Minds and Brains, Sleep and Psychiatry

Abstract

Objective This article offers a philosophical thesis for psychiatric disorders that rests upon some simple truths about the mind and brain. Specifically, it asks whether the dual aspect monism—that emerges from sleep research and theoretical neurobiology—can be applied to pathophysiology and psychopathology in psychiatry. Methods Our starting point is that the mind and brain are emergent aspects of the same (neuronal) dynamics; namely, the brain–mind. Our endpoint is that synaptic dysconnection syndromes inherit the same dual aspect; namely, aberrant inference or belief updating on the one hand, and a failure of neuromodulatory synaptic gain control on the other. We start with some basic considerations from sleep research that integrate the phenomenology of dreaming with the neurophysiology of sleep. Results We then leverage this treatment by treating the brain as an organ of inference. Our particular focus is on the role of precision (i.e., the representation of uncertainty) in belief updating and the accompanying synaptic mechanisms. Conclusions Finally, we suggest a dual aspect approach—based upon belief updating (i.e., mind processes) and its neurophysiological implementation (i.e., brain processes)—has a wide explanatory compass for psychiatry and various movement disorders. This approach identifies the kind of pathophysiology that underwrites psychopathology—and points to certain psychotherapeutic and psychopharmacological targets, which may stand in mechanistic relation to each other.

Non-Constructive Ruminations, Insomnia and Nightmares: Trio of Vulnerabilities to Suicide Risk

“… 23 This alteration would allow non-constructive ruminations to erupt into consciousness, thus generating an increase in anxiety and a deterioration in sleep quality. 23 , 33 , 34 This vicious circle would then become a ground of vulnerability to suicidal risk in populations. In parallel, the frequency of nightmares and the distress linked to them would play a reinforcing role in the vicious circle, significantly increasing the risk of suicide.…”

Neural Mechanisms and Psychology of Psychedelic Ego Dissolution

“…Hierarchical predictive coding is a mechanistic account of how the brain processes information (Friston, 2008). It is supported by empirical evidence (Mumford, 1992;Rao and Ballard, 1999) and informed by our understanding of synaptic communication (Adams et al, 2013;Friston, 2020;Hobson et al, 2021). Noting the neuromodulatory role of serotonergic neurotransmission (Picard and Friston, 2014) and the influence of psychedelics upon these receptors, it provides a unifying account of psychedelic subjective and therapeutic effects.…”

Neural Mechanisms and Psychology of Psychedelic Ego Dissolution

“…Hierarchical predictive coding is a mechanistic account of how the brain processes information (K. Friston, 2008). It is supported by empirical evidence (Mumford, 1992;Rao & Ballard, 1999) and informed by our understanding of synaptic communication (Adams, Stephan, Brown, Frith, & Friston, 2013;Karl J. Friston, 2020;Hobson, Gott, & Friston, 2021). Noting the neuromodulatory role of serotonergic neurotransmission (Picard & Friston, 2014) and the influence of psychedelics upon these receptors, it provides a unifying account of psychedelic subjective and therapeutic effects.…”