Opinion Towards a joint classification of neurological and psychiatric disorders 2026 White et al

Andy

Andy

Senior Member (Voting rights)
Peter White, Timothy R Nicholson, Jon Stone, Lisa Feldman Barrett, Adam Zeman

Psychiatry has been called the other half of medicine,1 reflecting the separation of mental health services from the rest of health care. Patients with a mental illness are treated in different clinics and hospitals to those with physical illnesses. Advances in neuroscience and medicine have gradually eroded the justification for this divide, but the compelling evidence for the interdependence of brain and mind is easily neglected within our siloed specialties and services. We believe this separation causes harm to patients with disorders on either side of the line and propose that a joint classification of neurological and psychiatric disorders is theoretically justified, practically feasible, and would benefit psychiatry, neurology, and medicine more broadly.

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Andy said:
Lisa Feldman Barrett
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I thought I had heard her name before.
She has written a book on emotions that was hyped a lot in psychosomatic circles.

Blurb from her website:

How Emotions are Made: The Secret Life of the Brain​

The groundbreaking book that has revolutionized our understanding of the human mind.

Why do emotions feel automatic and uncontrollable?
Does rational thought really control emotion?
How does emotion affect disease?
How can you make your children more emotionally intelligent?
How Emotions Are Made answers these questions and many more, revealing the latest research and intriguing practical applications of the new science of emotion, mind, and brain.

Today, the science of emotion is in the midst of a revolution on par with the discovery of relativity in physics and natural selection in biology — and this paradigm shift has immense implications for us all.
Leading the charge is psychologist and neuroscientist Lisa Feldman Barrett, whose theory of emotion is driving a deeper understanding of the mind and brain and sheds new light on what it means to be human.
Her research overturns the widely held belief that emotions live in distinct parts of the brain and are universally expressed and recognized.
Instead, she has shown that emotion is constructed in the moment, by core systems that interact across the whole brain, aided by a lifetime of learning.

This new theory means that you play a much greater role in your emotional life than you ever thought.
Its repercussions are already shaking the foundations not only of psychology but also of medicine, the legal system, child-rearing, meditation, and even airport security.
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From Timothy Nicholson’s biographic details at King’s website:

Dr Tim Nicholson is a Reader in Neuropsychiatry at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London. He leads the Neuropsychiatry Research and Education Group (NREG).

He is an Honorary Consultant Neuropsychiatrist at the South London and Maudsley NHS Foundation Trust. His clinical and research work focuses on Functional Neurological Disorder (FND), immunopsychiatry and broader neuropsychiatric disorders — including those resulting from COVID-19.

He set up a pioneering specialist multidisciplinary clinic for FND in 2012 and has over 20 years of experience working clinically with FND and it was the topic of his PhD and the majority of his subsequent research activity including leading on studies into mechanisms, outcome measures and novel treatments such as Transcranial Magnetic Stimulation (TMS) and more recently psychedelics and Virtual Reality.

He has also led and been involved in research investigating autoimmune causes of psychiatric symptoms, such as OCD and psychosis, and been involved in work seeking to understand the extent and causes of both acute and chronic neurological and psychiatric complications of COVID-19.
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Obviously Peter White (Queen Mary University, London) and Jon Stone (Edinburgh) are well known here.
 
Adam Zeman, University of Exeter biographical info:

Prof. Zeman trained in Medicine at Oxford University Medical School, after a first degree in Philosophy and Psychology, and later in Neurology in Oxford, at The National Hospital for Neurology in Queen Square, London and Addenbrooke’s Hospital, Cambridge. He moved to Edinburgh in 1996, as a Consultant and Senior Lecturer (later Reader) in the Department of Clinical Neurosciences and to the Peninsula Medical School (now University of Exeter Medical School) in September 2005 as Professor of Cognitive and Behavioural Neurology. His specialised clinical work is in cognitive and behavioural neurology, including neurological disorders of sleep.

His main research interests are disorders of visual imagery and forms of amnesia occurring in epilepsy. He has an active background interest in the science and philosophy of consciousness, publishing a wide-ranging review of the field in Brain(2001; 124:1263-1289) and an accessible introduction to the subject for a general readership (Consciousness: a user’s guide, Yale University Press, 2002). In 2008 he published an introduction to neurology for the general reader, A Portrait of the Brain(Yale UP), and in 2012, Epilepsy and Memory (OUP) with Narinder Kapur and Marilyn Jones-Gotman.

From 2007-2010 he was Chairman of the British Neuropsychiatry Association. He launched and continues to direct its training course in neuropsychiatry.

Broad research specialisms
  • Cognitive Neurology, especially:
    • memory disorders associated with epilepsy, including Transient Epileptic Amnesia, accelerated long-term forgetting and autobiographical amnesia
    • disorders of visual imagery
  • Neurological disorders of sleep
  • Case studies in neuropsychiatry
  • Conceptual issues in the relationship between neurology and psychiatry, mind and brain
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BPS had their go It was called CBT/GET. In the name of psychiatry they reduced a whole cohort of patients with non specific symptoms to "exercise avoidant deconditioned", who additionally held on to symptoms, illness identity , secondary benefits and sought out doctors who connived with them in maintaining the false illness belief/s that they had sth other than exercise avoidant deconditioning - not forgetting being "correctly" seen as neurotic. Such was their fundamentalist, one size fits all, whole hoggery, nothing buttery, one horse for every course and vice versa. Would this have been tolerated in GOOD psychiatry? Exercises for everyone? Prozac for all?

The concept of aspectual medicine where the psychological elements are considered in physical symptoms and the physical in psychological. is fine imo. Common sense, if well weighted. But do you have to deny (first deny/denigrate, then destroy) a whole boundary in medicine which may have benefits as well as disadvantages and are these people really the contractors s to do the demolition work? Baby and bathwater comes to mind.

Are they going to come out with the "please undersatnd . it's all physiological, we don't deny that, before going on to define what "it" is and talking repeatedly about blushing to "prove" theri point? Come on boys and girls, please show us that this is not just the old BPS vinegar in new bottles.

Regretting siloisation is one thing, seeking then , as has been the precedent , to subsume all MUPS under a psychiatric banner and then reinstating the very boundary they have decried with the patient poor stuck in what is essentially a restored psychiatric silo must be seen for the con-trick that it is and remain anathema.

If all they want is to say "Look, the bio stuff may be right but psychological matters affect it" , fair enough, whatver helps. But given power, they may well again seek to go far beyond this, and their ambition re. psych/neur silos suggests a dangerous and dubious abiding maximalism.

And how much of this is in the service of the "believism" of BPS etc applied to ME/CFS. "We can get you better if only you believe, and we will bend the truth to that end, but we can't tell anyone. of course. We must pretend to be objective, so belief can thrive". Meanwhile some don't get better, "since they don't believe and all we can do is make 'em unless they go somewhere else " What to the "connivers"?
It's a route back to the new/old silo of misapplied psychiatry isn't it?

And let's be fair and consistent. Shall we destroy the boundary between immunology and psychiatry too, or immunology and neurology or psychiatry and endocrinology or dermatology and psychiatry . Mind and body are one, so let's get to work.

But let's use our minds before throwing our weight about. Please.

If anyone is behind the paywall, any hope that this is new wine?
 
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Today, the science of emotion is in the midst of a revolution on par with the discovery of relativity in physics and natural selection in biology — and this paradigm shift has immense implications for us all.
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Hallucinating pretty hard here. Plato's cave but it's their own back end and the shadows are cast by gaslight.
His main research interests are disorders of visual imagery
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Funny overlap here as it was only in the last decade that anyone noticed that there is a % of people who have no mental imagery, something that could have been easily discovered a century ago, if not for the fact that they never listen to a damn thing we tell them and interpret everything to fit their hallucinated models. Because when they are in conflict they always freaking choose their models over reality.

Scientific discovery is often accidental, but stuffing crayons up their noses simply doesn't work the same way as actually studying reality and trying different things while adapting to contradictions to their models. This whole discipline couldn't make an accidental discovery if it smacked them in the face every second of the rest of their lives.
 
The paper said:
reflecting the separation of mental health services from the rest of health care
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And who did that? They keep pretending that things that were done entirely intentionally "just happened". It's true that mental health care is atrociously inept compared to the rest of medicine, but it's all been a choice that the profession continues to make. And seeing how they always double down on their mistakes, things are, somehow, likely to get even worse.
 
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