A Pill is Not Enough

It's also been a way for psychiatrists to compete with psychologists and social workers. Because here they say, "This is something only we can do, we give out drugs and no one else can." So the whole focus on medication has been extremely important for the psychiatric profession. One wonders where the psychiatric profession would be today if it didn't have drugs. Would it still exist?

It's not just psychiatrists. The whole medical community gains in prestige by saying, "We handle emotional problems, too; that's part of our bailiwick."

Craig Lassig

Michael Browne: "I really began to wonder if medication helped any of my patients."

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And we shouldn't overlook the fact that in the United States the biomedical research community is very powerful. And so long as you define emotional problems as biomedical then you can channel all kinds of government and foundation funds to psychiatric research. Unfortunately, we have a limited amount of money and the result of that is that you starve psychosocial researchers of money. And so often problems that really cry out for research money don't have it. Because we put our money into increasingly microscopic studies of the brain and of neurons and of neurochemicals.

It's not to disparage that kind of research, it's fine. But we're like the woman who every day lifts weights with her right hand while she sweeps with her left hand. Pretty soon she's got this enormous bicep on one side and the other one has atrophied. It's completely out of whack.

Another reason for this emphasis on drugs is that psychotherapy is an expensive proposition. And I really wonder if this isn't something that the managed care companies have gravitated toward as a way of reducing the expense of psychotherapy. On the other hand, right now the managed care companies are spending so much money on antidepressants and other drugs that I wonder if at some point they aren't going to see this as a failed strategy.