Modern functional brain imaging techniques are available to psychiatrists and are promising modern-day 'telescopes' to explore in vivo brain activity. Modern psychiatric neuroimaging suggests that only phenomena that may be seen and mathematically computed throughout the scan are real. As imaging techniques have grown ever more sophisticated, they have become in some cases surrogates for nature, rather than representations of it. Such a neuro-realistic approach is, therefore, grounded in the belief that psychiatric imaging enables us to capture a visual proof of brain activity.
However, nearly 3 decades after Johnstone's first computerised axial tomography of the brain of schizophrenics, no consistent or reliable anatomical or functional alterations have been unequivocally associated with any mental disorder, and no clinical application is currently available for psychiatric neuroimaging. No available article has ever addressed in a comprehensive way the methodological and theoretical limits and the high cost-to-benefit ratio of imaging techniques in clinical psychiatry. The phenomena observed by the scan 'speak hypothetically' about the true nature of psychiatric psychopathology seen in clinical experience. This is forgotten as a result of the seductive nature of pictures.