Reviewed by: Chemically Imbalanced: Everyday Suffering, Medication, and Our Troubled Quest for Self-Mastery by Joseph E. Davis David Herzberg Joseph E. Davis. Chemically Imbalanced: Everyday Suffering, Medication, and Our Troubled Quest for Self-Mastery. Chicago: University of Chicago Press, 2020. 244 pp. $30.00 (978-0-226-68668-4). It can be difficult for pharmaceutical historians to know as much as we should about the single most important characters in our histories: the people who actually consume medicines. Doctors, drug companies, state regulators, pundits and cultural critics all leave a much bigger paper trail and tend to dominate the archives and thus the stories we tell. Ethnographies and interview-based research provide a crucial resource for filling this gap, especially historically informed works like Joseph Davis's Chemically Imbalanced, which is based on eighty interviews with people who identified themselves as struggling with sadness, anxiety, or concentration and attention problems. While the interviews revealed a predictable wealth of individual detail, Davis argues that they also shared a "general tendency" or a "pattern behind the other patterns of meaning": the emergence of a "neurobiological imaginary" that now dominates how "ordinary people" interpret their suffering (pp. 14–15). Chemically Imbalanced explores this imaginary and its consequences. Davis defines the "neurobiological imaginary" as a mechanistic model that equates selfhood with the brain and that proposes a goal of physically fixing, [End Page 432] rather than reflectively understanding, suffering. People who adopt this imaginary ("socially shared meanings that animate and legitimate common practices" [p. 14]) lack faith in the potential of talk therapy and introspection and believe that "real" problems require (and are confirmed by) medication. The rise of the neurobiological imaginary, Davis argues, was not an inevitable result of widespread use of psychiatric medicines. Synthesizing secondary works by historians, he points out that the pill-popping cultures of postwar America supported a very different attitude toward suffering: a "psychological imaginary" that encouraged complex interiority and self-reflection about anxiety or depression, a process he refers to as "mental life" (p. 14). It was only amidst the broader shifts embodied by the emergence of symptom-based psychiatry in the DSM-III that pills and neurobiology became intimately and complexly linked—and even then, the relationship was not a causal one. By and large, Davis's research subjects embraced the neurobiological imaginary whether or not they personally used psychiatric medicines. Indeed, one of Davis's most important arguments is that people who find the neurobiological imaginary "compelling to think with" (p. 153) are not passive pawns of physicians and drug companies. Instead, his thoughtful, empathic analysis shows his interviewees "appropriating" (p. 74) diagnoses, pills, and the neurobiological imaginary to help them solve their predicaments. They are active agents who mix and match information from medical authorities, drug advertisements, popular media, and carefully selected confidants among family and friends. They adopt (and adapt) aspects of neurobiology that they find useful, such as categorizing unwanted or problematic aspects of their mental life as external to their identity or self, while resisting or working around aspects they find harmful, such as the stigma of mental illness or of being "dependent" on drugs, or the troubling implication that free will does not exist. What's left, Davis argues, is a vision of selfhood as "unencumbered volition" (p. 153) with all unwanted or limiting characteristics externalized as biological, mechanistic impingements that can be easily and inconsequentially "fixed" with drugs. Davis's analysis is insightful and empathic, and historians will find it useful as we work to understand the archivally elusive main characters in our own narratives. There are also elements that may give pause. For example, early on Davis points out that although he ensured diversity in his interview population, "demographic factors" such as race, gender, and class rarely "affect interpretive practice" (p. 24). The neurobiological imaginary is widely shared by "ordinary people" (e.g., pp. 6, 22) regardless of their social location. This is a remarkable finding given the importance of "demographic factors" in U.S. cultural and psychiatric history. How did groups with such disparate and unequal experiences all arrive at the same place? Davis does not attempt to explain this or, in general, to incorporate race...