🚀 go-pugleaf

Hello again, Jason. Thanks for the response. I must confess that it is
weird finding myself in a discussion defending the importance of
biological factors in psychopathology. I usually do not seriously
consider biological factors in the assessment, diagnosis, and treatment
of psychological problems, in part because of my limited knowledge and in
part because they do not fit with my model of human behavior. But here I
go again.

You wrote (in reference to genetic predisposition):
>The potential to be screwed up later under possible circumstances of
>development that add to one's presumed predisposition is very
> different from already being screwed up from birth. This is a crucial
>point because it's the difference between biological fatalism and
>existential humanism. There are no cases of complex behavior in which
>biology dictates experience profoundly more than vice versa, because
>experience is biology.

I agree that there is a huge difference between saying that someone has a
gene that may be expressed in response to particular environmental
stressors versus saying that someone has a gene that will certainly
result in the development of a disorder. Clearly, the research shows that
even for those individuals with genetic predispositions to particular
disorders, the crucial factor is the environment. I hope it didn't sound
like I was saying "since this man has an alcoholic father with certain
characteristics, this person will definitely develop alcoholism." I hoped
what I was saying would sound like "this person has a definite genetic
risk for developing alcoholism and the chances of their becoming
alcoholic are greater than the chances for other males without alcoholic
fathers." Doesn't this position support the fact that this person has
some biological abnormality? The explanation that their alcoholism is due
to the environment doesn't work, because sons of some alcoholic fathers
are at a higher risk for alcoholism regardless of their environment. This
is not a case where "biology dictates behavior more profoundly than vice
versa," but it still suggests that some biological factor is exerting an
influence.

You wrote:
>Increased heritability does not necessarily mean it happens through a
>genetic mechanism. It can mean that it is a behavior that is taught
>within the family. The methodology, assumptions, and inferences I have
>trouble with are just those: e.g., that heritability and genetic
>transmission are the same.

The research I have been referring to (see Cloninger's work) separated
out the effects of genetics and environment on the development of
alcoholism for adoptees. The researchers were able to analyze the
contributions of alcoholic biological parents and adoptive families, as
well as of non-alcoholic biological parents and adoptees. I have not seen
any confusion between "heritability" and "genetic," at least not in this
study. However, I am sure that there is a lot of bad research out there
that frequently uses these terms interchangeably, and I am guessing this
is where you may have formed your opinion about this type of research.

You wrote (in regard to the diagnosis of alcoholism):
>Tolerance and withdrawal are not biological factors. They are social and
>environmental factors. Research on the effects of changing environmental
>conditions on heroin overdose and withdrawal are what substantiate the
>instruction to the addict to not return to his/her original drug-using
>environment. This research is quite fascinating as an example of how
>there is no "internal" versus "external" process in psychology.

I do not understand how you can say that tolerance and withdrawal are not
biological processes. I understand your reluctance to discuss biological
factors in the absence of environmental influences, but tolerance and
withdrawal- come on! I am somewhat familiar with that heroin research you
cited, but I was under the impression that the effects of changing
environmental conditions are primarily an issue for the acute effects of
the substance and resulting overdose. Sure, this is an example of an
"internal" versus "external" process, but how does this relate to
tolerance and withdrawal?

You wrote:
>All treatments for alcoholism are psychosocial. And their effectiveness
is >not predictable by any internal "biological factors." The effects of
chronic >alcohol ingestion on brain functioning? What effects? There's no
research >that I know of linking any brain functioning study as a
diagnostic or >prognostic tool for any psychological problem, incl.
addiction. Again. This >is conventional wisdom based on assumptions and
politics, not research.

All treatments for alcoholism are not psychosocial, and the hopes of many
of those with the greatest amount of influence over alcoholism research,
funding, and policy are for new and more effective medications. Again,
whether or not I agree with this is a topic for another day. The other
day I said that treatment of alcoholism often fails partly because of the
effects of chronic alcohol use on brain functioning. Since I really do
not have much to back that up with, I am thinking that I may have been
using conventional wisdom based on politics and not research. Darn it! I
think that the establishment is trying to brainwash me into believing in
the disease concept. I will continue to try to fight this!

You wrote:
>Herein lies the politics of the matter. No one writing about the biology
>of alcoholism worries about being slammed for passing over the
>behavioral or environmental influences on substance abuse. The zeitgeist
>is with them.

You are so right about this. This is why researchers jeopardize their
careers when they suggest that controlled drinking is a viable
alternative to disease-based abstinence approaches. Until we get more
psychologists in positions of influence in this area, I am afraid that
research will continue to head in the direction of evaluating different
biologically-based treatments while neglecting promising psychosocial
treatments.

I really appreciate your discussion on these issues. You are obviously
very knowledgeable in this area and you have formed clear, strong, and
very defensible opinions about these issues. I am relatively new to this
field (second year in clinical) and am still eagerly learning. Discussing
these issues with you has made me think about these things in new ways
and has made me question some of my beliefs, which is always a very good
thing. This is process is crucial to the development of good
psychologists, and I want to thank you for your observations, criticisms,
and insight. By the way, I have no problem with any criticism over these
issues, so don't worry about sounding arrogant or belittling.

Thanks Jason!

Brett Deacon
bdeacon@niu.edu