The Neurobiological Turn in Therapeutic Treatment: Salvation or Devastation?

Abstract

If there is one hallmark of the mental health professions since their very beginnings, it is conflict. Not only was conflict a dominant motif within Freud’s privileged circle of colleagues, but since that time the professions have come to resemble a virtual battlefield of competing schools, practices, ideals and truths. Yet there is now a gathering of forces into two major camps, and far more hangs in the balance than the survival of one orientation as opposed to another. At the broadest level I am speaking here of a competition between two major ways of understanding human functioning, their resulting forms of practice and policy, and their impact on the culture more broadly. On the one side are professionals who emphasise the natural or biological roots of human behaviour, and on the other are those who are concerned with the cultural constitution of human action. From the former standpoint, rigorous diagnostics, neurological research, managed care and pharmacology are favoured routes to ‘curing mental illness’. From the latter standpoint, not only are there enormous dangers inherent in this naturalist orientation but there is rampant blindness to the cultural process in which human suffering is embedded, and to the kinds of therapeutic process that are essential to bringing about change. How are we to respond to this conflict? Much hangs in the balance.

Most Americans, and even many doctors, have never heard of social anxiety disorder, and it affects more than 5 million Americans, according to the National Institute of Mental Health. Drug companies, eager to expand their markets, are now spotlighting the disorder – and advertising medications to treat it … Technology is now helping to pinpoint changes in socially anxious brains.

(Newsweek, July 2003)