“The chemical imbalance idea was never actually held by psychiatry”

29 December 2019: Jesse Luke, a writer, researcher and cancer patient, started a social media thread with the following statement:

“The ‘chemical balance’ idea was never actually held by psychiatry. It is a persistent myth borne of misunderstanding”

The first response to this thread was by Dr Annie Hickox, a Chartered Clinical Psychologist, who said “Absolutely. It’s deliberately spread by self-styled critical psychologists as one of their myths about psychiatry.”

Yet, in August 2019, Professor Wendy Burn, President of the Royal College of Psychiatrists said this of the Chemical Imbalance Theory:  “It hasn’t actually been disproven, we won’t know till we can actually measure the chemicals in the brain”.

In the original thread Jesse Luke offered some clarification: “Nobody shows evidence of ‘chemical imbalance’ being an official position or theory of mental illness. I’d like to see real position statements, or widely used texts. Dr Peter Gordon cites Stahl but that’s just pharmacology. Best empirical research points to a Neuro/Genomic basis of mental illness”

Dr Ronald Pies, MD,  has described the ‘Chemical imbalance theory’ as a “trope” that has been “miss-attributed to the profession of Psychiatry”.

Dr George Dawson, MD, has repeatedly described the ‘Chemical imbalance theory’ as little more than “anti-psychiatry propaganda”.

Dr Joe Pierre, MD, describes the ‘chemical imbalance theory’ as “a straw-man argument by anti-psychiatrists” and that “it is not something that’s been seriously taught in medical school or psychiatry for 20 years.”

Another regular contributor [@philosofacespin] stated that “psychiatrists never advanced the chemical imbalance theory: a single drug company did in a f—ing advert”

Jesse Luke has previously confirmed: “I don’t even accept the biopsychosocial model . .  .” [23 December 2019] and in a Tweet to Dr Samei Huda: “At least the old admitted to what they were. Now anti-psych/critical-psychiatry has taken the form of ‘advocates’ and sits somewhere between pseudoscience and pseudophilosophy”

A small but influential number of mental health professionals who are on social media seem to generally equate those who advocate for the need to learn from unforeseen harms of psychiatric interventions with “anti-psychiatry”. Not infrequently the language used by these professionals conveys an attitude of disdain for those that they have labelled in this way. Jesse Luke, who the President of the Royal College of Psychiatrists retweets, stated on 28 December 2019: “There’s plenty of anti-psych. They’re especially despicable”

Yesterday, 30 December 2019, Dr Jonathan N. Stea, began another Social media thread: “An anti-psychiatry/dog-piling thread for those interested. People who experience mental health disorders deserve evidence-based information/patient-centered care. People should not be discouraged from seeking psychiatric care.”

[for this blog post I have anonymised those who are not mental health professionals]

Contributor #1:  “It’s patently dishonest to label a discussion about #prescribedharm as antipsychiatry.”

Contributor #2: “Yes, and patently irrational.”

Contributor #3: “It seems that patients harmed by psychiatric drugs are not entitled to discuss ethics of prescribing drugs which have caused the harm without being denigrated for doing so.”

Professor Joe Pierre, MD: “I’ve spent some time engaging with this crowd over the past month trying to understand where they’re coming from & what they want. I like to think that I do now, though for those that aren’t merely trolling, I think their efforts engaging with Mental Health professionals are counter-productive.”

Jesse Luke: “It’s truly Sisyphean but necessary when dangerous ideas are being spread”

[this language of otherness and disdain does nothing to advance scientific understanding]

In a recent post, I said: “A number of Psychiatrists, who have a prominent social media presence, have robustly argued that the Chemical Imbalance theory is a “theory that never was” and  that it had little to do with psychiatry and psychiatrists. As an NHS psychiatrist of over 25 years my experience was quite the opposite of this and I am left troubled that powerful voices are attempting to re-write the past”.

George Orwell also worried about the mutability of the past. This was one of a number of worries that inspired Nineteen Eighty-Four.

The Royal College of Psychiatrists [3 August 2017]:

the old idea that antidepressants correct a chemical imbalance in the brain is an over-simplification and we do not support this view


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