A Critical Look at Some Assumptions of Biopsychiatry

Biopsychiatry has been a dominant force in mental health research and practice since the 1960s. The biological perspective, with its focus on reductionistic explanations and pharmacological solutions, dominates current psychiatric thinking. Contemporary psychiatric textbooks read as if it has been established that most mental disorders are brain disorders and that pharmacological treatments compensate for known neurochemical deficits. Biological psychiatrists present a view of the nature of mental disorders in which brain-behavior explanations proceed in only one direction, from brain to behavior. This literature ignores two basic issues: (a) mental and social phenomena cannot be adequately understood in terms of physical explanations, and (b) brain-behavior influences also proceed from behavior to brain. The “knowledge” claims of biological psychiatrists are critically examined in this article, and are shown to be statements of beliefs and values. Adequate explanatory models of mental disorders, when they are developed, must integrate knowledge from multiple levels of analysis including personal biographical and social/historical forces, as well as biological factors, with each level providing unique and valid insights.