ABSTRACT
The presence of this chapter is a philosophical mistake. 1 The principle that the history of psychiatric treatments can be divided between those that are “somatic” and those that are “talk” is deeply lodged in the history of psychiatry, but reflects a confusion. Advocates of “somatic” treatments, often also referred to as “biological” treatments, are often styled as realists or materialists, who have little patience for the healing of the mind, the soul, or other immaterial things of dubious, or at least epiphenomenal, existence. What is striking about this view—usually expressed implicitly—is how much it owes to, and reproduces, a dualism it seeks to overturn. In a truly materialist worldview, everything is physical, including talk and the mind. When a therapist makes an interpretation or offers advice, she is moving molecules to send sound waves through the air, where they are received and interpreted by the brain of her patient. The brain then changes, either modestly, or dramatically. To a true materialist, talk therapy is as physical or biological as any other. Having a separate chapter on “somatic” treatments, then, reproduces a cultural artifact embedded in psychiatry. I hope also to use the occasion to question it.
