Metaphorical Brain Talk in Psychiatry: A Historical and Contemporary Perspective

This essay examines the persistent use of "metaphorical brain talk" in psychiatry, where mental illnesses are explained using simplistic notions of brain structure or dysfunction. From early 20th-century critiques by influential figures like Adolf Meyer and Karl Jaspers, to more contemporary examples involving researchers like Paul Meehl and Nancy Andreasen, the essay traces the enduring presence of this metaphorical language. Despite advances in neuroscience, phrases like "synaptic slippage" and "broken brain" remain commonplace. The author uses the monoamine neurotransmitter hypothesis as a case study, highlighting its limitations in explaining disorders like schizophrenia, mania, and depression. A real-world anecdote illustrates the impact of such metaphorical explanations on patients and the public. The essay concludes by noting that the pursuit of external funding and pharmaceutical advertising have exacerbated the prevalence of this phenomenon.