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As our field has moved inexorably toward a biologically reductionistic medical model for understanding mental disorders, with a concomitant preference for “evidence-based” treatments, the problem of treatment resistance has emerged as a prominent one. As we have noted throughout this evolving series of articles, efforts to approach the problem of treatment resistance generally focus on the development of biological treatment algorithms, with little attention to psychosocial factors or to meaning.
I often think our field is in much the same place physics was nearly a century ago. At that time Newtonian physics was preeminent, and seemed able to explain nearly everything. Among other things, it was quite clear that light was a wave, and not a particle. The focus on light as a wave allowed tremendous advances, including an understanding of the electromagnetic spectrum, and the development of lenses that enhanced vision, advanced our understanding of cells and bacteria, and allowed us to deepen our understanding of our solar system and the universe, to name only a few. In much the same way, mental illness is currently seen by most as caused by disordered biology—the Newtonian stance of “Light is a wave” of our profession in this time.
Einstein was a visionary who looked beyond light as a wave. He refused to be limited by Newtonian physics, threw aside conventional ideas, and came to the recognition that light was also a particle—not a particle instead of a wave, but a particle in addition to a wave. Recognition that light had qualities of a particle as well as of a wave, though it initially seemed counterintuitive to most, allowed the further elaboration