‘The mutability of the past’

It was interesting to read Professor Pies considerations on “Antipsychiatry” and his linkage of this with the “chemical imbalance trope” [Psychiatric Times, 2nd August 2019]

Like Professor Pies I am not at all sure what “Antipsychiatry” really is, other than being a single word, however I am reminded of this passage from Nineteen Eighty-Four by George Orwell:

Professor Pies divides considerations into either “anecdote” or “evidence”. Our family dictionary defines anecdote as a “biographical incident”.

My wife has been a General Practitioner for quarter-of-a-century and I have been a psychiatrist over the same period of time. Whilst we do not have experience of medical care in the USA, we can share our experience of working in NHS Scotland. The early part of our careers coincided  with the five-year-long ‘Defeat Depression Campaign’.

For me, as a Psychiatrist in training, at weekly educational events Stahl diagrams were used to explain the “chemical imbalance” in the brains of those who were depressed or anxious. This education was the basis of the information I provided patients. As a GP, my wife’s experience was that this “education” filtered through to her daily practice.

In reading Professor Pies account of what he terms a “trope” one is left wondering why the “chemical imbalance theory” has retained cultural persistence? Indeed the President of the Royal College of Psychiatrists recently stated that the chemical imbalance theory “hasn’t actually been disproven” [9 August 2019]

Professor Pies and his colleague Dr George Dawson MD have demonstrated that the “chemical imbalance theory” does not exist in the textbooks that partly informed their careers over many decades. If psychiatrists, scientists and academics were not part of this “trope” where then did it come from? George Orwell might have suggested (in fiction) that it came from the vast, dark and hidden sea of Oceania!

In Nineteen Eighty-Four, George Orwell revealed how language can be subverted to re-write the past:

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