Stimulating the self: The influence of conceptual frameworks on reactions to deep brain stimulation

Abstract

Deep brain stimulation (DBS) is generally considered to have great practical potential. Yet along with its remarkable efficacy, which is currently being tested in application to many pathologies, come a certain number of complications. In particular, there seem to be several adverse psychological implications behind a relevant number of postoperative situations. Whether these effects have to be attributed to a reactive response to a new situation or whether they are caused by the stimulation itself, or both, remains to be elucidated. This article takes up this issue, and evaluates how various views and conceptual schemes concerning the mind–brain relationship might play a role in the ensuing (mal)adaptation to DBS treatment. It is valuable to investigate the relationship between different conceptual assumptions and the onset of psychosocial maladaptations in clinical settings. In particular, we hypothesize that the frequently reported maladaptations might be partially caused by a concep-tual shift away from dualism and toward a “neurocentric” materialism, promoted by the scientific explanation of the pathological situation. This article examines which conceptual framework is likely to play a dominant role in the perception of the general public of how the mind relates to the brain, and how this contrasts with the opinions of experts in cognitive neuroscience. We investigate how these different conceptual frameworks might play a role in the occurrence of psychosocial maladaptations to DBS treatment in clinical settings. Finally, we suggest how a more inclusive, embodied embedded stance toward the mind–brain relationship might help to overcome such maladaptations.