by Howard Taynen, MD
Let me present to you an heretical view of psychiatric disorders. In the early nineteenth century “everyone knew” that infections were caused by “humours in the air” and anyone who didn’t know this was very ill-informed.
A Viennese doctor named Ignace Semmelweis was treated as an heretic for suggesting that obstetricians wash their hands between the autopsy room and the delivery room when women were dying like flies from puerperal fever, a childbirth infection caused of course by humours in the air.
Today, in our sophisticated techno-scientific era, “everyone knows” that depression is caused by “a chemical imbalance in the brain” and anyone who doesn’t know this is very ill-informed. Everyone also knows that this chemical imbalance is a genetically inherited organic illness which, in this case, needs to be treated with “medicine”, just like diabetes and epilepsy.
To formulate human suffering as a biological illness is enormously appealing to people because it grants us instant relief from feelings of guilt and helplessness, from fear of accountability in ourselves and others and especially from the unknown. Biological psychiatrists tell us that neurotransmitter depletion in certain parts of the brain (the famous “chemical imbalance”) can be demonstrated in the depressed human being and that the medications which so successfully relieve the debilitating effects of clinical depression can be shown to restore normal neurotransmitter levels in humans. It is, of course, very tempting to draw a causal relationship between these two apparent findings. This is fair enough.
In my opinion, the trouble starts when an intentional assumption is then added. The neurochemical changes are first anointed as the primary cause of the depression; then they have conferred upon them a genetic status. Now we have a simple genetic illness which causes depression in perfectly normal people, for no reason other than mechanics. The depression itself is deemed to be meaningless.
It has always seemed strange to me that we invoke genetics and neurochemistry as the exclusive fundamental cause of psychiatric disorders when their explanation is so often available to the naked eye of a reasonably intelligent and sensitive observer. We are so enraptured by the seemingly magical powers of science that we have had to start to refer to something called “scientism” to account for its excesses, i.e. materialistic reductionism, concrete thinking and a doctrinaire loss of the ability to think about intangibles like emotions and the drama of the human psyche. The term “scientific” has come to mean that which can be weighed and measured, only.
Here’s the rub. What if depression, anxiety and other psychiatric disorders (eating disorders, post-partum disorders, etc.) are meaningful expressions of the normal function of the human mind in a perfectly normal brain? What if the mind causes the “chemical imbalance” and not a gene? What if brain disorder is the expression of a distressed psyche rooted in human experience and buffeted by overwhelming life events which go much deeper and earlier than even intimate social and interpersonal problems?
Perhaps the deepest and most powerful influences we experience result from the prolonged exposure to the psyches of those who raised us—not even so much of what they said and did, but how they actually were emotionally and psychologically, consciously and unconsciously. There is no underestimating the power and dimensions of the adult influences that an unsuspecting child deals with every day in the silence of the mind. When these influences are sufficiently pathological, the child doesn’t stand a chance. Then we have a mind that is so chronically overwhelmed with turmoil that it is incapable of mastering alone that, as it seems to me, brain becomes exhausted and collapses.
Do not call a brain genetically vulnerable until you know the size of its psychological burden.
To what does all this fundamentally point? It is that people need and deserve a medical professional which heals and in so doing promotes health and personal growth. Human experience is fraught with pain and suffering and the older we are the better we know this. Where the meaning of experience can be found, there is a light of recognition which is in itself healing.
A patient of mine recently taught me that, though it may hurt, the truth heals and it known to be true because it heals. When the suffering of a human being is reduced to a module of brain illness, there is no hope of reaping such a harvest. “You have an illness, Sir. It is incurable. Take these pills for the rest of your life. And whatever you do don’t talk to me about your problems!”
When we find the truth, it has the ring of truth and it has the effect of making us more conscious. Through being more conscious we have something we can fairly call well-being and sense of self. True happiness however is, in my opinion, more of a spiritual matter than a psychological one.
You are only too old to learn when you are dead…except, of course, for those who are truly mentally or emotionally disabled. But age itself is not a barrier to insight or psychotherapy. However helpful medications are, and they are often very effective, they are a symptomatic remedy. They do not, in my opinion, address real causes. The often overt message that medications are themselves a sufficient response to the challenge of psychiatric disability disavows the purpose of the disorder they are trying to serve—that is, to force us to attend to what we are avoiding and, through that, to make us more conscious.
Originally published in Stride Magazine, December 2005.
Dr. Howard Taynen graduated from Queen’s University Medicine in 1973 and continued his education in psychiatry at McMaster University and was qualified in 1981. He has been in fulltime private practice of psychiatry and psychotherapy since 1984. He is presently working part-time at Joseph Brant Memorial Hospital in Burlington, Ontario as a consultant to outpatient psychiatry.
