Mental Illness: Network or Hierarchy? (World Psychiatrists and Psychologists Conference Webinar)

Keynote Video presentation to Psychiatry Meet 2020's World Psychiatrists and Psychologists Conference Webinar, August 28, 2020

The Conspiracy of Symptoms: Mental Illness as a Network – Metaphor or Reality?

Network methodology and concepts are recently being applied to mental health disorders (psychopathology): symptoms are treated as nodes, causally interconnected via biological, psychological, and societal mechanisms.

Symptoms can become selfsustaining and selfreinforcing as they get integrated in robust feedback loops. The entire network than becomes chaotic (disordered). Stable states of networked symptoms amount to discreet mental health diagnoses (Borsboom, D.(2017) A Network Theory of Mental Disorders, World Psychiatry, 16(1)513, ).

This reconception of mental illness as a network of directly and dynamically interacting symptoms is a reversal of the medicalized, static common cause and latent variable model where symptoms are brought on by a single mental health syndrome or disorder (Bringmann, L. F., & Eronen, M. I. (2018). Don't blame the modelReconsidering the network approach to psychopathology. Psychological Review, 125 (4), 606615. ).

In these nascent models, the emphasis is on internal psychodynamic etiology. They neglect social and interpersonal interactions as major drivers of mental dysfunction. Indeed, incorporating other people in such diagrammatics will serve the flesh out the network, materialize it, put on a human face on it, and connect the internal to the external, as is the case in real life. Interactions with significant or strangers, intimate partners of colleagues, family and friends are as symptom-inducing as any neurotransmitter. Indeed, they are often the direct cause for such secretions and for most crucial and relevant network affects and cascades in the first place.

As usual, evolution borrowed the best of all possible worlds, models, structural engineering approaches, and action principles. In living organisms and even moreso in human psychology, hierarchies combine with networks seamlessly to yield optimal favourable outcomes.

Thus, the brain is a delicate balancing act between these two models with interspersed and interacting stable and stochastic structures. Exactly like in the twin cases of cancer and viruses, lethal mutative pathologies which are also evolutionary agents – mental illness may be a way to experiment with variations on the themes of mental health in order to yield or discover higher, more efficient organizational structures, principles, and processes.

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