe it. Just as we need to believe in free will and our influence on the outside world, family members need to believe that they influence each other. If we didn’t why would we bother? The evolutionary psychologists would say that parents need to believe it to invest years and years bringing up their children. We’re biologically programmed to look after our children so we need some belief system to support it (just as they might say we’re biologically programmed to mate and need to believe in love to support it). It is proposed that such a belief is a mechanism for sustaining our attention to our biological task. The downside is, of course, guilt and blame. If we believe we have an influence we feel we have failed if things do not work out well. It is inescapable. Even in expressed emotion work where therapists insist emphatically that no one is to blame and that the aim is solely to find more effective coping strategies, families do feel blamed. ‘If only we weren’t so over-involved he would not have so many relapses.’ ‘Other families must have dealt with it better otherwise how would the therapist know what to advise?’ For some families feeling responsible, despite the guilt, is preferable. It implies the logical consequence that there must be something they can do to influence the outcome. Cultures which value resignation are less likely to blame themselves (high expressed emotion is less common in India than in Europe).