The Fourth Revolution in Psychiatry

What is meant by the term Revolutions in Psychiatry? So far, there have been three of these revolutions.


 

The first was inaugurated by the French psychiatrist, Philippe Pinel around the year 1791.  Pinel vigorously attacked cruel treatments foisted on the insane by the 'mad' doctors of the 17th and 18th centuries. Pinel stopped the use of chains, bloodletting, vomiting, cold water dunkings etc., in his psychiatric Salpetriere Hospital in Paris.

 
The second revolution of psychiatry was around the year 1900.
This was ushered in by Sigmund Freud (1856-1936). Freud was a neurologist like Pinel. He never gave up the idea that all psychological illnesses were due to organic causes.  However, realizing that there was no cure, Freud turned to hypnosis and "psychoanalysis". He became convinced that all neuroses stemmed from sexual problems and childhood experiences. Getting past this revolution was horrific but necessary.

Our book Broken Minds, Hope for Healing When You Feel Like Your Losing It demonstrates that a number of leading figures in Christian psychology and therapy owe their origins to Neo-Freudians and Freudians.


 
 John Cade, discovered Lithium  

The third revolution in psychiatry was in the 1950's when those with mood disorders and psychosis were given access to and treated with psycho-tropic medication. This revolution included the more wide spread of use of ECT, (Electro Convulsive Therapy). There have been many medications to treat the major mental illnesses since Cade's discovery. Various  drug companies did their own research and found new cures by modern medicine.

Lithium was the first line treatment for those with bipolar disorder.
Haldol was one of the first drugs for treating schizophrenia, and tricyclic antidepressants helped many with severe depression.  Prozac was first in line of what was to be  known as Serotonin Selective Re-uptake Inhibitors.  Many of those class of drugs and classes of drugs have been put on the list of drugs that treat mental illness. 
Some Christian organizations have denied the use of medications for mental illnesses but the next revolution has been very powerful regarding the biological origin of mental illness.



 
 Thomas Insel, National Institute of
Mental Health.


The fourth revolution in psychiatry is in the present, which is shifting from psychology and psychiatry to genomics and the neurosciences. This is connected to advances in DNA sequencing and functional imaging.

The next decade should see all of these strands intertwined into a more holistic approach. People are beginning to recognize that depression and schizophrenia, for example, are brain disorders related to physiological changes rather than simply behavioral ones.

What does it mean to think of mental illnesses in this way? Is psychiatry really just part of neurology? Many disorders of neurology, such as stroke, involve damage to a specific site in the brain. But psychiatric disorders may be more usefully thought of as brain circuit problems – what researchers have called “connect-opathies." We can make an analogy between mental illness and a heart condition. The behaviors and ways of thinking seen in a mental illness are symptoms of an underlying disorder; one that involves faulty brain circuits – a brain "arrhythmia," whereas a neurological disorder could include a heart attack- Thomas Insel

Broken Minds,(Kregel Publications) is not just any book on mental illness. It emerges from the deep suffering of Steve and Robyn Bloem that comes with a severe depression. The authors go into  more details about the failure of the  church to embrace mental illness.It is especially seen in chapter 15, A History of Mistreatment, pp. 171-180. http://www.amazon.com/Broken-Minds-Healing-Youre-Losing/dp/0825421187 

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