E185 | How Psychiatry Became Fixated on Chemical Imbalance (w/ Prof. Justin Garson)

Yeah.

Well, he, uh...

I, I think he graduated high school in 1955, so that would be a nice kind of reference point.

Well, really, let's go to 1950, because 1955 you already were having antipsychotic drugs and this kind of pharmacological revolution that was still very new.

So let's go back to 1950.

As you know, y- you have effectively these two camps in psychiatry.

You have the Asylum doctors who are very much into experimenting on patients' bodies, obviously a lot of times not getting informed consent, a lot of times with very, uh, kind of shallow theories.

So, uh, you know, there was this idea that people when they're having epileptic fits, they don't experience psychosis.

So they thought, "Aha, well, maybe if we induce, uh, seizures, uh, then that will be a cure for psychosis." So we know about the asylum doctors and these, uh, sometimes rather cruel experiments.

On the other hand, you had the Freudians, which in the United States, that was the dominant movement in psychiatry.

Uh, and of course, the, the psychoanalysts at the time generally believed that almost all psychological distress, whether we're talking about depression or bipolar disorder or schizophrenia, personality problems, whatever it was, ultimately was rooted in these unconscious conflicts, childhood, uh, conflicts, and that the key was to unearth these deep-seated, uh, conflicts.

Yeah.

So at the time, psychiatry was really treated with disdain by other medical specialists.

They thought, "Okay, on the one hand, you have these kind of barbaric experiments.

Uh, on the other hand, you have this psychoanalytic approach that doesn't seem to be really helping the people who are most in need of, uh, help." And so a lot of doctors just didn't really consider it a valid medical specialty.

Pills started to change that a little bit, but not initially, not by that much.

So by 1954, you have these new, uh, antipsychotic drugs.

They're helpful.

They're allowing some patients to go home and live on maintenance doses.

They're at, at least playing some role in helping to empty out, uh, uh, the asylums.

But at the time, w-we didn't really have any theory about why these drugs worked or how these drugs worked.

Uh, there was this wonderful, uh, quote by a, a Canadian, uh, psychiatrist named Heinz Lehmann, and he said, "It's just like giving a patient a chemical lobotomy."

Mm.

That was what he thought these drugs do.

It's kind of like giving a lobotomy, but not quite as, uh, invasive.