On building a clinical cognitive neuroscience

No one can or has doubted that the brain "lights up" in the context of normal and abnormal experience and behavior. The anatomy of the brain ensures that its regions, circuits, distributed pathways, and cell assemblies have to provide the "electricity" for the lights. Some of the relevant structures light up preferentially for some neurocognitive functions (e.g., language, attention and working memory, spatial orientation). However, many domains of experience and behavior relevant to mental health problems (e.g., motivation, attachment residuals, emotional responses) appear to have a different neural representation than traditional neurocognitive functions. At any rate, the preceding describes the territory that Strumwasser emphasizes should be taken into consideration in context of mental health problems. The territory he wants to connect with involves disturbances of experience and behavior, social inefficiency, behavioral breakdowns, and disordered thought, all of which demarcate the clinical domain. Strumwasser believes that a relevant and clinically useful bridge can be devised to cross and link together these territories in an effective way. He proposes and urges that attention be given to developing a frame of reference by means of which a solid correspondence can be established between the two territories. He provides a stimulating and provocative image of a future clinical cognitive neuroscience. His vision, however, raises many questions. Furthermore, whether future developments in the neural sciences will or can accommodate Strumwasser's wishes remains to be seen.