Dr. Stephan Schleim talks about his new book and his experiences at the Honours College

Congratulations on the publication of your book. What are some of the key conclusions that you were able to draw from your research?

The book “Mental Health and Enhancement: Substance Use and Its Social Implications” combines three perspectives: First, the scholarly debate on “neuroenhancement” or “brain doping”, thus the idea that people – in particular students – take psychoactive substances to become smarter. Second, the phenomenon that psychiatric diagnoses are increasing steeply in many countries since the 1980s; and with it prescriptions of psychopharmacological drugs. Third, illicit drugs are consumed for various reasons, including coping and self-medication.

After investigating these trends independently for some 10-15 years, I came to realize that many of the aims and reasons as well as the pharmacology of the substances are similar. For example, some people receive amphetamine as treatment for an attention disorder, some to feel better when they are depressed, some take it to stay awake or focused longer, and some to “feel up” while working or partying. Add to this the historical processes in the 19th and 20th centuries which distinguished different kinds of “drugs”, then regulated differently by medical professionals and social authorities, and we can understand people’s substance use more consistently.

This is the essential conclusion of the book. On the way, I address some other current topics, like the hype around “brain doping” in the media, which recently actually even drew the attention of the Dutch Ministry of Health and the Parliament. Colleagues and I have been demonstrating consistently for years – which is now also confirmed by a recent representative study in the Netherlands and by the minister himself – that this is actually not that common. That is, most of the prescription stimulant use (like Ritalin) is for medical reasons. Whether these drugs are overprescribed to treat attention disorders is a complex issue. Some surveys found startlingly high rates, for example, among black children and adolescents in the United States, which suggests social factors and calls for follow-up research.

You’ve been teaching at the Honours College for quite a while now. Can you tell us a bit about the course(s) you teach?

My former supervisor, Trudy Dehue, and I have indeed been teaching this module “Sociology of Mental Health” since the very beginning of the Honours programme, which must have been around 2010. For many years, I also offered a summer school and subsequent project about “brain doping” and living in a performance society. But when I received a grant from the Dutch Research Council (NWO) to carry out the research which eventually also culminated in the new book, I had to give up some teaching tasks and could only offer the module.

There’s really a large overlap between that module and the book. Each of the main chapters is also the essence of one of the sessions with the students. Or you could formulate it just as well the other way around. And that’s what I find so great about being a theoretical psychologist, that I can investigate current cultural processes, put them into a social and historical perspective, teach and write about it, each of which deepens my understanding – and, I hope, also that of the students.

We can also address some specific examples in more detail in the module, like attention or depressive disorders. About one third of the course consists in group work for the students. For example, in one role play they must argue for or against the introduction of a certain psychological condition as a new mental disorder. And while they think that this case is made up, I have a huge surprise for them at the end of that session.

What kind of value do you see in the Honours interdisciplinary Broadening module? And did Honours students contribute to your thinking and research during these years?

The Honours College is a great place to be. I already studied very broadly: philosophy, psychology, and computer science, then pursued a PhD in cognitive neuroscience. I have been intensively collaborating with psychiatrists, psychopharmacologists, and legal scholars throughout the years. Now guess which disciplines my Honours students come from! All of these and many more.

For me, it never made much sense to investigate real life problems from within the limited perspective of a single discipline. And I could imagine that this makes my research and teaching a good match for the Honours College and the students in a broadening module as well. Explaining complex ideas to such diverse groups of students also improved my skills to communicate my research to the public at large. For the summer schools and their follow-up projects, the participants made impressive documentaries or magazines which illustrated living in a performance society from their present perspective.

A very concrete example for a student’s contribution just occurred recently: I wanted to calculate the number of symptom combinations fulfilling the diagnostic criteria of ADHD. But it’s been a while since I solved mathematical problems. It turned out that my thoughts were too complicated. An Honours Student in artificial intelligence showed me an easy calculation. The correct answer is: According to the DSM-5, there are 116,220 combinations of ADHD. I acknowledged that student in my paper about whether mental disorders are brain disorders.

Could you tell us about your experience with the Honours Summer school over the years?

First and foremost, the Honours students are extraordinarily motivated. I thus never have to worry about their active participation in the classes. This also helps the professor to stay mentally alert and not stray into endless monologues. It’s also the case that while, sadly, much of the university’s teaching has been suffering from budget cuts, there was more financial leeway and thus there were also more possibilities for special activities in Honours courses – at least thus far. I also vividly remember a workshop offered by the Honours College to show us professors interactive ways for teaching in small groups. My tasks elsewhere actually also benefited from that.

What are your plans for the future? What are you currently working on as a researcher?

My new book was really intended as academic work. Although drug policy is such a pressing social issue, I thus tried my best to remain politically neutral. But the situation of the opioid epidemic (recently also featured in several documentaries and now even a new Netflix series) in the United States is just so bad that simply presenting the figures in my concluding chapter – more than 500,000 Americans died from overdoses thus far and that number is still increasing every day – becomes a political statement. I now want to contact several stakeholders to see whether my academic perspective can improve their decision-making.

I’ve also just received a grant from the university’s open access fund. That means that my next academic book can be made available freely, too. The topic follows from my earlier research on neuroscience and the law. In different debates – including those on drug policy – people derive normative statements from what we know about brain development. For example, when the maximum age for the application of juvenile criminal law was increased to 22 years here in the Netherlands, arguments about the brain played an important role. One challenge is that lawmakers and judges like to make categorical distinctions – you’re either guilty or not – while natural development necessarily occurs in degrees. (And, of course, judges can and do consider individual factors in their assignment of responsibility and punishment.) Finally, I also want to edit some classics in theoretical psychology and also translate my new German book on science and free will into English.