 It is not easy to evaluate claims like these, given that psychiatry does pay attention to social and biographical contingencies in a patient’s life. It may be that the force of the objection is that these extra-cranial factors are acknowledged but not taken seriously in treatment, which tends to be too much directed at aspects of the condition inside the patient that can be addressed by drugs. In defence of psychiatry, one might point out that changing a patient’s brain is often a lot easier than changing society or even the patient’s local environment or life circumstances. However, it does seem clear that prescinding from the details of the situation and assessing a patient in a context insensitive way does happen, and it can be a source of problems.