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Abstract
The assumption that the etiologies of DSM-IV disorders are fundamentally
related to "chemical imbalances" is challenged. While
the chemical imbalance model may eventually be empirically shown
to be unequivocally accurate in specific disorders, this is not
presently the case for any disorder. The attempt to correct chemical
imbalances through medication is at the heart of modern
psychiatric treatment, as are evidence-based protocols which follow
from the establishment of an accurate diagnosis. There is much to
be said for this approach, but the downside is that other medication
treatment strategies are rendered illegitimate. Instead of correcting
imbalances, it is argued that pharmacological agents may be viewed
as inducing particular psychological states
which though not specifically related to diagnosis, are nonetheless
the basis for the usefulness of the medication. This perspective
provides justification for using medications in clinical situations
that may not even be DS! M-IV defined. To properly use medications
in this way, patients must more often be viewed in the complexity
usually associated with psychotherapy. A case is made against the
widespread use of medications by non-psychiatrists as well as the
15-minute, once-a-month medication visits that have become standard
psychiatric practice, both the product of the chemical imbalance
model
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