I have to say where is the evidence that psychological theories have not been helpful in treating mental illness? A famous psychiatrist has noted that patients at the now gone Chestnut Lodge used to leave to marry and hold down jobs before the use of drugs became universal. After that very few went on to marry and rejoin mainstream society. There is no medication that helps folks recover from PTSD, so do we say it isn’t really a mental illness or what?

I believe NAMI’s contribution to the biological paradigm arose out of fear of being blamed for their children’s illness. Refrigerator mothers were a ridiculous theory, but the impact of child rearing practices and childhood abuse on the later development of mental illness is not.

I’m glad to brought up Kuhn. His paradigmatic-shift model only adds weight to the possibity (not probability) that biopsychiatry is blinded by the assumptions it unconsciously accepts. It may be true that Kuhn’s theories about how developments in science are stratafied are true but it hardly demonstrates that the current ideas about mental health are free from erroneous biases.

Psychological explanations do seem to have been even less useful than the catecholamine theory.

Really? I find it curious that since the biologic explanations (and treatments) became dominant, the prevalence of depression seems to have grown exponentially. Hardly a proof of the value of the “catecholamine theory”.

I do find it interesting how everyone who attacks the biological explanation attacks the serotonin-imbalance theory of depression – which, at this point, isn’t much more than a marketing gimmick for SSRI’s.

There’s an endless number of references I could provide for the ubiquity of the “serotonin-imbalance” therory of depression; without doubt it’s the dominant rhetoric around depression causation. I find it somewhat amusing that you would champion the “catecholamine theory” in one sentence then disparage the “serotonin theory” in the next. I agree that the “serotonin deficiency causes depression” theory is as unproven, as is attributing the cause to deficiencies in noradrenaline, dopamine or any other catecholamine.

…the biological understanding of how mental distress occurs should be priveledged because it represents the only realistic way forward towards better treatments and, perhaps, cures.

I’m bemused at how merely pointing out that we are biological and our behaviour has a biologial basis can be offensive to anyone.

If you’re bemused as how reducing one’s experience to neurology, dismissing the value and meaning that one gives to one’s experience, is disempowering and offensive, then I can’t help you.

I don’t deny that thought, emotion and meaning are real, only that a biological account of each is both possible and important.

Possible and important maybe, but grossly insufficient.

I hate to bring up Kuhn, but I’m going to have to. I don’t really find this shift of explanations disturbing – that’s how science tends to work. The dominant paradigm shifts from one certainty to the next, with each generation holding onto their explanations to the point of breakage. Psychological explanations do seem to have been even less useful than the catecholamine theory. I do find it interesting how everyone who attacks the biological explanation attacks the serotonin-imbalance theory of depression – which, at this point, isn’t much more than a marketing gimmick for SSRI’s.

As much as you claim that “Pretty much everyone agrees that the causes of mental illnesses are complex and probably involve both physical and environmental factors”, I wonder how secure “pretty much everyone’s” explanations of mental illness are.

Why should it need to be secure? Neither biopsychiatry nor psychology provide a convincing account of mental illness. That’s not secure, but that’s not a bad thing.

I’d argue that privileging biologic explanation of mental illness is now epidemic and the consequences of such is to distort our understanding of and remedies for the suffering that people experience.

Feel free to do so. I’d argue that while psychological remedies to mental distress are important, the biological understanding of how mental distress occurs should be priveledged because it represents the only realistic way forward towards better treatments and, perhaps, cures.

This is the worst kind of biologic reductionism that I object to most strenuously. To reduce people – who they are, the sum total of their lives and experience (mental illness included) – to neurology/neurobiochemistry, is not only misguided but offensive. It’s akin to saying that Beethoven’s Ninth Symphony is merely changes in air pressure. It may be literally true in a physical sense but it dangerously misses the point, it displays an almost embarrassing misunderstanding of what it means to be human.

I’m bemused at how merely pointing out that we are biological and our behaviour has a biologial basis can be offensive to anyone. I don’t deny that thought, emotion and meaning are real, only that a biological account of each is both possible and important.

Untrue. I’m certainly not antipsychiatry, either in its historical of literal sense, although I think that Thomas Szasz and RD Laing make a lot of interesting points. Yet I’m firmly of the belief that the dominance of biologic explanations of mental illness are not only interesting but relevant to how we view and deal with psychological suffering.

As I commented on a related post in another forum, “I’m certainly not against pharmaceutical use …; I’ve used antidepressants and would again if I really felt the need… [But] the shift in the dominant explanations for depression is interesting: it used to be caused by an excess of ‘black bile’ (hence the term melancholia), then it was caused by Freudian concepts of conflict in the unconscious etc., now it’s caused by neurotransmitter imbalance. (I know I’m grossly reducing the history here.) What’s most disturbing is that, at each historical point, the theorists of the dominant explanation were SO certain that their theory was correct and final. I wonder if, when the next theory displaces the current (how about “Depression is caused by not buying enough stuff; it’s a shopping deficiency”), will we be encouraged to consider the serotonin-deficient explanation as outdated and quant?”

As much as you claim that “Pretty much everyone agrees that the causes of mental illnesses are complex and probably involve both physical and environmental factors”, I wonder how secure “pretty much everyone’s” explanations of mental illness are.

“Aside from anything else, there is no contradiction between a disease being both biological and environmental.”

True, but I’d argue that privileging biologic explanation of mental illness is now epidemic and the consequences of such is to distort our understanding of and remedies for the suffering that people experience.

“Furthermore, the brain is biological and, if you don’t want to start inventing souls, the mind and its behaviour is what the brain does. Which means that all behaviour is biological in origin. “

This is the worst kind of biologic reductionism that I object to most strenuously. To reduce people – who they are, the sum total of their lives and experience (mental illness included) – to neurology/neurobiochemistry, is not only misguided but offensive. It’s akin to saying that Beethoven’s Ninth Symphony is merely changes in air pressure. It may be literally true in a physical sense but it dangerously misses the point, it displays an almost embarrassing misunderstanding of what it means to be human.

For the record, I am not my brain. To equate who I am with neurology is not only inadequate and disempowering but laughable in its stupidity.

The roots of the biological model go back to the 1930’s with Moniz’s development of the lobotomy. They were strengthened by the invention and widespread adoption of the antipsychotics in the 1950’s. And various psychiatrists – Laing and Szasz among others – began to dissent from this in the 60’s. Since NAMI wasn’t set up until the end of the 70’s, your statement is a little confusing.