Rozpad umysłu. Biografia schizofrenii

by Jeffrey A. Lieberman, Jan Dzierzgowski (Translator)

Schizofrenia. Przez wielu uważana za najbardziej tajemniczą chorobę psychiczną. Dawniej nie znano jej przyczyn, więc chorych uznawano za opętanych przez diabelskie siły. Nie dawało się jej leczyć, więc pacjentów i pacjentki trzymano w zamkniętych ośrodkach i poddawano okrutnym zabiegom. Jednak dzięki dziesiątkom badań, setkom eksperymentów, tysiącom prób i błędów dziś o schizofrenii wiemy już bardzo dużo i wkrótce być może uda się jej zapobiegać.

Jeffrey A. Lieberman w przystępny sposób dzieli się swoją bogatą wiedzą psychiatryczną. Wciągające opisy badań naukowców i przypadków klinicznych przeplata z dramatycznymi przeżyciami pacjentów i swoimi doświadczeniami z praktyki medycznej. Jego książka to obowiązkowa, pełna empatii lektura dla zainteresowanych historią medycyny i psychiatrią oraz tych, których życie zostało naznaczone schizofrenią – dla bliskich i rodzin osób zmagających się z tym zaburzeniem.

Genres: Nonfiction, Psychology, Medicine, Mental Health, Audiobook, Psychiatry, Science

600 pages, Paperback

Published June 5, 2024

Reviews

[Roxan AlexanderArntson · Rating 5 out of 5]

Fascinating deep dive into the history, treatments, and lives of people with schizophrenia. If you love psychology, you’ll love this book!

[Josh Sheehan · Rating 2 out of 5]

Given the positive reviews on both Amazon and Goodreads, and that one of my favorite reading topics is historical and wide-ranging perspectives on mental health, I REALLY wanted to enjoy this. I'm fascinated about trying to untangle the origins and root causes of mental health problems, whether sociocultural or biological, and as such thought I'd take tons of useful information away from this regardless of some expected disagreement with the author.

To my dismay, even the historical information (notably chapter 3, though the use of "Dark Ages" in opening chapter 2 was already a red flag) feels presented in a way that only glosses over anything that doesn't fit the authors narrative. Only a few introductory paragraphs are given to the origins of institutions, and rather dishonestly, while the rest of the chapter is largely devoted to the stores of histories "heroes" of the "mad" (Phillipe Pinel, Benjamin Franklin, Dorothea Dix). There's no discussion or elaboration on how prisons and asylums originally came from the same origins, that being "houses of corrections" meant to rehabilitate criminal or problematic and unproductive behavior and that a distinct sense of "madness" or "insanity" was yet to exist. Separate facilities exclusive to criminal confinement were non-existent in the west until the mid-1700s. Even in the 20th century, tuberculosis sanatoriums were eventually converted to mental institutions. These things are critical to understanding how mental health was seen and shaped by its physical, social, and cultural proximity to criminal and other stigmatized behavior. As Foucault said: "It was the depths of confinement itself that generated the phenomenon".

Further is the author's way of contending against the "anti-psychiatry" movement, of which Foucault is of course a huge name. The author writes with an extremely binary and self-aggrandizing view that seems to ignore any nuance or complexity. Again, I wanted to approach this without ideology, as I believe the answer to understanding mental health is not binary and lies in between grasping both sociocultural and biological/genetic causes. Unfortunately, chapter 8 on the "Anti-Psychiatrists" reads as if it was a hit piece written in self-defense, attacking opposition with straw-picking and almost personal attacks, rather than actually trying to elucidate the details or the author's arguments, understanding, or good intentions. He tears at Szasz for working with L. Ron Hubbard/the Church of Scientology to found the Citizens Commission on Human Rights, ignoring that this was an early on pragmatic move where Szasz agreed with their critiques on psychiatry and later distanced himself from them. He also goes on about RD Laing, referencing hyperbolic quotes about obviously outdated theories (which were about all that existed in psychiatry in the 70s...).

The author further mentions how 2 patients of Laings treatment later committed suicide, seemingly as some example as to how terrible his ideas were... this being despite the fact that the author himself has a record of unethical experiments, including administering intravenous methylphenidate to first-episode schizophrenic patients knowing that it was more likely to give them pronounced effects to study, including reports that one participant later themself committed suicide. This is on-top of his known ties with pharmaceutical companies, controversy over hypocritical statements over the ethics of diagnosing public figures, and their extremely questionable, off-base tweet last year resulting in widespread disciplinary actions.

Lastly, the chapters seem almost designed to just kinda... trail off at the ends leaving some peculiar idea or argument lofted high up with no further explanation (the author's "spiritual(?)" experience in Chapter 2, chapter 3's ending with optimistic musing about anti-psychotics being introduced down-the-line, or chapter 7 ending with a reference to a weird satirical story about Laing and other "anti-psychiatrists"). It just feels like a lot of bombast without much substance.

I will say, I liked the content in the Appendices. Nice diagrams!

Once more: really did give this a chance and wanted to take something from it, only to find it written with a goal of proving a point rather than contributing to the overall knowledge and discussion of mental health. Although not entirely focused on schizophrenia, as an alternative read I highly recommend Roy Richard Grinker's "Nobody's Normal: How Culture Created the Stigma of Mental Illness". Its a much wider-perspectived look at mental health and extremely thought provoking (rather than idea feeding).

Edit for clarity: I don't mean to entirely be bashing this book and believe what it DOES contain is largely accurately presented, it just leaves out so much as well and as such isn't actually a great book for giving a broad perspective on the subject.

[Michelle · Rating 4 out of 5]

The high volume of pages was a bit daunting at first. However, as I settled in for my first reading session, I quickly became re-acquainted with the distantly familiar writing style typical of professional medical literature. Dr. Lieberman presents a thorough medical history of schizophrenia packed with facts, research, and information on the neurobiological underpinnings of the condition.
The book offers comprehensive knowledge of the medical world's approach to understanding, researching, and treating this condition. Dr. Lieberman ends the book by sharing his own views on improving treatment approaches with an emphasis on community-based, effective treatment programming.
The only complaint I had about the book was its minimal use of clinical examples and/or case studies. I would have appreciated hearing more about Dr. Lieberman's direct clinical experience with his patients. Unfortunately, that was not the scope of this particular text.
Overall, I enjoyed this medical history and recommend it to anyone seeking to understand schizophrenia a bit/lot more.

Thank you Scribner and Netgalley for the egalley!

[Mateusz Buczek · Rating 3 out of 5]

W tej książce jest WSZYSTKO: historia zaburzeń psychicznych, neurologii, psychiatrii, opis badań nad schizofrenią, metody leczenia i wiele innych. Jak dla mnie, niestety, ta pozycja jest aż przeładowana wiedzą, nie sposób tego wszystkiego zapamiętać, szczególnie z perspektywy laika w temacie. Jak dla mnie to książka bardziej dla specjalistów, pracujących z pacjentami na codzień, niż dla zwykłego czytelnika.

[Taylor · Rating 3 out of 5]

This is not a book I would have chosen to read, but nevertheless I am glad I read it. The brief history of mental institutions was fascinating as was the history of treatments for schizophrenia. He lost me at all the brain stuff, I just don't care about it. I wanted more of treatment and outcomes. Each chapter also reset the timeline, if you will, and constantly bouncing back and for between modern times and not so modern times was not very cohesive for me. Over all I appreciated the optimism of this book and the perspective that schizophrenia can be treatable if the patient has access to the correct resources (which is a a big if). I am still unclear about why the author included a single case of psychosis that he felt was supernatural in origin (apparently an evil energy tried to attack him for attempting to treat a patient). It felt out of place in an otherwise scientific approach to schizophrenia and I fear it's inclusion will cause more harm than good, as it gives support to families persuing the exorcism route.

[po.czytane · Rating 4 out of 5]

4.5

To już nawet bardziej pozycja naukowa, niż popularnonaukowa. Więc jeśli czytelnik szuka zbioru ciekawostek do przytoczenia w czasie jakiegoś spotkania towarzyskiego, to polecam Czarną owcę medycyny tego samego autora. Rozpad umysłu, jest już bardziej szczegółowy, co nie znaczy że gorszy. Osoby, które psychologią się fascynują, będą zachwyceni, bo Lieberman jak nikt inny potrafi o tych specjalizacjach doskonale pisać.

[Mindy Greiling · Rating 5 out of 5]

Magnificent book mapping out where we have been with schizophrenia, the huge strides we have made, and what we must do to make those strides available to everyone. It is immensely readable and chocked full of case studies. Dr. Lieberman generously shares his candid and informed opinions throughout, not sparing any part of the mental health system or even himself.

[Snowman Reads · Rating 4 out of 5]

There’s a lot I wanted to say about this book. I should work on my lost words.

[Las Bookowy · Rating 4 out of 5]

Schizofrenia jest przez wielu uważana za najbardziej tajemniczą chorobę psychiczną. Dawniej jej przyczyny nie były znane i uważano chorych za opętanych przez diabelskie siły. Nie udawało się jej leczyć, więc pacjentów i pacjentki trzymano w zamkniętych ośrodkach i poddawano okrutnym zabiegom. Jednak dzięki dziesiątkom badań, setkom eksperymentów, tysiącom prób i błędów dziś o schizofrenii wiemy już bardzo dużo i wkrótce być może uda nam się jej zapobiegać.

Temat schizofrenii był dla mnie nieznanym zagadnieniem. Bardzo chciałam to zmienić i dowiedzieć się czegoś więcej o tej przypadłości. Ta książka to dosłownie encyklopedia na temat Schizofrenii. Tak jak w tytule, otrzymujemy pełną biografię tego schorzenia, od samych początków aż do teraźniejszości. Wiedza teoretyczna jest przeplatana z historiami z życia, co bardzo urozmaica lekturę. Momentami bywa drastycznie, ukazując, to jak były traktowane osoby zmagające się z tą chorobą. Książka opisuje postęp badań nad Schizofrenią i jestem w ogromnym szoku, jak ogromny rozwój na ten temat został poczyniony. Dramatyczne przeżycia pacjentów są bardzo przykre i obrazują, jak ta choroba jest straszna. Ta książka chwyta za serce i momentami jest ciężka w odbiorze, jednak jest bardzo ważna! Uważam, że wiedza na temat chorób psychicznych powinna być łatwiej dostępna.

Książka to obowiązkowa lektura dla bliskich i rodzin osób chorych na schizofrenię. Dzięki niej te osoby będą mogły spojrzeć inaczej na tę chorobę. Jednak jeśli nawet nie macie bliskich dotkniętych schizofrenią, a interesuje was ten temat, ogromnie polecam.

[Thomas Froula · Rating 5 out of 5]

Essential for anyone working with individuals with schizophrenia or seeking a deeper understanding of SMI

[mar · Rating 5 out of 5]

bardzo dużo historii samej choroby, neurologii, badań, metod leczenia, historii pacjentów i wiele więcej. rozmiar książki, ilość zawartych w niej informacji i terminy biologii mogą być przytłaczające, dlatego jest to raczej pozycja dla osób, które są już tematem zainteresowane. absolutnie polecam, szczególnie część trzecią.

[Ania ❤ · Rating 5 out of 5]

Wspaniała książka, świetny podręcznik z przykładami, więc jest zrozumiały i wciągający nawet dla osób spoza branży.

Dobrze było dotknąć schizofrenii bez uprzedzeń i z pełną otwartością. Mimo że to nie pierwsza książka tego typu na mojej półce, nadal udało jej się zaskoczyć mnie w kilku kwestiach, np.
- osoby ze S. Mają większą podatność na palenie nikotyny
- tylko 4% ciężkich przestepstw w USA jest popełnianych przez osoby z S.
- marihuana, a konkretnie THC w konkretnych stezeniaxh może wywołać S. U osób zdrowych lub powodować jej nawroty
- stygmatyzacja osób z S. Jest ogromna, najbardziej jaskrawy przykład to ubezpłodnienie ok 70 tyś osób w USA w latach 80 ubieglego wieku. „Leczenie” poprzez lobotomię
- wcześnie zdiagnozowana podlega leczeniu i daje szanse na normalne życie (nigdy wyzdrowienie).

[Kacper Bernaś · Rating 4 out of 5]

Audiobook: Całkiem, całkiem. Na początku bardziej przystępna dla laika, później ciężko było się połapać, turbo dużo nomenklatury medycznej, więc z czasem sam poziom, wymagania co do znajomości tematu jak i poziom zaangażowania/skupienia mega wzrasta. Prawie jak encyklopedia schizofrenii, są poruszone wszystkie tematy, a nawet może i za dużo. Z czasem coraz ciężej się słuchało, ale było na prawdę w porządku. Bardziej pozycja naukowa, niż popularnonaukowa

[sophia bokovikova · Rating 5 out of 5]

This book was a doozy and felt very necessary for me to read. It had both extreme depth and breadth; at points I found the intricate science parts more boring but they were an important foundation for the conversations about psychopharmacology, the potential origins of schizophrenia, and therapeutic procedures. I learned so much from this book and in areas I didn't expect to (ex: very in-depth about the history/origins of medicine, the history of certain scientific breakthroughs, etc.). Learning about mental institutions and mental health care was really interesting and made me think about how rapidly medicine has progressed, the crazy "therapeutic" procedures that were common practice, and the changes that need to be made. Something that I especially appreciated about this book was all of the personal excerpts (both from his patients and his own life) and it painted a really clear picture of different manifestations/presentations of schizophrenia. I appreciate how actionable the book is, both for the process of recovery in an individual and for steps that need to be taken federally and medically to improve the system(s). The author is also really great at explaining challenging concepts in an understandable way and making analogies for complex processes (I especially felt this in his explanation of delusions and hallucinations). I took so many photos of pages and will be going back to the notes I took from this book for sure. I just think it was really well done by the author and I learned a lot and it made me think a lot while reading it, both about my past experiences and how to take what I've learned from the book and apply it in a meaningful way.

[Becca · Rating 5 out of 5]

This book was extremely nuanced and informative. It succinctly outlined the complicated (and often haunted) history of psychiatry, before discussing the ethical dilemmas of our present day situation and how things could be different. The biggest takeaway from this book is that effective treatments are there, but we are not using them as much as we should be due to the mismatched priorities of practitioners, advocates, and patients and those of policymakers, the healthcare system, and research funders.

I loved the use of the parable of the long spoons at the end of the book: in the first room are people sat in front of an immaculate feast but they suffer because they cannot feed themselves with their long spoons. In the second room is an identical scene, except the people are enjoying the feast because they’re feeding one another. “Unless we eliminate this biased perception and these discriminatory policies, we will not close the unacceptable gap between what we know and what we do. We will be stuck in the nightmare of the long spoons: the optimal treatments as the feast, the long spoons our reticence, skepticism, and stigma, and our will and commitment determining whether we will help and nourish one another or not.”

[❤️My Dog is my Best Friend❤️ · Rating 4 out of 5]

Really interesting book if you are intrigued by schizophrenia or the history of mental health. Although I liked it overall I felt as if the author was very repetitive—the book could have been condensed. I also hoped there could be more stories about the patients themselves but the ones he chose to highlight still brought a lot of insight into schizophrenia in particular but also just how critical treatment is.

I definitely would recommend giving this a read if it sounds interesting. I think for my particular interest I would want to read less clinical and more personal experiences—from people who personally deal with having a mental illness as it does seem to vary person by person.

[Caroline · Rating 5 out of 5]

Prawdziwa trudność zrozumienia tekstu zaczęła się dopiero w części trzeciej. Dużo terminów z biologii, psychiatrii. Trzeba się skupić, żeby się nie pogubić. Niemniej świetna pozycja, można się wszystkiego dowiedzieć - nie tylko o chorobie, ale również o stanie zdrowia w USA. W tekście znajdują się odniesienia do innych wartościowych książek wartych przeczytania.

[Asia · Rating 5 out of 5]

Książka tworzy przejrzyste kompendium o schizofrenii. Odnosi się do badań na temat mechanizmu powstawania zaburzeń, wykorzystywanych lekach, a przede wszystkim odnosi się do etapu zdrowienia. Autor z ogromną empatią odnosi się do chorujących i zaznacza, co jeszcze możemy dla nich zrobić. Niestety kolejny raz ukazuje nam się obraz zagmatwanej polityki opieki zdrowotnej w USA.

[Zosia · Rating 2 out of 5]

do bólu amerykańska
kilka ciekawostek, poza tym dość lakoniczna i chaotyczna

autor jest zagorzałym przeciwnikiem deinstytucjonalizacji i zwolennikiem przymusowego leczenia - przykre, że publikacje znajdujace się w nurcie popularnym powielają starodawne przekonania

[Mimi · Rating 5 out of 5]

This book just made me realise how much I want to go into clinical psychology

[nika · Rating 4 out of 5]

600 stron wypełnionych po brzegi wiedzą

[Littlethecl0ud · Rating 5 out of 5]

Started to read to better understand my best friend 🥺 And suddenly it got sad 💀

[Andrea Keeler · Rating 4 out of 5]

Really interesting, but this book would benefit greatly from more clinical examples/client stories. The last section is more about mental health in general, not just schizophrenia.

[Peggy Popp · Rating 5 out of 5]

I hated this book but loved it. So much information and so overwhelming. The most important thing I got out of it is that Clozapine works. It’s used in other countries as first line of treatment. Last line in this country. 2nd most important thing is that early diagnosis and compliance with meds greatly improves outcome. 3rd important thing, deinstitutionalization of the mentally Ill topic. Forefathers had their hearts in the right place. People were found to be treated inhumanely, as if they were cattle. Not human beings. But very little forethought went into deinstitutionalization of the mentally ill. The issue was managed disastrously and many severely mentally Ill are homeless to this day. Lack of insight is part of the illness. Civil Libertarians jumped on that bandwagon and trumpeted that mentally Ill people have the right to chose to take their prescribed meds. My premise is that a person in a delusional state is not self directing at the time they are delusional. It’s not all or nothing. Once they are thinking rationally, they are self-directing. Many people who are compliant with their meds can lead full, productive lives.,

[Alexis · Rating 5 out of 5]

(Prefatory note:I picked this up because I noticed it in the new books section of the library right after I'd read Jonathan Rosen's The Best Minds. I don't Google random library pickups til after I read them, so I didn't know, or more likely didn't remember because it was in the New York Times, that the author got pretty seriously MeToo'ed. The review is for the book, not the author.)

This was very informative and detailed--I learned a lot about the presentation of schizophrenia, its progressive nature, the measurable effects on the brain, and treatment. Dr. Lieberman is primarily a research psychiatrist, but there are some interesting patient stories. He emphasizes the need for early intervention which can alter the progress of the disease and the need for comprehensive, wraparound treatment including life support.

I did disagree with him about forced treatment: we can force someone into an injection of an antipsychotic or to stay in a hospital, but we cannot make them comply with treatment, which makes efforts at forced treatment limited in their potential. While we may sometimes err on the side of freedom, we can't overestimate what we can force people to do.

[Mark · Rating 4 out of 5]

So this would have been a 5-star book if glossing over the history of asylums wasn't so. Moral treatment from the Quakers brought great reform to asylums that allowed humanity to be treated to those suffering from mental illness, (see Mad in America for more details) but then all that changed, and more barbaric practices emerged again.

Highlights of the books I liked were the case studies of vast functioning. Some with good prognoses others with poor. Some with improvements and others just so. I enjoyed reading in depth the lit on things of movements with psych developments in the treatment of sz and seeing the real-world impact on the patients in need of care.

It was an incredibly dense read. Did include diagrams and pictures throughout. Comprehensive appendixes.

[Sherif Gerges · Rating 5 out of 5]

Schizophrenia is a debilitating disorder, and one which has been wild misunderstood since the Middle Ages and well into the 21st century. The book describes the genetics that undergirds its manifestation and how these genetic predispositions, when coupled with some environmental trauma - can neurobiologically manifest into truly devastating symptomatology. The readability of this book is significantly aided by Leiberman’s exceptional scientific writing, his knowledge of the history of schizophrenia (which includes some truly grotesque descriptions, from exorcisms to lobotomies, for example), while narrating some touching stories about the lives of patients who have suffered from schizophrenia.

My singular qualm with the book is that it is actually a little weak on the genetics - it could have gone much further, particularly in describing the recent advancements in genome-wide association studies or exome-wide studies. Otherwise, this is an exceptional read - anyone who is unfamiliar with the field will find value here.

[Ellen Ulken · Rating 5 out of 5]

Here is a comprehensive study of a here-to-fore tragic disease with a poor prognosis. The author tells us, following many studies over several decades, that medical science has the knowledge to diagnose and treat Schizophrenia to the benefit of patients, their families and society, and to give patients much better prognoses. The trick is to catch the disease early and begin treatment with medicine and social therapies, and regular follow-ups; but our disorganized and underfunded mental health systems must be corrected before these standards can be universally applied. Anyone who has Schizophrenia or has a family member or friend with the disease, or works in health care, should read this important book. Early intervention prevents the disease and its agonizing relapses from causing such significant brain damage, rendering patients ever sicker.

[Ashley · Rating 4 out of 5]

This was sooooooo much information. Got a little cross-eyed trying to take it all in, though I appreciate the comprehensive detail. Some of it felt repetitive and some of it went over my head but I learned a lot. Schizophrenia has been such a mysterious and stigmatized illness and this author is working hard to change that, which I applaud.

[Meghan · Rating 4 out of 5]

Thank you Netgalley for an earc of this book in exchange for my honest view


Really fascinating dive into the history, treatments, and lives of people with schizophrenia. So much information in this book. If you love psychology and learning more then this is a good read