Blaming the Brain : The Truth About Drugs and Mental Health [Hardcover]

Elliot Valenstein (Author)

Book Description

Publication Date: October 5, 1998 | ISBN-10: 068484964X | ISBN-13: 978-0684849645

Over the last thirty years, there has been a radical shift in thinking about the causes of mental illness. The psychiatric establishment and the health care industry have shifted 180 degrees from blaming mother to blaming the brain as the source of mental disorders. Whereas experience and environment were long viewed as the root causes of most emotional problems, now it is common to believe that mental disturbances-- from depression and anxiety to schizophrenia-- are determined by brain chemistry. And many people have come to accept the broader notion that their very personalities are determined by brain chemistry as well.

In his award-winning, meticulously researched, and elegantly written history of psychosurgery, "Great and Desperate Cures", Elliot Valenstein exposed the great injury to thousands of lives that resulted when the medical establishment embraced an unproven approach to mental illness. Now, in "Blaming the Brain" he exposes the many weaknesses inherent in the scientific arguments supporting the widely accepted theory that biochemical imbalances are the main cause of mental illness. Valenstein reveals how, beginning in the 1950s, the accidental discovery of a few mood-altering drugs stimulated an enormous interest in psychopharmacology, resulting in staggering growth and profits for the pharmaceutical industry. He lays bare the commercial motives of drug companies and their huge stake in expanding their markets. Prozac, Thorazine, and Zoloft are just a few of the psychoactive drugs that have dramatically changed practice in the mental health profession. Physicians today prescribe them in huge numbers even though, as several major studies reveal, their effectiveness and safety have been greatly exaggerated.

Part history, part science, part expose, and part solution, "Blaming the Brain" sounds a clarion call throughout our culture of quick-fix pharmacology and our increasing reliance on drugs as a cure-all for mental illness. This brilliant, provocative book will force patients, practitioners, and prescribers alike to rethink the causes of mental illness and the methods by which we treat it.

Editorial Reviews

Amazon.com Review

The odds are high that someone close to you has been told he or she has a "chemical imbalance" in the brain, but the odds are slim that the doctor who said it could point to any convincing evidence that it was true. The increasing awareness that most biological theories underlying diagnoses of depression, schizophrenia, and other mental problems are based very loosely on accidental drug discoveries and promoted heavily by pharmaceutical companies is the basis for neuroscientist Elliot S. Valenstein's book Blaming the Brain. Compelling reading for the age of Prozac, Blaming the Brain looks at the history of medical treatments for psychiatric disorders, and particularly the modern era of drug therapies, with the intent of uncovering whether science or rhetoric determines courses of treatment.

Claiming that there are no widely accepted theories of mental illness and that therapies are guided more by marketing than lab work hasn't won Valenstein many friends in psychiatry, but his scientific credibility is impeccable, and, better for the reader, his explanations of his doubts are clear and sensible. Whether discussing the "good old days" of insulin coma and electroshock therapies (after which drugs seemed a humane godsend) or the modern prospects of scientific research and medical clinics owned and directed by pharmaceutical companies, he maintains a calm, measured style that seeks to clothe the emperor, not replace him. Blaming the Brain is a powerful, thoroughly enjoyable book that will provoke much-needed thought and discussion on all sides of this important topic. --Rob Lightner

From Publishers Weekly

In the past 25 years, theories of mental illness have shifted from blaming mother to blaming the brain. While the prevailing view is that "mental illnesses are medical illnesses just like diabetes, high blood pressure or heart disease," and it's estimated that 30 million people worldwide have taken Prozac, the truth, argues Valenstein, a professor of psychology and neuroscience at the University of Michigan and the author of Great and Desperate Cures, is that we are only at the dawn of an understanding of mental illness. The studies he reviews indicate that a combination of medications and therapy offers the best chance of success at treating common disorders, although no one knows exactly why. Valenstein does a fine job of illuminating the various interests at work behind the ascendancy of purely biological hypotheses. They appeal to pharmaceutical companies, he suggests, for all the obvious reasons, and he details the impact that these companies have, at every level, on today's psychiatric landscape: from sponsoring research and colloquiums to lobbying government to marketing directly to both consumers and primary-care physicians?the largest prescribers of psychiatric drugs. The companies also, he reports, pressure editors of psychiatric journals, in which they also advertise, to downplay studies that cast doubt on the safety or usefulness of their drugs. Families and patients, meanwhile, embrace biological theories because they relieve them of the burden of blame, and physicians, he says, neglect their responsibility to report side effects to the FDA. This meticulously researched, evenhanded work deserves a large audience. Unfortunately, it's about as exciting to read as the fine print in your HMO contract; Valenstein, who comes out with both guns blazing, concentrates more on clearly digesting the data than on giving the story a human face.
Copyright 1998 Reed Business Information, Inc.

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Product Details

• Hardcover: 304 pages
• Publisher: Free Press (October 5, 1998)
• Language: English
• ISBN-10: 068484964X
• ISBN-13: 978-0684849645
• Product Dimensions: 9.3 x 6.4 x 1.1 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.3 out of 5 stars  See all reviews (21 customer reviews)
• Amazon Best Sellers Rank: #1,027,759 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

48 of 52 people found the following review helpful:

5.0 out of 5 stars The Marketing of Mental Ilness, February 7, 2000

By 

Richard Warner (Seattle, WA) - See all my reviews

This review is from: Blaming the Brain : The Truth About Drugs and Mental Health (Hardcover)

In the 1940's psychiatrists began the effort to convince humankind that mental illness was an epidemic - a "disease" which could strike anyone at any time. This fear mongering has continued unabated for 50 years despite a complete absence of any solid evidence that mental and emotional problems are caused by brain pathology. Valenstein argues convincingly that psychiatric chemical imbalance theories are seriously flawed and reveals the marketing and hype behind the push to convince us that life is essentially a disease. Psychiatric treatment leads invariably and inevitably to diminishing mental and physical health. Read Valenstein's book and you'll gain a great deal of insight into why that is true.

35 of 38 people found the following review helpful:

5.0 out of 5 stars Controversial, possibly, but a wonderful and important book!, November 14, 1998

By 

Armando Machado - See all my reviews

This review is from: Blaming the Brain : The Truth About Drugs and Mental Health (Hardcover)

Valenstein does it again! After his insightful book on the history of psychosurgery, the author, a professor of psychology and neuroscience at Michigan University, examines the biochemical theories of mental disorders. In a well-written book, Valenstein (a) describes the history of the major "theories" relating mental disease to brain function, and the history of the main psychotherapeutic drugs; (b) the empirical and logical basis of the claims that mental disorders are caused by chemical inbalances in the brain; and (c) the social, economic, and cultural contexts surrounding the use of psychothrapeutic drugs. Although not a physician, psychiatrist, or clinical psychologist, I admire the book for its extensive review of the scientific literature, for its success at explaining the main ideas about mental disease and brain science to the nonspecialist, and for its thoughtful conclusions. Perhaps the book's greatest virtue is to remind us of how ignorant we still are about the causes of schizophrenia, manic-depressive disorder, and many other mental conditions. In a word, read this excellent book. The writing is also elegant.

41 of 47 people found the following review helpful:

5.0 out of 5 stars Silver Bullets and Free Lunches, January 3, 2007

By 

A. R. Cellura (Abbeville, SC) - See all my reviews
(REAL NAME)   

This review is from: Blaming the Brain : The Truth About Drugs and Mental Health (Hardcover)

Once or twice a month, in many psychiatric hospitals, researchers present data showing the therapeutic efficacy of a new drug (or tweaked older one with a new label). The charts and graphs about these "silver bullets" usually feature percentages of psychiatric patient improvements over six to eight weeks in comparison with those treated by placebo or competing meds. The sample sizes are typically small and, at least in the many of these presentations that I attended, even the simplest descriptive statistics (means, standard deviations, etc), to say nothing of measures of sample overlap (Cohen's d scores) and meta-analyses, are nowhere to be seen. Nor are they readily available from the presenter. The attending psychiatric staff sometimes raise questions about the area of the brain or nerve receptor the drug targets while they enjoy the fine and plentiful free lunch provided by the sponsoring pharmaceutical company. It would be difficult to conclude other than that issues of empirical validity had been comfortably settled long ago. Thus, these concerns were far beyond the mattering maps of the audience. An earlier generation's favored cure was lobotomy before, in the early 1950s, the discovery of Thorazine's (chlorpromazine) quieting effects ushered in this, now dominant, psychiatric treatment paradigm.

Elliot Valenstein's BLAMING THE BRAIN: THE TRUTH ABOUT DRUGS AND MENTAL HEALTH demonstrates why rationales for this paradigm ain't necessarily so. Valenstein, professor emeritus of psychology and neuroscience, University of Michigan, continues the program begun in his GREAT AND DESPERATE CURES: THE RISE AND DECLINE OF PSYCHOSURGERY AND OTHER RADICAL TREATMENTS FOR MENTAL ILLNESS (HarperCollins, 1987) and now followed by his most recent THE WAR OF THE SOUPS AND THE SPARKS: THE DISCOVERY OF NEUROTRANSMITTERS AND THE DISPUTE OVER HOW NERVES COMMUNICATE (Columbia Univ. Press, 2005). He helps his readers look beyond the shiny surfaces of therapeutic regimes and into the empirical heart of these matters. In BLAMING Valenstein draws our attention to the transition in psychiatric treatment ideology from mothers as causes of mental illnesses to the current conventional certainties about chemical imbalances in the brain, which he says, though in other words, rest solidly on a foundation of sand. He describes how neuropsychiatric theory got from there to here, then to now, jettisoning untidy, equivocal empirical data along the way.

In BLAMING, a rich historical context is provided to make sense of the scientific, social and economic forces that led to the now, largely unchallenged, happy and enduring marriage between the pharmaceutical industry and the psychotropic treatments that identify most of present-day psychiatry. [See Peter Breggin's TOXIC PSYCHIATRY, St. Martin's Press, 1991 and C. Ross & A. Pam's (Eds.) PSEUDOSCIENCE IN BIOLOGICAL PSYCHIATRY, Wiley, 1995 for notable exceptions in the psychiatric community]. Included on the theoretical side are the speculations of the 19th century figures like Thidicum, the founder of modern neurochemistry and Freud, both of whom suggested a neurochemical basis for mental illnesses, and the chemical elaboration of LSD accompanied by the English professor of pharmacology, John Gaddum's suggestion that LSD-25's effects might be caused by blocking the neurotransmitter serotonin, a newly discovered brain chemical he thought essential for balanced mental activity.

On the treatment side, Valenstein traces the emerging trials in the early 50s with Thorazine, initially marketed as a surgery anesthetic. This led to it and later generations of drugs becoming the treatments of choice for the schizophrenias. Similar development pathways are described for the anti-depressants and anti-anxiety meds. An anecdote not included, but that gives some idea of the patient's experience with these "tranquilizers," is the story of Dr. Cornelia Quarti, the psychiatric resident who submitted experimentally to a trial with Thorazine in the earliest days of its use. As the drug took effect she tried to shout out, "No! You are bothering me!" and tried to fight off the subsequent feeling of imminent death with all her energy. Later, she listened in amazement as the experiment tape recording revealed, a "weak and monotonous voice..." [cf. D. Cohen in S. Fisher & R.P. Greenberg (Eds.), FROM PLACEBO TO PANACEA, Wiley, 1997].

Professor Valenstein's treatment of the empirical and theoretical developments in neuroscience and psychopharmacology is detailed and exhaustive including issues surrounding electrical versus chemical stimulation of the brain (the Sparks and the Soups camps), relationships between the discoveries of neurotransmitters, brain centers for reward, eating, rage and physiological concomitants of emotion (sweating, changes in heart rate and blood pressure, etc.), and biochemical theories about how these might explain the effects of psychotropic medications and account for mental illnesses. Not the least of these accounts were theories of schizophrenia (excess dopamine) and depression (e.g. serotonin deficiency) that are still favored in the trenches of clinical psychiatry. For reasons that are carefully explored in Chapter 4 (A Closer Look at the Evidence) and Chapter 5 (The Interpretation of the Evidence), these and other biological theories are critiqued on grounds that are logical (cause/effect confusion, reductionism), empirical (brain plasticity in response to experience; complex, often indeterminate, disease pathways) and moral (political/economic forces through which marketing, corporation earnings and bare bones state hospital budgets coalesce in spite of the known limits and iatrogenic effects of sustained treatment with psychotropic meds and proven psychosocial community treatment). See Chapter 6 on the pharmaceutical industry influences and Chapter 7 on special interest groups.

BLAMING provides a thicket of facts woven together clearly, crisply and expertly. Following the evidence, Valenstein comes down hard on current treatment with psychotropics, biological psychiatry and the partnership between Big Pharma and medicine. He makes clear, there is an important place for medication. However, the complex interplay between biological and psychosocial phenomena means that the silver bullet, the wonder drug that can solve the lock and key problem of mental illness, or psychotropic cocktails, are unlikely fixes for problems of living. And, no lunch is free as medical staff surely ought to know.

If the reader wants more from similar terrain there is David Healy's THE ANTIDEPRESSANT ERA (Harvard Univ. Press, 1997), Healy's THE PSYCHOPHARMACOLOGISTS (Chapman & Hall, 1998), Larry Squires THE HISTORY OF NEUROSCIENCE IN AUTOBIOGRAPHY (Society for Neuroscience, 1996), Edward Shorter's A HISTORY OF PSYCHIATRY (John Wiley, 1997), Marcia Angell's THE TRUTH ABOUT DRUG COMPANIES (Random House, 2004), the classic Gordon Paul & Robert Lentz's PSYCHOSOCIAL TREATMENT OF MENTAL PATIENTS (Harvard Univ. Press, 1977) and A. R. Cellura's THE GENOMIC ENVIRONMENT AND NICHE-EXPERIENCE (Cedar Springs Press, 2006).