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Biological Psychiatry in the UK and Beyond

Introduction What is ‘biological psychiatry’?With biology being the scientific study of life, if one took the word literally, one could legitimately question whether there is any other kind of psychiatry. By this definition, psychology is part of biology. As taught in schools and universities, however, biology is the more constrained study of living organisms and includes anatomy, physiology and behaviour; human biology includes all those aspects as well as genetics, anthropology and nutrition and so on. That is still quite broad. What biological psychiatry is usually taken to mean is the search for neurobiological underpinnings of mental illness and application of drug and other physical treatments for them. This, of course, assumes that the brain–mind are sufficiently interlinked to justify that approach – something that is taken as read by most doctors and should be self-evident to anyone who has ever consumed any psychoactive drug, including caffeine and alcohol. What biological psychiatry does not (overtly) include are those key elements of human understanding that are the essential tools in the trade of the effective clinician: the application of insights from experience, perhaps informed by the arts and humanities, to the clinical encounter. There are, of course, those members of our broad church of psychiatry that prioritise psychosocial approaches to understanding and psychotherapy as treatment. To some of them, and many outside psychiatry, biological psychiatry is or at least can be reductionistic – reducing or ignoring the mind to little or nothing more than the brain. Anything so ‘mindless’ would be just as bad as dualism or mentalistic ‘brainlessness’. One would, however, be hard-pressed to find any so-called or self-declared biological psychiatrist who does not pay heed to the importance of our mental lives.