“We treatment [clinical] researchers now stand like Lucille Ball in front of a speeding conveyor belt of findings [from neuroscience] that we cannot put into practice.” – Dr. David Epstein
Dr. Epstein is a PI, experimental psychologist, and chief of the “RAPT” unit. The RAPT unit stands for “Real-world Assessment, Prediction, and Treatment” and its main goal is to apply scientific knowledge to real-world prevention and treatment.
Interview with Dr. David Epstein
1. Why did you decide to pursue a PhD?
“I have a really weird origin story. I started out as an English major and never expected to go into the sciences at all. I was in my senior year of college, not knowing exactly what I would do with my English major, when I read a book by Oliver Sacks. The book was called, The Man Who Mistook His Wife for a Hat, and I was fascinated – and a little bit terrified – by it. I had never fully stopped to think about how the mind is embodied in the brain – and what happens when the brain stops working. I found that haunting, and I thought I could not be scared and bored at the same time. I thought, if there is a way to do this [neuroscience] with my life, I want to do it. It was 1987, neuroscience was just blooming. I decided to take a year of psychology and biology courses, applied to five graduate programs, four of which rejected me, but one of which, Rutgers, accepted me with an “Excellence Fellowship” that paid my way through the first few years. I had very little idea what I was doing when I applied. It was not a very organized effort on my part; it was something that I fell into.”
2. Why did you move from neuroscience to clinical psychology?
“I did my thesis working in a rat lab at the Center for Alcohol Studies. I knew I did not want to work with rats forever, so I switched advisors and I started doing clinical neuropsychological assessments – and loved it. When I came to NIDA after graduate school, I thought I wanted to go into neuroimaging research, but the more I came to appreciate addiction research, the more I thought that it required answers that neuroscience alone couldn’t give me. The same inherent fascination I’d found in neuroimaging, I also started to find in social and psychological issues that help determine who gets addicted and who doesn’t. That was when I knew I wanted to carve my niche by trying to put those things together, or at least use each of them as best I could.”
3. What are the pros and cons of neuroscience research vs clinical psychology research?
“I definitely still have bench envy. There is a lot that you can do as a bench scientist that you cannot do in clinical. For example, neuroscientists have complete control over their materials. In neuroscience, you can actually ask causal questions and really powerfully address them. I would love to be able to do that, but you can’t do that in clinical. With neuroscience, you can get an experiment done in a matter of a few weeks, but for us, it is always years. If your results are inconclusive in neuroscience, you can run a quick control study, and we can’t. There are a million reasons I’m envious of what can be done as a bench scientist, but ultimately, I’m glad that I chose something where I can ask really big questions. One of the biggest pros of human research is being able to ask the questions, “Why do you think you did what you did?” or “Why are you planning to do what you’re planning to do?” These are things you can’t ask rodents.”
4. In the last 30 years, addiction neuroscience using rodents has not been able to be successfully applied translationally, what are your thoughts on this?
“I am cautiously optimistic that if we make our animal models better, we can do things in the lab that will start to have more predictive and translational value. We neuroscientists have an obligation to at least try, even if it never works.”
5. What do you think is the single best advice you could give to postbacs about a career in neuroscience/clinical psychology?
“If you have it in you – be creative. What I really value in a postbac is the ability to read widely, infer what is known and what is controversial in a given subfield, and to link a gap in the literature with data that are available from our section. It’s the combination of creativity, critical thinking, and engagement or passion. If you can do that, rather than taking a “cookbook” approach to try to find what is statistically significant, it shows engagement. The more that postbacs bring to the table in regards to what they care about and what they can do, the more I’m willing to help them get it done.”
6. What are you really proud of, but never have an excuse to talk about?
“I am equally proud and grateful that I’ve been able to be myself here at the IRP. To be as weird as I am, to be as opinionated as I am. I’m glad that has seemed to work out in my favor so far.”
7. As a PI, what is the best part of your daily routine?
“My favorite part of any given day is solving a problem – whether it’s big or small. It can happen in meetings with the rest of the section, it can happen in a one-on-one conversation, or it can happen when I’m alone writing a protocol or a manuscript. Managing to have an insight is the best part of the day. Reading information and being able to synthesize it differently than someone else has – that makes it a great day.”
8. Is there an experiment that you’ve dreamed of doing for a long time? If so, why haven’t you done it?
“My first thought is the NIH ABCD study. I’ve been saying for as long as I’ve been working at NIDA that someone should do a study in which kids are enrolled, before they start using drugs, to be followed longitudinally, scanned, tested. and interviewed, so that we can begin to get what would amount to an enormous data set on brain development and behavioral development, what things happen in what order, and what are common risk and resilience factors. This would have to be done on an enormous epidemiological scale with thousands of people. I was sure it would never happen. And now NIH is doing it. I don’t mind that I didn’t have anything to do with it. I’m just delighted that it’s happening. That was always my dream study. Related to this, our lab is working on GMA – “Geographical Momentary Assessment” – in which we assess people’s behavior through smartphones throughout the day. We add GPS tracking so we can get an indication of environmental exposures that that person experiences during the day. I wish we could do that ambulatory assessment on the scale of the ABCD study – and from what I’ve read, something like it really might be folded into the ABCD study.”
9. During your relapse assessment interviews, what have people most commonly reported to be their biggest relapse trigger?
“There are lots of them, but the one we heard repeatedly that hadn’t been specified in the literature from which we made our original checklists was this: Old friends or acquaintances would seem to come out of nowhere and suggest copping or using, and on the spur of the moment, it would happen. We specifically ask about that one now in our smartphone app.”
10. Was there ever a time you felt that you weren’t cut out for neuroscience research?
“I came into research thinking I was not cut out for it. I didn’t think I would go into research as my lifelong, primary career. I thought I would ultimately do some combination of teaching and neuropsychological evaluations. I guess I’ve learned over the years that the parts of research I’m good at, I must be sufficiently good at to have done as well I’ve a done. It was not my expectation to be where I am.”
11. As a person who has extensively studied the brain, what do you think is the nature of the brain?
“I suspect almost everyone in this building is what is called a “materialist”- in the philosophical sense. I’m not referring to the materialist who only cares about consumer goods; I mean the kind who doesn’t believe in an incorporeal soul. It’s the belief that the mind is what the brain does. That is why neuroscience is interesting, it wouldn’t be that interesting if that weren’t true. That’s what got me into neuroscience to begin with. And I still believe it as much as a I ever did. But I think I’ve become less and less optimistic that we will ever succeed in reductionism (explaining all mental processes in terms of physiological processes). I think that that explanation exists, but I don’t know if we will ever get there. Neuroscientists have gotten better at interrogating the brain in more sophisticated ways, but I’m not sure if we’re ever really going to explain the things I want to explain in purely physiological terms. I’m also less sure that some of the mental events that we need to deal with, like addiction, are always best dealt with at the physiological level. Even though I still believe that the mind is what the brain does, I also think we have to match the solution to the problem, and sometimes the neural level isn’t the best level to intervene on.”
Message to postbacs:
I proposed the idea that the newsletter should include interviews from scientists that were titans in the field of addiction to serve as an informative reference for all of the postbacs to benefit from. This can be a written record that exposes you to career and personal advice from successful PI’s.
-Holly Hake
If you would like to request for the newsletter to interview a specific PI, you can submit your requests to holly.hake@nih.gov
