Mick Hartley

Stick neuro- in front, and straightaway you're sounding serious, scientific. Look what it did for Neuro-Linguistic Programming. Now there are scores of these neurologisms – neuro-marketing, neuro-law, neuro-politics – most of them based on brain scanning: the phrenology of our times. Psychiatrist Daniel Carlat gets a personal reading at the Amen Clinic in California ($3,300 a pop):

After another 15 minutes of questions and conversation, he says, "Let's look at your scans." He takes the images that he printed out this morning and puts them side by side on a large table. He points to several views of the surface of my brain. "What I see here is that activity in your prefrontal cortex is low at rest but becomes better when you concentrate, and your thalamus becomes more active, too. I think this means you have a predisposition to depression."

I nod. Scrutinizing the scans some more, he says, "You need to be busy to be happy. Your brain is cool at rest. You need stuff in your life to feel alive, together, and connected." He looks at another view, this one showing only the most active regions of my brain. "In this scan, you have increased activity in your thalamus, your two basal ganglia, and your cingulate cortex." He picks up a pen and draws a line connecting these four regions to the right lateral temporal lobe. "I call this the diamond plus.' It's a pattern of angst, and we see it in people who have had significant trauma in their lives."

He puts down his pen and turns to me. "I would love to see your brain healthier, because you'll be happier if it's healthier," he says. "It's too low in activity. I recommend a multivitamin, and to get better blood flow I would take gingko." Just before I leave, he advises me to lay off the snowboarding and play more tennis. "With the lowered activity in your cerebellum," he explains, "I'd like to see you do more coordination sports." 

….I find myself comparing my assessment meeting with Amen to experiences I've had with shrewd palm readers. Like them, Amen made vague pronouncements that could apply to anyone: "You're happier when you're busy." When he made specific statements about my moods and life events, they seemed to be based on information he obtained the old-fashioned way — by asking questions. He already knew about my family history of depression and my mother's suicide when he mentioned a "predisposition to depression" and "significant trauma." Occasionally, he was completely off the mark, like when he saw neural signs of temper problems. In fact, when my wife and I argue, my calmness is exasperating, leading her to ask, "Do you even have a pulse?"

"All right," I say to Rubin. "Let's assume that Amen really has no solid evidence that imaging can diagnose conditions. But he does seem to make some people feel better when they are in distress."

"Oh, I'll give him that," he says. "It's a fantastic placebo effect." I'm reminded of a recent study in which Yale researchers gave participants various nonsensical explanations of human behavior. Half of the time, the researchers added the phrase "Brain scans indicate" before the explanation, and then inserted the spurious finding. When this brain-speak was added, participants judged the explanations more satisfying.

Which is not to say that brain scanning doesn't have its medical uses, or isn't an interesting research tool, but it's that same old urge to jump ahead of the science and find direct links between the brain and the mind when it just ain't that simple. Or, to put it another way, it's yet another tool in the armoury of the psychotherapy industry to extract money from the gullible.