Psychiatry's second coming.

Abstract

American psychiatry is in ideological flux. The established professional approach--the environmentalist one, the one that has concerned itself almost exclusively with the influence of the external environment on development and behavior, that has focused on individual psychology, on childhood, on the search for unconscious motivations, on psychoanalysis, on psychotherapy, on the primacy of feeling and meaning and growing, on Freud--is under serious attack. And a new approach--a biological one, one centered on the brain, on neurochemistry, on pharmacology, on medications--is rapidly gaining adherents, not only among young psychiatrists, but also in the press, among the public, and within a universe of newly hopeful and expectant patients. Some American psychiatrists, particularly those in the environmentalist camp, deny that any changes are taking place at all, or that those changes represent anything important--certainly not a significant challenge to the truth and usefulness of the traditional psychiatric concepts and practices; many of them seem perplexed about the increasing power of biologism and about the rush among younger psychiatrists to embrace it. And the biological psychiatrists themselves, or at least some of them, feel that their time has rightfully come, that their ascendance is, simply, an appropriate and direct result of the truths they bear, the science, the knowledge; they interpret their growing strength as a recognition that their explanations for abnormalities of feeling and thinking and being are more correct than the purely psychological ones, that in explaining those human functions in chemical terms they have finally and successfully brought together the mind and the body, and that the understanding of human behavior in health, as well as its therapy in illness, will ultimately be achieved most quickly and most fully through their methods of research and through their approaches to treatment.