It wasn’t until the 19th century that French and German scientists began to study human behavior in adaptive terms. A new paradigm emerged that labeled problems as “disorders”. That was the beginning of the attempt to control behavioral symptoms with psychopharmacology.
This change brought relief to many psychiatrists who were happy to be “real scientists”. They set aside Jungian and Freudian theories in favor of chemical compounds. Thanks to the testimony of people like Bessel van der Kolk, we know more about the true history of psychopharmacology. These testimonies also help us better understand the strong influence that psychopharmaceuticals have today.
The beginning of psychopharmacology
In the early 50s, a group of French scientists discovered chlorpromazine (Thorazine). This drug helped calm patients down and reduce agitation and delirium. Before this discovery, the Massachusetts Mental Health Center’s (MMHC) primary treatment for mental illness was conversational therapy. Therapists derived this kind of treatment from Freud’s psychoanalysis.
In the late 60s, Bessel van der Kolk witnessed the beginnings of psychopharmacology. He saw the transition toward mental illness. Bessel worked as a research assistant at MMHC. His goal was to figure out the best way to treat young people who had suffered their first psychotic breakdown.
Bessel committed to keeping his patients busy in age-appropriate activities and spent a lot of time with them. He saw things the physicians never noticed during their short visits. At night, when many of the young people had insomnia, they told him their life stories. Many had experienced abuse, sexual assault, mistreatment, etc.
The power of active listening vs. treatment with pharmaceuticals
During morning rounds, MMHC assistants presented their cases to their superiors. However, they rarely mentioned the stories their patients shared with them. Nevertheless, many later studies confirmed the relevance of these confessions.
What was also surprising was the little attention they paid to their patient’s goals and achievements. They didn’t seem to care about who their patients loved or hated, what their motivations and concerns were, or what kind of mental blocks they had.
However, Bessel consulted medical histories and asked people about their lives. Many patients felt so grateful and liberated that they questioned the need for continued treatment.
Truth is stranger than fiction
Bodily hallucinations are common in patients with schizophrenia. One example would be sexual hallucinations that usually correspond to real sensations. Thus, Bessel asked himself if the stories that he heard in the wee hours of the morning were true.
Is there a clear line between memory and imagination? What if hallucinations are actually fragmented memories of real experiences? Fortunately, research shows that a lot of violent, strange, or self-destructive behaviors are the product of past trauma. Patients engage in these behaviors when they feel frustrated, confused, or misunderstood.
For researchers to be able to communicate their results accurately and systematically, they needed “diagnostic criteria for investigation”. This gave way to the first system for diagnosing psychiatric issues, called the Diagnostic and Statistical Manual of Mental Disorders. The American Psychiatric Association published this manual. In 1980, experts recognized that this diagnostic system was inaccurate. However, psychologists still use it as a fundamental clinical tool since there’s no better alternative.
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