While Dr. Kandel is careful to make note of the importance of learning as well as social and developmental factors in accounting for the efficacy of psychotherapy and "the variance of a given major mental illness," respectively, his framework is clearly intended to place "greater emphasis on biology." I fear that the adoption of more overtly biological paradigms will result in psychiatry’s losing its already somewhat tenuous clinical credibility. My credibility with the department of family practice in which I work and teach, for example, is not based on my superior knowledge of neuroscience, my "facility with validated and objective criteria," nor even my knowledge of psychopharmacology. Rather, it is primarily based on my ability to calm agitated patients, elicit the hopes and fears of those who are ill, and earn the trust of the mistrustful—skills that have been developed through painstaking training and practice. Dr. Kandel’s framework does not necessarily preclude the teaching and acquisition of these skills, but I fear that as psychiatry becomes more deeply embedded in overtly biological models, the result will be the further erosion of those assessment and therapy skills that are less than well understood from the biological perspective.