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Minds are enabled but not reducible to brains
- D B Double (12 April 2006)
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D B Double, Consultant Psychiatrist Norfolk & Waveney Mental Health Partnership NHS Trust
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dbdouble{at}dbdouble.co.uk D B Double
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I agree wholeheartedly with Moncrieff (2006) about the problems created by regarding chemical imbalances in the brain as the cause of mental illness. However, I do not think that the only reason for the prominence of this theory is the politics of neoliberalism. People have always taken an anti-rational approach to dealing with illness. We all wish for a quick, cheap, painless and complete cure to our health problems. It is true that the pharmaceutical industry exploits this situation. It may best be seen as a marketing machine to sell drugs of dubious benefit (Angell, 2004). This development has encouraged psychiatry in its longstanding claim that "mental diseases are diseases of the brain" (Griesinger, 1965). Since the development of psychotropic medication, one of the current versions of this claim is that mental illness is due to chemical imbalances in the brain. This hypothesis is as much without proof and requires as much faith and self-deception as somatic theories from the past, for example, that underpinned the excesses of lobotomy and surgical detoxification of chronic infections (Scull, 2005). What present day psychiatry forgets is that mental illness is a functional disorder (Feuchtersleben, 1976). This view has been more acceptable in the past. The reasons for human actions may not be understood by postulating that they are caused by chemical imbalances. I agree with Joanna Moncrieff's position that psychiatry's encouragement of overly simplistic hypotheses about chemical imbalance does not sufficiently acknowledge that minds are enabled but not reducible to brains (Double, 2006). More specifically, the question needs to be asked, as she does, about whether people may gain more benefit in the long-term from working through their personal and social problems without psychotropic medication. It may not be surprising that the pharmaceutical industry avoids this issue, but psychiatry should face up to its responsibilities.
Angell, M. (2004) The Truth About the Drug Companies: How They Deceive Us and What to Do About it. New York: Random House Double, D.B. (2006) (ed) Critical Psychiatry: The Limits of Madness Basingstoke: Palgrave Macmillan Feuchtersleben, E. von (1976) The Principles of Medical Psychology. (Reprint edition) New York: Arno Press Griesinger, W. (1965) Mental Pathology and Therapeutics. (Reprint of 1867 edition, which was translated from second edition of Die Pathologie und Terapie der psychisechen). New York: Hafner Moncrieff, J. (2006) Psychiatric drug promotion and the politics of neoliberalism. British Journal of Psychiatry, 188, 301-302. [Full text] Scull, A. (2005) Madhouse. A Tragic Tale of Megalomania and Modern Medicine. London: Yale University Press |
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