Does the “brain disease” belief actually reduce stigma? NO, it increases it

I’m reposting this with some edits because it establishes what many of us have been saying for years. The disease model is far more stigmatizing than understanding emotional distress as psychologically and generally trauma based. The fact is we are holistic beings and we can do much, including supporting our physical bodies, to help ourselves with mental distress. Biopharm, instead, supported by the disease model, often makes things worse and far more intractable.

So what that means is the answer does not lie in the biological reductionism that psychiatry most often espouses and makes up stories about.  Everything matters. Until we start attending to the individual as part of the whole of life, intertwined with everyone and everything, we’ll continue to harm.

What happens to us matters. Trauma matters.

In the New York Times Magazine from January, 2010, an essay adapted from a new book: Crazy Like Us: The Globalization of the American Psyche:

A very damning excerpt:

But does the “brain disease” belief actually reduce stigma?

In 1997, Prof. Sheila Mehta from Auburn University, Montgomery in Alabama decided to find out if the “brain disease” narrative had the intended effect. She suspected that the biomedical explanation for mental illness might be influencing our attitudes toward the mentally ill in ways we weren’t conscious of, so she thought up a clever experiment.

In her study, test subjects were led to believe that they were participating in a simple learning task with a partner who was, unbeknownst to them, a confederate in the study. Before the experiment started, the partners exchanged some biographical data, and the confederate informed the test subject that he suffered from a mental illness.

The confederate then stated either that the illness occurred because of “the kind of things that happened to me when I was a kid” or that he had “a disease just like any other, which affected my biochemistry.” (These were termed the “psychosocial” explanation and the “disease” explanation respectively.) The experiment then called for the test subject to teach the confederate a pattern of button presses. When the confederate pushed the wrong button, the only feedback the test subject could give was a “barely discernible” to “somewhat painful” electrical shock.

Analyzing the data, Mehta found a difference between the group of subjects given the psychosocial explanation for their partner’s mental-illness history and those given the brain-disease explanation. Those who believed that their partner suffered a biochemical “disease like any other” increased the severity of the shocks at a faster rate than those who believed they were paired with someone who had a mental disorder caused by an event in the past.

“The results of the current study suggest that we may actually treat people more harshly when their problem is described in disease terms,” Mehta wrote. “We say we are being kind, but our actions suggest otherwise.” The problem, it appears, is that the biomedical narrative about an illness like schizophrenia carries with it the subtle assumption that a brain made ill through biomedical or genetic abnormalities is more thoroughly broken and permanently abnormal than one made ill though life events. “Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as physically distinct. Biochemical aberrations make them almost a different species.” (read the whole article here)

I’ve been saying this for years. I love validation.

While there may in fact be diseases of the brain, there is very little to no evidence at all that those emotional phenomena that get labeled as psychiatric illness have any relation to any real disease process at all. All the diagnostic classes in psychiatry that claim to be disease can and do respond to holistic measures that are both deeply empowering and healing to those dealing with such distress. Mental “illness” is NOT just like diabetes. Antipsychotics (or antidepressants, mood stabilizers, etc) are not the equivalent of insulin.