The trouble with psychiatry

If you want an incisive critique of modern psychiatry, look no further than an excellent article in The New York Review of Books.

It brilliantly captures the fights over diagnosis and the DSM, the problem of drug companies buying influence by paying physicians, and why the promises of drug treatments are often propped up with marketing hype.

The article is well-informed, doesn’t mince words, and the author is no anti-psychiatry flak. She’s Marcia Angell, ex-editor of the New England Journal of Medicine, one of the world’s leading medical journals.

One of the leaders of modern psychiatry, Leon Eisenberg, a professor at Johns Hopkins and then Harvard Medical School, who was among the first to study the effects of stimulants on attention deficit disorder in children, wrote that American psychiatry in the late twentieth century moved from a state of “brainlessness” to one of “mindlessness.” By that he meant that before psychoactive drugs (drugs that affect the mental state) were introduced, the profession had little interest in neurotransmitters or any other aspect of the physical brain. Instead, it subscribed to the Freudian view that mental illness had its roots in unconscious conflicts, usually originating in childhood, that affected the mind as though it were separate from the brain.

But with the introduction of psychoactive drugs in the 1950s, and sharply accelerating in the 1980s, the focus shifted to the brain. Psychiatrists began to refer to themselves as psychopharmacologists, and they had less and less interest in exploring the life stories of their patients. Their main concern was to eliminate or reduce symptoms by treating sufferers with drugs that would alter brain function. An early advocate of this biological model of mental illness, Eisenberg in his later years became an outspoken critic of what he saw as the indiscriminate use of psychoactive drugs, driven largely by the machinations of the pharmaceutical industry.

If you want a great insight into the difficulties of psychiatry and how they’ve emerged, this article is one of the best introductions you could hope for.

Link to article in the NYRB (via 3QD).

View the original article here