Family Therapy as an Alternative to Medication: An Appraisal of Pharmland

By Phoebe S. Prosky; David V. Keith | Go to book overview

Chapter 5

A Systemic Frame for Mental Health Practices
Marcelo Pakman, MD

For some minutes Alice stood without speaking, looking out in all directions over the country—and a most curious country it was. There were a number of tiny little brooks running straight across it from side to side, and the ground between was divided up into squares by a number of little green hedges that reached from brook to brook.

Lewis Carroll, Alice's Adventures in Wonderland

Three significant forces have reshaped the mental health field in the last decade. I will name them in order from those more specific to the mental health domain to those that are more general and contextual:
1. The first one has been the fascinating, prodigious development of psycho-neuro-pharmacology. The “decade of the brain” was signaled by significant resources, unequaled in almost any other area of research, poured into the development of new pharmaceutical agents. Fifteen years ago we had only a small percentage of the pharmacological agents currently available to treat mental conditions and influence human behavior. Most of them were what are now called “dirty drugs, ” because they caused significant side effects and were poorly targeted to specific pharmacological actions. Since then the understanding of the chemistry, the physiology, the

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