Blaming the Brain: The TRUTH about Drugs and Mental Health

By Kogan, Steven M. | Journal of Marital and Family Therapy, January 2000 | Go to article overview

Blaming the Brain: The TRUTH about Drugs and Mental Health


Kogan, Steven M., Journal of Marital and Family Therapy


Valenstein, E. S., (1998). Blaming the brain: The TRUTH about drugs and mental health. New York: Free Press, 292 pp., $25.00.

At last fall's AAMFT conference in Dallas, the dominance (and acceptability) of biochemical explanations for mental illness was hotly contested in response to the Intimacy and Depression campaign. It was at the book exhibit that I happened upon Elliot Valenstein's 1998 book, Blaming the Brain: The TRUTH About Drugs and Mental Health. The opening paragraph summarizes this effort:

American psychiatry is said to have changed from blaming the mother to blaming the brain. It was not so very long ago that the cause of mental disorders was thought to be rooted in early experiences within the family, but now it is widely believed by most authorities and the public alike that the cause is a chemical imbalance in the brain.. .How did these radical changes occur within the span of a few decades and does the evidence really support these new theories? Whose interests are served by promoting drug treatment and biochemical explanations and how are these interests advanced? What are the long-range implications of the biochemical theory of mental disorders and the growing reliance on drugs to treat all psychological and behavioral problems?

Valenstein investigates these questions by placing the evolution of research hypotheses and evidence in a historical and economic context. The results are instructive: a partial look into how researchers have thought about the brain and mental illness, and, according to Valenstein, the surprisingly irrational ways the field has progressed. Among the more interesting things Valenstein discusses are:

* The major neurological aspects of the dopamine theory of schizophrenia and the serotonin deficiency theory of depression.

* That most psychoactive drugs were "discovered" accidentally, having been developed for other purposes. They were not developed in response to a discovery about the biochemical nature of a disorder.

* That biochemically oriented researchers do not understand how or why thought and affective disorders develop and manifest. …

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