Dear Commons Community,
I just finished reading, Shrinks, the Untold Story of Psychiatry by Jeffrey Lieberman with Ogi Ogas. Dr. Lieberman who as Professor and Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons, tells the story of psychiatry as an insider. He traces the field from its beginnings as a “pseudoscience” through its “cult of shrinks” years to its current stage as a science-driven profession that saves lives.
Sigmund Freud and the entire area of psychoanalysis does not come off looking very good whereas the work of Eric Kandel is presented as getting psychiatry on a firmer scientific footing. Here is an excerpt from a New York Times review:
“Freud knew he lacked evidence for many of his “daring ideas about mental illness,” Lieberman says. Yet rather than conducting research to fill in the gaps, he instead began attacking anybody who questioned him. “He demanded complete loyalty to his theory, and insisted that his disciples follow his clinical techniques without deviation,” Lieberman argues, thereby “fossilizing a promising and dynamic scientific theory into a petrified religion.”
Lieberman hails the advent of the Diagnostic and Statistical Manual of Mental Disorders, the “bible of psychiatry” that describes in symptomatic detail all mental illnesses currently recognized by its publisher, the American Psychiatric Association, and therefore billable for insurance purposes. He recounts, at rather too much length, the infighting that erupted over different editions of the manual, including the latest version, published during his tenure as president of the A.P.A., but he makes a convincing case that its format has given the field a precision and reliability it lacked in the past. Psychiatrists have also taken advantage of new imaging technology to scan the brains of living patients, tracking subtle differences between the well and the ill that may not be obvious post-mortem.
Ultimately, though, the real secret to psychiatry’s success is drugs. One by one, the most devastating and formerly intractable mental diseases were tamed, if not completely routed, by pharmaceuticals: chlorpromazine for schizophrenia, lithium for bipolar disease, imipramine for depression. Lieberman describes the serendipity behind each spectacular discovery. He glides over the very real problem of side effects, and the fact that psychiatric drugs don’t always work or stop working over time. Still, for all the hand-wringing in some quarters that we are an overmedicated society, psychiatric drugs give patients what no rubber hose or hectoring daddy can: peace of mind, a piece of sky, a life.”
The story in Shrinks is probably known to those who have taken coursework in psychology. As someone who has not, I found the book most helpful in clarifying the evolution and current state of the field.