There is an interview with Gail Hornstein in The Sun Magazine this month.
She has a refreshingly non-pathologizing way of working with people. I have posted a couple of excerpts below. More of the article is on the website. For the entire interview you need to buy the print version of the magazine.
The Voices Inside Their Heads
Gail Hornstein’s Approach To Understanding Madness
Frisch: Why do you feel so strongly about avoiding the phrase “mental illness”?
Hornstein: The term “mental illness” is heavily charged, politicized, and ambiguous. I prefer to talk about “anomalous experiences,” “extreme emotions,” and “emotional distress.” The main reason I don’t use medical language is that people who are suffering often don’t find it very helpful. No one experiences “schizophrenia” — that’s just a technical name for a lot of complicated feelings.
People who have been taught that “mental illnesses are brain diseases” see psychiatric patients as dangerous and unlikely to recover. And those in crisis are often understandably reluctant to consult mental-health professionals, because the stigma of mental illness is so severe: it’s possible to lose your job, your home, and your family as a consequence of being diagnosed with a mental illness. In cultures that take a social view of emotional distress, by contrast, people more readily seek help because they aren’t as likely to be ostracized and are assumed to be capable of full recovery….
Frisch: How does what is commonly called “mental illness” differ from physical disease?
Hornstein: In psychiatry mental illness is a metaphor imposed on people’s behavior. There aren’t any physical methods of diagnosing a mental illness: There’s no blood test. There’s no mri. So-called mental illnesses are diagnosed on the basis of behavior. The “chemical-imbalance” theory was invented by the marketing departments of drug companies to try to convince doctors to prescribe their products. Some doctors say depression is just like diabetes: you have an imbalance of a neurotransmitter, the way a diabetic might need more or less insulin, and this drug will restore your balance. But with diabetes it’s possible to measure the amount of sugar and insulin in your blood. We know what a balanced level is. No doctor who has given anyone an antidepressant has ever measured the level of a neurotransmitter in the patient’s body. There is no independent means by which to tell if someone has a “chemical imbalance.”…
Frisch: Is there ever a role for psychiatric drugs in treatment?
Hornstein: Psychiatry is a very politicized field. People who raise questions about drug treatment are often dismissed as knee-jerk critics, and people who see something positive about it are often considered apologists. Both those extremes are wrong. The challenge is to understand medication in a much more complex way, not oversimplifying people’s experiences and cramming them all into one box or another.
I take seriously the people who find drugs helpful. If a person says, “I was unable to get out of bed until I began taking this antidepressant,” I think we should applaud that. The number of people who experience such results, however, is far smaller than drug-company advertisements or ardent proponents of biological psychiatry make it seem. read the rest
Gail Hornstein contributed a great post to this blog a while back. It’s a chapter of her wonderful book.
You can buy her book here: