Shrinks: The Untold Story of Psychiatry

by Jeffrey A. Lieberman

The inspiration for the PBS series Mysterious of Mental Illness, Shrinks brilliantly tells the "astonishing" story of psychiatry's origins, demise, and redemption (Siddhartha Mukherjee). Psychiatry has come a long way since the days of chaining "lunatics" in cold cells and parading them as freakish marvels before a gaping public.But, as Jeffrey Lieberman, MD, the former president of the American Psychiatric Association, reveals in his extraordinary and eye-opening book, the path to legitimacy for "the black sheep of medicine" has been anything but smooth.In Shrinks, Dr. Lieberman traces the field from its birth as a mystic pseudo-science through its adolescence as a cult of "shrinks" to its late blooming maturity — beginning after World War II — as a science-driven profession that saves lives. With fascinating case studies and portraits of the luminaries of the field — from Sigmund Freud to Eric Kandel — Shrinks is a gripping and illuminating read, and an urgent call-to-arms to dispel the stigma of mental illnesses by treating them as diseases rather than unfortunate states of mind.“A lucid popular history...At once skeptical and triumphalist. It shows just how far psychiatry has come.” —Julia M. Klein, Boston Globe

Genres: Nonfiction, Psychology, History, Psychiatry, Science, Medicine, Audiobook

332 pages, Kindle Edition

First published March 10, 2015

Reviews

[Alex.andthebooks · Rating 5 out of 5]

Bardzo pozytywnie się zaskoczyłam — szczególnie w kwestii historii psychiatrii, bo bałam się, że ilość informacji może mnie przytłoczyć, a uważam, że autor opowiadał o tym w sposób ciekawy.

Dodatkowo warto pamiętać, że jest to książka sprzed 8 lat i wiele terminów/szczegółów/sposobów opisu chorób zdezaktualizowało się. I tak jestem pod wrażeniem, że tak obszerny temat udało się w tak ciekawy sposób opisać w jednej książce.

[Paul Bryant · Rating 5 out of 5]

I have been waiting for this book for years : an honest account of the history of psychiatry, and for this subject, when you say warts and all, you have to be prepared for warts to be pretty much all there are until the 1970s. What a horror story! Here is Dr Lieberman’s mission statement:

There’s a good reason that so many people will do everything they can to avoid seeing a psychiatrist. I believe that the only way psychiatrists can demonstrate how far we have hoisted ourselves from the murk is first to own up to our long history of missteps and share the uncensored story of how we overcame our dubious past.

Why do psychiatrists get hated on by so many of us?
- They overmedicate
- they pathologise ordinary human behavior
- They forever spout psychobabble
(That’s according to Jeffrey.) But that ain’t nothing compared to what they used to do. )

In Shrinks we are on a giant slalom from Franz Mesmer (he was mesmerizing in the 1770s) all the way up to Silver Linings Playbook (2012). Dr L does finally leave us on a highly optimistic note – more of a full chord – explaining how practitioners have ditched the loony stuff, thrown Freud under the bus, and armed with the new hot psycho drugs will confidently and successfully manage all but the most profoundly ill schizophrenic and depressive. Say 98% of everyone. So put a smile on your face for the whole human race. It’s almost like being in love. But only almost – he still can say

Even now, charlatans drawn from the ranks of professional psychiatry continue to dupe desperate and unsuspecting patients as the institutions of psychiatry stand passively by.

***

The problem for the would be doctors of mental ailments is simply put – they could not agree for the first 200 years what mental illness was nor how to treat it. Was there a biological origin? Or did it originate in that ghost we call mind? Because of that

Unable to find a biological basis for the illnesses within its province, psychiatry became ever more scientifically estranged.

and

Psychiatry has trumpeted more illegitimate treatments than any other field of medicine

As for instance

The Rotational Chair : a psychotic patient would be strapped snugly into the chair and then spun around and around like an amusement park Tilt-a-Whirl until his psychotic symptoms were blotted out by dizziness, disorientation and vomiting.

(There’s worse, much worse to come.)

ENTER THE VIENNESE DOCTOR

Freud stands in a class of his own, simultaneously psychiatry’s greatest hero and its most calamitous rogue

At first a minority European sect, the Freudians relocated en masse to America in the early 1940s, fleeing from Hitler, most of them being Jewish. They set up shop in the New World and found rich pickings.

The worried well became the primary market for psychoanalysis… instead of wearing white coats and shouldering through a daily grind of raving and catatonic inmates, psychiatrists could chat with well-heeled businessmen about their childhood memories and gently guide well-coiffed matrons through their free association.

What the Freudians did was locate the origin of the mental illness in an unconscious conflict between the patient and in 99% of cases the parents. (I’m generalizing here.) Autism? Caused by the “refrigerator mother”. Homosexuality? (But yes, this was considered to be a mental illness until the 15th of December 1973. Before that, it was diagnosis 302.0. Hey, the World Health Organisation retained their classification “Homosexuality Disorder” until 1990.) Anyway, homosexuality was “induced by domineering mothers who instilled a fear of castration in their sons along with a deep seated rejection of women”.

(The mothers got put through the Freudian wringer.)

But the Freudians also tried to give the talking cure to the severely ill, so you got “a psychiatrist urging a psychotic person to talk about his sexual fantasies” or “a psychiatrist encouraging a suicidal person to accept that her parents never loved her”. Dr J’s head is in his hands here.
By the 60s “the psychoanalytic movement had assumed the trappings of a religion”. The Freudians believed everyone was slightly mentally ill.

Being “shrunk” had become the ne plus ultra of upper-middle-class American life.

***

Meanwhile, outside the bubble, other medical disciplines considered psychiatry as a racket populated by hucksters selling invisible snake oil.

Vladimir Nabokov :

Let the credulous and the vulgar continue to believe that all mental woes can be cured by a daily application of old Greek myths to their private parts.

ASYLUMS

The fate of the seriously ill was gruesome. A quote from 1917 :

We can rarely alter the course of mental illness. We must openly admit that the vast majority of the patients placed in our institutions are forever lost.

In 1904 there were 150,000 Americans in asylums, and by 1955 that had increased to 550,000. And there they stayed. Now comes the horrendous part.

Driven by compassion and desperation, asylum-era physicians devised a succession of audacious treatments that today elicit feelings of revulsion or even outrage at their apparent barbarism. Unfortunately, many of these early treatments have become forever linked with the public’s dismal image of psychiatry. [But] the simple fact is that the alternative to these crude methods was interminable misery, as there was nothing that worked.

What were these audacious treatments?

- Giving patients malaria to cure or abate their psychosis caused by advanced syphilis
- Overdosing schizophrenics with insulin to put them in a coma for maybe six days in a row (one side effect was that patients invariably became grossly obese, another side effect for some patients was death). Coma therapy “was used at almost every major mental hospital in the US and Europe in the 1940s and 50s”.
- And the big one, the leucotomy aka lobotomy, which is where you either drill in to the patient’s skull above each eye, or if you don’t fancy that, there is an alternative method :

First the patient’s eyelid was lifted up. Next a surgical instrument that closely resembled an ice pick was slid under the eyelid until it came into contact with the thin bone at the back of the eye socket. Next, a small mallet was used to hammer….

Anyway, Dr J describes the process as similar to coring an apple. The effect on the patient was (maybe not surprisingly) dramatic.

Patients who had previously hurled food, smacked the walls and shouted at invisible specters now sat placidly, disturbing no one. Among the more notable people subjected to this dreadful treatment were Tennessee Williams’ sister Rose and Rosemary Kennedy, the sister of President Kennedy.

Finally – the other famous shocking treatment given to patients was shock treatment, also known as electro-convulsive therapy or ECT. This one is different from the comas and the lobotomies, because, everyone is agreed, it works. That is, it works in the case of severely depressed people. A blast of volts through the brain will get them back to a functioning state where they can once again converse and smile and live their life. And they still don’t really understand why. So ECT is still routinely practiced.

Please note : the guy who invented the lobotomy was given a Nobel prize in 1949 "for his discovery of the therapeutic value of leucotomy in certain psychoses."

So you got these barbarities dished out to the severely ill, and the quack talking cures of the Freudians dished out to the well-heeled worried well, and no wonder that in the late 60s/early 70s you got an Anti-Psychiatry movement. Which I do not have space to go into, but that’s fascinating too.

***

As you can see this is a hell of a story, which has affected most of us in one way or another, and this book is a practically perfect account of it all, written with heart and soul and with all the technicalities explained for us general dogsbodies. Totally recommended.


SONG LIST

Cracking : Suzanne Vega
Like The Weather : 10,000 Maniacs
Boys Of Bedlam : Steeleye Span
Twisted : Joni Mitchell
Sleepy Man Blues : Bukka White
19th Nervous Breakdown : Rolling Stones
Love In A Faithless Country : Richard Thompson
Like A Monkey In A Zoo : Daniel Johnson
Feel : Syd Barrett
Black Eyed Dog : Nick Drake

[not my high · Rating 3 out of 5]

2.75

Ta książka jest... chaotyczna, nieaktualna i jednostronna. Nie polecam po nią sięgać, jeśli chcecie reportażu o psychiatrii, bo podczas zdobywania wiedzy przy okazji można przeczytać kilka niepoprawnych informacji.

Jestem wyczylona na sposób mówienia o autyzmie, który tutaj został nazwany chorobą psychiczną (jest zaburzeniem rozwojowym), a przecież tyle może być błędów, których NIE zauważyłam.

Rozczarowanie :/

[Margitte · Rating 5 out of 5]

Let's get frivolous first:

"I became insane with long intervals of horrible sanity." ~
Edgar Allen Poe

~~~~~

When we remember we are all mad, the mysteries disappear and life stands explained. ~ Mark Twain

~~~~~

How many psychiatrist does it take to change a light bulb:
One, but the light bulb has to want to change.

~~~~~

How many psychiatrist does it take to change a light bulb:
Just one, but it takes nine visits.

~~~~~

On and on it goes...

***

Sometimes it takes laughter to cure a few ailments of the mind. Well...almost.

Shrinks: The Untold Story of Psychiatry by Jeffrey A. Lieberman
provides an honest, in-depth view of the history and development of psychiatry and it is not a pretty picture.

Chapter 1: The Stepchild of Medicine: Mesmerists, Alienists, and Analysts

Not many things in life make you feel as violated as trusting your most intimate needs to a medical professional, only to have that trust betrayed through incompetence, deception, or delusion

AND

QUOTE FROM THE BOOK:
The use of antibiotics for colds is widespread, even though antibiotics have no effect on the viruses that cause colds, while useless arthroscopic surgery is too often performed for osteoarthritis of the knees. Bogus stem cell treatments for incurable neurological illnesses like ALS and spinal cord injuries were the topic of a recent 60 Minutes exposé.

...Sham treatments for autism abound, including vitamins, neutraceuticals, dietary supplements, stem cell injections, purges, and the removal of heavy metals from the body by chelation therapy. Patients trek across oceans in order to obtain exotic, expensive, and entirely worthless treatments for every imaginable disease...

...Nevertheless, psychiatry has trumpeted more illegitimate treatments than any other field of medicine, in large part because—until quite recently—psychiatrists could never agree on what actually constituted a mental disorder, much less how best to treat it. If each physician has his or her own definition of illness, then treatments become as varied as shoes, each season bringing a parade of new colors and fashions… and if you don’t know what you are treating, then how can treatment ever be effective?...Franz Mesmer’s animal magnetism, Benjamin Rush’s “Bilious Pills,” Julius Wagner-Jauregg’s malaria therapy, Manfred Sakel’s insulin shock therapy, Neil Macleod’s deep sleep therapy, Walter Freeman’s lobotomies, Melanie Klein’s sexual orientation conversion therapy, and R. D. Laing’s existential psychiatry...

...I’m sorry to say that much of the responsibility for this state of affairs rests squarely on my profession. As the rest of medicine continues to enhance longevity, improve quality of life, and elevate expectations for effective treatments, psychiatrists are regularly accused of overprescribing drugs, overpathologizing normal behaviors, and spouting psychobabble. Many people harbor suspicions that even the best practices of twenty-first-century psychiatry might ultimately prove to be modern versions of Reich’s orgonomy, spurious methods unable to relieve the suffering of individuals with bona fide illnesses...

Horrific depictions of asylums would continue for the better part of the next two centuries, forming one of the most prominent themes of psychiatry and serving as endless fodder for journalistic exposés and causes for civil rights activism.) Inmates could expect to be chained, whipped, beaten with sticks, submerged in freezing water, or simply locked up in a cold, tiny cell for weeks at a time. On Sundays, they would often be displayed as freakish marvels before a gasping and taunting public....

The author discusses the competition between psychologists and psychiatrists to establish a supremacy over the treatment of illnesses caused by the brain and mind. Different solutions by different professionals cause feelings of disillusionment and mistrust in the patients. Added to that is the establishment of the internet, which allows the general public to voice their opinions publicly on just about anything, and the playing field for professionals becomes a rocky hotbed to conquer.

The severe rejection of psychiatry by Scientologists is discussed, as well as the impact of Freud and his Jewish fraternity of psychoanalysts who initially fled to America from Europe are spotlighted in detail.

QUOTE: A “Project for a Scientific Psychology”
In W. H. Auden’s poem In Memory of Sigmund Freud, he writes of the difficulty of understanding Freud through our modern eyes: He is no more a person now but a whole climate of opinion.” It’s a pretty safe bet that you’ve heard of Freud and know what he looks like; his Edwardian beard, rounded spectacles, and familiar cigar make him the most famous psychiatrist in history. The mention of his name instantly evokes the phrase, So tell me about your mother. It’s also quite likely that you have an opinion on the man’s ideas—and, I’d wager, an opinion shading into skepticism if not outright hostility. Freud is often maligned as a misogynist, a self-important and domineering phony, or a sex-obsessed shrink endlessly probing people’s dreams and fantasies. But, to me, he was a tragic visionary far ahead of his time. In the pages of this book, we will encounter many psychiatric luminaries (like Nobel laureate Eric Kandel) and psychiatric frauds (like orgonomist Wilhelm Reich). But Sigmund Schlomo Freud stands in a class of his own, simultaneously psychiatry’s greatest hero and its most calamitous rogue.


~~~~~
Let's take a break again. INTERVAL!

"Psychiatry enables us to correct our faults by confessing our parents’ shortcomings." ~LAURENCE PETER

~~~~~~
"Sigmund Freud was a novelist with a scientific background. He just didn’t know he was a novelist. All those damn psychiatrists after him, they didn’t know he was a novelist either." ~JOHN IRVING









BACK TO THE BOOK

Chapter 2: Down the Garden Path: The Rise of the Shrink

Freud instead made a decision that would seal the fate of psychoanalysis and critically affect the course of American psychiatry, fossilizing a promising and dynamic scientific theory into a petrified religion...

...Freud chose to present his theory in a way that discouraged questioning and thwarted any efforts at verification or falsification. He demanded complete loyalty to his theory, and insisted that his disciples follow his clinical techniques without deviation. As the Psychoanalytic Society grew, the scientist who had once called for skeptical rigor in A Project for a Scientific Psychology now presented his hypotheses as articles of faith that must be adhered to with absolute fidelity.

The book discusses the war which ensued when Psychiatrists stepped into the ring. They intended to change the science of the human mind from social ailments without scientific basis(psychoanalysts with Freud as Jesus, based on opinion or tradition), to a modern physical data-based discipline(spearheaded by Robert Leopold Spitzer. He was a psychiatrist and professor of psychiatry at Columbia University in New York City and a major force in the development of the DSM).

The US military forced the cacophonical confusion of theories, definitions, and ideas to get organized, which lead to the publishing of the Bible of Psychology: the Diagnostic and Statistical Manual of Mental Disorders (DSM). Homosexuality was included until DSM III although the definition was changed to "Sexual Orientation Disturbance", as a consolation to the psychoanalysts. (The author failed to mention that 'masturbaters' were also institutionalized, but given the extensive research discussed in the book on other issues, it is not a burning issue. Just for interest's sake).

Homosexuality, defined as a "Sexual Orientation Disturbance" was still listed as an ailment until 1990 by the World Health Organization.

It was definitely a full-scale war.

Chapter 4: Destroying the Rembrandts, Goyas, and Van Goghs: Anti-Freudians to the Rescue
For four decades, the Freudians had ruled the profession unchecked. They controlled the academic departments, university hospitals, private practices, and even (so they assumed) the American Psychiatric Association; they were the face, voice, and pocketbook of psychiatry. It was simply inconceivable that something as insignificant as a classification manual would threaten their supreme authority.

Bottomline: It was also about money. Serious scientists who wanted to cure serious ailments such as schizophrenia, depression, and bipolar, who also wanted to change the lives of patients who were locked up, chained, electrified, and tortured in government institutions, expected the shrinks -who fed on the affluent upper classes for less serious conditions- to step aside and allow the sciences of the soma and psyche to connect. Serious research funding as well as income streams for everyone was involved. Insurance companies would stop pay-outs for 'conditions' removed from the list, and a few million professionals stood to lose big money. It was a vicious battle. The serious psychiatrists won. And mankind changed forever.

An afterthought. In Johannesburg two grade-one classes in two different primary schools had every single pupil on Ritalin. Not prescribed by psychiatrists, but by doctors. Nobody launched an investigation. Nobody goes against the professionals.

African sangomas, for thousands of years, treated ailments of the body, mind and brain with herbal remedies(and a few other grizzly methods). The herbal remedies were later confirmed scientifically as the correct medicines for the correct ailments. It took the western world recently a century or three to discover the same secrets and finally stop killing the herbal doctors and witches in their own midst. Legislation banning witchcraft in England was only removed in the 1950s, so by the way. The entire world had witch-doctors, healers, sangomas and doctors curing or killing people with all kinds of remedies. The Chinese, African, Arabians and Indian development of these sciences are thousands of years old. It is traditional and deeply rooted in a specific social-cultural context. Still is.

This is the story of the development of the western model of modern psychology and psychiatry. An informative and entertaining publication which exposes the horror but also the hope for the people involved in this scientific disciplines.

I feel like the waiter who had to endure the scientific and philosophical conversation in the fashionable coffee houses in Europe, when the intellectuals started enjoying the cream of the crop instead of alcohol. In his book The Devil's Cup: A History of the World According to Coffee Stewart Lee Allen says this:

Sartre and Camus nutted out existentialism in the Paris based Café Flore. Picasso doodled at Le Lapin Agile and the surrealists held court at the Rotonde. In fact, things got so bad that the owner of Café Momu complained: “Our waiter was reduced to an idiot in the prime of his life, as a result of the conversations he had to listen to.”

Soooo for those who want to take revenge on the shrinks and psychiatrist, read this book, you will have a field day. And for those who want to defend the mind and brain of every shrink or psychiatrist ever born, this is your moment. This book acknowledges both disciplines and celebrate the compromise.

A great read!

PS: You can also read Paul Bryant's highly entertaining review: https://www.goodreads.com/book/show/2...

[Debbie "DJ" · Rating 5 out of 5]

A big thank you to Goodreads first reads giveaways!

I am amazed by this most comprehensive and thoroughly researched book on the subject of psychiatry. It's divided into three main sections: The story of diagnosis, The story of treatment, and Psychiatry reborn. I found it fascinating to explore the birth of psychiatry right up to it's present day developments. In fact, I was jotting down so many important details I found myself with 18 pages of notes! It does cover a lot of territory, but Lieberman's writing style flows, and the information is easy to understand and follow. His interspersions of the personal also make it a more intimate read, one I will not soon forget.

The first two sections focus on the history of how diagnosis's were established, and treatments progressed over the years. Some of the early treatments were so bizarre and horrific, I wondered just who was mentally ill! The third section was my favorite as it focuses on the brain itself, genetics, and a disease which not only involves the brain but emotions as well; PTSD. It is a grand adventure to peer into the intricacies of what it took to finally become a respected profession which now offers real help to those who suffer mental illness.

I decided to just list a few of the highlights I felt were the most important gathered from this read.

* From 1800 - 1950 nothing could be done to treat mental illness, which meant a lifetime of languishing in an asylum.

* Physicians used to believe mental illness had moral origins. Those with this disease had chosen to behave badly, and God was punishing them for their sins.

* Two distance professions arose. For identifiable disorders physicians became neurologists. For unidentifiable disorders they became psychiatrists.

* Freud changed U.S. thinking with his use of psychoanalysis, essentially that all mental illness stem from the unconscious. His emphasis on sex is because sex urges are essential for survival, and contribute heavily to a persons evolutionary success.

* Psychiatry is mostly German, as most of the pivotal thinkers originated from this country.

* The Diagnostic and Statistical Manual (DSM) of mental illness was founded in 1844. It is the equivalent to the bible of psychiatry, and directly impacts everything from insurance coverage to whether people go to jail. The DSM - 3 was the most fought over ever published. It firmly established mental illnesses, and now required an M.D.

* In 1973 psychiatry experienced the biggest crisis to date. "Science" journal exposed them as a scam through secret experiments of their own and discovered " They cannot distinguish the same from the insane in psychiatric hospitals." This caused state legislators to cut funding, dumping patients out into the community. It is a very real factor for the U.S.'s current problem with homelessness and prison overpopulation.

* In 1843 most all blacks were considered mentally ill, and advocates of slavery argued that slavery had mental health benefits!

* It took until 1987 to finally eliminate homosexuality from the DSM. Last year the first openly gay man became president of the APA.

The author ends by saying the biggest hinderance to treatment today is the social stigma. He relates a recent encounter with a woman who hard suffered with schizophrenia for 39 years. Her wealthy family had hidden her in a far wing of the home. They were forced to bring her to the hospital when her hands became infected to the point of staff infection. Once treated, they refused mental illness treatment and hid her back in the far wing as how would they explain her disappearance for so long, and what would the woman say once treated.

It is extremely sad with all the available treatments that mental illness is still a mark of shame, especially since it affects one out of four people in their lifetime. The promising areas of research going on in genetics, better drugs to precisely target disease, better tools for diagnostic tests, and so much more provide hope for us all.

Highly recommended for anyone interested in psychiatry. It's all here!

[Negar Afsharmanesh · Rating 3 out of 5]

راستش کتاب رو خیلی خوشم نیومد😁آلان همه میگن چرااااا؟
کتاب درباره خود روانشناسی و روانپزشکی نبود درباره تاریخچه ی این موضوع بود که چه خرافه هایی بوده و بعد به رشته علمی تبدیل شد.

[Kate · Rating 3 out of 5]

First, like some other reviewers have pointed out, this story of psychiatry is hardly "untold".

Second, the author is a True Psychiatric Believer. Not that that's surprising, considering he was the president of the APA (that's the American Psychiatric Association, not the American Psychological Association - they are different!) from 2013-2014 - but it does mean that this book is for sure biased when it comes to talking about the efficacy and wonderfulness of psychiatric treatment and research. And in many ways, I agree with Lieberman - I'm not a fan of Freud or psychoanalysis, I like the idea of applying scientific research principles to the diagnosis and treatment of mental health, but he paints a crazy rosy picture of drug treatments for mental illness. While I'm sure that it was a revelation when drugs were discovered that could treat mental illnesses, they're not miracle cures. He tells many stories of people whose lives were immeasurably improved by some drug + some therapy, and a lot of the stories he tells with poor outcomes are because the patient stopped taking their medicine or the family of the patient couldn't deal with the stigma; it's never because the therapy/medication itself was ineffective. Yes, there are lots of people who are effectively treated with anti-psychotics or anti-depressants or anxiolytics - there are also people who improve psychologically but suffer from other side effects, people who won't take meds because of the side effects, people who don't get side effects but don't do any better on meds, people for whom CBT doesn't help them improve, etc., not to mention the scads of people who can't afford either therapy or medication or both, or the people who get overworked psychiatrists with no time to spend learning about them or psychiatrists who only prescribe meds without therapy or vice versa and so on. It's not really fair to say that psychiatry is doing super duper amazingly as long as you ignore the people without insurance and the social/environmental/neurological/medical factors that might make a person not react to drugs or stop taking them and the psychiatric professionals who aren't as good at their jobs as they should be. I would rather read a book like this, written by the former president of the APA, can sing the praises of his profession while still acknowledging areas that need improvement. Instead, he listed off a bunch of terrible things that psychiatry used to do in the past "but we're so much better now! the end."

So what I'm saying is, read this book with a grain of salt. I'm sure that everything he's saying is true, but I'm also sure there's some stuff he leaves out.

ALSO - there's one paragraph in the middle of the book that I feel I need to address because it made me do a double-take - apparently when Lieberman was in med school his pharmacology prof had them do an assignment where they were all given a MYSTERY DRUG to INGEST INTO THEIR BODIES and then guess what drug it was based on the effects they noticed in themselves??!?!?!???!?! THIS WAS A REAL ASSIGNMENT?? And he doesn't even seem to think that it was a big deal because he just mentions it in the context of him having felt the effects of certain psych drugs!! What year was it when person said, hm, maybe this assignment is crazy unethical? I hope everyone at least got the option to opt out! If anybody knows any more about this, I am intensely curious. Was this a common assignment in med schools in the 70s? Or was it just this one particular professor? When did it stop? Did anyone suffer adverse consequences from this assignment? Is that why it stopped??

[Brennan · Rating 3 out of 5]

Dear Psychiatrist - I have now read this book about the history of your profession. Is it somewhat ironic that it has made me more depressed??? haha. Just kidding, right! Seriously, though, isn't it is fair to say that your profession is a crazy one! Ha, I'm cracking myself up! I know we talked about using humor in our last session, so I thought you might appreciate that.

As you know, I personally owe a lot to psychiatry. I worked as a college intern at the APA in 1994 and got my first full-time job there after graduation in 1995. Not only did this get me out of Utah (an immediate anti-depressant), I eventually worked there for 5 years, and it was fun to read about details in this book that only someone on the inside would know (working at the Assembly each November at the Marriott in downtown Washington DC).

Having said that . . . . . I doubt this book will translate to a general audience. Outside of psychiatrists, mental health professionals, and those on the spectrum who have a fascination with psychiatry, haha - see even more humor!! - even though now I will probably have to issue a formal apology to all those who suffer with autism -- this book is not going to appeal to many.

I did really enjoy seeing the context of how my fields of psychology and marriage and family therapy came to be (although not specifically addressed). And I am happy to know that psychiatry has moved beyond phrenology, institutionalization, lobotomies, and ECT to more scientific and humane treatments for the severely mentally ill.

If someone were born with one of the 3 major mental illness - schizophrenia, bipolar disorder, unipolar depression - before 1970 or 80, they likely not only led a life of incredible stigmatization, but also one of abject suffering. To know that these conditions can now be effectively treated was comforting and gave me hope.

Another thing I really liked about the book was the discussion Freud and his work. Watching how psychoanalysis became an institution in American psychiatry and academia was fascinating. And I was also very interested about the details about trauma, and the relationship between psychiatry and the US military.

Well, I am sure you have already read the book and I hope you feel like it validates your choice to go into psychiatry. Ha! - see now I am the one validating your feelings! But seriously, it reminds me of the old Woody Allen joke when the man says to the shrink - "doc, my brothers crazy, he thinks he's a chicken. The psychiatrist asks the man why he doesn't tell his brother the truth, And the man replied, 'I can't, because we need the eggs."

Well, doc, in the end that is how I feel about life sometimes. Although I want to let go of my craziness . . . . sometimes I just can't . . . because . . . well . . . I need the eggs.

[Perry · Rating 1 out of 5]

Antiseptic Analysis of Psychiatry, a Story Better Left Untold
Terribly Heavy Going, Like Running Uphill in Roller Skates

I assign such a low rating based on my reasonable expectations from the publisher's description aimed at convincing potential readers that the book gives an inside, layperson's look at the practice of psychiatry.

I found instead that it's overly didactic, providing a wearisome history of psychiatry, a prosaic argument for its recognition and development as a field of medicine, and a flat discussion of the different psychiatric approaches and diagnostic systems.

This is your book if you are considering psychiatry as a profession or seek a better understanding of either its history or the more technical aspects of the practice.

If not, you may agree with me that the book is "terribly heavy going" and reading it akin to "running uphill in roller skates," to lift a quip from the playwright Alan Ayckbourn.

[Joanna Okuniewska · Rating 3 out of 5]

Niektóre rozdziały bardzo ciekawe i skupiające uwagę, a inne rozwleczone i nic nie wnoszące. Nie przesłuchałam jej „jednym tchem”, miejscami się męczyłam, ale nie żałuję. Nie jest to jednak najlepsza książka o historii psychiatrii, a zaczynała się tak dobrze :(

[Beauregard Bottomley · Rating 5 out of 5]

Most of us today have a warped view of what psychiatry does based on its early history and the way it has been portrayed by popular media during earlier time periods. Psychoanalysis (think Freud) was pseudoscience. It thought that diseases of the mind and brain were caused by repressed memories and such, and that it had no empirical data to support it. The author really doesn't dance around the problems inherent within Psychoanalysis. Each psychoanalyst needed to be psychoanalyzed before becoming a psychoanalyst a perfect way to create a pseudoscience.

Psychoanalysts were arguing that all mental problems were behavioral problems and everybody suffered from some sort of mental problem. They had lost touch with reality. The media was right to mock the profession. Things started to change in the 1970s when Washington University in St. Louis, MO started emphasizing the role that data should play in diagnosis instead of tradition and intuition. They even started developing CBT (Cognitive Behavioral Therapy) as an antidote to the meaninglessness of blaming the patient for his neurosis. With data it was shown to work.

The first step in developing science is to first define categories. In this case, the DSM (Diagnostic Statistical Manual) III started insisting on scientific categories instead of the pseudo classifications that the psychiatrists (mostly psychoanalyst) had been using previously. The tenor of the times had tarnished the image of the psychiatrists and something needed to be done to put the profession back on a scientific basis.

The next step comes about through the realization that the mind and the brain both effect mental health. The first major step (early 1900s) was introducing malaria into patients who had severe mental problems due to advance syphilis. The ensuing fever cured the patients. Unfortunately, lobotomies started being performed, and had no data to support their efficacy. Ultimately, a whole slew of drugs are discovered which led to control of some mental related diseases.

The author shows how today the profession really does add value. Many people's perceptions about the profession were warped by what they saw in popular media while growing up, but the world has changed and so has the profession of psychiatry. For those who want to remain in the dark and only offer criticism they should skip this fine book, for all others who want to enter the 21st century and unlearn their misconceptions I would highly recommend this well written book.

[Catherine Davison · Rating 5 out of 5]

I thoroughly appreciated the way this book made psychiatry and the history of psychiatry accessible. It was never dry, dull or boring. It illuminated so much about theories and treatments in the past and how these have either been developed or jettisoned and how each new development has led to our current, hopeful situation.
I recommend this book to anyone who cares about mental health. A really good read.

[Corina Ventura · Rating 5 out of 5]

Extraordinário!

[Петър Стойков · Rating 5 out of 5]

Винаги съм казвал, че в момента развитието на психологията е на същото равнище, на което е било развитието на медицината преди 500 години - налагане с пиявици и кръвопускане и надяване пациентът да оживее, за да си плати. Но не съм предполагал, че съм бил толкова много прав.

Авторът е председател на Асоциацията на психиатрите в САЩ и в тази изключително информативна и интересна книга описва с изумително красноречие историята на разбирането на човечеството за психиката и психическите заболявания, произходът и развитието на двете дисциплини, които се занимават с тях: психология и психиатрия и тяхното ниво в момента.

Знаете ли, че до 1960 г. един от основните методи за третиране на сериозни психични заболявания е била лоботомията? Забиват (с чук) през окото на пациента в мозъка му един шиш и го развъртат така, че да нарани дълбоко фронталния лоб, превръщайки човека в интелектуалния и емоционален еквивалент на зеленчук. Още по-доскоро, че и чак до 90-те години психолозите са смятали, че заболявания като шизофрения и аутизъм, с доказано физиологичен и наследствен произход, могат да бъдат лекувани с психотерапия - т.е. с разговор.

Влиянието на Фройд върху психологията и психиатрията е огромно - от една страна, той е основоположникът на начина, по който гледаме днес на съзнанието, а от друга - отричането му на научния метод в работата му налага за десетилетия наред по-скоро сектантски, отколкото рационален и медицински подход при работата на психолози и психиатри.

Задължителна книга за всеки, който се интересува от работата на човешкия ум и мозък, както и от институциите за неговото лечение.

[Arezoo · Rating 2 out of 5]

کتاب تخصصی بود در مورد تاریخ و روند پیشرفت علم روان . چندان باهاش ارتباط نگرفتم و اصطلاحات تخصصی داشت.

[Mateusz]

nareszcie po dwóch latach udało mi się przez nią przebrnąć 🫡

[Zuzia · Rating 4 out of 5]

4,5⭐️

[BAM doesn’t answer to her real name · Rating 3 out of 5]

Decent background of the psychiatric profession
Discusses DSM I, II, and III diagnoses
Whole chapters on mental diseases and various treatments as well as well known psychiatrists
Not sure what is discussed here that would not be discussed in a couple of introduction college courses

2017 Lenten Buddy Reading Challenge book # 10

[Maggie · Rating 4 out of 5]

This is an amazing account of where psychiatry has been and where it has gone. For anyone with mental illness, a family member with mental illness, or simply interested in the field it is a must-read. An extended thank you to the author for acknowledging that people with mental illness are fully capable of living full and amazing lives.

[Jay Hamm · Rating 1 out of 5]

This is an at times self-aggrandizing, always disconcertingly self-assured and unbalanced rendering of the history of psychiatry. Despite touting improved science in the field, the book glaringly and uncritically presents hypotheses and contested areas in the field as truisms. Full of paternalism and a concerning lack of humility.

[Jeremy Phillips · Rating 2 out of 5]

Thumbs down. Patchy, self-agrandising and at times blatantly mis-respresentative of the people and ideas it pretends to chronicle. A contemporary pill-pusher propping his trade up by a shallow attempt at re-branding. If you're going to pick Wilhelm Reich as your example of a white-coated charlatan, why would you sanitise his ideas?

[Azita Rassi · Rating 5 out of 5]

A much-needed book that informs its readers of the many great changes in psychiatry. It aims to increase public awareness, fight the stigma attached to mental illnesses, and encourage bright young minds to choose psychiatry for a career. I enjoyed the audiobook and learned a lot from it as well.

[Aysha · Rating 4 out of 5]

Very informative, the author did his best to sustain an objective perspective

[Rishab · Rating 3 out of 5]

I picked this up as part of a book club for an interest group at school after being recommended to me by my faculty advisor. Shrinks is a book about how psychiatry developed from a fringe discipline with little efficacy or validity to a mainstream specialty of medicine and yet still today is shrouded in much distrust and confusion. I suspect that the subtitle reads "The Untold Story" rather than "History" because while the author Dr. Lieberman often narrates in an omniscient voice, he has many stories to share with the reader about his interactions with key figures in the field and on relating his life experiences to explain basic principles in psychiatry (this is the only book he has written for a lay audience).

The book is divided into three parts that trace the internal strife within psychiatry as well as external pressures in the struggle over what he dubs the "soul of psychiatry." The main topic he tackles is the question of what a mental illness actually is as it intersects with the long quest for evidence-based diagnostic constructs and treatments. As the profession transitioned from the era of alienists (psychiatrists who worked in mental institutions "alienated" from the rest of medicine) to psychoanalysts and activists, from quack theories of orgone spirits and animal magnetism to specific pharmacotherapies for schizophrenia and bipolar disorder, the transitions were often messy and contentious. Lieberman juxtaposes the groundbreaking developments in other medical specialties with the relatively sparse ones in psychiatry, noting that patients suffering from mental illnesses rarely saw improvements in their conditions while patients with cancer and cardiovascular disease would receive breakthrough treatments. He notes that the reason quack treatments were so pervasive partly stemmed from the lack of tangible or clearly localizable brain lesions in mental illness, thus giving cover for grifters to exploit helpless people (such as the poor woman from Ch. 1)

Creating a Bible for psychiatry, then, was necessarily going to involve a tension between the psychodynamic and biological camps. Questions I have debated with others when defending psychiatry are (1) whether mental illnesses necessarily need a biological substrate to be considered as such and (2) when one is found, do they automatically get shipped off to internal medicine or neurology? I am thankful to Lieberman for really giving me clarity on (1), particularly in Chapter 4 "Destroying the Rembrandts, Goyas, and Van Goghs: Anti-Freudians to the Rescue." I could not book the book down as he detailed how a revolutionary named Robert Spitzer underwent sham treatments to try to learn more about himself, became a leading critic of psychoanalytic thought, and proceeded to introduce a more objective and organized diagnostic manual and clinical interview.

Tasked with writing the DSM-III, Spitzer was caught in a tough bind on whether to remove homosexuality as a diagnosis. "If he disavowed homosexuality, he could open the door to the antipsychiatrists to argue that other disorders…should also be disavowed." As a result, he devised the concept of “subjective distress,” or that an illness label is justified only when a condition caused emotional distress or impairment in everyday functioning. Homosexuality was removed as an illness in 1973 and DSM-III was approved resoundingly.

There were several moments similar to the ones above in which I found myself reading this book as if it were an epic novel with lines like "Rosenhan openly admitted his antipathy toward the psychiatric profession, and on the heels of the outrage provoked by his first study, he saw another opportunity to inflict damage on psychiatry’s crumbling credibility." They made for nice attention-grabbers in the backdrop of numerous names and dates.

But Lieberman's style comes with the caveat of being told through a particular lens. again, this is his story of psychiatry, not a dispassionate history. This becomes apparent mostly in the third part "Psychiatry Reborn." In describing a new era of psychiatry rooted in genetics and advanced imaging, for example, he cites twin studies as foundational despite their flawed assumptions and methodologies. He explains how the US military came to adopt psychiatric care in combat, but when discussing the creation of the PTSD diagnosis after the Vietnam war, I found it interesting that he did not delve into some ethical qualms held by psychiatrists over the false pretexts of the war (only calling them "dovish" and "exaggerative").

In recounting the controversy over the DSM-V, Lieberman mainly focused on how the task force addressed the lack of transparency, and he spent less time responding to the claim that psychiatry pathologizes normal human behavior. He states that it is the reductive Freudians who do that (which they do), that illnesses like hoarding disorder are not as silly as they seem and have real consequences, and that the decrease in the number of diagnoses is evidence enough that 21st-century proves that psychiatry does not have an interest in expanding its scope (but the number of diagnoses and the nature of those diagnoses are different things). He did not, however, attempt to respond to broader critiques that mental illnesses today are contingent on different sociopolitical contexts and that the forces of capitalism, racism, and sexism can make certain illnesses more likely to manifest, which the DSM can then exploit. On that note, I felt that Lieberman missed an opportunity to mention Foucault and respond to arguments in works such as Madness and Civilization, instead choosing to debunk the lower-hanging fruits like Szasz and Laing. Also, one of the architects of the DSM-IV Dr. Allen Frances whom Lieberman praised maintains similar views (and he recently delivered a grand rounds presentation at the Dept of Psychiatry at my institution).

For all the thoroughness and humility in the first 6-7 chapters, it seemed to be diminished toward the end. While Lieberman would otherwise give a nuanced account of the progress and setbacks in psychiatry, the last chapter felt very hagiographic as he draws a sharp distinction between psychiatry of the past and present. (I write my critiques not yet having read any of the other reviews of this book to not bias my own, though I am aware its reception was controversial.) Still, the rosy and feel-good and anecdotal evidence about his patients and peers going from the lowest points in their lives to happy, functioning members of society made me feel warm and inspired as a medical student hoping to go into psych, and I am very thankful to my advisor for recommending this book. I also felt it was a good intro to later engage with texts on the philosophy of psychiatry and psychiatric nosology. Related books I plan to read are:
• The Medical Model in Mental Health: An Explanation and Evaluation
• Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness
• The Protest Psychosis: How Schizophrenia Became a Black Disease

3.5/5

[Miku · Rating 4 out of 5]

Każda gałąź medycyny ma swoje wzloty i upadki, by dojść do punktu wspólnego - skutecznego leczenia człowieka. Jednak psychiatria to jest droga bardzo wyboista oraz pełna upadków. Do dzisiaj są ludzie, którzy jako najgorszą karę oraz największy wstyd traktują pójście do psychiatry. Autor książki postanowił przybliżyć nam historię tej gałęzi medycyny oraz to skąd wzięła się ta ludzka niechęć. Jeżeli interesuje Was jakie były początki psychiatrii, pierwsze metody leczenia pacjentów oraz ich diagnozowanie to w tej książce znajdziecie sporo ciekawych informacji, napisanych prostym językiem. Nie nudziłam się przez całą lekturę, czytało mi ją błyskawicznie i co najważniejsze - dużo ciekawostek zapamiętałam. Wiadomo, że medycyna cały czas idzie do przodu, więc wszystkie te tzw. nowinki w momencie powstawania książki mogły już stracić na aktualności, więc niektóre rzeczy trzeba brać z przymrużeniem oka.

Zostawiam 4 gwiazdki.

[Emilia · Rating 5 out of 5]

✨4,75✨
Świetna książka, która pokazuje, że zdrowie psychiczne jest tak samo ważne jak fizyczne. Obrazuje dokonanie pionierów tej dziedziny zarówno w białych i jak czarnych barwach. Mam nadzieję, że jak najwięcej osób sięgnie po tą pozycję, gdyż (niestety) osoby dotknięte chorobami psychicznymi nadal są stygmatyzowane w społeczeństwie

[Kate · Rating 5 out of 5]

"Diagnostic and Statistical Manual of Mental Disorders I-5: The Origin Story"

"Mózg jest jedynym narządem, który może cierpieć (...) gdy jego działanie zaburzone jest nie przez fizyczne uszkodzenie, ale przez niedostrzegalne doświadczenie. Każdy inny narząd ciała musi otrzymać jakiś bodziec fizyczny, by zachorować - toksyny, infekcje, zwykły uraz mechaniczny - ale tylko mózg zachorować od takich bezcielesnych bodźców jak samotność, upokorzenie, czy lęk."

💯

[brekekeks · Rating 4 out of 5]

No nie napisze nic odkrywczego bo książka jest dosłownie o historii psychiatrii która jest bardzo wciągająca, miałam jedynie problem z początkiem - jest dużo o Freudzie, którego ja osobiście nie trawie i o tych wszystkich mrożących krew w żyłach sposobach leczenia ale ogólnie polecam 🤓

[Pooria · Rating 5 out of 5]

کتابی ارزشمند در باره ی تکامل تاریخی علم روانپزشکی(به تعبیر نویسنده: فرزند خوانده ی پزشکی) و پستی ها و بلندی های این علم در راه رسیدن به تشخیص و درمان بیماران، مبتنی بر شواهد بالینی. طوری که این علم دیگر یکی فرزندان خلف علم پزشکی بوده و مانند سایر زیرشاخه های آن، بدور از رکود بوده و علمی پویاست...

بخش های مربوط به تاثیر روانکاوی و فرضیات فروید و پیروان پس از او و به بیراهه راندن اصل درمان بر اساس اصول زیست شناختی و علایم ، به درمان بر اساس تعارض درونی( و etc )، واقعا کامل و روان بود... کاش نویسنده ادامه ی تکامل علم روانپزسکی در اروپای پسا فروید را هم توضیح میداد و فقط به آمریکا اکتفا نمی کرد...
یه کاش دیگه اینکه: کاش نویسنده معیار های ICD و سیر پیشرفت اونرو، که سیستم مورد قبول سازمان بهداشت جهانیه(WHO) رو، تو یه فصل جداگانه ای توضیح میداد ...
ترجمه ی کتاب در حد یه ترجمه ی علمی خیلی خوبه؛ فقط مترجم بعضی عبارت های مورد قبول در باره ی یک سری عبارات علمی رو جوری ترجمه کرده بود که تو ادبیات روانشناسی ترجمه مستعملش جور دیگست. البته یکی دو مورد اینجوری بود...

پ.ن: آشنایی با اریک کندل و کارای اون و تاثیر بی بدیلش روی نسل خودش و نسلای بعد، یکی از نکات مثبت کتاب برای من بود.

[Roman · Rating 3 out of 5]

Bardzo dobra, choć amerykocentryczna (za co odjąłem jedną gwiazdkę), szczególnie w drugiej połowie książki. Szczerze pisze o błędach psychiatrii z przeszłości, aby przekonująco budować zaufanie do jej dzisiejszych możliwości. Oby przeczytało ją jak najwięcej ludzi - by nie bali się szukać pomocy i nie stygmatyzowali jej potrzebujących.