Brain Stimulation in Psychiatric Treatment by Sarah H. & Lisanby M.D
In our scientific journals, there is an explosion of information about neuroscience and about the bidirectional nature of brain and behavior. The matter was previously debated as if one had to choose between two camps (mind versus brain), but a rapidly developing new paradigm is replacing this former dichotomy— that the brain influences behavior, and that the mind (ideas, emo-tions, hopes, aspirations, anxieties, fears, and the wide realm of real and perceived environmental experience) influences the brain.
The term neuropsychiatryhas served as successor to the former term organic psychiatryand is contrasted with notions of psychodynamics, such as the concept of unconsciously motivated behavior. As our field evolves and matures, we are developing a new language for meaningful but imperfectly un-derstood earlier concepts. Subliminal cuesand indirect memoryare among the terms of our new language, but the emerging under-standing that experience itself can activate genes and stimulate protein synthesis, cellular growth, and neurogenesis is a ground-breaking new synthesis of concepts that previously seemed in-compatible. Among the remarkable conclusions that these new findings suggest is that psychotherapy can be construed as a biological treatment, in the sense that it has the potential to alter the cellular microanatomy of the brain.
In the context of this rapidly changing scientific and clinical landscape, we selected for the 2004 Review of Psychiatry four broad areas of attention: 1) research findings in developmental psychobiology, 2) current recommendations for neuropsychiatric assessment of patients, 3) new treatments in the form of brain stimulation techniques, and 4) the application of cognitive-behavior therapy as a component of treatment of patients with severely disabling psychiatric disorders. Perhaps the logical starting place in the 2004 series is Devel-opmental Psychobiology, edited by B. J. Casey. Derived from re-search that uses animal models and studies of early human development, this work summarizes the profound impact of early environmental events. Following a comprehensive over-view of the field by Casey, elegant studies of the developmental psychobiology of attachment are presented by Hofer, one of the pioneers in this work......
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