Theravive Home

A study in the Harvard Review of Psychiatry reviewed language used in studies about biological causes of mental health disorders, noting that, “The message delivered to laypeople is that mental disorders are brain diseases cured by scientifically designed medications.” The implication is that the media is too quick to cover studies that lean toward reductionist theories.

Evan Haines, co-founder of Oro House Recovery Centers agrees that we give too much weight to the biological causes of mental illness. Haines says, “Our problem isn’t a medical one; it’s a cultural problem. By medicalizing addiction and mental health problems, we have just made more subtle our centuries-old impulse to lock up and hide away anyone who is different, the sensitive ones who we should listen to instead. Making it a biological problem implies only doctors can talk about it. And so we continue to search for that ‘magic bullet,’ when what we should really be talking about is what we’re doing here.”

Lee Keyes, PhD, Keyes and Polychronis Consulting, LLC, sees this perspective as harmful to the individual patient. “When a person attributes their issues to only biological contributions it can lead to an illness identity, such as ‘I am X Disorder’,” said Keyes. “Taking responsibility for self is not the same as blame and guilt, which are appropriate for acts of behavioral wrongdoing. Still, too often, clients may excuse the latter by saying ‘I am so bipolar’, for example.” 

Jason Shiers, psychotherapist and transformative coach, is also concerned with approaches that only treat the biological part of mental illness. In his work with clients, he sees a benefit for clients when they better understand themselves. “With deeper understanding of who they are and how thought creates their reality, people can live happily, with all the joy and contentment they wanted,” said Shiers. “The idea they are broken, damaged, or need medication is a complete misunderstanding of experience. 

Marc Lener, psychiatrist and CEO of Singula Institute sees some rationale for a biological approach because it views mental illness as a deficiency in our biology instead of a weakness of will. But he still believes it’s a biopsychosocial disorder that needs more than biological treatment. He gives the example of people with depression. “A depressed patient develops panic attacks from medication side effects worsening his depression but responding to a second-tier medication that helps him sleep, which turned out to be the main contributing factor of his depression. Another person remains depressed despite being on maximal doses of medication and begins to self-harm until she switches schools leading to resolution of her symptoms. How is it that these two people with depression have vastly different problems with vastly different solutions? Each case has individual nuances that must be understood through a biopsychosocial approach.”

Psychotherapist Robert Grigore views biological expression of mental health disorders as only the tip of the iceberg; the symptoms, not the cause. “Exploring the individual's life from a trauma-informed perspective reveals traumatic or negative experiences which created the psychological foundation for the biological symptoms to emerge,” said Grigore. “If the reverse were true, the individual's life history would be clear of such negative experiences, and I've never met anyone who escapes their childhood psychologically unscathed.”

Since biology is only a part of the equation, Keyes advocates for different terminology referring to biology as a contribution rather than a cause. “A biological only explanation does not address origins from other areas such as the extrapersonal, societal, and spiritual-existential. It is hard to find professional articles or popular media addressing other origins and interventions, partly because they run counter to industry profit motives.”

Psychiatrist Carole Lieberman, M.D. believes her field is especially guilty of giving too much weight to biological causes of mental illness to the detriment of the profession. “Psychiatrists used to do psychotherapy and I still do. Now most psychiatrists only do ‘med visits’,” said Lieberman. She is concerned with providers who only treat the biological root of mental illness. “No one was ever ‘cured’ by medication,” added Lieberman. “Medication is a band aid that can help calm symptoms so the patient is better able to engage in psychotherapy. Some illnesses, like schizophrenia or bipolar disorder, often require a patient to take medication for their whole life, but they still benefit from psychotherapy.”

But Dr. Gan Eng Cern, a physician, has concerns if we deemphasize the role of biology. “The overemphasis on the biological causes of mental illnesses is a ray of hope for the people suffering from them; it signifies that their conditions can actually be treated by professionals and that there are medications available to eradicate them. If a mental illnesses' biological factors are de-emphasized, it may propel us back to a time when people had less understanding, tolerance, and intellectual recognition of mental disorders. It will drive people back to their old practices of dismissing the scientific basis of the development of these psychological conditions, when the world has already come so far in terms of mental health awareness.”