Eric Kandel’s work on the “new biology of mind” remains profound and influential. It established that there is “a biological component” to conditions such as PTSD and toxic stress, as you point out. What it didn’t do was resolve the question of etiology (and thus of influence and treatment at the level of symptoms); to many others, it also posed tantalizing but unanswered questions about the status of “mind” following his biological emphasis.

The pressure to identify biomarkers for psychiatric conditions has only intensified that difficulty, which the researchers quoted have now brought fully into the open. Clearly, they anticipated that some would not wish to revisit this problem, but rather to insist that the matter was settled and solved. It isn’t. The difficulty is not a “false dichotomy” between environment and biology. As epigenetics reveals in the form of environment influencing gene expression, in ways still greatly unknown, the problem is far more open-ended and less conclusive than those asserting otherwise would like to acknowledge.

Let me quote the researchers here, to avoid any impression that they are anti-biology: "Past research efforts have shown that neurotransmitters such as dopamine are clearly implicated in psychopathology, and there have been major advances in uncovering the structure of the polygenic background of mental disorders. However, these findings have not been translated into convincing reductive explanations of mental disorders through central pathogenic pathways rooted in neurobiology, as many had expected."

Their point is echoed across the lively debate in Behavioral and Brain Science, with John Ioannidis at Stanford corroborating their point that, despite “intensive searches for informative biomarkers of treatment response and toxicity, the yield is close to nil.” That isn't exactly news. It has been known for some time. As noted in the article and in my previous review, of Nikolas Rose's "Our Psychiatric Future," however, it has led to a “dead end” of great concern to doctors and patients.

The researchers' point is not to jettison biology but to reprioritize the research paradigm and the discourse around mental health, to draw in “other, potentially more fruitful paths” that the single-minded focus on biology has to a large extent eclipsed.

I find that rebalancing hopeful, pragmatic, and long overdue. To the extent that it may also open up options beyond or in addition to drug-related treatments, that can only be a good thing for those suffering from their many adverse effects.

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