Hi. As a graduate student in clinical psychology I was delighted to read the interchange between Dr.'s Salkovkis and Martin. The oversimplification of clinical problems in psychiatry/psychology as "chemical imbalances" is something that I have had to contend with on a daily basis. Hearing others acknowledge some of the shortcomings of biological models of mental illness is a rare treat that, unfortunately, I usually only get by reading a journal article by someone I've never met or, as in this case, an electronic bulletin board. Thanks in advance :) Troy
In my more wildly optimistic moments I dream that a fundamental shift in philosophy may occur in the decades to come (20 or 30 years) that will lead people to be as open to accepting non-biological (behavioral, interpersonal, cognitive) scientific explanations as they are to accepting biological (scientific or not) explanations--one major problem with the existing philosophical framework being a tendency to conflate notions of "biology" and "science." For the time being, I am left with the practical problem of trying to explain to patients (in language that they can understand and in a way that will be helpful to them) what we know about their condition and how to "treat" it (from both biological and nonbiological perspectives). In trying to do so, I've had to deal with two major obstacles: 1) INFORMATION OVERLOAD: the absolute complexity of the system within which "mental disorders" occur and the abundant (yet often ambiguous) research literature that attempts to identify the most important elements within this system; and 2) PHILOSOPHICAL INCOMPATIBILITY: the fact that, in the minds of many, biological and non-biological explanations are not compatible; meaning that if one accepts the fact that biological models have something to tell us about a particular problem any other explanations are rendered invalid or, at best, redundant. I was hoping to elicit some responses from experienced clinicians who are aware of the importance of non-biological explanations of psychological problems as to how best to deal with such questions as, "My doctor said that I have a chemical imbalance in my brain that is causing my depression/anxiety/interpersonal difficulties; how can just talking with you make any difference?" As an aside, I'm not meaning to imply that my graduate training has not prepared me to deal with such questions, I'm just interested to hear how other professionals prefer to respond to them.
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