This chapter invites readers to consider how an engagement with hip-hop music and culture can contribute to a better understanding of mental health, psychiatry, psychology, public health, and neuroscience. It provides an introduction to hip-hop therapy, highlighting the use of rap by psychologists and counsellors to promote mental well-being. The chapter goes on to examine the work that the Hip-Hop Psych initiative has undertaken in advancing the role of hip-hop in primary care. With hip-hop’s pre-eminence as a global musical force, greater attention to how mental health is represented in hip-hop can provide healthcare professionals with tools to aid discussions with patients about potential trends related to hip-hop icons, such as contagion effects of suicide, self-harm, and self-medication. Hip-hop offers a platform for artists and those who embrace the culture to address their emotional experiences through rap. By exploring lyrical content, the chapter uncovers how performers express their mental health challenges and fashion resilience within challenging circumstances. It argues that attention to this material could also help identify language disturbances associated with mental health conditions, and indicates the potential gains from the use of technology and neuroscientific research to support hip-hop music interventions.

A growing literature examines the relationship between compassion and various aspects of nervous system function, especially the brain. The chapter starts by outlining neuroimaging studies of compassion and then examines the topic of empathy and the brain, noting evidence that observing another person’s emotional state activates parts of the neuronal network that are also involved in processing that same state in oneself. Research suggests that multiple areas within the brain are involved in compassion and compassion training, with some regions more strongly implicated than others. Finally, relevant conclusions are presented and potential directions for future work outlined. Overall, research into the neuroscience of compassion supports the idea that compassion can be cultivated deliberately through training. There is evidence that activities such as compassion training and meditation can increase positive affect, boost resilience, facilitate altruistic behaviour, and possibly even assist with equanimity. These ideas are underpinned by growing neuroscientific evidence of impact on the brain. These valuable findings underscore the importance of developing compassion as a skill and fundamental attribute for healthcare workers across all settings.

The different needs, concerns, and preferences of the professions constituting the multidisciplinary team (MDT), including medicine, psychology, nursing, and social work, reflect the hybrid nature of psychiatry and the knowledge and skills required for clinical practice.

Neuroscience has evolved at impressive speed over recent decades. Many of its findings have relevance to psychiatry but are rarely directly translatable into clinical practice. Improving understanding of the psychological dimension of mental illness has led to new treatments with similar efficacy to medications. Our current approach to treating mental illness has also benefited greatly from insights from sociology and anthropology. The value conflicts relating to liberty and personal autonomy versus the medical value of restoring health and societal values around managing risk have led to the development of legal frameworks to aid clinical decision-making. These are, however, far from perfect, and values-based practice (VBP) principles could meaningfully contribute to improving them.

Although traditionally medicine sat at the top of the hierarchy in the MDT, this hierarchy has become more horizontal in recent decades. Close working together with social care is key, but there are pros and cons for both integrated and separate services. Values-based practice can ease some of the tensions in MDT working.

Even though values are crucial to our understanding of psychiatry, prevailing models of mental illness fail to properly integrate them. Neuroscience has produced a large amount of knowledge, but it needs to be augmented to fully integrate other relevant dimensions, such as the experiential, the social, and the existential. Engel’s biopsychosocial model, Leigh’s genetic-memetic model, the enactive model (e.g., in Haan), and the hybrid model by Berrios and Markova all foreshadow a new epistemology that, when worked out fully, will be able to achieve that and provide robust theoretical foundations for psychiatry.

A key problem in psychiatry is resolving disputes about mental capacity that often relate to the patient’s values being at odds with those of others. A new, VBP-informed stakeholders’ tribunal, including a philosopher, a VBP-trained clinician, and optional members with expertise relevant to the case, could provide a good process for working with these values.

Choosing our instrumental values appropriately at the person and societal levels is key to the prevention and treatment of mental illness. However, psychiatry needs to make it clear that it is only one of the players, and if these values are to be fully realized, public health, government, and the public need to work collaboratively.

Working conditions in psychiatry have worsened in many healthcare systems, allowing less time for person-centred care. There is a conflict between management and clinical values. Though IT carries great potential, many current systems fail to free up time for human-to-human contact. All these factors affect retention.

The ever-increasing expectation towards psychiatry to prevent suicides has taken to mean complete elimination in some places. This is problematic as suicide is not completely preventable; it is not a form of harm equivalent to other patient safety errors; and there is a plurality of relevant values. The impact on ‘second victims’ is also an important issue.

Owing to its relatively undeveloped conceptual foundations, psychiatry has often struggled to defend itself against various criticisms. A VBP-based analysis of the terminal and instrumental values of anti-psychiatry can highlight some of the weaknesses of its arguments. Critical psychiatry draws attention to problematic areas of psychiatric theory and practice to provide constructive criticism. Remarkably, much of that has now been adopted by mainstream psychiatry. A self-reflective stance and constructive criticism play an important role in keeping our profession on a sound ethical footing. A genuine dialogue about values among all stakeholders is needed for constant calibration.

Abstract: Anne and Jack researched the effects of dopamine on striatal cells. They worked with graduate student Helen Pan, fellow Roger Albin and colleague Anton Reiner. Anne and Jack were invited to present their theory at a symposium on basal ganglia research in Manchester, UK. In August 1987, the Michigan Chapter of the Committee to Combat Huntington’s Disease hosted the national organization’s annual meeting in Ann Arbor, where Jack and Anne gave talks to the attendees. Nancy stayed at Anne and Jack’s and spent time with Jessie and Ellen. They witnessed an explosion in the sky, which turned out to be a terrible plane crash. When Anne was in London for an Alzheimer’s symposium, Jack had a life-threatening internal bleed from taking 12 aspirin a day. Jack was very stoic and didn’t like to complain about his health. Anne and Jack’s lab became the most popular among MD/PhD students interested in neuroscience. The longer Jack and Anne lived together, the more they became one person. Anne, Roger Albin and Jack put together a manuscript titled, “The Functional Anatomy of Basal Ganglia Disorders” as a speculative review for the journal Trends in Neuroscience, which was published in 1989. The model has stood the test of time and is cited often 35 years after it was published.

Anne Young, a neurologist at Harvard and Mass General, experiences a traumatic life change when her husband, a neurologist and collaborator in her field, returns from a week of neuroscience meetings in Aspen, Colorado, complaining of pain in his throat and dies suddenly in his sleep from a heart attack. Anne tries to be strong for her daughters, Jessie and Ellen. She gains comfort from friends in her field and family, who give her the strength to cope. Most of all, Anne is comforted by Nancy Wexler, a dear friend who is like a second mother to her daughters. Having Nancy by her side lightens the burden and impossibility of caring for herself and her daughters while experiencing an unbearable loss. Nancy accompanies Anne to the Ether Dome for Neurology Grand Rounds for a presentation on organ donation. It is an opportunity for Anne to thank her colleagues and friends during this terrible time and tell them how she donated as many of Jack’s organs as she could for research. The courageous steps she takes to express herself are cathartic, yet, in times of desperation and loneliness, she doesn’t know how her future will unfold.

This chapter explores the complex nature of depression, a mood disorder affecting millions worldwide. It discusses the various symptoms, causes, and types of depression, highlighting the interplay between biological, psychological, and social factors. The chapter emphasizes the importance of early recognition and treatment, as well as the potential for music therapy to offer significant benefits. It looks at how music can evoke emotions, regulate moods, and foster social connection, serving as a valuable tool for managing depression. The chapter also explores specific music therapy techniques, such as improvisation and targeted playlists, that can aid in emotional expression, self-regulation, and the cultivation of resilience. The chapter concludes by underlining the importance of a holistic approach to depression treatment, combining music therapy with conventional therapies and lifestyle changes for optimal results.

This chapter introduces the transformative power of music through the inspiring story of Michael, a young man with epilepsy and mutism who experienced remarkable progress through music therapy. It highlights the growing body of research on music’s therapeutic effects, while acknowledging the challenges of studying music’s impact in a rigorous scientific manner. The author emphasizes the importance of integrating music therapy into healthcare, advocating for policy changes to increase access for those in need. This chapter sets the stage for exploring the multifaceted ways music can enhance our health and well-being, drawing on insights from neuroscience, psychology, medicine, and musicology. It invites readers on a journey to discover the extraordinary potential of music to heal, inspire, and transform lives.

This chapter introduces the methods used in cognitive neuroscience to study language processing in the human brain. It begins by explaining the basics of neural signaling (such as the action potential) and then delves into various brain imaging techniques. Structural imaging methods like MRI and diffusion tensor imaging are covered, which reveal the brain’s anatomy. The chapter then explores functional imaging approaches that measure brain activity, including EEG, MEG, and fMRI. Each method’s spatial and temporal resolution are discussed. The text also touches on non-invasive brain stimulation techniques like TMS and tES. Throughout, the chapter emphasizes the importance of converging evidence from multiple methods to draw robust conclusions about brain function. Methodological considerations such as the need for proper statistical comparisons are highlighted. The chapter concludes with a discussion of how neurodegenerative diseases have informed our understanding of language in the brain. Overall, this comprehensive overview equips readers with the foundational knowledge needed to critically evaluate neuroscience research on language processing.

This chapter provides a comprehensive overview of the structural foundations of language in the human brain, tracing the development of localization theories from phrenology to modern neuroimaging. It introduces key anatomical terminology and landmarks, including major brain regions, gyri, and sulci. The chapter explores the evolution of language localization theories, highlighting influential figures like Broca and Wernicke, and the shift from single-region to network-based models of language processing. It discusses various approaches to brain mapping, including macroanatomical, microanatomical (cytoarchitectonic), and functional definitions. The chapter also covers important anatomical pathways, particularly the dorsal and ventral streams for speech processing, while noting that these simplified models may not fully capture the complexity of language networks. The chapter concludes by acknowledging the challenges in precisely labeling brain regions and the complementary nature of different naming conventions, setting the stage for deeper exploration of language neuroscience in subsequent chapters.

This chapter highlights several aspects of human communication that rely on brain regions outside the traditional fronto-temporal language network. Factors affecting the neural resources needed for communication include the task demands (including acoustic or linguistic aspects), and abilities of individual listeners. When speech is acoustically challenging, as may happen due to background noise or hearing loss, listeners must engage cognitive resources compared to those needed for understanding clear speech. The additional cognitive demands of acoustic challenge are seen most obviously through activity in prefrontal cortex. During conversations, talkers need to plan the content of what they are saying, as well as when to say it – processes that engage the left middle frontal gyrus. And the cerebellum, frequently overlooked in traditional neurobiological models of language, exhibits responses to processing both words and sentences. The chapter ends by concluding that many aspects of human communication rely on parts of the brain outside traditional “language regions,” and that the processes engaged depend a great deal on the specific task required and who is completing it.

This chapter utilizes an existential perspective to educate readers on the importance of responsible decision-making and creating meaning in life. The author explores how social and emotional intelligences help foster wellbeing and create meaning in life. However, decisions can be affected by negative emotions and desire for risk-taking. This chapter discusses the negative psychological effects of the COVID-19 pandemic and how it caused existential crisis for many around the world, influencing emotional responses and thus decision-making habits. Recovery and wellbeing can be found again in the ability to create meaning from the years of death and psychological destruction.

This chapter comes in two related but distinct parts. The first presents general trends in the neurosciences and considers how these impact upon psychiatry as a clinical science. The second picks up a recent and important development in neuroscience which seeks to explain mental functions such as perception and has been profitably extended into explanations of psychopathology. The second part can be viewed as a working example of the first’s overarching themes.

The focus of this chapter is how the material body is represented in the brain. The aim is to demonstrate the neural mechanisms underpinning body representation in order to show how the sense of self is experienced as embodied. Furthermore, given the underlying mechanisms underpinning the integration of self and body, how to understand the possibility of a separation of self and body as seen in autoscopy. I rely on the experiments of Olaf Blanke and his group in this regard.