Preserving a Biopsychosocial Approach in Medication and Medical Services
by Nicholas Holliday, MD
When I arrived at Austen Riggs in 1997, the biological revolution in psychiatry was gaining momentum, increasingly eclipsing the biopsychosocial model in which I was trained. Psychological difficulties developed in highly individual lives -- with complex and textured psychological, family, and social contexts -- were progressively reduced to derangements of molecules, or "chemical imbalances." The person's unique humanity was at risk of being ignored at the same time that the field of biological psychiatry was making exaggerated claims about what psychotropic medications and other biological treatments could provide. While most patients at Riggs today take psychotropic medications (as they did in 1997), we strive to preserve a biopsychosocial approach and hold firmly the conviction that taking (or prescribing) medications is as rich with meaning as most other endeavors in our lives.
I am very pleased to be taking up the position of director of psychopharmacology and medical services, a role which had been split into two positions several years ago and is now reunited. I hope this will help to integrate the work of the Medical Office and that of our psychiatrists – the medical treatment with the pharmacotherapy. Along with other aspects of the treatment, including our increasing health and wellness offerings, this gives us a great opportunity to address the person as a whole.
In keeping with the core values at Riggs, we hope to foster agency and independence by helping our patients appreciate that their feelings, behavior, and relationships – including their relationship with medications and their own bodies – have meaning. As the director of psychopharmacology and medical services, I look forward to helping our patients integrate, broaden, and enrich their experience by moving away from labels such as "chemical imbalance" toward a more vital and fully engaged personhood.
Read more about Psychodynamic Psychopharmacology at Riggs: