Mental Health's Stalled (Biological) Revolution: Its Origins, Aftermath & Future Opportunities

Abstract

Abstract The 1980s, by common consensus, saw a big and remarkably rapid pivot away from previously dominant psychoanalytic and social science perspectives in American psychiatry and toward a so-called medical model foregrounding biology and the brain. The standard understanding is that this happened because, after years of wandering lost in a Freudian desert, the field had finally gained some fundamental new biological understandings of mental illness. The standard understanding is wrong. Nothing of sudden significance had happened on the biological front. There had been no major scientific or therapeutic breakthroughs. Why, then, did the field really pivot? This essay aims to explain. The answer is important, not least because choices made back then have directly shaped the fraught world of psychiatry with which we live today.