Neuroanthropology

Neurotosh. The best word from the entire Montreal Critical Neurosciences conference! There was Cordelia Fine, capturing perfectly her frustration at the manipulation of data and science in the service of stereotypes. Just pure neuro-nonsense.

The neurotosh in question was Louann Brizendine’s The Female Brain, an excellent representative of the neurosexism sold in recent popular books. It is popular, a bestseller translated into many languages, and it is simply bad science. In Nature Rebecca Young and Evan Balaban describe the book as “dressing the [gender] myth up in new clothes” and selling a “melodrama,” noting that “The Female Brain disappointingly fails to meet even the most basic standards of scientific accuracy and balance.”

Cordelia Fine took us step-by-step through several passages, examining the supposed citations and supporting evidence. Gender differences were confirmed by (a) studies with only women, (b) studies on a different topic entirely, and (c) personal communication. Ouch.

Plenty of other people have gotten on the bash-Brizendine-bandwagon, helping to undermine the moral authority that Dr. Brizendine wields through her academic credentials and “scientific” claims. Language Log has several critical analyses of the gender difference claims about language (see here, here and here). Mother Jones takes Brizendine to task on her approach to medicine. The most popular Amazon reviews of the book lead with titles calling The Female Brain “disappointing” and “nonsensical.” Vaughan Bell at Mind Hacks gets in on the pile-on-party as well.

Still Simon Cohn, a British anthropologist at the meeting, was rather nonplussed at Cordelia’s agonizing over the data and methods and claims made by Brizendine. As Simon said to me, “It’s called ‘The Female Brain.’ Doesn’t that tell you everything right from the start?” His point was that knowledge gets turned in the service of ideology and profit and power all the time.

But the specifics of how that happen matter, as Laurence Kirmayer brought up in the general discussion following Cordelia’s presentation. He mentioned an article he found on Brizendine, Men are from Mars, Women from Venus, Drug Firms from Pluto. The ending quote from Brizendine goes: “Biotech and pharmaceutical companies would do well to take the gender differences in pharmaceutical and genetics and protein synthesis seriously in the next generation of products. There’s a huge market in that.”

Dr. David Peterzell, the most prominent critic on Amazon, writes about Brizendine’s book that “The book felt like an advertisement for certain drug treatments, including controversial hormone therapies and the anti-depressant drug Zoloft… My radar went up when I kept reading about Zoloft. Zoloft is a popular antidepressant but just one brand out of many SSRIs (e.g., Prozac, Celexa, Paxil, Lexapro). Why emphasize Zoloft?”

Zoloft is made by Pfizer, but it took some digging to turn up a link between Brizendine and Pfizer. Obviously neither Brizendine nor Pfizer are out there advertising their mutually beneficial linking. But scientific journals generally make their authors declare any “interests” they may have that could skew their study.

In The Journal of Family Practice, Brizendine has an article Managing Menopause-Related Depression and Low Libido. Basically the piece boils down to Brizendine prescribing, literally and figuratively, testosterone to improve “Anne’s” sex life. At the article’s end, there is this brief statement: “Dr. Brizendine is a speaker for Pfizer, Lilly, and Wyeth.”

Besides getting paid to represent these drug companies, Brizendine runs her own Women’s Mood and Hormone Clinic. As the website declares in bold, “Please keep in mind that we are a clinic specializing in the psychological aspects of hormones on the female brain.” In other words, The Female Brain is an excellent ad for Brizendine’s services.

Drug companies, selling clinical services, playing to stereotypes to get that best-selling book. It all adds up to neuro-dosh. Dosh as in cash. Money makes the world go round, and Brizendine is working the system (hmm, she’s breaking her own stereotype, what does that tell us?).

Still, the system also works on her. Determinist biology and drug company money have her in their grips. Her website is full of nuggets like this, “oxytocin (a happy hormone)” and “You are as brave as your basal amygdala.” Human qualities, reduced down to whatever is the biological object in question.

That is the definite theme of The Female Brain—whatever gender differences there are (or, even more relevant, that we think there are), the different “brains” of men and women are the cause. That’s how she sells herself, saying she “specializes in the relationship dynamics that result from the neurobiology of male and female brains.”

Drug companies have given her the tools to manipulate those relationship dynamics. In her case study “Anne” has a stressful marriage which suffers from a lack of intimacy. Testosterone appears as the cure.

But, remember, Brizendine declared in Mother Jones that she is no fan of placebo studies—they are “cruel.” She is not actually interested in whether testosterone works. Her case study intervention, where treating a woman for depression, getting her to focus on rating her sexuality (only room for improvement), and talking about sex in her marriage, already has its foregone conclusion. What the drug companies give Brizendine works.

Is that last statement going too far? No, it’s not in the light of reporting on the close links between psychiatry and drug companies (as in all of medicine). The New York Times recently published “Psychiatric Group Faces Scrutiny Over Drug Industry Ties.” As the Times reports, in 2006 the drug industry accounted for over 30% of the American Psychiatric Association’s $62.5 million in financing. Big pharma also pushes their stuff on doctors themselves, with rather obvious results

While data on industry consulting arrangements are sparse, state officials in Vermont reported that in the 2007 fiscal year, drug makers gave more money to psychiatrists than to doctors in any other specialty. Eleven psychiatrists in the state received an average of $56,944 each. Data from Minnesota, among the few other states to collect such information, show a similar trend…

An analysis of Minnesota data by The New York Times last year found that on average, psychiatrists who received at least $5,000 from makers of newer-generation antipsychotic drugs appear to have written three times as many prescriptions to children for the drugs as psychiatrists who received less money or none. The drugs are not approved for most uses in children, who appear to be especially susceptible to the side effects, including rapid weight gain.

Today, over half the psychiatrists revising the Diagnostic and Statistical Manual have drug industry ties, much as happened with the previous version. And if you want to know more about the drug industry and its often pernicious and corrupting influence, see Furious Seasons, a wonderful blog on the infiltration of psychotropic drugs into all areas of everyday life.

In Nigeria, to dash is just part of life, giving money to officials to make sure you get a favorable outcome. When I spent a year living there, it was the first thing I had to do on entering the country—dash the customs official to get a speedy pass-through without excessive “import taxes” on anything in my luggage.

But the drug companies have turned that around, dashing money to psychiatric associations, clinics, and individual doctors. In this case, it’s a much bigger showering of riches to shape official policy and decision making. It’s the neurodash.

So, remember, tosh, dosh and dash. Nonsense, money, and corruption. They feed each other. For critical neuroscience to be successful, we will have to take on all three.