For docs, more biology info means less empathy for mental health patients

Give therapists and psychiatrists information about the biology of a mental disorder, and they have less — not more — empathy for the patient, a new Yale study shows.

The findings, released Dec. 1 in the Proceedings of the National Academy of Sciences, challenge the notion that biological explanations for mental illness boost compassion for the tens of millions of Americans who suffer from mental-health problems.

Conventional wisdom suggests that biological explanations for psychiatric symptoms should reduce the blame patients receive for their behavior by making genes and brain cells the culprits. This, in turn, should increase feelings of compassion.

In a series of studies, U.S. clinicians read descriptions of patients whose symptoms were explained using information that focused on either genetics and neurobiology or on childhood experiences and stressful life circumstances. Among other questions, the clinicians were asked how much compassion they felt for the individual, an essential element of therapy.

The clinicians consistently expressed less empathy and compassion for the patient when his or her symptoms were explained using biological factors, the researchers found.

“Biological explanations are like a double-edged sword,” said Matthew Lebowitz, a Yale graduate student in psychology and lead author of the study. “They tend to make patients appear less blameworthy but the overemphasis on biology to explain psychopathology can be dehumanizing by reducing people to mere biological mechanisms.”

Clinicians also viewed psychotherapy as less likely to be effective when provided biological explanations for illness rather than psychosocial ones. This is problematic because many studies suggest certain types of psychotherapy are important and effective treatments for many mental disorders, the authors note.

There are other downsides of biological explanations. According to the authors’ research published last year, depressed individuals tend to be more pessimistic about their prognoses the more they attribute their symptoms to biological causes.

The researchers stressed the importance of recognizing that biological factors are one piece in the complex puzzle of how mental disorders arise.

“We’re certainly not saying that people should ignore biological factors when studying mental disorders, but it’s crucial to understand biology as something that’s part of all human experience, rather than something that separates so-called mentally ill people from everyone else,” said Woo-kyoung Ahn, professor of psychology and a co-author of the study.