Biological Ideas about Mental Illness Reduce Physicians’ Empathy

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The more that physicians are persuaded by biological explanations of mental illnesses, the less empathy they feel for patients who are experiencing psychological difficulties, according to a study from Yale University in the Proceedings of the National Academy of Sciences.

“In a series of studies, U.S. clinicians read descriptions of patients whose symptoms were explained using information that focused on either genetics and neurobiology or on childhood experiences and stressful life circumstances,” explained a Yale University press release. “Among other questions, the clinicians were asked how much compassion they felt for the individual, an essential element of therapy. The clinicians consistently expressed less empathy and compassion for the patient when his or her symptoms were explained using biological factors.”

“Biological explanations are like a double-edged sword,” lead author Matthew Lebowitz said in the press release. “They tend to make patients appear less blameworthy, but the overemphasis on biology to explain psychopathology can be dehumanizing by reducing people to mere biological mechanisms.”

“Clinicians also viewed psychotherapy as less likely to be effective when provided biological explanations for illness rather than psychosocial ones,” stated the press release. Meanwhile, “depressed individuals tend to be more pessimistic about their prognoses the more they attribute their symptoms to biological causes.”

(Abstract) Effects of biological explanations for mental disorders on clinicians’ empathy (Lebowitz, Matthew S. and Ahn, Woo-kyoung. Proceedings of the National Academy of Sciences. Published online before print December 1, 2014. doi: 10.1073/pnas.1414058111)

For docs, more biology info means less empathy for mental health patients (Yale University Press Release on EurekAlert!, December 1, 2014)

16 COMMENTS

  1. yep. It seeems this study reflects my personal experience that believing you’re flawed because of your chemistry is depressing as it not just blames the patient, but also exonerates any other very real factors in a person’s life.

    …and the hostility “biological” doctors express should you decide not to take the medications they prescribe and/or report negative side effects, is directly proportional to their belief that your are chemically deficient and could be healthy and blissfully happy if only you’d get with their drugging program to fix that darned imbalance!

    Truly brutal.

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  2. Yep. Nice they did the study but it’s another one in the category “No sh*t Sherlock”.
    So much about de-stigmatization campaigns “it’s a brain disease” and therapeutic value of the chemical imbalance explanation.

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  3. This study joins at least three others that reach the same conclusions.

    1. Does the disease view of mental disorder reduce stigma?
    Mehta S., Farina, A, Journal of social and clinical psychology ISSN 0736-7236 CODEN JSCPFF
    1997, vol. 16, no4, pp. 405-419 (2 p.1/4)

    2. Evolution of public attitudes about mental illness: a systematic review and meta-analysis
    G. Schomerus1, C. Schwahn2, A. Holzinger3, P. W. Corrigan4, H. J. Grabe1, M. G. Carta5, M. C. Angermeyer5,6Article first published online: 13 JAN 2012
    Acta Psychiatrica Scandinavica

    3. The Chemical Imbalance Explanation of Depression: Reducing Blame at What Cost?
    Journal of Clinical and Social Psychology, 28, 415–435.
    Brett J. Deacon, Grayson L. Baird , University of Wyoming

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    • The over emphasis of the biological view can lead the physician and initially the patient to feel better, yet often makes the patient feel worse in the long run. It should be clear that the biological reductionist view leaves physicians less empathetic to the emotional suffering of the patient and leaves the patient stuck with the inner sense of being fundamentally damaged. The decreased empathy of physicians then makes it less likely that the patient will feel comfortable to tell the doctor about ongoing suffering, thus letting doctors continue to believe that their approach works.

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      • It’s not important how you feel, why you think you feel this way, what is going on with your life, what traumas and difficulties you have. It’s all your faulty brain, otherwise you’d be flying around with the rainbow projecting out of your a**.
        You have to be a moron not to see a problem with it.

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  4. I agree, this should be a no-brainer. Telling people their own life experiences don’t matter and that there is nothing they can personally do to alter their own emotional experiences can do nothing but depress a person further than they already are. And doctors’ beliefs clearly impact their decisions, so driving them in the direction of less connection and empathy for the patient seems so obviously counterproductive.

    A corollary to this: doctors who choose to adopt the biological model of “mental illness” may already be prone to lacking empathy, and this explanation may provide them more justification for their pre-existing blamefulness or insensitivity toward their own patients. I wonder if psychiatry may attract more practitioners with this attitude on the average, because the philosophy may appeal to people who have their own issues with empathy which they are unwilling to face?

    —- Steve

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  6. My entire life was eventually declared a “credible fictional story” by a deluded psychiatrist / neurologist who’d been defaming and poisoning me to cover up the sexual abuse of my child based upon documented lies from the alleged child molesters, documented in my family’s medical records.

    But prior to learning the truth, after some decent nurses’ handed over my entire family’s medical records and I informed him of it, he had previously thought he was only covering up a “Foul up” to Risperdal, one of his industies’ “new wonder drugs,” and /or a bad reaction to Voltaran, an anti-inflammatory.

    The fictitious DSM “biological explanations are like a double edged sword,” they’re a way to blame patients, to cover up the stupidity and lack of ethics of the medical community.

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  8. Scientists, pseudo-scientists anyway, are busy theorizing away the freedoms that we as nation were fighting for not that long ago. I wonder, in relation to slavery, what that’s supposed to make us now. Slaves, of course, didn’t rank very high on anybody’s empathy list either.

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  9. This study’s finding sums up the malaise throughout the current dog-and-pony-show approaches in psychotherapy, where:

    Efforts to treat symptoms are maximized, and approaches to treat causes are minimized;
    The therapist is in charge, not the patient;
    The thinking brain is the all-in-all, while the feeling and instinctual parts of the patient’s brain that drive behavior are suppressed.

    http://surfaceyourrealself.com/2015/02/15/want-empathy-from-your-therapist-dont-give-a-scientific-explanation-of-your-condition-surfaceyourrealself/

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