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The Evolution of Precision Psychiatry | Dr. Andrew Gerber | TEDxBerkshires


let me tell you a story an

let me tell you a story an all-too-common story in all two tragic

all-too-common story in all two tragic

all-too-common story in all two tragic story that someone who might come to

story that someone who might come to

story that someone who might come to Austin Riggs or end up in any the

Austin Riggs or end up in any the

Austin Riggs or end up in any the offices of psychiatrists and

offices of psychiatrists and

offices of psychiatrists and psychotherapists around the world

psychotherapists around the world

psychotherapists around the world imagine a boy 3rd or 4th grade who has

imagine a boy 3rd or 4th grade who has

imagine a boy 3rd or 4th grade who has trouble sitting still fidgeting maybe

trouble sitting still fidgeting maybe

trouble sitting still fidgeting maybe he’s like some of you in the audience

he’s like some of you in the audience

he’s like some of you in the audience right now get sent to the principal and

right now get sent to the principal and

right now get sent to the principal and then to the counselor’s office

then to the counselor’s office

then to the counselor’s office turns out this boy’s got some difficult

turns out this boy’s got some difficult

turns out this boy’s got some difficult things going on at home his parents are

things going on at home his parents are

things going on at home his parents are fighting there’s an illness in one of

fighting there’s an illness in one of

fighting there’s an illness in one of his siblings but the teachers have to do

his siblings but the teachers have to do

his siblings but the teachers have to do their job they have to get him to sit

their job they have to get him to sit

their job they have to get him to sit still and listen to the lesson so he

still and listen to the lesson so he

still and listen to the lesson so he gets sent to a therapist maybe a

gets sent to a therapist maybe a

gets sent to a therapist maybe a psychiatrist to diagnose him with

psychiatrist to diagnose him with

psychiatrist to diagnose him with something we all know about called ADHD

something we all know about called ADHD

something we all know about called ADHD attention deficit hyperactivity disorder

attention deficit hyperactivity disorder

attention deficit hyperactivity disorder he may improve somewhat get put on a

he may improve somewhat get put on a

he may improve somewhat get put on a medication get some therapy for that

medication get some therapy for that

medication get some therapy for that flash-forward several years now for that

flash-forward several years now for that

flash-forward several years now for that same young man now a teenager he’s in

same young man now a teenager he’s in

same young man now a teenager he’s in high school gets into the wrong crowd

high school gets into the wrong crowd

high school gets into the wrong crowd starts using alcohol and drugs again

starts using alcohol and drugs again

starts using alcohol and drugs again gets sent to a counselor he’s lucky

gets sent to a counselor he’s lucky

gets sent to a counselor he’s lucky actually to a therapist or a

actually to a therapist or a

actually to a therapist or a psychiatrist who gives him another

psychiatrist who gives him another

psychiatrist who gives him another diagnosis the diagnosis of substance

diagnosis the diagnosis of substance

diagnosis the diagnosis of substance abuse disorder may be alcoholism or

abuse disorder may be alcoholism or

abuse disorder may be alcoholism or maybe something else boy get some help

maybe something else boy get some help

maybe something else boy get some help goes back to high school but now it’s

goes back to high school but now it’s

goes back to high school but now it’s time for graduation his classmates are

time for graduation his classmates are

time for graduation his classmates are moving out going off to college getting

moving out going off to college getting

moving out going off to college getting jobs he struggles he has a job briefly

jobs he struggles he has a job briefly

jobs he struggles he has a job briefly sleeps later on more than one occasion

sleeps later on more than one occasion

sleeps later on more than one occasion loses his job ends up staying in bed for

loses his job ends up staying in bed for

loses his job ends up staying in bed for much longer than his good friend plays

much longer than his good friend plays

much longer than his good friend plays video games during the day rather than

video games during the day rather than

video games during the day rather than going out and socializing his friends

going out and socializing his friends

going out and socializing his friends aren’t in town anyway again he gets sent

aren’t in town anyway again he gets sent

aren’t in town anyway again he gets sent to some kind of counselor for therapist

to some kind of counselor for therapist

to some kind of counselor for therapist and this time the diagnosis may be

and this time the diagnosis may be

and this time the diagnosis may be depression or maybe gets referred to as

depression or maybe gets referred to as

depression or maybe gets referred to as having an anxiety disorder a few more

having an anxiety disorder a few more

having an anxiety disorder a few more years go on and his life doesn’t improve

years go on and his life doesn’t improve

years go on and his life doesn’t improve he starts to self-injure he cuts himself

he starts to self-injure he cuts himself

he starts to self-injure he cuts himself and after one particularly bad breakup

and after one particularly bad breakup

and after one particularly bad breakup with a girlfriend he threatens to commit

with a girlfriend he threatens to commit

with a girlfriend he threatens to commit suicide and again luckily ends up in the

suicide and again luckily ends up in the

suicide and again luckily ends up in the hospital

hospital

hospital rather than young through he gets yet

rather than young through he gets yet

rather than young through he gets yet another set of diagnosis is told that he

another set of diagnosis is told that he

another set of diagnosis is told that he has bipolar disorder or borderline

has bipolar disorder or borderline

has bipolar disorder or borderline personality disorder now this is not the

personality disorder now this is not the

personality disorder now this is not the exception that I’m describing

exception that I’m describing

exception that I’m describing unfortunately this is how the diagnosis

unfortunately this is how the diagnosis

unfortunately this is how the diagnosis in our field have developed over time

in our field have developed over time

in our field have developed over time that it’s surprisingly easy to end up

that it’s surprisingly easy to end up

that it’s surprisingly easy to end up with five or even six diagnoses that I

with five or even six diagnoses that I

with five or even six diagnoses that I just described in one individual with

just described in one individual with

just described in one individual with one set of problems a quarter of

one set of problems a quarter of

one set of problems a quarter of Americans will get diagnosed with a

Americans will get diagnosed with a

Americans will get diagnosed with a psychiatric disorder at some time in

psychiatric disorder at some time in

psychiatric disorder at some time in their lives and the majority of those

their lives and the majority of those

their lives and the majority of those will get more than one diagnosis so what

will get more than one diagnosis so what

will get more than one diagnosis so what does this mean about our field what does

does this mean about our field what does

does this mean about our field what does it mean that someone can have so many

it mean that someone can have so many

it mean that someone can have so many different labels associated with them

different labels associated with them

different labels associated with them I’m not here to criticize those label in

I’m not here to criticize those label in

I’m not here to criticize those label in fact each and every one of them is given

fact each and every one of them is given

fact each and every one of them is given by someone caring in order to facilitate

by someone caring in order to facilitate

by someone caring in order to facilitate in their minds some kind of treatment

in their minds some kind of treatment

in their minds some kind of treatment but there’s a truth in there that I

but there’s a truth in there that I

but there’s a truth in there that I think we speak to all too infrequently

think we speak to all too infrequently

think we speak to all too infrequently in the field and that is where we are in

in the field and that is where we are in

in the field and that is where we are in the fields of psychiatry and psychology

the fields of psychiatry and psychology

the fields of psychiatry and psychology is that we’re describing symptoms we’re

is that we’re describing symptoms we’re

is that we’re describing symptoms we’re describing how somebody feels how

describing how somebody feels how

describing how somebody feels how somebody presents whether they’re

somebody presents whether they’re

somebody presents whether they’re depressed whether they’re anxious

depressed whether they’re anxious

depressed whether they’re anxious whether they’re abusing substances what

whether they’re abusing substances what

whether they’re abusing substances what we haven’t been able to describe yet is

we haven’t been able to describe yet is

we haven’t been able to describe yet is what the underlying causes are let me

what the underlying causes are let me

what the underlying causes are let me make an analogy to medical illnesses to

make an analogy to medical illnesses to

make an analogy to medical illnesses to make this clear imagine that instead of

make this clear imagine that instead of

make this clear imagine that instead of describing someone who’s having an

describing someone who’s having an

describing someone who’s having an appendicitis we describe someone as

appendicitis we describe someone as

appendicitis we describe someone as having abdominal pain fever nausea all

having abdominal pain fever nausea all

having abdominal pain fever nausea all very real all very important symptoms

very real all very important symptoms

very real all very important symptoms but each one doesn’t specify the foil

but each one doesn’t specify the foil

but each one doesn’t specify the foil note in fact there’s multiple reasons

note in fact there’s multiple reasons

note in fact there’s multiple reasons one could have fever nausea or abdominal

one could have fever nausea or abdominal

one could have fever nausea or abdominal pain but put together in a certain way

pain but put together in a certain way

pain but put together in a certain way with a certain type of dominant pain and

with a certain type of dominant pain and

with a certain type of dominant pain and you have appendicitis so that diagnosis

you have appendicitis so that diagnosis

you have appendicitis so that diagnosis is not just a symptom in fact it gets to

is not just a symptom in fact it gets to

is not just a symptom in fact it gets to something that in medicine we refer to

something that in medicine we refer to

something that in medicine we refer to as pathos

as pathos

as pathos physiology a word that means we

physiology a word that means we

physiology a word that means we understand what the underlying problem

understand what the underlying problem

understand what the underlying problem is we know that the appendix is inflamed

is we know that the appendix is inflamed

is we know that the appendix is inflamed infected and in also in most cases

infected and in also in most cases

infected and in also in most cases refers to a potential treatment we know

refers to a potential treatment we know

refers to a potential treatment we know that the way to treat an appendicitis is

that the way to treat an appendicitis is

that the way to treat an appendicitis is to remove the appendix in appendectomy

to remove the appendix in appendectomy

to remove the appendix in appendectomy so by identifying the underlying cause

so by identifying the underlying cause

so by identifying the underlying cause that not referring to it as a series of

that not referring to it as a series of

that not referring to it as a series of symptoms as important as those are we

symptoms as important as those are we

symptoms as important as those are we set ourselves up to treat and to heal

set ourselves up to treat and to heal

set ourselves up to treat and to heal another example this would be pneumonia

another example this would be pneumonia

another example this would be pneumonia pneumonia involves a cause but we don’t

pneumonia involves a cause but we don’t

pneumonia involves a cause but we don’t refer to it as a call we refer to it by

refer to it as a call we refer to it by

refer to it as a call we refer to it by its underlying name pneumonia what you

its underlying name pneumonia what you

its underlying name pneumonia what you might not know is the history of

might not know is the history of

might not know is the history of medicine is filled with examples where

medicine is filled with examples where

medicine is filled with examples where we refer to things initially by their

we refer to things initially by their

we refer to things initially by their symptoms because that’s what we knew

symptoms because that’s what we knew

symptoms because that’s what we knew famous example of this is a disorder

famous example of this is a disorder

famous example of this is a disorder that used to be known called dropsy or

that used to be known called dropsy or

that used to be known called dropsy or hydrops II was the full name and what it

hydrops II was the full name and what it

hydrops II was the full name and what it meant was an accumulation of fluid but

meant was an accumulation of fluid but

meant was an accumulation of fluid but in the limbs or the abdomen what today

in the limbs or the abdomen what today

in the limbs or the abdomen what today we usually refer to as a demon now you

we usually refer to as a demon now you

we usually refer to as a demon now you may know there’s many reasons one can

may know there’s many reasons one can

may know there’s many reasons one can have an accumulation of fluid for

have an accumulation of fluid for

have an accumulation of fluid for example one very important reason would

example one very important reason would

example one very important reason would be heart failure but another could be a

be heart failure but another could be a

be heart failure but another could be a problem with the kidneys or even another

problem with the kidneys or even another

problem with the kidneys or even another could be some kind of a cancer that’s

could be some kind of a cancer that’s

could be some kind of a cancer that’s impairing the body’s ability to resort

impairing the body’s ability to resort

impairing the body’s ability to resort water but we don’t refer to it as dropsy

water but we don’t refer to it as dropsy

water but we don’t refer to it as dropsy anymore because we have those other

anymore because we have those other

anymore because we have those other names and we understand the underlying

names and we understand the underlying

names and we understand the underlying pathophysiology and therefore we can

pathophysiology and therefore we can

pathophysiology and therefore we can call it heart disease or kidney disease

call it heart disease or kidney disease

call it heart disease or kidney disease or cancer this is where we are in

or cancer this is where we are in

or cancer this is where we are in psychiatry today in psychology we are on

psychiatry today in psychology we are on

psychiatry today in psychology we are on the brink of being able to describe

the brink of being able to describe

the brink of being able to describe disorders by their pathophysiology not

disorders by their pathophysiology not

disorders by their pathophysiology not merely by their symptoms now that’s not

merely by their symptoms now that’s not

merely by their symptoms now that’s not an easy task and in order to get there

an easy task and in order to get there

an easy task and in order to get there we have tough things to understand so

we have tough things to understand so

we have tough things to understand so let me start with one this is a normal

let me start with one this is a normal

let me start with one this is a normal distribution curve or bell curve many of

distribution curve or bell curve many of

distribution curve or bell curve many of you may have learned about this in high

you may have learned about this in high

you may have learned about this in high school or college what does the bell

school or college what does the bell

school or college what does the bell curve tell us what it tells us is that

curve tell us what it tells us is that

curve tell us what it tells us is that average things happen more frequently

average things happen more frequently

average things happen more frequently than things at the extreme so if we

than things at the extreme so if we

than things at the extreme so if we imagine that to be higher on

imagine that to be higher on

imagine that to be higher on Merve means more people have that

Merve means more people have that

Merve means more people have that particular trait or symptom and to be

particular trait or symptom and to be

particular trait or symptom and to be off to the right side or to the left

off to the right side or to the left

off to the right side or to the left side is to suggest that fewer people

side is to suggest that fewer people

side is to suggest that fewer people lower have more extremes many many

lower have more extremes many many

lower have more extremes many many natural phenomena are described in this

natural phenomena are described in this

natural phenomena are described in this way height weight for example most

way height weight for example most

way height weight for example most people are somewhere in the middle and

people are somewhere in the middle and

people are somewhere in the middle and then some people fewer are higher and

then some people fewer are higher and

then some people fewer are higher and fewer or lower well it turns out that

fewer or lower well it turns out that

fewer or lower well it turns out that virtually every one of the psychiatric

virtually every one of the psychiatric

virtually every one of the psychiatric symptoms that we talk about depression

symptoms that we talk about depression

symptoms that we talk about depression anxiety substance abuse when measured

anxiety substance abuse when measured

anxiety substance abuse when measured lie along bell curve and what that tells

lie along bell curve and what that tells

lie along bell curve and what that tells you is that rather than falling neatly

you is that rather than falling neatly

you is that rather than falling neatly into groups of those who have the

into groups of those who have the

into groups of those who have the problem and those who don’t

problem and those who don’t

problem and those who don’t we’re actually describing something very

we’re actually describing something very

we’re actually describing something very human that we all are depressed

human that we all are depressed

human that we all are depressed sometimes that we all are anxious

sometimes that we all are anxious

sometimes that we all are anxious sometimes that there are fewer of us who

sometimes that there are fewer of us who

sometimes that there are fewer of us who have more and fewer who have less so

have more and fewer who have less so

have more and fewer who have less so what we are doing in most of

what we are doing in most of

what we are doing in most of contemporary psychiatry nowadays is

contemporary psychiatry nowadays is

contemporary psychiatry nowadays is drawing the vertical line on this chart

drawing the vertical line on this chart

drawing the vertical line on this chart and saying well we have more than a

and saying well we have more than a

and saying well we have more than a certain amount we’re going to refer to

certain amount we’re going to refer to

certain amount we’re going to refer to that as a diagnosis depression anxiety

that as a diagnosis depression anxiety

that as a diagnosis depression anxiety and so on and if you have less than that

and so on and if you have less than that

and so on and if you have less than that we’re going to refer to you as not

we’re going to refer to you as not

we’re going to refer to you as not having a diagnosis we’re dichotomizing

having a diagnosis we’re dichotomizing

having a diagnosis we’re dichotomizing something that is not intrinsically

something that is not intrinsically

something that is not intrinsically dichotomies and we do that for an

dichotomies and we do that for an

dichotomies and we do that for an important reason we have to make

important reason we have to make

important reason we have to make decisions about who to give treatments

decisions about who to give treatments

decisions about who to give treatments to and who to fund for other treatments

to and who to fund for other treatments

to and who to fund for other treatments but we can’t lose sight of the fact that

but we can’t lose sight of the fact that

but we can’t lose sight of the fact that right now that is what we’re describing

right now that is what we’re describing

right now that is what we’re describing by the way this is true of attentional

by the way this is true of attentional

by the way this is true of attentional disorders as well as much as it may seem

disorders as well as much as it may seem

disorders as well as much as it may seem that there are children who fit neatly

that there are children who fit neatly

that there are children who fit neatly into the category of ADHD or not in fact

into the category of ADHD or not in fact

into the category of ADHD or not in fact attentional disorders lie along this

attentional disorders lie along this

attentional disorders lie along this continuum so where do we need to go we

continuum so where do we need to go we

continuum so where do we need to go we need to move to a graph like this we

need to move to a graph like this we

need to move to a graph like this we need to be able to identify different

need to be able to identify different

need to be able to identify different aspects again pathophysiology of the

aspects again pathophysiology of the

aspects again pathophysiology of the mind the brain that allow us to as Plato

mind the brain that allow us to as Plato

mind the brain that allow us to as Plato said carved nature up by its joints to

said carved nature up by its joints to

said carved nature up by its joints to separate things out in a way that

separate things out in a way that

separate things out in a way that actually makes intrinsic

actually makes intrinsic

actually makes intrinsic since let me give you the medical

since let me give you the medical

since let me give you the medical example if we asked a group of people to

example if we asked a group of people to

example if we asked a group of people to describe some aspect of abdominal pain

describe some aspect of abdominal pain

describe some aspect of abdominal pain most people have some abdominal pain

most people have some abdominal pain

most people have some abdominal pain they fall somewhere in the middle much

they fall somewhere in the middle much

they fall somewhere in the middle much greater pain would be off to one side

greater pain would be off to one side

greater pain would be off to one side and lucky people who have no abdominal

and lucky people who have no abdominal

and lucky people who have no abdominal pain ever at all would be off to the

pain ever at all would be off to the

pain ever at all would be off to the other side and that would look like a

other side and that would look like a

other side and that would look like a normal distribution and if we will find

normal distribution and if we will find

normal distribution and if we will find our question though and instead of just

our question though and instead of just

our question though and instead of just asking about abdominal pain we did an

asking about abdominal pain we did an

asking about abdominal pain we did an x-ray or cat scan of the appendix and we

x-ray or cat scan of the appendix and we

x-ray or cat scan of the appendix and we saw in how many people is the appendix

saw in how many people is the appendix

saw in how many people is the appendix inflamed it would look more like this

inflamed it would look more like this

inflamed it would look more like this that is we would see a smaller sub group

that is we would see a smaller sub group

that is we would see a smaller sub group that had two inflamed appendices and we

that had two inflamed appendices and we

that had two inflamed appendices and we know what the treatment is for that and

know what the treatment is for that and

know what the treatment is for that and a larger group that doesn’t this is

a larger group that doesn’t this is

a larger group that doesn’t this is where we need to go in psychology and

where we need to go in psychology and

where we need to go in psychology and psychiatry but getting there is pretty

psychiatry but getting there is pretty

psychiatry but getting there is pretty tricky there are three parts that we

tricky there are three parts that we

tricky there are three parts that we have to accomplish and I’m happy to say

have to accomplish and I’m happy to say

have to accomplish and I’m happy to say that I think these are happening in the

that I think these are happening in the

that I think these are happening in the coming decade or two first we have to

coming decade or two first we have to

coming decade or two first we have to understand something about underlying

understand something about underlying

understand something about underlying vulnerabilities as much as we would like

vulnerabilities as much as we would like

vulnerabilities as much as we would like it to be true that we are all born

it to be true that we are all born

it to be true that we are all born exactly the same and everybody has the

exactly the same and everybody has the

exactly the same and everybody has the opportunity to be as healthy as the next

opportunity to be as healthy as the next

opportunity to be as healthy as the next we also know from many genetic analyses

we also know from many genetic analyses

we also know from many genetic analyses that this is not true we each come into

that this is not true we each come into

that this is not true we each come into the world with vulnerabilities that we

the world with vulnerabilities that we

the world with vulnerabilities that we inherit from our genome amazingly we now

inherit from our genome amazingly we now

inherit from our genome amazingly we now have the capacity to read out that

have the capacity to read out that

have the capacity to read out that genome for a relatively reasonable

genome for a relatively reasonable

genome for a relatively reasonable amount of money we can spend about a

amount of money we can spend about a

amount of money we can spend about a thousand dollars now to read out the

thousand dollars now to read out the

thousand dollars now to read out the totality of someone’s genome a project

totality of someone’s genome a project

totality of someone’s genome a project that only 20 years ago would cost

that only 20 years ago would cost

that only 20 years ago would cost billions the famous Human Genome Project

billions the famous Human Genome Project

billions the famous Human Genome Project which set the stage for current

which set the stage for current

which set the stage for current technologies that means that we have the

technologies that means that we have the

technologies that means that we have the ability to read this code we don’t yet

ability to read this code we don’t yet

ability to read this code we don’t yet know what the code means but gives us

know what the code means but gives us

know what the code means but gives us the opportunity to understand that

the opportunity to understand that

the opportunity to understand that within that code where are the

within that code where are the

within that code where are the vulnerabilities that will make certain

vulnerabilities that will make certain

vulnerabilities that will make certain individuals more likely to develop

individuals more likely to develop

individuals more likely to develop certain disorders in certain

certain disorders in certain

certain disorders in certain environmental contexts so that’s number

environmental contexts so that’s number

environmental contexts so that’s number one

one

one number two we need to understand the

number two we need to understand the

number two we need to understand the pathophysiology of

pathophysiology of

pathophysiology of the mind and the brain that’s the organ

the mind and the brain that’s the organ

the mind and the brain that’s the organ it’s the most complicated organ in the

it’s the most complicated organ in the

it’s the most complicated organ in the body and it’s the one we know the least

body and it’s the one we know the least

body and it’s the one we know the least about

about

about but we’re developing technologies that

but we’re developing technologies that

but we’re developing technologies that allow us to understand how the brain

allow us to understand how the brain

allow us to understand how the brain works in health and in illness the most

works in health and in illness the most

works in health and in illness the most important of those new technologies is

important of those new technologies is

important of those new technologies is something you’re probably familiar with

something you’re probably familiar with

something you’re probably familiar with MRI or magnetic resonance imaging that

MRI or magnetic resonance imaging that

MRI or magnetic resonance imaging that same technology that can be used to get

same technology that can be used to get

same technology that can be used to get those incredibly beautiful pictures of

those incredibly beautiful pictures of

those incredibly beautiful pictures of ones need when children can also be used

ones need when children can also be used

ones need when children can also be used to get a picture of the brain and this

to get a picture of the brain and this

to get a picture of the brain and this is relatively new technology been around

is relatively new technology been around

is relatively new technology been around for about 20 years and we’re making

for about 20 years and we’re making

for about 20 years and we’re making rapid progress just in the last couple

rapid progress just in the last couple

rapid progress just in the last couple years a major government effort that was

years a major government effort that was

years a major government effort that was inspired by the human human genome

inspired by the human human genome

inspired by the human human genome project this project called the human

project this project called the human

project this project called the human connectome project gathered data on over

connectome project gathered data on over

connectome project gathered data on over a thousand individuals healthy

a thousand individuals healthy

a thousand individuals healthy individuals to understand the way the

individuals to understand the way the

individuals to understand the way the brain is structured the way it functions

brain is structured the way it functions

brain is structured the way it functions and even the way different parts of the

and even the way different parts of the

and even the way different parts of the brain are connected the image I have

brain are connected the image I have

brain are connected the image I have above me is something called diffusion

above me is something called diffusion

above me is something called diffusion tensor imaging or DTI what it looks at

tensor imaging or DTI what it looks at

tensor imaging or DTI what it looks at is the pathways the wires that connect

is the pathways the wires that connect

is the pathways the wires that connect different parts of the brain that can

different parts of the brain that can

different parts of the brain that can process it and colors are used to

process it and colors are used to

process it and colors are used to illustrate the direction of those wires

illustrate the direction of those wires

illustrate the direction of those wires so really for the first time we’re able

so really for the first time we’re able

so really for the first time we’re able to apply technologies like this in an

to apply technologies like this in an

to apply technologies like this in an experimental research oriented way to

experimental research oriented way to

experimental research oriented way to individuals and look at the differences

individuals and look at the differences

individuals and look at the differences and the similarities between them that’s

and the similarities between them that’s

and the similarities between them that’s truly revolutionary and will give us I

truly revolutionary and will give us I

truly revolutionary and will give us I believe the opportunity to start to

believe the opportunity to start to

believe the opportunity to start to identify which regions of the brain and

identify which regions of the brain and

identify which regions of the brain and how they’re connected affect individuals

how they’re connected affect individuals

how they’re connected affect individuals we’re not there yet we can’t use MRIs

we’re not there yet we can’t use MRIs

we’re not there yet we can’t use MRIs today to diagnose or to treat mental

today to diagnose or to treat mental

today to diagnose or to treat mental illness but we’re getting there we can’t

illness but we’re getting there we can’t

illness but we’re getting there we can’t get too distracted by these technologies

get too distracted by these technologies

get too distracted by these technologies the excitement of the human genome

the excitement of the human genome

the excitement of the human genome project the excitement of the human

project the excitement of the human

project the excitement of the human connectome project to forget that where

connectome project to forget that where

connectome project to forget that where we are now and still need to understand

we are now and still need to understand

we are now and still need to understand the stories of our patients just like

the stories of our patients just like

the stories of our patients just like that boy and young man I described to

that boy and young man I described to

that boy and young man I described to you at the beginning of

you at the beginning of

you at the beginning of stalk it’s not enough to say that he’s

stalk it’s not enough to say that he’s

stalk it’s not enough to say that he’s depressed he’s anxious he has a

depressed he’s anxious he has a

depressed he’s anxious he has a substance abuse problem we need the full

substance abuse problem we need the full

substance abuse problem we need the full story would we at Austin Riggs often

story would we at Austin Riggs often

story would we at Austin Riggs often refer to as the deep story what’s

refer to as the deep story what’s

refer to as the deep story what’s happening the symptoms for sure also

happening the symptoms for sure also

happening the symptoms for sure also what the symptoms mean to him what did

what the symptoms mean to him what did

what the symptoms mean to him what did it mean that he was left behind when his

it mean that he was left behind when his

it mean that he was left behind when his friends went off to college or had jobs

friends went off to college or had jobs

friends went off to college or had jobs what does it mean that he’s depressed or

what does it mean that he’s depressed or

what does it mean that he’s depressed or using substances or even later on

using substances or even later on

using substances or even later on cutting himself these meanings are key

cutting himself these meanings are key

cutting himself these meanings are key we must match them up to those things

we must match them up to those things

we must match them up to those things that we learn in neuroscience as well as

that we learn in neuroscience as well as

that we learn in neuroscience as well as in genetics if we do that the future is

in genetics if we do that the future is

in genetics if we do that the future is bright

bright

bright [Applause]

”

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