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Thoughts & reflections on psychiatry
Psychiatric uncertainty and the neurobiological buzzword
by Steven P Reidbord MD
April 17th, 2014
Yet many of us clutch at illusory certainty. Decades ago, psychoanalysis purportedly held the keys to unlock the mysteries of the mind. It later lost favor when many conditions, particularly the most severe, were unaffected by this lengthy, expensive treatment. Now the buzzword is that psychiatric disorders are “neurobiological.” This is said in a tone that implies we know more than we do, that we understand psychiatric etiology. It’s a bluff.
Patients are told they suffer a “chemical imbalance” in the brain, when none has ever been shown. Rapid advances in brain imaging and genetics have yielded an avalanche of findings that may well bring us closer to understanding the causes of mental disorders. But they haven’t done so yet — a sad fact obscured by popular and professional rhetoric. In particular, functional brain imaging (e.g., fMRI) fascinates brain scientists and the public alike. We can now see, in dramatic three-dimensional colorful computer graphics, how different regions of the living brain “light up,” that is, vary in metabolic activity. Population studies reveal systematic differences in patients with specific psychiatric disorders as compared to normals. Don’t such images prove that psychiatric disorders are neurobiological brain diseases?