This post is by Jason Moehringer, a doctoral student in clinical psychology at George Washington University
As part of my duties in a part-time job, I recently spent three days in a conference listening to experts and industry leaders discuss the intersection of technology and neuroscience. Specifically, so-called “brain training” as a primary or secondary treatment for chronic psychiatric disorders is being explored. The idea is that cognitive deficits (for the uninitiated: difficulties with concentration, organization, memory, attention, or emotional recognition and/or regulation) are frequently, if not always, an underlying component of psychopathology. These deficits derive from subtle brain dysfunction: their brains “misfire” or don’t have the proper “wiring.” So, treating these deficits (in this case, through remediation or skill-building provided by video games, ranging from Medal of Honor to Lumosity) will improve individual functioning and treatment outcome. Additionally, these improvements will be visible in changes in brain functioning or structure that can be seen in MRIs.
Alongside this, a growing trend in mental health treatment is to measure outcome based on how a patient’s functioning “improves.” In this context, “functioning” represents the idea that the individual or group in question can perform the activities necessary for living. So, a low-functioning individual may have trouble with personal hygiene, holding down a job, forming or maintaining relationships, or controlling their impulses (anything from inappropriate angry outbursts, to excessive shopping, to wearing tin-foil hats in public). As you might have guessed, a high-functioning individual will have little difficulty completing these activities.
As a clinician in training who works intensively with individuals who have moderate-to-severe personality and psychotic disorders – a population that was of particular interest to a subset of the attendees of this conference – I was hard-pressed to set aside my attention to the undercurrents of social control implicit in this approach to mental health treatment. Central to this unwitting adherence to conformity is the unquestioned fallacy of the emerging mainstream clinical phenomenon of “functioning.”
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