If You Seek a Bio-chemical Cause for Mental Health Disorders, You will become the “Little Train that Couldn’t”
By Linda J. Gottlieb, LMFT, LCSW-r
My opinion on the origin of mental illness is controversial to many in my profession. I maintain that emotional disturbances are situationally and not bio-chemically caused. But this position did not originate with me. It originated with my mentor, Salvador Minuchin, the world-renowned, highly respected child psychiatrist. Dr. Minuchin (as with his contemporaneous psychiatrists who founded the family therapy movement, such as Murray Bowen, Don Jackson, Jay Haley, Carl Whitaker, Nathan Ackerman, John Weakland, et al.) does not accept an intra-psychic or biochemical cause of mental disorders. Resulting from 65 years of practice, Dr. Minuchin affirms that traumatic situations; unhealthy relationships; and dysfunctional family dynamics, such as the PAS, cause mental health disorders. Diagnosis of mental health is not a science! There is no empirical evidence for any mental health disorder. You cannot inject the brain, withdraw serum, and have it analyzed. Any psychiatrist or mental health diagnostician worth his/her salt (and even those who are not worth their salt) must acknowledge that diagnosis of emotional disorders is based merely upon “impressions.”
Mental health patients are guinea pigs when they are prescribed an array of psychotropic medications and subjected to a host of invasive procedures, such as ECT. At least Dr. Minuchin’s assessment for the cause of mental disorders offers optimism while remedy is benign and unintrusive: if you discard unhealthy relationships and situations, you will be symptom-free. A symptom free life is therefore possible without being subjected to invasive medications and procedures. Dr. Minuchin has recognized that he is a salmon swimming upstream when he articulates this; but think about it: if his analysis was to become the norm, then 90% of the psychiatric community would need to become educated about relationship therapy. And it would also be more costly for the health insurance industry, which would then have to incur the expenses of reimbursing for more protracted relationship therapy instead of for the quick fixes of drug therapy. No wonder there is such resistance to accepting this not so novel assessment of mental health diagnosis—-in spite of 60+ years of empirical evidence and scientific support for this perspective.
Although this may come as a shock to many readers, our current state of psychiatric diagnosis is NOT science. If it were, then psychotropic medications would not need to be persistently adjusted up or down in dosage, completely changed, and/or supplemented with other medications. The simple explanation for why medications so frequently fail to achieve a reduction in symptoms is because symptoms do not result from a chemical imbalance. Just compare the administration of medications for medical disorders: when, for example, an antibiotic is given for an infection, it is highly probable to be effective in resolving the symptoms. And if Dr. Minuchin was to be asked, he would likely explain that it is a patient’s history of having taken psychotropic medications that subsequently caused her/his chemical imbalance: in essence, such medications had upset a NORMAL chemical balance. Do not take my word for it: read the many books by Dr. Minuchin and the previously referred- to psychiatrists—-all of whose writings are listed in the reference at the conclusion of this article.
Dr. Minuchin’s opinion is supported by the recent research of Dr. Irving Kirsch, psychologist at Harvard University, who discovered that a placebo was equally as effective as were antidepressants in treating mild to moderately depressed patients. It was only the small percentage of highly depressed patients who responded better to antidepressants.
My opinion on the origin of mental illness is controversial to many in my profession. I maintain that emotional disturbances are situationally and not bio-chemically caused. But this position did not originate with me. It originated with my mentor, Salvador Minuchin, the world-renowned, highly respected child psychiatrist. Dr. Minuchin (as with his contemporaneous psychiatrists who founded the family therapy movement, such as Murray Bowen, Don Jackson, Jay Haley, Carl Whitaker, Nathan Ackerman, John Weakland, et al.) does not accept an intra-psychic or biochemical cause of mental disorders. Resulting from 65 years of practice, Dr. Minuchin affirms that traumatic situations; unhealthy relationships; and dysfunctional family dynamics, such as the PAS, cause mental health disorders. Diagnosis of mental health is not a science! There is no empirical evidence for any mental health disorder. You cannot inject the brain, withdraw serum, and have it analyzed. Any psychiatrist or mental health diagnostician worth his/her salt (and even those who are not worth their salt) must acknowledge that diagnosis of emotional disorders is based merely upon “impressions.” 
Although this may come as a shock to many readers, our current state of psychiatric diagnosis is NOT science. If it were, then psychotropic medications would not need to be persistently adjusted up or down in dosage, completely changed, and/or supplemented with other medications. The simple explanation for why medications so frequently fail to achieve a reduction in symptoms is because symptoms do not result from a chemical imbalance. Just compare the administration of medications for medical disorders: when, for example, an antibiotic is given for an infection, it is highly probable to be effective in resolving the symptoms. And if Dr. Minuchin was to be asked, he would likely explain that it is a patient’s history of having taken psychotropic medications that subsequently caused her/his chemical imbalance: in essence, such medications had upset a NORMAL chemical balance. Do not take my word for it: read the many books by Dr. Minuchin and the previously referred- to psychiatrists—-all of whose writings are listed in the reference at the conclusion of this article.
Dr. Minuchin’s opinion is supported by the recent research of Dr. Irving Kirsch, psychologist at Harvard University, who discovered that a placebo was equally as effective as were antidepressants in treating mild to moderately depressed patients. It was only the small percentage of highly depressed patients who responded better to antidepressants.
