The Social Determinants of Painted Brain
- David Israelian
- February 10, 2016
I spent a lot of time alone in my head during a conference in Washington D.C. this past week, taking in what I could from the experience. It made me revisit an old question I have about myself and about information. As I’ve mentioned in earlier editorials, I have a much better grasp of concepts than of facts. Socrates asserts that true knowledge begins with the acceptance of our basic ignorance, and I woke up this morning thinking about icebergs.
Icebergs are often used to symbolize the disparity between the known and the unknown. Traversing the world is about navigating the icebergs. At the most basic level, you don’t have to know anything about any of them, just enough to avoid running into them. Science is either an iceberg or a thousand icebergs, but one can survive pretty well in this world without even understanding science at all, though this ignorance may, one day, doom us all. If you weren’t able to perform a number of calculations in your head, unconsciously and intuitively, you couldn’t avoid running into other people, either on-foot or in a car. The depth of this physics/calculus iceberg, for example, is enormous, but thanks to our incredible brains, we calculate how much to swerve as we avoid collisions while remaining completely ignorant of the mathematical calculation of trajectories involved.
The best talk I attended at the conference in Washington was given by Michael Compton, a psychiatrist from Lennox Hill Hospital in New York City. He wrote a book several years ago about the social determinants of mental health called (interestingly enough) The Social Determinants of Mental Health. This work is tied to an article from 1998 by Felitti and Anda that made the “startling” discovery that the number of “Adverse Childhood Experiences” or ACEs a person experiences is in direct correlation to a raft of negative health and mental health outcomes later on.
The clearest and most obvious antecedent to a high number of ACEs is poverty. Children can, of course, experience violence or loss regardless of income level, and low family income in no way dooms a child to experience such. The obvious take away from this research, the glaring truth, is that any real attempt to prevent social ills concerning emotional and physical well-being must deal with the underlying issues of poverty and inequality, and that anything less fails to address the root causes of our various and preventable American health crises.
Dr. Compton ended his talk with a question, something I am pounding at the gates of academia with myself, “Why do we need to further study things that we already know? Why don’t we just simply act?”
Interestingly, he asks this question even as a research professional. One of the things I liked about Dr. Compton is that he is also a practicing psychiatrist. He was able to acknowledge that, on an individual level, his work with his patients is largely based on a combination of his knowledge base, his experience and his intuition rather than on the rote, manualized expectations of “best practices.” He knows what he does not know, and he still acts in the here-and-now of his patients anyway.
So I wonder sometimes whether I actually have a use for new knowledge. I know the icebergs of the mental health system. I know the icebergs by name, have an appreciation of their depth, and a working knowledge of their contours beneath the surface. I also know, and believe in, a couple of basic things about the practice of social work that serve as guiding principles in PB’s quest. The Painted Brain is an attachment object because people have a need for attachment as a source of identity development. We know ourselves in relation to others. Integrating an acceptance of one’s own mental health symptoms into one’s identity is deeply connected to attachment, so Painted Brain needs to create an identity that itself accomplishes this integration.
We need to keep growing while showing proof that what we do works so that others will aid us in our continued growth.
We don’t need further proof that it works.
We know that already.
Dave Leon LCSW is the founder and director of Painted Brain
- Dave's Brain