Friday, May 7, 2010

Bi-polar 20th Century American Psychiatry

" the first half of the 20th century, American psychiatry was virtually 'brainless.' In the second half of the 20th century, psychiatry became virtually 'mindless.'"
Leon Eisenberg, an early pioneer in psychopharmacology at Harvard

The notion of the brainless period refers to psychiatry's total infatuation with Freud and his theory of psychoanalysis; as we all know the reference to the mindless period well describes our modern day love affair with prescription drugs.

Today psychiatry is focused primarily on alleviating symptoms, corralling them into scientific categories (see psychiatry's diagnostic manual, DSM-IV and new DSM-V) and then finding the appropriate drug to match.

Perhaps we need to re-think this bi-polar pendulum and re-frame the question of how best to serve the needs of those seeking help for their mental health problems. What exactly do we mean by mental health anyway?

For starters you could read the excellent article in the April 25th issue of The New York Times Magazine - Mind over Meds by Daniel Carlat. He really does a great job of framing the issues and describing the challenges of 21st century American psychiatry.

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