Freud and Pharmacology

I was in Vienna recently. There were two competing and seemingly conflicting attractions - I was there mainly to attend a big pharmacology confernence all about medication, but Vienna is of course also the home of Sigmund Freud and there is a museum here at his house which I made a pilgrimage to. I am also not a huge fan of Freud's version of psychoanalysis, though we can draw on many of the concepts and understanding to help understand clinical situations.


All this got me thinking about how the various approaches to understanding mental distress work together and alongside each other. The problem with only just sticking with one model - as we are all tempted to do - is that everything looks like it can be tackled by that model which it probably can't! I have tried to outline below what I use each model for and what can happen if you take it too far as the answer to everything.


  What it is good for
  When you take it too far
Biological   Looking for underlying brain chemistry changes, either as causes [eg, schizophrenia] or consequences [eg, depression] and offering medication treatments that do work fairly well.
  Medication is seem as able to bring happiness. Everything is categorised, even things like love, at the expense of understanding and compassion. Drug Companies direct research to get profit margins.
Psycho-analytical   Trends, tendencies, urges are placed in a framework that directs understanding and predicts behaviour. People feel their past makes sense. Distress is seen as to be tolerated as much as relieved.
  Not everything is caused by child abuse or sexual urges. Understanding is pursued at the expense of efficacy. God is seen as a neurosis to compensate for a poor father figure.
Psycho-social   Places people in their current context leading to understanding but also a problem list to be tacked. Effective in depression and anxiety especially - as exemplified by CBT.
  Chipping away at problems and slowly correcting unhelpful thinking styles is not an end in itself. It may bring freedom from illness, but does not give the full picture of health.
 Spiritual   Gives clear [but unprovable] assertions about where distress comes from and where we are all heading both in this life and the one to come. Acknowledges the spiritual questions of distress and despair.   Although it gives the bigger picture, the sacred texts do NOT give enough detail to answer all the questions. Also, Christians can needlessly exclude other models which can helpfully fill in a lot of the detail and inform process.

As a Christian, I often get asked if I think the Christian or spiritual model is the overarching model. My answer to this is both yes and no and I think is best explained by some work by Ravi Zacharias as he explains how the four ancient elements of earth, water, fire and air can be seen as building blocks, but man has always searched for the thing that binds them together - the 5th element/essence, the 'quintessence'. For me, I can use the other four models of mental distress in various ways, but Christianity provides the quintessential [linking and vital] worldview within which they sit.


It gives hope, if nothing else.

Rob Waller, 13/10/2007