This article replies to comments made in the July 2011 issue of this journal on the author's original article (Murray, 2009). Kaut (2011) encourages mental health counselors to consider biological reductionism as the preferred lens through which to understand both psychological and emotional symptoms and the high prevalence and superior efficacy of psychopharmaceuticals. His position stands in stark contrast to what I espoused in 2009, when I drew parallels between the methods of the psychopharmaceutical industrial complex and those used in cult indoctrination. While Kaut focuses on biological reductionism and the legitimacy of pharmacological intervention, I propose that mental health counselors have an ethical mandate to confront the oppressive effects of dominant social narratives associated with the psychiatric disease model and move toward a more socially just understanding of the role of psychopharmacology.
RESPONSE TO KAUT
If you can define a particular condition and its associated symptoms in the minds of physicians and patients, you can also predicate the best treatment for that condition.
Vince Parry (2010), pharmaceutical marketing consultant
I am deeply grateful for the perspectives Kaut (2011) presents in his paper and for his response to my attempt to draw parallels between the process of cult indoctrination and our current mental health care system. The purpose of this response is to (a) compare Kaut's position (2011) with mine (Murray, 2009), and (b) introduce the drug-centered model as a socially just alternative to the disease model of psychopharmaceuticals.
One of my undergraduate psychology professors claimed that all of human experience can be boiled down to electrical and chemical processes in the brain. Mind you, this was during the Decade of the Brain (1990-1999) when President George H.W. Bush issued a proclamation "to enhance public awareness of the benefits to be derived from brain research" (Decade of the Brain Home Page). | questioned whether I was pursuing the right goal in becoming a psychotherapist when psychopharmaceuticals were promoted as the panacea for human suffering. Perhaps I should become a psychiatrist, l thought, so that I could prescribe specialized medication to "fix" chemical hiccups occurring within the brain. Scientific reductionism appeared to be central to psychopharmacology research and practice. When human problems were described as a function of faulty brain chemicals, it made sense that the solution would be chemical.
Kaut (2011) makes it very clear where he stands on the use of psychopharmacology for those suffering emotionally. He wrote, "I view pharmacology as an essential component in mental health treatment" (p. 198) and "I see modern psychopharmacology as less a problem and more a solution to psychological disorders" (p. 217; emphases added). He contends that advances in neuroscience led directly to advances in psychopharmacology. More, it appears that Kaut's acknowledgment of the explosion of the research on the "biological underpinnings of behavior" shows evidence of widespread consensus and that this body of research exceeds the contributions of other disciplines. Kaut also seems to claim that this body of research has led to drugs that treat specific conditions, and do so safely, appropriately, and competitively, which may explain his "confidence in the integrity of the modern pharmacological enterprise" (p. 205). What follows, with a look at the social justice implications of psychopharmacology, is my response to Kaut's endorsement of reductionism and his cult-versus-culture debate.
Cult or Culture?
Kaut asserts that the overwhelming reliance on psychopharmaceuticals has much more to do with U.S. culture than any parallels with cult indoctrination, though he did not specifically address any of the similarities I proposed in my paper. According to Kaut, biological reductionism clearly has had a positive impact on our understanding of medical and human services. …