The new authority in behavioral science involves a combination of biopsychology, pharmacology, medicine and the insurance industry.
The time has come for more thoughtful conversation about the convergence of big business and the needs of patients.
As the fields of counseling, psychotherapy and bio-psychiatry have become profit-driven, I’ve grown more concerned about the business and market focused emphasis behind these disciplines. It’s worth asking if the narratives used for assessing behavior are potentially self-serving to business interests in ways that could hurt the people in need of help.
Professional opinion on sources behind human behavior has undergone a relatively recent social revolution. The two most prominent narratives for understanding human behavior are nurture (social context) and nature (genes and brain chemistry). Consider a simple overview of these two sources.
Nurture – You are the product of social context
Social context, for many years, supplied the main narrative for understanding personal behavior. Nurture has to do with the roles of parents and other significant adults or life-altering circumstances that explain a persons thoughts, attitudes, emotions and behaviors. You are the product of social context.
The focus here is on how you were hurt or helped by others. Were you deprived of nurture as a child? We can explain you by the things done to you or withheld from you. This has been the dominant assumption behind most of psychotherapy. Words like “wounded,” ”dysfunctional” and “co-dependent” became stock vocabulary for psychiatrists.
The nurture assumption also influenced the primary objectives for helping wounded people. The path to healing focused on rebuilding self-esteem through therapy. Over time, therapeutic psychology highly influenced public education so that even teachers had to view it as part of their work. Building self-esteem in students was added to the educational agenda.
It also became fashionable to go to therapy and to have a personal therapist/psychiatrist. The social stigma diminished as the prominent role of the psychotherapist increased.
In social and behavioral sciences, therapeutic psychology occupied the authoritative seat in helping people with life issues. But the recent emergence of bio-psycholgy and pharmacotherapy dethroned therapeutic psychology.
Nature – You are the product of genetics and brain chemistry
Advancements in science (particularly in genetics and neuroscience) gave way to new conclusions about reasons behind human behavior. Scientific discoveries led researchers to conclude that our lives are largely shaped by genetic physical conditions and brain chemistry.
This narrative is offered as the most objective explanation for emotions and behaviors and gave rise to the discipline of biopsychiatry. It also shifted the source for diagnosis and cure toward medical professionals. As progress was made in these fields, a new leader took a seat at the table: pharmacotherapy.
This led to a kind of unholy wedding between big business pharmacology, the insurance industry and biopsychology.
Without denying the effects of social context, biopsychiatry appears to offer hard scientific conclusions as a reigning narrative for the sources and cures to human behavior. And, since sources to behavior trace to your body and brain, medical prescriptions (it’s postulated) offer the most objective solutions. It is widely accepted that neuro-chemical deficiencies explain a host of personal problems ranging from depression and anxiety to learning deficiencies.
The most prominent example of the influence of biopsychiatry is the exponential increase in depression and anxiety diagnoses and the prescription of medications for alleviating them. Treatment of depression in outpatient services increased by 300% toward the end of the 20th century. Antidepressant medications have become the largest selling prescription drugs in America. During the 1990s, spending increased by 600% exceeding 7 billion dollars annually by the year 2000. Estimates now indicate that major depression afflicts 10-12% of Americans. A disconcerting by-product has been an inability to distinguish biologically based depression from normal sadness.
Until recently, nurture has provided the dominant narrative and therapeutic psychiatry has been the authoritative discipline for helping people understand their behavior. Relatively recent breakthroughs in science and medicine shifted mainstream opinion to nature as the new reigning source for explaining behavior.
But this new authority in behavioral science is now a big business merger of biopsychology, pharmacology, medicine and the insurance industry. When profit-driven interests occupy a controlling piece of the narrative, the losers in will be counselees and patients.
I realize that this problem is not easily solved, but it ought to be receiving more focus and discussion.
We also need more objective efforts in working toward a holistic narrative for helping people understand themselves and their problems. The merging of big business and behavioral research is a slippery and potentially harmful arrangement.
Human beings are more complicated than narratives of nurture and nature. Each dimension offers important considerations but neither should be permitted to exclude the other.
An additional discipline should also be invited to the table. The discipline of theology offers a wider perspective because it reinforces the fact that God created humans as physical, social, psychological and spiritual beings. When counseling others, each of these dimensions should be considered. The counselor who respects this view of humanity will be better situated to help those in need.
Appeal to Christian counselors
Christian counselors should use the widest possible lens for understanding and addressing human behavior. A theologically grounded vision of humanity provides counselors with a unique advantage for being holistically honest in dealing with human problems. Counselors who understand that God has made us physical, social, psychological and spiritual beings (with three dimensions of personhood: emotion, intellect and volition) will not disrespect any part or dimension of humanity when helping others.
Those who accept the Biblical narrative of creation in God’s image and the subsequent fall from this glory will also acknowledge that the most corrupting and alienating force in the world (sin) has affected each dimension of life. Diagnosis and solution that does not take seriously this painful truth will be superficial at best and ultimately harmful.
Counselors who accept the multidimensional nature of humans are better positioned to avoid inadequate and hurtful conclusions on the sources behind behavior.