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Number 9: Winter 2013

Cracked: Why Psychiatry is Doing More Harm Than Good By James Davies

Alan Pope

The most startling example of this phenomenon is that of serotonin. Serotonin and its fluctuating ‘levels’ in the brain have been widely accepted as signifiers of depression.  The debate has often been more about which comes first: the feelings of distress and depression or the changes in levels of serotonin. However, Davies from his reading of the research argues there is no firm evidence to place levels of serotonin as a conclusive marker of depression. What is clear though, is that it is in the interests of the pharmaceutical industry to foster a chemical explanation. In other words, we are back to the old battle of the biological versus the social, a battle that was waged by R.D. Laing and others on orthodox psychiatry, but which has subsequently appeared to be ultimately lost. What Davies reveals is that this battle is still on and the case for resisting biological approaches remains strong. However, this battle is not currently being waged in the wider public domain and might even be being deliberately suppressed.

In a recent conversation I had with Davies about the widespread public acceptance of biological explanations of emotional distress he had this to say:

“In writing the book my views changed greatly. When I started working as a therapist I took the line that many therapists take today which is this: in combination, therapy and drugs are the best way of proceeding. I now believe that view to be completely wrong.  Medications get in the way of therapy!  They undermine the work we are trying to do. If you believe that part and parcel of someone’s recovery is encountering and working through difficult feelings and emotions. Well, medications that numb those emotions simply stop that process from unfolding. Another conflict we encounter is when working with clients who have been led to believe that their brain is in control here. Then how do you get those clients to begin to subscribe to the notion that they are more in control of their lives than they have been led to believe? This really is the prerequisite to get therapy to work; the assumption that therapy can work.  Receiving a diagnosis can sometimes undermine that belief and lead to a fatalism in the client that whatever they do, however hard they work they are forever doomed to this biological misfortune.”3

Davies, in bringing this information to the general reader, is helping patients and service users to make an informed choice.  For several years now the NHS has been trumpeting its commitment to patient choice. There is little or no patient choice in mental health services. They operate on a strictly postcode basis. If there isn’t a good service where you live tough! From a clinical perspective the aim of the book is to challenge the medicalisation of distress and in doing so to depathologise the patient’s experience – a project I assume all readers of Sitegeist would sign up for.  It is a call to arms from Davies and he is passionate about this. The case studies that illustrate some of the text are both moving and disturbing.


  1. Pope, A. (2013). “Dubious Diagnoses and the Medicalisation of Distress – An interview with James Davies”, Private Practice, Autumn Lutterworth: British Association for Counseling and Psychotherapy.