INTRODUCTION
I have recently read:
‘The Explanation You Have Been Looking For’: Neurobiology as Promise and Hermeneutic Closure
The piece was written by Joseph E. Davis, PhD, Research Professor of the Institute of Advanced Studies in Culture, University of Virginia. It was published online by Culture, Medicine, and Psychiatry on the 5th of August, 2021.
ABSTRACT
Here’s the paper’s abstract, quoted in full:
“The biomedical aspiration of psychiatry has fundamentally reoriented clinical practice since the DSM-III in 1980 and reverberated in the public sphere. Over time, lay public understanding of the causes of mental suffering has increasingly endorsed biological conceptions. In this paper, I explore the sources from which a neurobiological model for mental suffering reaches ordinary people, and investigate its rhetorical appeal, personal appropriation, and consequences. Drawing on interviews and other data, I show that these sources—physicians, popular media, and advertising—share common ontological and moral assumptions. These assumptions, in turn, influence how people take up neurobiological explanation to account for their suffering, and how, paradoxically, they join it to their projects of self-determination. I conclude by considering how, from a phenomenological perspective, a neurobiological account fails to enhance self-knowledge or determination but leads to a hermeneutic dead end.”
MAIN THEMES
There’s a lot of material in the article and in the abstract. Note the phrases: “The biomedical aspiration of psychiatry has fundamentally reoriented clinical practice…”; and “…over time, lay public understanding of the causes of mental suffering has increasingly endorsed biological conceptions”; and “…a neurobiological account fails to enhance self-knowledge or determination but leads to a hermeneutic dead end”; etc.
Throughout the article Dr. Davis provides an abundance of evidence for these themes, and links their sources unambiguously to psychiatrists, medical websites, “screening days”, “educational” programs, autobiographical stories, social media, and pharma advertising.
SOME ILLUSTRATIVE QUOTES
“Despite a claim to be atheoretical with respect to etiology, the whole range of mental disorders would come to be regarded as primarily physical illnesses, ‘just like heart disease or diabetes’ to quote the American Psychiatric Association (Davis 2020; Harrington 2019; Whooley 2019).”
“In this paper, I explore the channels through which a neurobiological model for mental suffering, popularly known as a ‘chemical imbalance,’ reaches ordinary people and with what promises to them and consequences for them. My evidence is drawn from interviews with members of the lay public about how they account for everyday suffering, as well as related studies and the writing of psychiatrists.”
“Toward the end of her history of psychiatry’s long search for the biology of mental illness, the historian Anne Harrington poses the following question. She begins by noting that a century ago, doctors were diagnosing patients with fictive maladies like ‘bad nerves’ and ‘neurasthenia’ and knew by then that nothing was actually wrong with their ‘nerves.’ The patients, she writes, ‘may or may not have known, or they may or may not have cared.’ They may not have cared because having a medical label for their suffering provided institutional acknowledgment of its gravity and a ‘coherent explanation for real symptoms.’ Similarly, today, she writes:
Patients present with acute mental or emotional distress, and doctors look for a DSM diagnosis that will make sense of their suffering … [and] prescribe drugs … By acting this way, general practitioners and psychiatrists perpetuate the fiction that the drugs they are prescribing are correcting biochemical deficiencies caused by disease, much as (say) a prescription of insulin corrects a biochemical deficiency caused by diabetes.
And her question: ‘Is this wrong?” (Harrington 2019: 273).”
“Our social character and concrete and situated way of being-in-the-world are replaced by a ‘kind of tinker-toy self,’ composed of thoughts, feelings, and behaviors that can be easily detached and laid aside or reconfigured into a new, but momentary self-configuration (Cushman 2002, cited in Aho 2019). And medication is imagined as a technology that can facilitate this cutting and reassembling. Such an account does not clarify or enhance or restore self and self-determination. By rejecting the sources of meaning and connection that make self-knowledge possible, they disavow them.
To Harrington’s question, is perpetuating this debunked biochemical deficiency theory wrong? The answer must be affirmative.”
CONCLUSION
This is a must-read piece. It embraces many of the topics that are central to the anti-psychiatry position, and marshals compelling arguments for its final conclusion: that perpetuating the biochemical deficiency theory is simply wrong.
Please read, discuss, and pass along. There are five pages of references for those who wish to delve further into these critically important topics.
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Disclosure: I had no role in the creation of this scholarly piece, and have no financial interest in its dissemination. I am promoting it here purely on its merits, scope, utility, depth of analysis, and relevance.