It was not until the 19th century that French and German scientists began to investigate human behavior in terms of adaptation. Then appeared a new paradigm considering problems as "troubles", giving the same green light to various attempts to control their symptoms by psychopharmacology.
Many psychiatrists began to feel relieved and delighted to be "true scientists". Ofleave out theories like those of Freud and Jung. Testimonies such as those of Bessel Van Der Kolk allow us to learn more about the true history of psychopharmacology and some causes explaining its current influence.
The beginnings of psychopharmacology
A group of French scientists discovered chlorpromazine (sold under the name Thorazine) in the early 1950s. It helped calm patients and reduce agitation and delusions. previously, the main treatment of mental illness in Massachusetts Mental Health Center (MMHC) was conversational therapy (derived from Freud's psychoanalysis).
Bessel Van Der Kolk witnessed the beginnings of psychopharmacology in the late 1960s.In other words, from the transition from the medical approach to psychic suffering. He worked as a research assistant at the MMHC to determine the best way to treat young people who had experienced their first psychotic attack.
Bessel was dedicated to keeping youth involved in popular activities for their age group. He spent a lot of time with them, observing details that the doctors had never seen during their brief visits. During sleepless nights, especially,patients told stories of their lives, how they had been beaten, assaulted, abused …
The power of active listening to psychopharmacological treatments
The MMHC assistants presented their cases to their superiors during the morning medical rounds. However, they rarely told stories that patients had shared about their lives. Ofmany subsequent studies, however, confirmed the relevance of these confessions.
"I was surprised by the coldness with which they talked about patients' symptoms and the time they spent trying to manage their suicidal thoughts and self-destructive behaviors instead of trying to understand the possible causes of their desperation and their helplessness. "-Bessel Van Der Kolk-
Reality exceeds fiction
Body hallucinations in schizophrenia are common. The same goes for sexual hallucinations, where most correspond to real sensations.Bessel wondered about the truth of the stories he listened to in the early hours of the morning.
Is there a clear line between memory and imagination? What if the hallucinations were actually fragmented memories of real experiences? Fortunately, the research showed that manyviolent, bizarre or self-destructive behaviors are, when patients are frustrated, confused or misunderstood, the product of past trauma.
Bessel was surprised and alarmed by the gestures of satisfaction he found in the professionals when they managed to keep a patient on the ground to administer an injection.He gradually realized that the health organization was very concerned that the professionals had control. So much so that this goal was often prioritized over what was best for the patient.
The pharmacological revolution
Due to antipsychotic medications in 1955, psychiatric residents in the United States increased from 500,000 to less than 100,000 in 1996. Patients gradually dispersed. Some hospitals had to close. Others took the name of asylum (psychiatric hospital).
In 1968, the American Journal of Psychiatry published the results of the study Bessel participated in. The latter showed that schizophrenic patients who received only medication had better results than those who spoke to Boston therapists three times a week. In the 70s, scientists began to find evidence that associated abnormal levels of brain substances with different disorders (like depression or schizophrenia).
Researchers needed "diagnostic criteria for research" in order to be able to communicate their results accurately and systematically. This gave rise to the first system to diagnose psychiatric problems in a systematic way. It's aboutDiagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. It was recognized in 1980 that this diagnostic system was defective.Nevertheless, despite the absence of a better system or better accepted, the DSM remains today used as a fundamental tool in clinical practice.
The triumph of psychopharmacology
Medications have allowed doctors to be more efficient. They also increased their income and profits.Scholarships also provided more labs filled with students and sophisticated instruments. From an outside perspective, the staging seemed more scientific insofar as chemistry played a role.
The departments of psychiatry, which used to be in the cellars, began to rise, both in factories and in terms of prestige. Bessel observed in the 1990s that the only place in the MMHC where they could experience some physical well-being (pool, gym …) had become a laboratory to "fix" the patients.
Otherwise,leading medical journals publish and / or rarely fund studies on the treatment of mental health problems without drugs. They also require standardized protocols that do not adapt to the individual needs of patients. They continue during this time to increase overdoses due to the combination of psychiatric and analgesic drugs.
In the end, the pharmacological revolution generated enormous benefits, finding biological theories explaining the chemical imbalances of the brain. However, it has often deteriorated patient treatment and intervention plans. The negative side is thatpsychopharmacology has often displaced therapy, banished or relegated to the background, thus preventing the resolution of the underlying causes of the problems.
Van der Kolk, BA (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard review of psychiatry, 1 (5), 23-30.