Mental health is a significant national issue -- increasing numbers of people have mental problems -- yet psychiatry still remains suspect as a science. In fact, psychiatry is said to have a "split personality," with the traditional psychiatrists and psychologists on one side and the high-tech medical scientists, (using designed and controlled studies of mood-altering drugs, CAT and PET imaging of brain diseases and abnormalities, and the genetic studies of mental illness), also called the biomedical psychiatrists on the other side. Do these new techniques tip the scale and put psychiatry into the realm of science and take it out of the realm of philosophy?
“Right now, we're moving farther away from social support & talking, and zooming toward just giving someone a pill.”
-- Robert Epstein
Editor-in-Chief
Psychology Today
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Psychology Today's Robert Epstein fears that treatments will descend into mere pill popping. Neuropsychiatrist/ MacArthur fellow Dr. Nancy Andreasen, whose work centers around these new techniques (and whose seminal work on schizophrenia has redefined the field), is also one of the most staunch champions of traditional talk psychotherapy. "Young psychiatrists don't learn how to interview and that is a real loss." She recognizes that disorders of the human mind are not like diseases of the human kidney. Subtle physical variations -- far below our detection capacity -- can combine with intense psychological experiences to induce debilitating mental illnesses that can benefit from the insights and interventions of skilled clinicians as well as from drugs. And Peter Loewenberg, dean of the Southern California Psychoanalytic Institute, argues that Freudian-type analysis, updated, continues to provide insights obtainable in no other way.
With the numbers skyrocketing for depression today in addition to the steady state of the more severe mental illnesses, both approaches are critical for effective treatment. However, there is now a greater burden of proof on talk or psychodynamic methods than the new biomedical approach which uses the yardstick of science as its credential.
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Nancy C. Andreasen M.D., Ph.D.
Editor-in-Chief, The American Journal of Psychiatry
Andreasen, also featured in "Ask the Experts" talks about the key developments in the field of biomedicine.
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Robert Epstein Ph.D.
Editor-in-Chief, Psychology Today
Epstein discusses what he sees as the schism between psychologists and psychiatrists today.
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