ABSTRACT
While Freud and others were developing their theories that adult psychopathology is rooted in adverse childhood experiences, Kraepelin was promulgating very different ideas (Bentall 2003; Read 2004b). The second half of the twentieth century saw a new player enter the fray in this age-old debate about whether the failings of our genes or the slings and arrows of outrageous fortune are primarily responsible for driving some of us crazy. The pharmaceutical industry tipped the balance decisively in favour of the bio-genetic view (Mosher et al. 2004), reflecting the power, throughout recorded history, of social, economic and political forces in shaping our understanding of disturbed people (Read 2004a, 2005). In August 2005 Dr Steven Sharfstein, the president of the American Psychiatric Association, in an article entitled ‘Big Pharma and American psychiatry: The good, the bad, and the ugly’, was both honest and brave in stating:
There is widespread concern at the over-medicalization of mental disorders and the overuse of medications. Financial incentives and managed care have contributed to the notion of a ‘quick fix’ by taking a pill and reducing the emphasis on psychotherapy and psychosocial treatments. There is much evidence that there is less psychotherapy provided by psychiatrists than 10 years ago. This is true despite the strong evidence base that many psychotherapies are effective used alone or in combination with medications. . . . If we are seen as mere pill pushers and employees of the pharmaceutical industry, our credibility as a profession is compromised.
