What Wouldn’t Have Been

The following comments were made to the advisory council of the National Institute of Mental Health during the council’s deliberations on the future of basic behavioral science at the Institute.

In 2004, three psychologists were elected to the prestigious National Academy of Sciences: Elizabeth Loftus, Elissa Newport, and Walter Mischel. All had significant NIMH funding at critical points in their careers, and studies by Newport and Mischel are currently funded by NIMH.

I contacted all three and asked them about their NIMH support. Their uniform response was that they simply could not have made the advances they did without NIMH, and there probably was not another federal agency that would have supported them in the same way.

I mention these scientists today to make two points:

First, the research areas of all three are transparently linked to the NIMH mission.

Loftus’s research reveals the malleability of human memories. The research is, at one level, about how normal learning and memory need to be understood before we can tease out the abnormal cognitive functioning that accompanies serious mental illness. But at another level, her research has caused a sea-change in the public’s attitudes toward false memories and toward non-science-based therapists who have exploited “memory recovery techniques” to torment those who may have been abused as children, as well as those who have been falsely accused of child abuse.

Newport’s basic linguistic science is aimed at understanding language and the cognition that surrounds it, and finding the special neural machinery that lies beneath it. Her research is essential to understanding important parts of illnesses such as schizophrenia, autism, aphasia, and others. These diseases do such damage and have such implications for the remarkable human ability to acquire and maintain complex communication systems that we cannot hope to treat them completely without understanding Newport’s linguistic findings.

And Mischel’s lifetime of work on the characteristics of personality and emotion that change behavior in certain situations are a part of understanding and treating a host of mental disorders. I recall sitting with former NIMH Director Steve Hyman when Walter presented his work at a featured NIH colloquium a few years ago. It was a typical Mischel presentation, at which what was so apparent was the elegance of a rigorous program of research aimed at understanding difficult questions of personality-situation interactions. Steve turned to me at the end and said, “Now that is exactly the kind of research NIMH should be funding.”

So, along with APS, NIMH should be proud of these three grantees and their accomplishments in support of the NIMH mission.

But my second point is more troubling. These same three areas of research – basic learning and memory, basic linguistics, and basic personality – are criticized both outside the Institute and, sometimes, inside the Institute as being less relevant to NIMH, notwithstanding the links I just described. These areas are cited by critics among examples of NIMH investing too much in basic science and not enough in clinical application.

Frankly, I wholeheartedly endorse the notion that NIMH ought to be pushing its basic researchers more toward studying mental disorders, and it is wonderful to see that emphasis in the Workgroup report as well. This is exactly why APS pushed so hard for the NIMH report on “Translating Basic Behavioral Science into Action” and the Institute of Medicine report on “Building Bridges in the Brain, Behavioral, and Clinical Sciences” – an IOM report that Tom Insel was part of before he became NIMH Director.

But that is not what these critics of basic science mean. These criticisms are aimed at abandoning areas of basic research in a misguided (if sometimes well-intentioned) attempt to focus more on applications, as if you can simply will that to happen by placing the name of a disorder in the title of a grant application, rather than working with basic science investigators, their colleagues, and their students to speed the links more directly to disorders.

I hope this becomes the time for NIMH to assert its leadership in response to those criticisms and to reaffirm its commitment to the basic science of mental illness. That means taking advantage of the considerable basic science expertise already in the Institute and, in the case of behavior, filling vacant positions with those who appreciate basic behavioral science as well as the links between the science and mental disorders. And, if NIMH feels it is shouldering too much of the basic science burden in this flat budget environment, it means making sure other NIH institutes share the load.

But I do think the Institute needs to assert itself in some specific and positive way so that it becomes clear just where at a reorganized NIMH and where else at NIH this important research belongs. The excellence of the research, the promise of the research for understanding our disorders, and the rich history of NIMH demand it.