The Biopsychiatric Bluff

Dear Dr. Zev,

I’m a junior in college. I started seeing a psychologist about a year ago because I suddenly lost all of my confidence and began avoiding social situations. When this happened, I was too self-conscious to take my final exams, so I took “incompletes” in all my classes and moved back to the safety of my parent’s house. It was then, that I started to see a psychologist.

When I first met Dr. Jack, I saw that he was brilliant and very charismatic in a soft-spoken way. His office and waiting room were lined with books.  I was immediately drawn to Jack’s confidence. Whenever he spoke, he had a little smile and a knowing twinkle in his eyes. I could see why so many people believed in him. 

In my second session, Dr. Jack gave me a blank piece of paper and a pencil and told me to draw a picture of a house, a tree, and a person. It took me about 10 minutes to complete. From these drawings, Jack diagnosed me as suffering from “endogenous depression.” He contrasted endogenous depression to reactive or situational depression. He said that reactive depressive was a temporary depression that resulted from reacting to a trauma or other precipitating event and was not biological in origin. He told me that endogenous depression is a more complicated and serious type of depression which is biological in origin. This meant that I needed to take anti-depressant medication. Dr. Jack told me that talk therapy by itself would not be enough to help me.

As Dr. Jack continued to explain the difference between the two types of depression I felt myself sinking deeper into hopelessness.  It was very painful to hear that the core of who I am is a damaged and defective person who was incapable of being happy like other people. In effect, the doctor told me that my whole identity was to be depressed. As I left his office, I never felt so bad about myself in my life. My whole existence had just been reduced to nothing – I felt like killing myself. He even dismissed whatever happiness I remembered as “isolated experiences.” Due to my biological impairment, he was sure that I have always experienced an underlying depressive mood.

I couldn’t fight his logic. My doctor convinced me that I have endogenous depression. The problem now is what to do about it. Even with the medication and therapy that I’m receiving, I’m still not feeling any better. What’s your advice?

Sincerely Yours,
Jonathan

Dear Jonathan,

There are great many people whose doctors have told them that their depression was biological. The truth is that there is considerable controversy within the scientific community itself about “endogenous depression” and other hypothesized bio-psychiatric disorders.

The popular view is that endogenous depression and other so called “mood disorders” are a reflection of a ‘chemical imbalance’ in the brain. The chemical imbalance hypothesis states that a chemical imbalance within the brain is the main cause of psychiatric conditions and that these conditions can be improved with medication which corrects this imbalance. In this hypothesis, emotions within a “normal” spectrum reflect a proper balance of neuro-chemicals, but abnormally extreme emotions, such as  clinical depression reflect an imbalance.

The good news for you, Jonathan, is that there is absolutely no proof for this hypothesis and this whole conceptual framework has been challenged within the secular scientific community itself! 

Bio-psychiatric research has only been able to show that people with psychiatric problems have differences in the way their brains look and function compared to other people – they don’t have any proof that a brain that’s a bit different from the norm is the cause of psychiatric conditions. In other words they have found correlations but no causes. Let them study Nobel Prize winners or great spiritual masters – I’m sure they’ll find that their brains are also different from the norm.

The biological psychiatrists have the same problem with their genetic research. Although they have identified a  “genetic component” that people with psychiatric illness share, again there is no proof that it’s the people’s genes which are causing their problems.  In addition  by their own admission, researchers don’t have reliable markers to clearly know why people feel better from psychiatric medication.

In short, it was irresponsible and unethical of your psychologist to diagnosis you with something that has not been proven to exist. His belief that there are biological factors that are causing you to feel down is just his opinion and has no basis in fact even from a secular perspective.

I suggest that you find yourself a new therapist, preferably a student of Rabbi Arush who will help you to see who you really are. The only “you” is your soul which is perfect and eternal like G-d Himself. Never  identify yourself with diagnostic labels. It is dehumanizing to be categorized in this way.  For example, many people have the false belief that they are addicts. This falsehood has become their identity. If you ask them who they are they’ll say: “I’m an addict” but it’s not the truth. What they do have are problems with addictive behaviors – but we can help people change their behaviors. A person is much more than his external behavior.

Whenever I have the feeling that someone who I’m working with doesn’t need medication anymore, I send them to a Torah-observant psychiatrist who I trust and to Rabbi Shalom Arush. In one recent case, both the doctor and the Rabbi agreed that it would be okay for the person to stop the psychiatric medications that he was taking for 15 years.

Good therapy starts by challenging the false and limiting believes that people have about themselves, and then helping them to change their  behavioral patterns so they are free to become everything that they  were meant to be.

May Hashem help you, Jonathan to find the right people to help you, and may you soon see a complete and permanent end to your suffering.

Sincerely Yours,
Dr. Zev Ballen