Prescriptions for the Mind: A Critical View of Contemporary Psychiatry

by Joel Paris

The practice of psychiatry has undergone great changes in recent years. In this book, Joel Paris, MD, a veteran psychiatrist, provides a fluently written and accessible "state-of-the-field" assessment. Himself a clinician, researcher, and teacher, Paris focuses on the most striking change within the field - the diverging roles of psychopharmacology and psychotherapy in contemporary practice. Where once psychiatrists were trained in Freudian psychoanalysis - which involved, more than anything else, talking - current pressures in mental health practice, including those imposed by managed care, are leading psychiatrists to treat more and more of their patients exclusively with medication, which is cheaper and faster. At the same time, psychotherapy is increasingly not being taught to new psychiatrists-in-training, even though, as Paris reveals, there is scientific evidence that both talk therapies and medication can play an important role in the treatment of mental illness. These
developments are occuring against a backdrop of exploding research in the genetics and neurobiology of mental illness that will continue to drive the field. Paris ends by contemplating how going forward psychiatry can best respond to all these forces and proposes a team-based approach to mental health care. The book will appeal both to specialists and nonspecialists, particularly psychiatric residents and fellows, medical students considering specialization in psychiatry, clinical psychologists, social workers, and general readers, especially consumers of mental health services.

Genres: Psychiatry, Psychology

272 pages, Hardcover

First published June 10, 2008

About the author

Dr Paris is Professor, Department of Psychiatry, McGill University, and Research Associate, Department of Psychiatry, Jewish General Hospital. He obtained his psychiatric training at McGill. His research interests include: developmental factors in personality disorders (especially borderline personality), culture and personality.
Current projects: risk factors for borderline personality disorder in children the biological correlates of borderline personality disorder.

Reviews

[Gavin · Rating 3 out of 5]

Not what you’d expect (“DSM hiss!! Pharma woo!!”). An ‘evidence-based psychiatrist’ (a good guy), his main target is people who overinterpret current neuroscience and just churn out pills. He concedes that the old analysts were ‘brainless’ but calls the worst of the new brain-scan boom ‘mindless’.

The evidence for talk therapy – things like CBT (for anxiety and personality disorders) – is much better than I’d thought, and Paris reckons this is now overlooked in favour of cheaper and truthier biological determinism.

A good, hard thing to say: “What causes mental illness? By and large, advances in neuroscience notwithstanding, we still don’t know.”

[Xexets · Rating 4 out of 5]

A very good overview of the state of psychiatry. Sufficiently critical if somehow biased. Too much utopian hope rests on the future of the neurosciences. Too little is said of community and social approaches which are dismissed as a fad. Too much hope is given to EBM and the idea that rigorous clinical trials can indeed bring solace to those suffering from mental illness. Psychoanalysis is as is customary dismissed with an absurd superficiality.
Nevertheless, if someone wants to have a precise idea of what psychiatry means today, this book is unbeatable.

[Kristen · Rating 4 out of 5]

At a time when I am considering the specialty of psychiatry, this book gives a fantastic critical perspective on the state of the field written by a reputable source.