Strange Loop

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https://en.wikipedia.org/wiki/Strange_loop

A strange loop is a cyclic structure that goes through several levels in a hierarchical system. It arises when, by moving only upwards or downwards through the system, one finds oneself back where one started. Strange loops may involve self-reference and paradox. The concept of a strange loop was proposed and extensively discussed by Douglas Hofstadter in Gödel, Escher, Bach, and is further elaborated in Hofstadter's book I Am a Strange Loop, published in 2007.

A tangled hierarchy is a hierarchical system in which a strange loop appears.

Definitions

A strange loop is a hierarchy of levels, each of which is linked to at least one other by some type of relationship. A strange loop hierarchy is "tangled" (Hofstadter refers to this as a "heterarchy"), in that there is no well defined highest or lowest level; moving through the levels, one eventually returns to the starting point, i.e., the original level. Examples of strange loops that Hofstadter offers include: many of the works of M. C. Escher, the Canon 5. a 2 from J.S. Bach's Musical Offering, the information flow network between DNA and enzymes through protein synthesis and DNA replication, and self-referential Gödelian statements in formal systems.

In I Am a Strange Loop, Hofstadter defines strange loops as follows:

And yet when I say "strange loop", I have something else in mind — a less concrete, more elusive notion. What I mean by "strange loop" is — here goes a first stab, anyway — not a physical circuit but an abstract loop in which, in the series of stages that constitute the cycling-around, there is a shift from one level of abstraction (or structure) to another, which feels like an upwards movement in an hierarchy, and yet somehow the successive "upward" shifts turn out to give rise to a closed cycle. That is, despite one's sense of departing ever further from one's origin, one winds up, to one's shock, exactly where one had started out. In short, a strange loop is a paradoxical level-crossing feedback loop. (pp. 101–102)

In cognitive science

According to Hofstadter, strange loops take form in human consciousness as the complexity of active symbols in the brain inevitably leads to the same kind of self-reference which Gödel proved was inherent in any sufficiently complex logical or arithmetical system (that allows for arithmetic by means of the Peano axioms) in his incompleteness theorem. Gödel showed that mathematics and logic contain strange loops: propositions that not only refer to mathematical and logical truths, but also to the symbol systems expressing those truths. This leads to the sort of paradoxes seen in statements such as "This statement is false," wherein the sentence's basis of truth is found in referring to itself and its assertion, causing a logical paradox.

Hofstadter argues that the psychological self arises out of a similar kind of paradox. The brain is not born with an "I" – the ego emerges only gradually as experience shapes the brain's dense web of active symbols into a tapestry rich and complex enough to begin twisting back upon itself. According to this view, the psychological "I" is a narrative fiction, something created only from intake of symbolic data and the brain's ability to create stories about itself from that data. The consequence is that a self-perspective is a culmination of a unique pattern of symbolic activity in the brain, which suggests that the pattern of symbolic activity that makes identity, that constitutes subjectivity, can be replicated within the brains of others, and likely even in artificial brains.

Strangeness

The "strangeness" of a strange loop comes from the brain's perception, because the brain categorizes its input in a small number of "symbols" (by which Hofstadter means groups of neurons standing for something in the outside world). So the difference between the video-feedback loop and the brain's strange loops, is that while the former converts light to the same pattern on a screen, the latter categorizes a pattern and outputs its "essence", so that as the brain gets closer and closer to its "essence", it goes further down its strange loop.

Downward causality

Hofstadter thinks that minds appear to determine the world by way of "downward causality", which refers to effects being viewed in terms of their underlying causes. Hofstadter says this happens in the proof of Gödel's incompleteness theorem:

Merely from knowing the formula's meaning, one can infer its truth or falsity without any effort to derive it in the old-fashioned way, which requires one to trudge methodically "upwards" from the axioms. This is not just peculiar; it is astonishing. Normally, one cannot merely look at what a mathematical conjecture says and simply appeal to the content of that statement on its own to deduce whether the statement is true or false. (pp. 169–170)

Hofstadter claims a similar "flipping around of causality" appears to happen in minds possessing self-consciousness; the mind perceives itself as the cause of certain feelings.

The parallels between downward causality in formal systems and downward causality in brains are explored by Theodor Nenu in 2022, together with other aspects of Hofstadter's metaphysics of mind. Nenu also questions the correctness of the above quote by focusing on the sentence which "says about itself" that it is provable (also known as a Henkin-sentence, named after logician Leon Henkin). It turns out that under suitable meta-mathematical choices (where the Hilbert-Bernays provability conditions do not obtain), one can construct formally undecidable (or even formally refutable) Henkin-sentences for the arithmetical system under investigation. This system might very well be Hofstadter's Typographical Number Theory used in Gödel, Escher, Bach or the more familiar Peano Arithmetic or some other sufficiently rich formal arithmetic. Thus, there are examples of sentences "which say about themselves that they are provable", but they don't exhibit the sort of downward causal powers described in the displayed quote.

Examples

Hofstadter points to Bach's Canon per Tonos, M. C. Escher's drawings Waterfall, Drawing Hands, Ascending and Descending, and the liar paradox as examples that illustrate the idea of strange loops, which is expressed fully in the proof of Gödel's incompleteness theorem.

The "chicken or the egg" paradox is perhaps the best-known strange loop problem.

The "ouroboros", which depicts a dragon eating its own tail, is perhaps one of the most ancient and universal symbolic representations of the reflexive loop concept.

A Shepard tone is another illustrative example of a strange loop. Named after Roger Shepard, it is a sound consisting of a superposition of tones separated by octaves. When played with the base pitch of the tone moving upwards or downwards, it is referred to as the Shepard scale. This creates the auditory illusion of a tone that continually ascends or descends in pitch, yet which ultimately seems to get no higher or lower. In a similar way a sound with seemingly ever increasing tempo can be constructed, as was demonstrated by Jean-Claude Risset.

Visual illusions depicting strange loops include the Penrose stairs and the Barberpole illusion.

A quine in software programming is a program that produces a new version of itself without any input from the outside. A similar concept is metamorphic code.

Efron's dice are four dice that are intransitive under gambler's preference. I.e., the dice are ordered A > B > C > D > A, where x > y means "a gambler prefers x to y".

Individual preferences are always transitive, excluding preferences when given explicit rules such as in Efron's dice or rock-paper-scissors; however, aggregate preferences of a group may be intransitive. This can result in a Condorcet paradox wherein following a path from one candidate across a series of majority preferences may return to the original candidate, leaving no clear preference by the group. In this case, some candidate beats an opponent, who in turn beats another opponent, and so forth, until a candidate is reached who beats the original candidate.

The liar paradox and Russell's paradox also involve strange loops, as does René Magritte's painting The Treachery of Images.

The mathematical phenomenon of polysemy has been observed to be a strange loop. At the denotational level, the term refers to situations where a single entity can be seen to mean more than one mathematical object. See Tanenbaum (1999).

The Stonecutter is an old Japanese fairy tale with a story that explains social and natural hierarchies as a strange loop.

A strange loop can be found by traversing the links in the “See also” sections of the respective English Wikipedia articles. For instance: This article->Mise en abyme->Recursion->this article.

Transgenerational trauma

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Transgenerational_trauma 

Transgenerational trauma, or intergenerational trauma, is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary mode of transmission is the shared family environment of the infant, causing psychological, behavioral and social changes in the individual.

Collective trauma is when psychological trauma experienced by communities and identity groups is carried on as part of the group's collective memory and shared sense of identity. For example, collective trauma was experienced by Jewish Holocaust survivors and their contemporaries within the wider Jewish community. As another example, the Indigenous Peoples of Canada experienced it within the Canadian Indian residential school system. African Americans who were enslaved is another. When this collective trauma affects subsequent generations, it is called transgenerational trauma. For example, when Jewish people, who are born into a later generation, learn about the Holocaust (presumably from older family members), and then experience extreme stress or practice survivalism out of fear of another Holocaust.

Transgenerational trauma can be a collective experience that affects groups of people who share a cultural identity (e.g., ethnicity, nationality, or religious identity). It can also be applied to single families or individual parent–child dyads. For example, survivors of individual child abuse and both direct survivors of the collective trauma and members of subsequent generations individually may develop complex post-traumatic stress disorder.

Examples of this include collective trauma experienced by descendants of the Atlantic slave trade; segregation and Jim Crow laws in the United States; apartheid in South Africa; the Scramble for Africa, Armenian genocide survivors, Jewish Holocaust survivors and other members of the Jewish community at the time; Bosnian war survivors; by the First Peoples of Canada within the Canadian Indian residential school system; by Native Americans when they were forcibly displaced and removed from their land; and, in Australia, the Stolen Generations and other hardships inflicted on Aboriginal and Torres Strait Islander peoples. Descendants of survivors may experience extreme stress, leading to a variety of other consequences.

While transgenerational trauma gained attention in recent decades, the hypothesis of an epigenetic mechanism remains controversial due to a lack of rigorous experimental results on humans.

History

This field of research is relatively young, but was expanded in the mid-to-late-2000s. Intergenerational trauma was first recognized in the children of Holocaust survivors. In 1966, psychologists began to observe large numbers of children of Holocaust survivors seeking mental help in clinics in Canada. The grandchildren of Holocaust survivors were overrepresented by 300% among the referrals to a psychiatry clinic in comparison with their representation in the general population. Since then, transgenerational trauma has been noted amongst descendants of African-Americans forced into slavery, Native American genocide survivors, war survivors, refugees, survivors of domestic violence, and many other groups that have experienced collective distress.

Research on possible biological mechanisms for inheritance of trauma began in the late 1990s. It has been suggested that traumatic stress can be passed down to future generations via epigenetics. However, the effect is difficult to separate from environmental and cultural transmission and conclusive evidence that it occurs in humans has yet to be found.

Although methylation of stress-related genes in humans may affect development, there is no evidence that these changes in humans are passed on to subsequent generations. Methylation is normally erased when an egg cell is fertilized.

Definitions and description

Transgenerational trauma is a collective experience that affects groups of people because of their cultural identity (e.g., ethnicity, nationality, or religious identity). Because of its collective nature, the term is not usually applied to single families or individual parent–child dyads. However, like survivors of individual child abuse, individually, both direct survivors of the collective trauma and members of subsequent generations may develop complex post-traumatic stress disorder.

Trauma may be transmitted socially (e.g., through learned behaviors) or through the effects of stress on development before birth (inc. increased smoking/alcohol use).

Historical trauma

Historical trauma, a sub-type of transgenerational trauma, is the collective devastation of the past that continues to affect populations in the present through inter-generational transmission. Historical trauma results in vulnerability to mental and physical health problems due to ancestral suffering which has been collected throughout generations into "legacies of disability for contemporary descendants". Although the actual traumatic event and affect group(s) are heterogeneous, all historical traumas consist of three elements: a traumatic event, a resulting collective suffering, and a multigenerational impact of that trauma. Over time the trauma and relationship to the victims typically evolve in a similar but more complicated way to genetic anticipation, resulting in a greater loss of identity of the victims and further integration into society.

For individual victims, historical trauma often manifests in four ways: depression, hyper-vigilance, traumatic bond formation, and reenactment of the trauma. Building upon the clinical observations by Selma Fraiberg, child trauma researchers such as Byron Egeland, Inge Bretherton, and Daniel Schechter have empirically identified psychological mechanisms that favor intergenerational transmission, including dissociation in the context of attachment, and "communication" of prior traumatic experience as an effect of parental efforts to maintain self-regulation in the context of post-traumatic stress disorder and related alterations in social cognitive processes.

Symptoms

Symptoms of intergenerational trauma always begins with the survivor of a trauma, which tend to manifest as symptoms of PTSD. Oftentimes trauma in the second generation is deemed as a traumatic response to parental trauma. Transmission between the parent and child can be broken down into five measures: communication, conflict, family cohesion, parental warmth, and parental involvement. High levels of maternal stress were directly correlated with weak family functioning and indirectly correlated with deviant behavior among children. Common symptoms in children consisted of depression, antisocial behavior, delinquency, and disruptive behavior in school. Some children experienced direct transmission in which their trauma stemmed from the interactions and relationships with their parents, while others experienced indirect transmission in which their trauma was mainly rooted in guilt. Those who were affected through direct transmission were more likely to lash out through their actions, while those who were affected through indirect transmission were more likely to develop depression, anxiety, and guilt.

Symptoms also differed based on ethnicity and type of original trauma. Enslavement, genocide, domestic violence, sexual abuse, and extreme poverty are all common sources of trauma that lead to intergenerational trauma. A lack of therapy also worsens symptoms and can lead to transmission. For instance, survivors of child sexual abuse may negatively influence future generations due to their past unresolved trauma. This can lead to increased feelings of mistrust, isolation, and loneliness. Descendants of enslaved persons when faced with racism-motivated violence, microaggressions, or outward racism, react as if they were faced with the original trauma that was generationally transmitted to them. There are a variety of stressors in one's life that led to this PTSD-like reaction such as varying racist experiences, daily stressors, major race-related life events, or collective racism or traumas. This also presents itself in parenting styles. Goodman and West-Olatunji proposed potential transgenerational trauma in the aftermath of natural disasters. In a post-Hurricane Katrina New Orleans, residents have seen a dramatic increase in interpersonal violence with higher mortality rates. This phenomenon has been also been reported in the descendants of Indigenous students at residential schools, who were removed from their parents and extended family and lacked models for parenting as a result. Being punished for speaking their native language and forbidden from practicing traditional rituals had a traumatic effect on many students, and child abuse was rampant in the schools as well.

Symptoms of transgenerational trauma have in recent years been identified among black Americans, in relation to the effects of slavery and racial discrimination. This passing of trauma can be rooted from the family unit itself, or found in society via current discrimination and oppression. The traumatic event does not need to be individually experienced by all members of a family; the lasting effects can still remain and impact descendants from external factors. For example, black children's internalization of others' reactions to their skin color manifests as a form of lasting trauma originally experienced by their ancestors. This reaction to black skin stems from similar attitudes that led to the traumatizing conditions and enslavement of slaves. Black children and youth are more susceptible to racial trauma because they have not yet acquired the knowledge to have a full understanding of racism and its effects. However, these traumatizing behaviors experienced at such a young age are a reflection of a child's parenting. A White child may learn racist behaviors from their environment, but by the same token a black child can learn to assert their blackness and how to respond to racist remarks and actions from their parents. Traces of trauma have an impact on black and other minority children's success in an educational context. Transgenerational trauma has also been heavily recorded in refugees and their children, which can last through several generations. Such traumas can stem from violence, political persecution, familial instability, as well as the hardships of migration.

Affected groups

Descendants of enslaved people

In general, black Americans who have any mental illness are resistant to receiving treatment due to stigma, negative conceptions, and fear of discrimination. This reduces the number of those affected to seek help. Lack of treatment causes the symptoms to compound leading to further internalization of distress and a worsening of mental health in the individual. Those affected by race-based trauma oftentimes do not seek treatment not only because of stigma but because of fear that the medical professional will not understand their perspective of a disenfranchised minority. Furthermore, the existing stigma of mental health has led to a lack of research and consequently treatment. However, lack of treatment can also be attributed to the misdiagnosis of symptoms. Signs of trauma exhibited in black children are often labeled as behavioral or educational disabilities, allowing the trauma to go untreated. While trauma symptoms often manifest as other mental illnesses such as depression and anxiety, the larger diagnosis often goes untreated.

Koreans

Main article: Han (cultural)

Han is a concept of an emotion, variously described as some form of grief or resentment, among others, that is said to be an essential element of Korean identity by some, and a modern post-colonial identity by others.

Michael D. Shin argues that the central aspect of han is loss of identity, and defines han as "the complex of emotions that result from the traumatic loss of collective identity". Han is most commonly associated with divided families: families who were separated during the Korean War. According to Shin, all Koreans may experience han, or a "constant feeling of being less than whole", because of not having a collective identity as a result of the continued division of Korea. Furthermore, new generations of Koreans seemingly inherit it because of growing up in a divided country.

Refugees

Refugees are often at risk of experiencing transgenerational trauma. While many refugees experience some sort of loss and trauma, war-related trauma has been documented to have longer-lasting effects on mental health and span through more generations. Children are especially prone to the trauma of resettling, as their childhood may have been disrupted by migration to a new country. Additionally, they often face the difficulty of learning a new language, adapting to a new environment, and navigating the school's social system in their host country. Normal caregiving is disrupted by the process of fleeing from their original home, and it may continue to be disrupted by their parents' PTSD symptoms and challenges faced in their new home. Furthermore, many host countries do not provide adequate mental healthcare systems to refugees, which can worsen symptoms and lead to transmission of trauma. In general, children of refugees exhibited higher overall levels of depression, PTSD, anxiety, attention deficiency, stress, and other psychological issues. Most refugees who flee from their homes do so to escape war, conflict, or natural disasters. More often times than not the wellness of refugees' homeland does not improve which causes continuous exposure to the originating trauma. This can be described as secondhand trauma and can be experienced by many. However, the offspring who have both transgenerational trauma and intergenerational trauma may experience secondhand trauma and a greater scale.

Vietnam war refugees

Since 1975, the US has accepted many refugees from Vietnam, Cambodia, Thailand, and Laos. As a result of the Vietnam War, many of these Southeast Asian refugees are at high risk of experiencing transgenerational trauma. Factors occurring both before and after immigration to America could contribute to traumatization in these groups. Being forced to witness and flee violence and war was a uniquely traumatic occurrence, resulting in high levels of psychological distress. Upon arriving in the United States, Vietnamese Americans struggled to adapt to their new environment, resulting in limited social mobility, high rates of poverty within the community, and exposure to community violence. Exposure to these stressors is correlated with higher trauma symptoms in first-generation Vietnamese-American refugees. In turn, these traumatic experiences impacted the ways that refugees raised their children since they internalized notions of being outsiders in a new country and emphasized success in the face of their many sacrifices. This cultural and familial transmission of trauma has led second-generation Vietnamese Americans to face their own forms of intergenerational trauma. These unique forms of mental health and stress are often not addressed due to socio-cultural standards of silence and refusal to seek treatment.

While a majority of these groups were fleeing war and poverty, Cambodian refugees were also fleeing a genocide from the Khmer Rouge. The atrocities of violence, starvation, and torture were common themes experienced by these refugees. Many Cambodian refugee families refused to talk about their trauma which created an isolating environment for the child. This led to a transmission of trauma through the continuing pattern of silence and refusal to acknowledge an issue or seek treatment. There has also been data showing that the children of survivors from regions with higher rates of violence and mortality displayed stronger overall symptoms. The parenting style of caregivers may also contribute to the rate of impact among children of Khmer Rouge survivors. A 2013 study found that among Khmer Rouge survivors with PTSD who engage in role-reversal parenting, a form of parenting where the parent looks to the child for emotional support, there may be higher rates of anxiety and depression in the children.

Indigenous Australians

Many Aboriginal Australian and Torres Strait Islander children were forcibly removed from their parents and placed in Aboriginal reserves and missions in the late 19th and first half of the 20th century. Some were subsequently placed with white families, and this practice continued after people were no longer forcibly removed to reserves. These people became known as the Stolen Generations, and successive generations suffer from intergenerational trauma as a result of this as well as other issues related to the colonisation of Australia, such as dispossession of land, loss of language, etc. Many Aboriginal Australians often face discrimination and resistance when trying to access many services including legal, health, housing, and education. It was found that in 2019, 28% of the total prison population consisted of Aboriginal Australians and Torres Strait Islanders. As of 2022, this percentage has increased to 32% of all prisoners. A study consisting of 43 Aboriginal women found that Aboriginal women often face more struggles when incarcerated compared to their peers. With these struggles Aboriginal Australians face, the trauma is often passed down to their offspring as they are on the receiving end of the discrimination, often are targeted themselves as children, or grow up to face similar of not the same struggles as their family members.

Native/Indigenous Peoples of the Americas

Settler-colonization encompasses a wide range of practices: war, displacement, forced labor, removal of children, relocation, destruction, massacre, genocide, slavery, unintentional and intentional spread of deadly diseases, banning of indigenous language, regulation of marriage, assimilation, eradication of culture, social and spiritual practices. European colonization has, in some instances, involved subjugation of the indigenous peoples of the Americas through violence, ethnic cleansing, forced assimilation, and acculturation. Indian reservations, and harmful policies excluding and oppressing Natives evoked similar responses to trauma as the descendants of Holocaust survivors. In a similar way we find transgenerational trauma in Holocaust survivors we find the same patterns and effects in Indigenous populations and their children and grandchildren.

Due to the effects of settler colonialism, oppression, racism, and other aversive events, Native Americans disproportionately experience adverse childhood experiences as well as health disparities, including high rates of posttraumatic stress, depression, substance abuse, diabetes, and other psychiatric disorders.

Military personnel and their families

Transgenerational trauma is also commonly known as secondary trauma due to the transmission of symptoms that can take place between individuals in close proximity (i.e., children, spouses/partners, and other family members). Transgenerational trauma affects everyone, including those in the military and their families. Patterns of transgenerational trauma can be recognized through the use of a genogram, a family tree that provides a visual representation of hereditary patterns. Specifically, a trauma-focused genogram can be used with those who suffer from acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Traumatic family patterns could include things such as sexual abuse, domestic violence, and even things such as natural disasters. This type of genogram is inclusive to military personnel in that it takes into consideration the servicemembers' experiences. Some of these considerations include taking into account how long the servicemember served, what their role was, if they were a prisoner of war and if they witnessed the death or injury of others. However, not all military personnel pass down intergenerational trauma.

Military personnel who have seen or participated in abusive acts of violence have been found to transmit the trauma they experienced to their children. Children of these veterans have been found to suffer from behavioral disturbances such as aggression, hyperactivity, and delinquency. Children whose parent was diagnosed with PTSD had a higher rate of anxiety as well as aggression when compared to children of civilians or non-veterans. These children can also have increased depressive symptoms and other PTSD symptoms. However, it has been found that spouses and partners of military veterans can help to buffer the effects of the transmission of trauma symptomology.

This type of intergenerational trauma can be experienced and transmitted not only to children of veterans but also to their spouses/partners, ultimately affecting the whole family unit. Veterans who experienced PTSD or wartime combat stress reaction (CSR) had spouses/partners who experienced increased psychiatric symptoms. These symptoms included feelings of loneliness and having impaired relationships within the family unit and marriage. Much like veterans who suffer from PTSD, their spouses or partners can suffer from many of the same symptoms as well. Spouses or partners of military veterans can experience the avoidance of thoughts, behaviors, and emotions. Spouses or partners may also experience intrusions such as unwanted cognitions and images that may remind them of the negative experiences of their spouse or partner. Common symptoms of emotional distress that spouses may experience are depression and anxiety. These symptoms are intergenerational trauma symptoms that are being passed down from the veteran to the spouse.

Intergenerational trauma can sometimes go unrecognized by the spouse or partner suffering from the transmission of trauma. It sometimes can be difficult for those suffering from intergenerational trauma to recognize that they are emotionally affected, and thus difficult for these individuals to find treatment. Resources such as a genogram can be an excellent way in which an individual can recognize the trauma that has been passed down to them.

When it comes to transgenerational trauma, it can be transmitted quite quickly and can affect many people in which the servicemember has encountered. This also includes mental health workers and primary care physicians with whom the servicemember may be working. Mental health workers and primary care physicians asked to take a survey entitled "Secondary Traumatic Stress Scale" reported that they had trouble sleeping, feeling emotionally numb, and having intrusive thoughts about clients.

Treatment

Mental health workers who are considering working with veterans who suffer from PTSD and other traumatic experiences should have experience working with veterans and servicemembers. Cultural sensitivity is another aspect to consider when working with this population. Understanding the military culture and lifestyle is informative when developing the therapeutic relationship and treatment plans. Another cultural consideration is the family component. This can include the servicemember's actual family or their chosen family. The military can bring on a lot of stress when it comes to the servicemember and his family. These include, moving to different places on short notice, deployment plans constantly changing, difficulty transitioning when coming back from deployment, and many other stressors. Therefore, it is crucial that a mental health worker truly understands military life.

In the case of PTSD, in order to prevent or minimize intergenerational trauma, it is important that the family also seek mental health services. A spouse/partner who is receiving mental health services and is at a better place in their life because of these interventions can help the family unit overall. In a military family, the roles are constantly changing due to the service member being on deployment and other factors. The family, as a unit, needs to adjust to the service member coming into and out of their lives. With a healthy family unit, the spouse/partner becomes a predicting factor of soldier retention and a functioning family unit. Resiliency can also play a role in this dynamic. A few things can contribute to resiliency in a family unit. These include flexibility/organizational style, the family's belief system, and the communication process. These are important things to look for and identify as they can help in the treatment of intergenerational trauma. Making the family unit strong can help to empower each individual member of the family, and together they can overcome intergenerational trauma within the family. Understanding military culture can help aid families through the process of overcoming intergenerational trauma.

In addition to the genograms, solution-focused brief therapy (SFBT) has been found to be successful with military families. It uses an emphasis on the client's successes and creating small steps that are attainable for the client. This type of therapy uses the client's language and experience to address things systematically within the family. SFBT, together with the genograms, can be informative to both the client and clinician and can help to inform the future of practice. As the genograms can help to give a clear picture as to what the trauma patterns are in the family, SFBT can help to change these patterns and provide the family with a healthier way of living and functioning. This specific type of therapy can help to educate the client and their family as to what exactly has been passed down from previous generations. It can also inform the family as to what is now beginning to be transmitted and can help to change the trajectory in the future and change the family dynamic principles.

Transmission

There are many current transgenerational studies that have been done on adults that have experienced natural disasters or adversities. One study found that the children of torture victims showed more symptoms of anxiety, depression, post-traumatic stress, attention deficits, and behavioral disorders than the comparison group of those who had not experienced the specific trauma. A qualitative study was done on the Brazilian children of Holocaust survivors and proposed a supported model of the transgenerational transmission of traumatic experiences but also one of resilience patterns, which can be transmitted in between generations and developed within generations. According to Froma Walsh, resilience theory suggests that individuals' and families' responses to traumatic experiences is an ever-changing process that involves both exposure to challenges and the development of coping mechanisms that aide in one's ability to overcome such challenges. Regardless of risk, there are also opportunities for the development of resilience via exposure to meaningful resources that support one's ability to overcome adversity. The researchers Cowan, Callaghan, and Richardson studied the impact of early-life adversities on individuals and their descendants. Their research was also consistent with the transmission theory in which their findings revealed that the stress phenotype that was expressed in individuals who experienced the adversity was also observed in children and even grandchildren.

The oppression that black people experienced through slavery and racism has a psychological impact on how they view achievement. In terms of the social aspects, that seems to make it difficult for black people to surpass a certain socioeconomic status threshold, escape a certain neighborhood, or move beyond a certain lifestyle or status.

For Native Americans, past government policy and internal displacements are theorized to have an effect even generations later. The social enforcement of their ostracization causes them to be generally removed from society, to be powerless and uninvited in government, and to be left to fend for themselves. The transgenerational transmission of colonial trauma is also considered a contributing factor in the high rates of mental health difficulties that Native Canadian communities experience. Displacement and maltreatment during colonization had led to negative effects in the children of those who survived such experiences. This is passed down generationally via ongoing social marginalization and lateral violence. The loss of cultures and resulting lack of community cohesion poses a further challenge for groups in resolving transgenerational trauma.

The fetal environment is influenced by the maternal diet. This environmental history can cause the fetal developmental response to change to produce a metabolic phenotype that suits the anticipated environment.

It has been suggested that a mother's mood may influence the fetus, though studies on this have mixed results. It is unclear whether any of the effects persist after birth.

Treatment

Because transgenerational trauma is a form of indirect traumatic exposure, it often goes unrecognized or is misdiagnosed by clinicians. A lack of treatment accessibility can have several consequences such as health, behavioral, and social issues that may persist across an individual's lifespan.

The experience of traumatic stress can modify cognitive, behavioral, and physiological functions, which can increase susceptibility to both mental and physical health issues. Because transgenerational trauma is a form of traumatic stress, it can increase risk for developing psychological disorders such as post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, schizophrenia, autism, and substance use disorders.

Several therapy modalities have been found to be effective in treating various trauma and stress disorders, such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure, compassion focused therapy, dialectical behavior therapy, and narrative therapy. Each of these therapies share similar components that are useful in addressing trauma, such as psychoeducation, emotion regulation and processing, cognitive processing and reconstruction, and trauma processing. Given that transgenerational trauma is a unique form of traumatic exposure, such therapy modalities can be effective in reducing its negative long-term effects. However, there are specific components of transgenerational trauma that must be addressed directly despite the modality of therapy chosen. Because the attachment relationship between parent or caregiver and child is a dominant mechanism through which transgenerational trauma is transmitted, treatment should focus on the importance familial and interpersonal patterns relative to the client, and utilize attachment-focused interventions.

Effective treatment for those experiencing transgenerational trauma also focuses on exploring, developing, and maintaining protective factors that can reduce the negative impact of transgenerational trauma. Some protective factors include fostering secure attachment between parent and child, as well as having access to several sources of support (i.e., family, peers, community). One treatment model that places focus on the parent-child relationship is the Intergenerational Trauma Treatment Model (ITTM). The model incorporates several features from existing empirically supported methods of treatment, such as trauma exposure, cognitive processing and reframing, stress management, and parent education. ITTM gives specific attention to the intergenerational nature of traumatic experiences and targets the parent's or caregiver's ability to respond to a child's traumatic experiences. Fostering secure attachment and a supportive home environment can mitigate the potential negative impact of transgenerational trauma.

Other less conventional modalities of therapy have also been found useful in addressing the negative impact of transgenerational trauma. Music therapy has been found to be an effective form of treatment for those who have witnessed or experienced a traumatic event. For example, music therapy has been successfully implemented with military personnel, traumatized refugees, and Holocaust survivors. Specifically, analytic music therapy (AMT) was found to be effective in facilitating a degree of healing through self-exploration that mitigates the negative impact of transgenerational trauma. Trauma healing stories have been suggested as a form of therapy.

Outside the treatment modalities described, several tools and techniques were also found to be helpful in bringing awareness to the effects of transgenerational trauma, as well as decreasing its psychological impact. For example, the Transgenerational Script Questionnaire (TSQ) has been used to compliment psychotherapy sessions as a means of helping to develop consciousness of both the internal and external family system. The TSQ targets transgenerational scripts, which are unconscious systemic patterns that persist in families and groups, and are perpetuated through emotions, beliefs, and behaviors. These scripts are then used to explore a client's implicit and explicit perceptions about their family dynamic and system. In using the TSQ, the clinician can guide the client to separate their ancestors' experiences from their own. In more complex cases of intergenerational trauma, the Transgenerational Trauma and Resilience Genogram (TTRG) can help guide clinicians to better understand and assess the impact of such trauma. The TTRG targets the various components that contribute to the maintenance of transgenerational trauma by implementing an ecosystemic view of trauma, as well as attention to specific sociopolitical concerns. The TTRG maps out the family unit, marking those who have experienced trauma and their experience, as well as relationships between individuals, and patterns of functioning. This process allows for clinicians to better assess the origins and maintaining factors of an individual's experience of transgenerational trauma, which ultimately contributes to a more comprehensive conceptualization of treatment.

In conceptualizing treatment for individuals experiencing transgenerational trauma, it is critical to take into account the ways in which various cultural factors impact how different treatments may be received or perceived. Although the mechanisms through which transgenerational trauma are consistent across cultures, there are variations in the degree of salience regarding sociocultural factors that may exacerbate the effects of transgenerational trauma in different marginalized communities.Additionally, therapists must incorporate a culturally responsive perspective to whichever modality of therapy they chose to implement. It is imperative for therapists to focus on establishing a concrete basis of trust and safety within the therapeutic relationship, as several minoritized groups who have transgenerational trauma may have developed significant mistrust within interpersonal interactions, as well as mistrust of larger organizations or institutions.

Criticism of inherited trauma via epigenetics

One discredited model suggests that a parent's trauma could be inherited through an epigenetic biological mechanism. Although the idea has been widely touted in the media, it is not supported by robust evidence.

Research in rodents suggests that epigenetic changes can be observed in genes associated with the hypothalamic-pituitary-adrenal (HPA) axis, which coordinates the body's stress response system. Non-heritable stress-related epigenetic changes have also been studied in monkeys. However, most epigenetic effects are not transmitted to the next generation, and most transfer of information across generations does not involve epigenetic inheritance.

According to geneticist Kevin Mitchell, "these are, in fact, extraordinary claims, and they are being advanced on less than ordinary evidence." He says "This is a malady in modern science: the more extraordinary and sensational and apparently revolutionary the claim, the lower the bar for the evidence on which it is based, when the opposite should be true." Mitchell adds that many have looked at it as a "get out of genetics free card" and adds, "I think people don't like the idea, some people anyway, that we are born with certain predispositions that are hard to change." He says that experiences are expressed through changes in human neuroanatomy, not patterns of gene expression and says that scientists in this area have contributed to the misleading research in this area: "There is a hype industry around science, which I think is corrosive. And I think scientists are willing participants in it in a way that I find more and more distasteful the older I get, because it does a massive disservice cumulatively to how science is understood by the general public because we have this constant hype."

The biologist Ewan Birney specifically criticized a paper which used a sample size of 32 people to back its claim that children of Holocaust survivors showed evidence of inherited stress. He argues that a mechanism for epigenetic inheritance in humans remains elusive due to the many other influencing factors including "complex societal forces that persist over time", and the fact that human developing females already have all their eggs as a foetus in the womb, and lastly that throughout one individual's life epigenetic influences remain so influential that "epigenetic cell memory" is what cause our genetically identical cells to differentiate into their specific forms. Furthermore, even in mice, where these confounding influences can be controlled, "true trans-generational epigenetic inheritance is extremely rare."

A 2026 review examining the transgenerational inheritance of post-traumatic stress disorder (PTSD) and war-related trauma confirmed these methodological limitations in the human literature. While some studies report DNA methylation variations in stress-related genes (such as FKBP5, NR3C1, NR3C2, and BDNF) among parents or offspring exposed to combat or genocide, the results across the field remain highly inconsistent. The reviewers concluded that genuine epigenetic inheritance and causality cannot be definitively established, as the majority of existing human studies are heavily limited by small sample sizes, cross-sectional designs, and an inability to adequately control for environmental and psychosocial confounding variables.

To address the ongoing controversy and methodological bottlenecks in mammalian models, recent literature has proposed stringent validation frameworks. A 2025 review examining the transgenerational transmission of acquired nervous system phenotypes emphasized that establishing true epigenetic inheritance of trauma requires overcoming severe confounding factors, including postnatal care, the maternal uterine environment, and the global epigenetic reprogramming that naturally erases most DNA methylation during embryonic development. The authors critique the frequent misapplication of the term "transgenerational" in trauma literature, noting that many studies erroneously conflate it with "intergenerational" inheritance—where the F1 fetus or F2 germ cells are directly exposed to the maternal stressor in utero. To definitively prove that behavioral or stress-related traits are inherited epigenetically rather than socially or genetically, it has been proposed that researchers meet strict criteria: the phenotype and corresponding molecular marks must persist into unexposed generations (the F2 generation for paternal exposure, or F3 for maternal), transmission must be isolated to the germ cells, and study designs must utilize absolute controls like cross-fostering and in vitro fertilization to exclude environmental transmission.

Furthermore, human observational cohorts are inevitably confounded by socioeconomic status, culture, and parenting practices, which can easily mimic or obscure epigenetic inheritance. The review also cautions against the ethical and societal risks of attributing psychiatric or cognitive vulnerabilities to ancestral epigenetic trauma; doing so without solid mechanistic proof risks stigmatizing families or inappropriately blaming prior generations.

Extended mind thesis

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Extended_mind_thesis

In philosophy of mind, the extended mind thesis says that the mind does not exclusively reside in the brain or even the body, but extends into the physical world. The thesis proposes that some objects in the external environment can be part of a cognitive process and in that way function as extensions of the mind itself. Examples of such objects are written calculations, a diary, or a personal computer; in general, it concerns objects that store information. The hypothesis considers the mind to encompass every level of cognition, including the physical level.

It was proposed by Andy Clark and David Chalmers in "The Extended Mind" (1998). They describe the idea as "active externalism, based on the active role of the environment in driving cognitive processes."

For the matter of personal identity (and the philosophy of self), the EMT has the implication that some parts of a person's identity can be determined by their environment.

"The Extended Mind"

"The Extended Mind" by Andy Clark and David Chalmers (1998) is the paper that originally stated the EMT. Clark and Chalmers present the idea of active externalism (not to be confused with semantic externalism), in which objects within the environment function as a part of the mind. They argue that the separation between the mind, the body, and the environment is an unprincipled distinction. Because external objects play a significant role in aiding cognitive processes, the mind and the environment act as a "coupled system" that can be seen as a complete cognitive system of its own. In this manner, the mind is extended into the physical world. The main criterion that Clark and Chalmers list for classifying the use of external objects during cognitive tasks as a part of an extended cognitive system is that the external objects must function with the same purpose as the internal processes.

Clark and Chalmers present a thought experiment to illustrate the environment's role in connection to the mind. The fictional characters Otto and Inga are both travelling to a museum simultaneously. Otto has Alzheimer's disease, and has written all of his directions down in a notebook to serve the function of his memory. Inga is able to recall the internal directions within her memory. The argument is that the only difference existing in these two cases is that Inga's memory is being internally processed by the brain, while Otto's memory is being served by the notebook. In other words, Otto's mind has been extended to include the notebook as the source of his memory. The notebook qualifies as such because it is constantly and immediately accessible to Otto, and it is automatically endorsed by him. They also suggest Otto's notebook should be considered an extension of himself; the notebook in a way becomes a "fragile biological limb or organ" that Otto wants to protect from harm.

The thought experiment has been criticised with the notion that what happens with Otto is not very similar to what happens with Inga. This criticism is addressed by Clark in Supersizing the Mind:

[The] claim was not that the processes in Otto and Inga are identical, or even similar, in terms of their detailed implementation. It is simply that, with respect to the role that the long-term encodings play in guiding current response, both modes of storage can be seen as supporting dispositional beliefs. It is the way the information is poised to guide reasoning ... and behavior that counts.

Research

The shared intentionality hypothesis yields yet another perspective to the idea of extended mind. Based on evidence in neuroscience and psychophysiological research, Latvian Researcher Igor Val Danilov proposed that implicit interpersonal dynamics in groups leads to improved individual performance. Later in 2024, he argued that an embryo's nervous system (being a part of the external environment to the mother's nervous system) can take part in the mother's cognitive process and function as an extension of the mother's mind. This neuronal coupling provides social learning during the embryonal period. Indeed, numerous studies on fetal responses to external stimuli have revealed signs of fetal cognition; the movements of the fetuses seem intentional. In 2012, MRI neuroscience research showed evidence of fetal cognition through categorization at 33 weeks of gestation, registering responses in the fetal brain to language and voice stimuli. Specifically, neuronal activity increased in the left temporal lobe of the fetal brain in response to an unfamiliar female voice compared with pure tones. Then, a maternal voice elicited significantly more neuronal activity in the lower bank of the temporal lobe than an unfamiliar female voice. According to Latvian researcher Igor Val Danilov, a mother–fetus neurocognitive model provides insights into the emergence of object perception in naive organisms. Beginning at the cellular level, it explains neurophysiological processes during fetal neuronal development. In short, we know that the fetal environment is a cacophony of stimuli: electromagnetic waves, chemical interactions, and pressure fluctuations. The binding problem stands that the relevant stimulus cannot overcome the noise threshold when it passes through the senses. While the fetal nervous system needs to integrate stimuli to combine objects, background, and abstract or emotional features into a single experience for building a representation of the surrounding reality, it cannot distinguish relevant sensory stimuli independently to integrate them into object representations. Therefore, the fetal perception is limited. The mother-fetus neurocognitive model explains how electromagnetic and acoustic oscillations of the mother's heart shape an ensemble of neuronal activity across both nervous systems. During the mother's intentional act with her environment, specifically the acoustic environment shared with the fetus in the low-frequency sound band, the brainwave entrainment provides clues to the fetus's nervous system, linking neuronal activity with relevant stimuli. From this perspective, the Mother-fetus neurocognitive model and Shared intentionality approach provide empirical evidence of the extended mind thesis.

Criticism

Philosophical arguments against the extended mind thesis include the following.

1. When focusing on cognition, the thesis confuses claims about what is constitutive about the concept of cognition with claims about causal influences on cognition (the "causal-constitutional fallacy"). For example, Adams and Aizawa (2010) write, "Question: Why did the pencil think that 2 + 2 = 4?, Clark’s Answer: Because it was coupled to the mathematician."
2. It stretches the limits of our ordinary concept of cognition too far ("cognitive bloating"), potentially implying that everything on the Internet is part of individual cognitive systems.
3. It uses coarse-grained functionalism about the mind that ignores plausible differences between internal and external processes, such as differences between beliefs and external props and devices; or for creating a notion of cognition too heterogeneous to make up a scientific natural kind.

Each of these arguments is addressed in Clark (2008), in which he notes:

1. While coupling is important for cognition, that is not to say that it is sufficient – coupling must play a functional role in cognition. Many couplings do not do so and thus would not be 'extensions' (and this is consistent with a strong extended mind thesis).
2. Any putative part of a system – internal or external – is unlikely to yield "cognition" on its own. Thus, examples such as calculators, and pencils, should be considered in parallel with neural regions. Simply looking at the part is not enough for cognition.
3. One can imagine circumstances under which a biological being might retain information in non-neural ways (a hypothetical Martian with a bitmap-based memory, or humans with prosthetics to support memory). Thus, being neural cannot be a necessary condition for being cognitive.

While in Supersizing the Mind Clark defends a strong version of the hypothesis of extended cognition (contrasted with a hypothesis of embedded cognition) in other work, some of these objections have inspired more moderate reformulations of the extended mind thesis. Thus, the extended mind thesis may no longer depend on the parity considerations of Clark and Chalmers' original argument but, instead, emphasize the "complementarity" of internal and external elements of cognitive systems or processes. This version might be understood as emphasizing the explanatory value of the extended mind thesis for cognitive science rather than maintaining it as an ontological claim about the nature of mind or cognition.

Vincent C. Müller argues that the extended mind "sounds like a substantive thesis, the truth of which we should investigate. But actually the thesis turns about to be just a statement on where the demarcations for the 'mental' are to be set" and that "this discussion about demarcation is merely verbal and thus to be avoided".

Relation to embodied and enacted cognition

As described by Mark Rowlands, mental processes are:

• Embodied involves more than the brain, including a more general involvement of bodily structures and processes.
• Embedded functioning only in a related external environment.
• Enacted involving not only neural processes but also things an organism does.
• Extended into the organism's environment.

This 4E cognition contrasts with the view of the mind as a processing center that creates mental representations of reality and uses them to control the body's behaviour. The field of extended cognition focuses upon the processes involved in this creation and subsumes these processes as part of consciousness, which is no longer confined to the brain or body but involves interaction with the environment. At a 'low' level, like motor learning and haptic perception, the body is involved in cognition, but there is a 'high' level where cultural factors play a role. This view of cognition is sometimes referred to as enaction to emphasise the role of interplay between the organism and its environment and the feedback processes involved in developing an awareness of, and a reformation of, the environment. For example, Japyassú and Laland argue that some spider's web is something between part of its sensory system and an additional part of its cognitive system.

Neuropsychiatry

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Neuropsychiatry

X-ray image of deep brain stimulation, an experimental procedure used to treat disorders such as OCD and depression.

Neuropsychiatry is a branch of medicine that deals with psychiatry as it relates to neurology, in an effort to understand and attribute behavior to the interaction of neurobiology and social psychological factors. Within neuropsychiatry, the mind is considered "as an emergent property of the brain", whereas other behavioral and neurological specialties might consider the two as separate entities. Those disciplines are typically practiced separately.

Currently, neuropsychiatry has become a growing subspecialty of neurology as it closely relates the fields of neuropsychology and behavioral neurology, and attempts to utilize this understanding to better understand psychological trauma, autism, attention deficit hyperactivity disorder (ADHD), and Tourette syndrome, among others.

The case for the rapprochement of neurology and psychiatry

Given the considerable overlap between behavioral neurology and neuropsychiatry, there has been a resurgence of interest and debate relating to neuropsychiatry in academia over the last decade. Most of this work argues for a rapprochement of neurology and psychiatry, forming a specialty above and beyond a subspecialty of psychiatry. For example, Professor Joseph B. Martin, former Dean of Harvard Medical School and a neurologist by training, has summarized the argument for reunion: "the separation of the two categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway." These points and some of the other major arguments are detailed below.

Mind/brain monism

Neurologists have focused objectively on organic nervous system pathology, especially of the brain, whereas psychiatrists have laid claim to illnesses of the mind. This antipodal distinction between brain and mind as two different entities has characterized many of the differences between the two specialties. However, it has been argued that this division is fictional; evidence from the last century of research has shown that our mental life has its roots in the brain. Brain and mind have been argued not to be discrete entities but just different ways of looking at the same system. It has been argued that embracing this mind/brain monism may be useful for several reasons. First, rejecting dualism implies that all mentation is biological, which provides a common research framework in which understanding and treatment of mental disorders can be advanced. Second, it mitigates widespread confusion about the legitimacy of mental illness by suggesting that all disorders should have a footprint in the brain.

In sum, a reason for the division between psychiatry and neurology was the distinction between mind or first-person experience and the brain. That this difference is taken to be artificial by proponents of mind/brain monism supports a merge between these specialties. These specialities are different but rely on each other.

Causal pluralism

One of the reasons for the divide is that neurology traditionally looks at the causes of disorders from an "inside-the-skin" perspective (neuropathology, genetics) whereas psychiatry looks at "outside-the-skin" causation (personal, interpersonal, cultural). This dichotomy is argued not to be instructive and authors have argued that it is better conceptualized as two ends of a causal continuum. The benefits of this position are: firstly, understanding of etiology will be enriched, in particular between brain and environment. One example is eating disorders, which have been found to have some neuropathology but also show increased incidence in rural Fijian school girls after exposure to television. Another example is schizophrenia, the risk for which may be considerably reduced in a healthy family environment.

It is also argued that this augmented understanding of etiology will lead to better remediation and rehabilitation strategies through an understanding of the different levels in the causal process where one can intervene. It may be that non-organic interventions, like cognitive behavioral therapy (CBT), better attenuate disorders alone or in conjunction with drugs. Linden's demonstration of how psychotherapy has neurobiological commonalities with pharmacotherapy is a pertinent example of this and is encouraging from a patient perspective as the potentiality for pernicious side effects is decreased while self-efficacy is increased.

In sum, the argument is that an understanding of the mental disorders must not only have a specific knowledge of brain constituents and genetics (inside-the-skin) but also the context (outside-the-skin) in which these parts operate. Only by joining neurology and psychiatry, it is argued, can this nexus be used to reduce human suffering. Combining these subjects would help improve patient care and reduce stigma.

Organic basis

To further sketch psychiatry's history shows a departure from structural neuropathology, relying more upon ideology. One example of this is Tourette syndrome, which Sándor Ferenczi, although never having seen a patient with Tourette syndrome, suggested was the symbolic expression of masturbation caused by sexual repression. However, starting with the efficacy of neuroleptic drugs in attenuating symptoms the syndrome has gained pathophysiological support and is hypothesized to have a genetic basis too, based on its high inheritability. This trend can be seen for many hitherto traditionally psychiatric disorders (see table) and is argued to support reuniting neurology and psychiatry because both are dealing with disorders of the same system.

Linking traditional psychiatric symptoms or disorders to brain structures and genetic abnormalities.
(This table is in not exhaustive but provides some psychodynamic and neurological bases to psychiatric symptoms.)

Psychiatric symptoms	Psychodynamic explanation	Neural correlates
Depression	Overwhelming aggression turned inward, guilt	Limbic-cortical dysregulation, monoamine imbalance
Mania	Avoidance of pain of the reality principle	Prefrontal cortex and hippocampus, anterior cingulate, amygdala
Schizophrenia	Projection of inner fantasies outwards due to ego disintegration	NMDA receptor activation in the human prefrontal cortex
Visual hallucination	Projection, cold distant mother causing a weak ego	Retinogeniculocalcarine tract, ascending brainstem modulatory structures
Auditory hallucination	Projection, cold distant mother causing a weak ego	Frontotemporal functional connectivity
Obsessive-compulsive disorder	Shame regarding a pleasurable childhood experience	Frontal-subcortical circuitry, right caudate activity
Eating disorder	Attempted control of internal anxiety	Atypical serotonin system, right frontal and temporal lobe dysfunction, changes to mesolimbic dopamine pathways

Improved patient care

Further, it is argued that this nexus will allow a more refined nosology of mental illness to emerge thus helping to improve remediation and rehabilitation strategies beyond current ones that lump together ranges of symptoms. However, it cuts both ways: traditionally neurological disorders, like Parkinson's disease, are being recognized for their high incidence of traditionally psychiatric symptoms, like psychosis and depression. These symptoms, which are largely ignored in neurology, can be addressed by neuropsychiatry and lead to improved patient care. In sum, it is argued that patients from both traditional psychiatry and neurology departments will see their care improved following a reuniting of the specialties.

Better management model

Psychiatrist Randolph B. Schiffer, pediatrician Daniel L. Hurst, neuropsychiatrist Walter Lajara-Nanson, and psychiatrist Russell C. Packard argue that there are good management and financial reasons for rapprochement.

US institutions

"Behavioral Neurology & Neuropsychiatry" fellowships are accredited by the United Council for Neurologic Subspecialties (UCNS; www.ucns.org), in a manner analogous to the accreditation of psychiatry and neurology residencies in the United States by the American Board of Psychiatry and Neurology (ABPN).

The American Neuropsychiatric Association (ANPA) was established in 1988 and is the American medical subspecialty society for neuropsychiatrists. ANPA holds an annual meeting and offers other forums for education and professional networking amongst subspecialists in behavioral neurology and neuropsychiatry as well as clinicians, scientists, and educators in related fields. American Psychiatric Publishing, Inc. publishes the peer-reviewed Journal of Neuropsychiatry and Clinical Neurosciences, which is the official journal of ANPA.

International organizations

The International Neuropsychiatric Association was established in 1996. INA holds congresses biennially in countries around the world and partners with regional neuropsychiatric associations around the world to support regional neuropsychiatric conferences and to facilitate the development of neuropsychiatry in the countries/regions where those conferences are held. Prof. Robert Haim Belmaker is the current president of the organization whereas Prof. Ennapadam S Krishnamoorthy serves as President-Elect with Dr. Gilberto Brofman as Secretary-Treasurer.

The British NeuroPsychiatry Association (BNPA) was founded in 1987 and is the leading academic and professional body for medical practitioners and professionals allied to medicine in the UK working at the interface of the clinical and cognitive neurosciences and psychiatry.

In 2011, a non-profit professional society named Neuropsychiatric Forum (NPF) was founded. NPF aims to support effective communication and interdisciplinary collaboration, develop education schemes and research projects, organize neuropsychiatric conferences and seminars.

Criticism

Main article: Anti-psychiatry

Antipsychiatry is a political movement based mostly in philosophy (postmodern neo-Marxism) and hermeneutics (interpretative story telling) which denies the existence of psychiatric illnesses ignoring what most patients say. Fernando Vidal and Francisco Ortega argue that neuropsychiatry strengthens the conception of mental suffering as a product of individual irresponsibility yet neuropsychiatrists say the opposite. In Capitalist Realism, Mark Fisher states that when depression is made to be a consequence of individual biochemical imbalance, social causation is ruled out. This uses a neo-Marxist perspective with chemical imbalance a straw man argument. Social factors contribute to all illnesses, but social factors are not an exclusive cause for severe illnesses. In contrast, everyday unhappiness is extremely common and not a medical illness.