The Myth of Normal 194

of Canada and pronounced, Joan-like, that I have seen the future in which he leads the global fight against climate change, beginning with giving up his reliance on campaign funding from the fossil fuel industry. Other than modern culture’s typical, left-brain materialist bent, how did we arrive at this view of mental illness as an essentially biologically rooted phenomenon? In part, it seems to be a holdover from a once tantalizing aspiration in medical science, a mission unaccomplished. “Psychiatry today stands on the threshold of becoming an exact science, as precise and quantifiable as molecular genetics,” wrote the journalist Jon Franklin in a Pulitzer Prize–winning series in 1984.[4] As with the ultimately unfulfilled promise of the genomic revolution to explain health and illness, the initial enthusiasm for the prospect of a science-based psychiatry was virtually unbounded. Nearly forty years later we are no closer to crossing this imagined threshold; if anything, we are further away. When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published by the American Psychiatric Association in 2013, Dr. David Kupfer, head of the task force responsible for it, acknowledged as much. “In the future,” he stated in a press release, “we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses that can be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”[5] The journalist and author Robert Whitaker, formerly the director of publications for Harvard Medical School, was a firm believer in the chemical-imbalance theory of mental illness—until he wasn’t. “When I first started writing about psychiatry, I believed that to be true,” he told me. “I mean, why wouldn’t I?” His disillusionment arose from research he uncovered while reporting for the Boston Globe. “I said to people, ‘Can you just tell me where you found that depression is due to serotonin or where you actually found that schizophrenia is due to too much dopamine?’ I asked to read the source materials and, I swear to God, they said, ‘Well, we didn’t really find that. It’s a metaphor.’ The most amazing thing was, when you