The bio-bio-bio model of madness, by John Read

RDoC are based on the brain-disease model of mental health just at a time when the “bio-bio-bio” model (Read 2005; Read, Bentall, and Fosse 2009), which combines neurobiology, genetics, and pharmacology, has come under attack at the epistemic, ontological, sociomoral, and cultural levels.

What are the grounds for criticism of the “bio-bio-bio” model? First, recent and in principle better-targeted medication has not worked as anticipated. The new generations of antipsychotics are not more effective than older and (by now) much cheaper drugs like Thorazine, a trademark of chlorpromazine. The new drugs, moreover, have been related to sudden cardiac death, cardiovascular risk, weight gain, and the development of diabetes (Álvarez-Jiménez et al. 2008; Foley and Morley 2011; Luhrmann 2012; Ray et al. 2009; Weinmann, Read, and Aderhold 2009).

Second, psychological therapies have made a comeback. The cerebralization of psychiatry has conflicted with psychodynamic, mainly psychoanalytic approaches, around issues of efficacy, diagnostic validity, and prevalence.

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Excerpt of the article

At a conference in Vancouver last year Dr Robin Murray gave an encouraging plenary address. He acknowledged some of the recent research about the role of psychosocial factors influencing schizophrenia. He concluded, however, that ‘the schizophrenia wars were over years ago’. He was referring to the truce established under the banner of the ‘bio-psycho-social’ model, which says that schizophrenia is an interaction between a genetically inherited predisposition and the triggering effect of social stressors. But I think the war is far from over.

I explained that in most wars the invading power is premature in announcing a cessation of hostilities, usually once they have reduced the inhabitants of the invaded country to uncoordinated, sporadic resistance. I said that many of us still feel we are living in occupied territory. The war would end, I continued, only when simplistic biological ideologies and technologies withdrew to the appropriate boundary and acknowledged the damage caused by their illegitimate incursion. [...] 

Nevertheless, the supposed integration of perspectives implied by the term ‘bio-psycho-social’ model since the 1970s is more illusion than reality. An integral part of this has been the ‘vulnerability-stress’ idea that acknowledges a role for social stressors but only in those who already have a supposed genetic predisposition. Life events have been relegated to the role of ‘triggers’ of an underlying genetic time-bomb. This is not an integration of models, it is a colonisation of the psychological and social by the biological.

Read the full article below:

Read, John. 2005. “The Bio-bio-bio Model of Madness.” The Psychologists 18 (10): 596–597.

Source of image and caption: Dr. John Read's profile at University of East London