Psychological Issues in Treatment of the “Chemical Imbalance”

Recently, neuroscience has begun to greatly expand our knowledge of the biological basis of psychiatric illness. A great deal of emphasis has been rightly placed on not overlooking the importance of biologic disturbances or chemical imbalances in causing our patients’ problems. Emerging biologic concepts of disease or chemical imbalance with their implications of uncontrollability may be misapplied when used as a defense or as a resistance to treatment, creating a unique challenge for the psychiatrist. In this paper, I discuss some of the issues involved in working with patients who use biology or a “chemical imbalance” as a defense.