Contents Part I What Is Mental Illness? An Epigenetic Model 1 Genes and Mental Illness... 3 1.1 The Evolution of the Concept of Mental Illness... 3 1.2 Gene-Environment Interaction and Brain Morphology and Function... 4 1.3 Gene Environment Interaction: Serotonin Transporter GeneasanExemplar... 5 1.4 Emerging Model of Mental Illness: Gene Meme Interaction 7 References... 8 2 How Does Stress Work? The Role of Memes in Epigenesis... 11 2.1 Stress,Aging,andDisease... 11 2.2 Stress,Memes,andtheBrain... 12 2.3 Role of Stress and Nurturing in Development: Epigenesis... 15 2.4 Environment Changes Epigenome..... 16 2.5 Memes and Epigenesis...... 20 2.6 Stress Awakens Dormant Memes Resulting in Mental Illness. 21 References... 22 3 Culture and Mental Illness... 25 3.1 CultureandPresentingSymptoms... 25 3.2 Culture-Specific Psychiatric Syndromes... 26 3.3 EnculturationandMemes... 26 3.4 MemesforBeingIll... 26 References... 27 4 Genetic Memetic Model of Mental Illness Migration and Natural Disasters as Illustrations... 29 4.1 Migration... 29 4.2 NaturalDisasters... 32 References... 33 xi
xii Contents Part II Evolution and Mental Health: Genes, Memes, Culture, and the Individual 5 What Do We Inherit from Our Parents and Ancestors?... 37 5.1 LikeParent,LikeChild... 37 5.2 HowDoesCultureAffectBehavior?... 38 5.3 Memes and Cultural Change... 38 5.4 Memeplexes... 39 References... 39 6 Genes... 41 6.1 Human Genes...... 41 6.2 Mendelian Genetics... 42 6.3 Genes and Mutation... 42 6.4 Sex-Linked Genes.... 46 6.5 Polygenic Inheritance... 47 6.6 How Do Genes Work?...... 48 References... 49 7 Evolution... 51 7.1 In the Beginning...... 51 7.2 In a Changing, Hostile World... 54 7.3 TheSelfishGene... 54 7.4 Wonderful Random Errors.... 56 7.5 Wonderful Invention of Sex.... 56 7.6 DarwinandNaturalSelection... 58 7.7 SomaticEvolution... 62 7.8 UniversalDarwinism... 64 References... 81 8 Learning, Imitation, and Memes... 83 8.1 EvolutionofComplexOrganisms... 83 8.2 TrialandError... 84 8.3 LearnorPerish... 84 8.4 Imitation, Shortcut to Learning... 85 8.5 CoevolutionoftheBrainandMemes... 86 8.6 EmpathyandMirrorNeuronSystem... 88 8.7 Meme Generation and Meme Infection... 89 8.8 WhatIsaMeme?... 91 References... 93 9 Storage and Evolution of Memes in the Brain... 95 9.1 StorageofMemesasMemory... 95 9.1.1 ImplicitMemory... 96 9.1.2 ExplicitMemory... 99 9.1.3 Learned Fear...... 100 9.1.4 LearningSafety... 101
Contents xiii 9.1.5 WorkingMemory... 102 9.2 EvolutionofMemesintheBrainandtheBrainCode... 103 References... 107 10 External Storage of Memes: Culture, Media, Cyberspace... 109 10.1 NicheCulture... 110 10.2 HowMemesJumpBrains... 111 10.3 CommunicationandMemes... 113 10.4 Memes as a Paradigm Shift in Evolution andextraterrestrialdiffusionofmemes... 114 10.5 Cyberspace and Extracerebral Memes... 116 10.6 ImplicationofLiberationofMemesfromBrains... 116 References... 117 11 Culture and the Individual... 119 11.1 Culture as Memetic Niches.... 119 11.2 Individual Brain in a Petri Dish of Culture...... 120 11.3 Memes, Culture, and Anthropology..... 121 11.4 Dominant and Nondominant Memes in Cultures, Zeitgeist,DeviousMemes... 122 11.5 PathologicMemes... 124 11.5.1 Memes That Inhibit or Attenuate the Brain s Executive (Ego) Function: Tradition and Prejudice. 124 11.5.2 Memes That Are Devious, Entering Under False Pretenses, Then Causing Disease or Destruction 124 11.5.3 Memes that Replicate Virulently, Often Bypassing the Executive Function...... 125 11.5.4 Memes that Are Virulent Because They Arouse Passion, Bypassing Executive Function... 125 11.5.5 Memes that Cause an Indolent Infection, to Become Virulent Later..... 125 11.6 Protective Memes and the Placebo Effect... 126 11.7 How Memes Come in Under the Radar... 128 11.8 SpreadofMemes... 129 11.9 Internal Processing of Memes and Consciousness: ThinkingasMemeManipulation... 130 11.10 FreeWill... 132 11.11 The Unconscious, Collective Unconscious, Freudian Unconscious... 133 11.12 Selfplex and the Shadow: We Are All Multiple Personalities. 134 11.13 Transcendence...... 135 11.14 The Individual as a Pawn in the War of Memes... 137 References... 137
xiv Contents 12 What Is Mental Health?... 141 12.1 Normality and Health... 141 12.2 Gene MemeInteractionandMentalHealth... 143 12.3 Neurobiology of Pleasure, Punishment, and Inhibition.... 144 12.4 MentalHealth:ADemocracyofMemes... 147 References... 152 13 What Is Mental Illness?... 155 13.1 Unhappiness... 155 13.2 MemesandMentalIllness... 157 13.3 CultureandMentalIllness... 158 13.4 Mental Illness and Psychiatric Syndromes...... 159 References... 160 Part III Principles of Diagnosis and Treatment of Mental Illness 14 Psychiatric Diagnosis: Toward a Memetic Epigenetic Multiaxial Model... 165 14.1 Psychiatric Diagnosis and Problems with DSM... 165 14.2 What Is Diagnosis?... 168 14.3 Psychiatric Diagnosis: Dysregulation and Final Common Pathway Syndromes, Resurrection of Neurosis... 169 14.4 Proposal for a New DSM Scheme..... 170 14.4.1 Axis I: Memetic/Phenomenological (Neurophysiomemetic) Diagnosis: Psychiatric Syndromes, Symptoms, and Traits, Based on Deviations of Normal Brain Function..... 171 14.4.2 Axis II: Geno-Neuroscience Diagnosis: Genes (Including Family History of Psychiatric Illness), Brain Morphology, Biochemistry and Pathology, Functional Changes and Conditions Potentially Influencing Axis I... 172 14.4.3 AxisIII:MedicalDiseasesandConditions... 173 14.4.4 Axis IV: Stresses: Childhood, Recent, and Current. 173 14.4.5 Axis V: Psychosocial Assets and Recent/Current Functioning... 173 14.4.6 Axis VI: Biopsychosocial and Epigenetic Formulation 174 14.5 AnIllustrativeCase... 174 References... 179 15 Memetic Diagnosis, Memetic Assessment and Biopsychosocial Epigenetic Formulation... 181 15.1 Memetic Diagnosis... 181 15.2 MemeticAssessment... 182
Contents xv 15.3 ConsciousMemes... 182 15.4 Unconscious Memes... 183 15.5 Priming Factors and Role Models...... 183 15.6 The Need for New Memetic Diagnostic Tools.... 184 References... 184 16 Principles of Memetic Therapy... 187 16.1 Blocking the Entrance and Induction of Pathogenic Memes.. 187 16.2 TreatingMemesintheBrain... 188 16.2.1 Identifying Pathogenic Memes and Memeplex Components..... 188 16.2.2 IdentifyingCapsulesandVehicles... 189 16.2.3 NeutralizingCapsulesandVehicles... 190 16.2.4 Deconstructing and Suppressing Memes...... 191 16.2.5 AugmentingProtectiveMemes... 191 16.3 Conventional Meme Directed Therapies... 192 16.4 NeedforNovelTherapies... 192 References... 193 17 Broad-Spectrum Memetic Therapies... 195 17.1 What is Broad-Spectrum Meme-Oriented Therapy?..... 195 17.2 Sleep, Sedation, and Electroconvulsive Therapy... 196 17.3 RelaxationandMeditation... 197 17.4 Hypnosis... 197 17.5 Music and Dance Therapy.... 198 17.6 MassageTherapy... 199 17.7 Exercise... 200 17.8 Bibliotherapy... 200 References... 200 18 Specific Memetic Therapies... 203 18.1 Psychotherapies as Memetic Therapies... 203 18.2 Behavior Therapy, Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Rational Emotive Behavioral Therapy (REBT), Interpersonal Therapy (IPT)... 204 18.3 Psychodynamic Psychotherapy... 206 18.4 Toward a United, Integrated Memetic Concept of Psychotherapy.... 207 18.5 Need for New Meme-Literate Psychotherapies.... 209 References... 210 19 Genetic Memetic Prevention... 213 19.1 Epigenesis in Prevention..... 213 19.2 Early Diagnosis and Treatment of Vulnerable Children... 214 19.3 Early Protection from Pathogenic Memes...... 215 19.4 Vaccination... 216
xvi Contents 19.5 Education... 217 19.6 Gene Meme Cooperation vs. Gene Meme Conflict: Mind and Body... 217 References... 218 Part IV Specific Psychiatric Syndromes 20 Overview of Specific Syndromes... 223 20.1 Introduction... 223 20.2 Gene Meme Symbiosis and Mental Illness...... 224 20.3 Toward a Dimensional Approach in Identifying andtreatingmentalillness... 225 21 Attention-Cognition Spectrum Syndromes: Delirium, Dementia, Impulse Control Syndromes, ADHD, Antisocial Personality, Obsessive-Compulsive Personality Traits, Obsessive-Compulsive Syndrome... 229 21.1 Gene Meme Interaction, Evolutionary Adaptation, and Syndromes..... 229 21.1.1 Global Dysregulation of Meme Processing: DeliriumandDementia... 230 21.1.2 Dysregulation of Infrastructure for Meme Processing: Attention-Deficit Disorder (ADHD), Impulse and Aggression Dyscontrol, Antisocial Personality..... 231 21.1.3 Dysregulation of Meme-Processing Loop: Preoccupations, Obsessions, Compulsions..... 232 21.2 Treatment... 235 References... 236 22 Anxiety-Mood Spectrum Syndromes: Anxiety, Panic, Phobias, ASD, PTSD, Borderline Syndrome, Dependent and Avoidant Personalities, Social Phobia, Bipolarity and Mania, Depression Neurotic and Syndromic, Adjustment Disorders... 237 22.1 Gene Meme Interaction, Evolutionary Adaptation, and Syndromes..... 237 22.1.1 Anxiety... 238 22.1.2 Panic Syndrome and Agoraphobia..... 239 22.1.3 Specific Phobias.... 239 22.1.4 Acute Stress and Posttraumatic Stress Syndromes.. 240 22.1.5 Borderline Syndrome and Traits...... 240 22.1.6 Dependent Personality Traits and Syndrome.... 241 22.1.7 Avoidant Personality Traits and Syndrome, Social Phobia...... 241
Contents xvii 22.1.8 BipolarityandMania... 242 22.1.9 Depression Neurotic and Major Depressive Syndrome... 242 22.1.10 AdjustmentDisorders... 244 22.2 Treatment... 244 22.2.1 Prevention... 244 22.2.2 Mild Symptoms (Problems of Living andadjustmentreactions)... 245 22.2.3 Neurosis... 245 22.2.4 Major Syndromes.... 245 References... 247 23 Reality Perception Spectrum Syndromes (Imagination, Dissociation, Conversion, Somatoform, Misattribution Somatization, Psychosis)... 249 23.1 Gene Meme Interaction and Evolutionary Adaptation... 249 23.1.1 ImaginationandDreaming... 250 23.1.2 Dissociation... 250 23.1.3 Dissociative Identity Disorder (DID, Multiple Personality)... 251 23.1.4 Misattribution Syndromes: Conversion, Somatization, Hypochondriasis, Chronic Pain(SomatoformDisorders)... 252 23.1.5 Psychosis... 253 23.1.6 Schizophrenia...... 253 23.2 Treatment... 256 23.2.1 Mild Dissociative Symptoms, Dissociation in Borderline Syndrome, PTSD...... 256 23.2.2 Dissociative Identity Disorder (DID, Multiple Personality Syndrome)...... 256 23.2.3 Misattribution Syndromes: Conversion, Somatization, Hypochondriasis, Chronic Pain,Fibromyalgia,etc.... 257 23.2.4 Psychosis and Schizophrenia... 257 References... 258 24 Pleasure Spectrum Syndromes (Substance Use/Abuse, Addictions to Substances and Beliefs, Fanaticism)... 261 24.1 Gene Meme Interaction, Evolutionary Adaptation, and Syndromes..... 261 24.1.1 Substance Use/Abuse... 263 24.1.2 Addictions to Substances and Beliefs, Fanaticism.. 264 24.2 Treatment... 264 References... 265
xviii Contents 25 Primary Memetic Syndromes: Eating Disorders, Factitious Disorders, Malingering, Meme-Directed Destructive Behaviors.. 267 25.1 Gene Meme Interaction, Evolutionary Adaptation, and Syndromes..... 267 25.1.1 EatingDisorders... 268 25.1.2 Destructive Meme Infections and Epidemics: Mass Hysteria, Factitious Illness, Suicide, SuicideBombing,Aggression... 269 25.1.3 Irrational Beliefs and Delusions...... 270 25.2 Treatment... 270 References... 272 26 Challenges for the Future... 275 26.1 Genes and Memes How to Achieve a Peaceful Coexistence. 275 26.2 Need for New Diagnostic and Therapeutic Approaches andtools... 276 26.3 Testable Hypotheses of Gene Meme Environment Interaction... 276 26.4 Memes, Social Sciences, and Neuroscience..... 277 26.5 EthicalConsiderations... 278 26.6 Post-humanEvolutionofMemes... 278 Index... 281
http://www.springer.com/978-1-4419-5670-5