Evolutionary Psychiatry has, in the
past, been branded as a ‘fairy tale’ science, rich in conjecture
but lacking in hard evidence. Dr Burns attempts to reconcile
this in The Decent of Madness, a far reaching and ambitious journey
through pertinent evolutionary theory and neuroscience.
The central theory is that our brains have evolved to allow us to
engage in social behaviour, and it is this process, particularly
the establishment of large sweeping white matter tracts, that may
become dysfunctional in those with psychotic disorders. This,
in itself, is an old argument but Dr Burns supports it by
incorporating a review of the latest fMRI data as well as examples
of comparative anatomy amongst the great apes, charting the
potential pitfalls of our own cerebral phylogeny.
Such an approach moves away from traditional psychiatric thinking
concerning the proximate causes of a person’s distress and focuses
on the ultimate factors. The author postulates that any
deviation from normal cognitive processes must have an adaptive and
evolutionarily desirable process at its baseline. It is such
variations that we see at the extreme end of human thinking and
behaviour. Surprisingly, the genetic mechanisms by which
these traits have survived in our collective gene pool are covered
only briefly, although admittedly further technical detail may
alienate some readers.
The best chapter of the book is a slight deviation from its primary
aims. In a review of some of the best phenomenological
thought of the past decades, Burns attempts to reconcile
evolutionary theory with psychopathology, in particular the
importance of dysfunctional theory of mind processing. The
importance of this type of cognition in evolutionary terms and how
it becomes maladaptive in mental health to produce positive
symptoms is fascinating.
The Decent of Madness is a very readable, comprehensively
researched and ultimately empathetic introduction to this rich and
varied field. Despite some of the theories presented being
well trodden paths, this synthesis of different schools of thought
gives a unique and cutting edge insight into the future of
psychiatric thinking.
Dr Harry Haynes