These people speak of a chemical imbalance as if it is NOT one of several competing hypotheses to explain mental health issues. While I have certainly witnessed some medication have miraculous effects on people, it rarely is a total cure. Moreover, I have witnessed sufficient examples of medication having little to no effect to be confident that the chemical imbalance hypothesis is just that -- a hypothesis.
So, why do people buy into the chemical imbalance hypothesis more so than the psychological and social hypotheses of mental health problems? If I were a cynical person I would think that it is simply about money. That there is more money to be made in pharmacy than there is in self-help books and support groups or even therapy session bills. That may play its role, but I actually don't believe that to be the reason for the success of the chemical imbalance hypothesis in the fight for the hearts and minds of people.
Certainly one reason may be that biology is viewed as a hard science -- more "true" because it involves things that can be easily touched and measured. Measurement leads to numbers and attaching numbers to life can be reassuring to people. Numbers are believed to be a meaningful reference, a touchstone that people can believe tells them something about what is happening and if there is change. This is of course not exactly true. There is no true "zero" on these scales and thus they are really arbitrary with no fixed scale. Thus, the numbers are only relative to other numbers on the exact same scale. Therefore, the information can not be easily generalized.
Another explanation is the loss of guilt. If biology is to blame, that means the identified patient is not. Come on? Who can choose their biological make-up? Even the parents aren't somehow responsible. Afterall, they too were born with unchosen genetics and had no way to control what they would pass along and in what combination. This also means that a person is essentially powerless by themselves to change the situation. This leads to solutions external to themselves. While this could result in such a person seeking medication advice from a physician, it seems as likely that they will seek external "solutions" through the use of alcohol and illegal drugs.
The last reason I imagine that the chemical imbalance hypothesis is so appealing is that people want relief from discomfort and they want it quickly. The idea of "life is pain" to many is just a funny throwaway line from a movie ("Princess Bride"). The chemical imbalance hypothesis is appealing in this manner as it leads to a quick solution. No need to change your lifestyle or how you view or react to life. Take this pill and problem solved. Of course, it rarely if ever works out that way.
I don't think any one of the above reasons explains the success of the chemical imbalance hypothesis. It unfortunately is likely a combination of these reasons that keeps some people misinformed, powerless, and dissatisfied with the care they receive. And, more importantly, not looking to other possible explanations and solutions.
The most distressing point is "The emphasis has become almost entirely on biology."
ReplyDeleteIt seems like we had it in our grasp of healing models to incorporate pharmaceuticals complimentary to other modes of treatment. We give up so many other options for a magic pill. Rather than using medical interventions as a tool, we use them as the solution,(done!). Changing our own genetics appears like the desired ultimate solution for all of our ails. I don't buy into that.
When we improve due to some intervention, medical or none, we need to capitalize on that gain. Otherwise, 6 months from now we are back to the same situation.
On the responsibility issue, when I've done prison workshops I've found it helpful to make the following distinction. "I am not responsible for X" can mean at least two things: (1)"X has a cause outside of me/independent of my autonomous choices"; (2) "I am not capable of TAKING responsibility for X/changing X through my choices."
ReplyDeleteIt seems to me that (1) is often true. But (1) does not imply (2). And whether (2) is true is usually the more important question. In fact, I suspect that (2) is very often false in precisely those cases where people believe it (mistakenly) on the basis of (1). They think that because they were plunged into deeply destructive habits by forces outside themselves, they lack the power to take charge of their lives and, with appropriate help, work to overcome these destructive habits.
But, as my daughter teaches me daily, just because she was dressed by someone else doesn't mean she can't strip off those clothes and put on something else.