Phil, thank you for another excellent post. These psychiatrists’ attempts to revise history by exonerating their profession from promoting the chemical imbalance hoax must not be allowed to stand. It is still happening to this day. In the article you critiqued, Dr. Aftab said, “Generally, I agree with you that the chemical imbalance was never accepted as the ‘truth’ by academic psychiatry or by our professional organizations. It was likely an advertisement strategy by pharmaceutical companies that took on a life of its own.” Here is a link to The Royal Australia and New Zealand College of Psychiatrists website page on the topic of “Medication for Mental Illness”: https://www.yourhealthinmind.org/treatments-medication/medication. I quote: “How do medications treat mental illness? Medications work by rebalancing the chemicals in the brain.” Nothing has changed. I’d also like to speak to the biopsychosocial (BPS) model Pies venerates. If you read Engel’s famous article, he never actually articulates such a model but instead denigrates medicine in general and psychiatry in particular for being overly biological and paying only lip service to the psychological and social. I would expect that Pies’ favored version of the BPS involves physical pathology (e.g., chemical imbalance) plus psychosocial factors. And if so, that makes “mental disorders” fundamentally medical diseases. Psychosocial factors are relevant to cancer and diabetes, but these are literal diseases of the body, and it is understood that despite their relevance psychosocial factors do not alter the obvious reality that the condition in question is a medical illness. This is what I expect Pies and other psychiatrists who fancy themselves enlightened for adhering to the BPS do – construe psychological struggles as medical diseases caused by physical pathology but also acknowledge the relevance of psychosocial factors. From this perspective, the BPS is not fundamentally different than the disease model. You can put lipstick on a a pig but it’s still a pig.