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).

4 thoughts on “The trouble with psychiatry”

  1. As someone who’s been diagnosed with both Major Depressive and Borderline Personality Disorders, I’m naturally interested. I took a quick peek at the article and knew I had to return (after a quick comment here) to read the whole thing when she started out by acknowledging “the epidemic of mental illness” that’s going on in the world today.

    I’ve been calling it an epidemic for years and have only received the tired old “but you see the world through the eyes of your depression” in response. Thank you so much for providing such a great link!

  2. A wonderful article on the sad state of affairs.Psychiatrists should never be allowed to see a kid.I think they should set a age limit.Who knows,what they can come with.New symptoms and new diagnosis while the baby is still in mothers womb,just to extend their “prescription spectrum”.Even though this off label prescribing is a good thing,exception should be made in the field of psychiatry.They should not be allowed to prescribe unless there is a clear indication.It is not an emergency situation besides it is definitely not improving the quality of life of the patient.Actually there is this added trouble of dealing with the side effects on top the diagnosis they have received which might not be true in the first place!!

  3. That was one of the most interesting and informational things I’ve read in a long time. Thank you for sharing this!

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