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Shrinks: The Untold Story of Psychiatry –…
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Shrinks: The Untold Story of Psychiatry (alkuperäinen julkaisuvuosi 2015; vuoden 2015 painos)

– tekijä: Jeffrey A. Lieberman

JäseniäKirja-arvostelujaSuosituimmuussijaKeskimääräinen arvioMaininnat
1186183,733 (4.17)6
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, reveals, the path to legitimacy for "the black sheep of medicine" has been anything but smooth. Here, 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. It's a history full of fanciful theories--from Franz Mesmer's nineteenth-century notion of "animal magnetism" to the classification of homosexuality as a mental disorder as late as the 1970s--and reckless treatments, including "coma therapies" and ice-pick lobotomies. It's also the story of a field divided against itself, torn between mind-focused psychiatrists like Sigmund Freud, whose theory of psychoanalysis dominated American psychiatry for more than half a century, and brain-focused neuroscientists like Eric Kandel, whose pioneering research helped bring the reign of Freud, his hero, to a close. At its heart, Shrinks is a detective tale, propelled by the central questions, what is mental illness and how can it be treated? The true heroes of this tale are the men and women who dared to challenge the status quo in pursuit of answers.--From publisher description.… (lisätietoja)
Jäsen:soybeans
Teoksen nimi:Shrinks: The Untold Story of Psychiatry
Kirjailijat:Jeffrey A. Lieberman
Info:Little, Brown and Company (2015), Hardcover, 352 pages
Kokoelmat:Oma kirjasto
Arvio (tähdet):*****
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Shrinks: The Untold Story of Psychiatry (tekijä: Jeffrey A. Lieberman) (2015)

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Näyttää 1-5 (yhteensä 6) (seuraava | näytä kaikki)
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?? ( )
  katebrarian | Jul 28, 2020 |
Excellent book on the history of the psychiatric profession. Now there's a statement I never dreamed I would utter! This book is very easy to read, full of interesting facts on the early days of diagnosing and treating mental illness (or trying to) and in the last section, it highlights the enormous strides they have made in just the last 20 or so years in bringing mental illness more into the biological realm of "medicine". With the advent of new technologies to scan the structures of the brain and provide detailed highlights of how they function, doctors are now able to make more definitive diagnoses than ever before, and are even having greater success in treating many illnesses that in the past would have left many a victim to languish in an asylum for the rest of their days. The next realm for psychiatrists to conquer is that of genetics -- looking for genetic mutations or markers of disease in order to perhaps provide preventative therapies for mental illness. The amount of progress that has been made in such a short time is staggering! ( )
  merrittfamily1990 | May 1, 2018 |
Fascinating. Given how Freud dominates most peoples awareness of and introduction to psychology, this is a sensational eye opener into how his theories are substantively discredited and, once again, the rationale for scientific endeavour - testing, evidence, etc. Also, makes a total mockery of our UK Government's appalling funding of mental health care. With time and resources, it seems the vast majority of sufferers of mental illness can be treated and lead full and productive lives in society. The costs to them and society as a whole of not meeting those realistic needs is horrific and shaming. ( )
  mnorfolk49 | Aug 19, 2017 |
I listened to the audible version downloaded from the library. I am not a scientist, but this was a super interesting book. It is a defense and vision of the future of practice of psychiatry. I appreciated how Lieberman breaks down the history of the profession, showing how it was dominated for many years by Freudian psychoanalysis. But with recent advances in brain imaging and gene mapping among other things, there are more real solutions for people suffering with mental illness.

There were couple places I thought it was a little dull, like the early revisions of the DSM manual. It was a little too detailed for me to listen to. I thought about quitting, but then I made it to "The Story of Treatment" and "Desperate Measures: Fever Cure, Coma Therapy and Lobotomies" and well there you had me. How could I stop?

One take away I got from this book is that much of my negativity I've had to the whole field of psychiatry is based on old facts and even cultural biases that have been perpetuated through media. Leiberman admits much of these criticism have been well-deserved. However, he makes the case that there are some great advances in the field of psychiatry in the past few decades.

This book also gave me a good look at the history of quackery that is still pervasive today.

You may not agree with everything in this book. It is so persuasive I felt skeptical...."c'mon what about all your patients you can't help?" And what about the fact that the patients he described all came from upper class backgrounds? And because really now, there is so much about the brain or consciousness that we don't know or may never know.

Yet, people do suffer from from real illnesses that can be treated successfully. Schizophrenia, for example, was very untreatable before the mid 1980s. But now it is possible to live a normal productive life with the support of a loving family and friends and good medical care. Who can deny the good done for one of the most difficult forms of psychosis?

If anything, this book will help you have compassion for those suffering with debilitating forms of mental illness and even for the people who help treat them.


( )
  kerchie1 | Jun 9, 2017 |
This is a great prescription that perhaps needs one more drug.

There is probably no field of medicine more controversial than psychiatry -- and rightly so. Until the late nineteenth century, it didn't really exist. When it did come to be a genuine field, it was because of Sigmund Freud -- and Freud had all sorts of things wrong, and his followers were worse, and let's face it: Psychoanalysis doesn't work, and should have been exposed as a fraud at least half a century before it was. And psychiatry continues to be the least precise branch of medicine, and most of the valuable parts of Freudian talk therapy are just as available to psychologists as psychiatrists -- so who needs psychiatrists? And this is apart from the whole issue of handing out a bazillion pills.

For the most part, this book faces the issues squarely. It admits that psychiatry had its teething pains. It gives a good history of this early history. And it outlines the steps by which psychiatry overcame this heritage -- the discovery of the first effective psychotropic medicines, the creation of the Diagnostic and Statistical Manual third edition (which converted psychiatric diagnosis from a matter of pure opinion to a matter of strict criteria), the adoption of cognitive behavioral therapy.

On top of all that, it's a very good read.

My only real complaint is that it's too optimistic. In essence, it lists the discovery of just three drugs -- imipramine, the first antidepressant; lithium, the first mood stabilizer; and chlorpromazine (thorazine), the first antipsychotic. This in effect treats each of the three as a perfect cure for every case of one of the three major classes of mental illness (depression, bipolar disorder, and schizophrenia). And it is true -- antidepressants, mood stabilizers, and antipsychotics are the best treatments yet devised for those conditions, especially the latter two.

But they aren't perfect. For starters, they aren't cures; all they do is control the condition. And -- sometimes they don't do that. It's quite universal: Effective antidepressants work for 60%-70% of users. Never more than that. And, remember, for depression, placebo works at least 30% of the time. And most cases go away in six to eight months on their own. (Which is probably how Freud achieved much of the success he did: The people got over their problems on their own, with no help from him.) The other classes of medication also fail in a lot of cases.

And that ignores side effects. Ever hear of the Thorazine Shuffle, Dr. Lieberman? That's the way people who have been given thorazine walk -- because the first-generation antipsychotics did so much nervous damage that they in effect gave the people who used them Parkinson's Disease. (Second-generation antipsychotics don't do this as much, but it still happens sometimes.) One class of antidepressants can kill you if you eat certain foods. Many of them cause sexual dysfunctions or extreme weight gain. In other words, while psychotropic drugs cure mental illnesses (two-thirds of the time, anyway), they cause other problems which can be almost as unpleasant. But I think the phrase "side effects" was mentioned only once in this book, and certainly the problem wasn't explored.

And that, these days, is psychiatry's real problem: psychiatrists pass out pills as if the prescription is what matters and their patients are the unfortunate side effect. This isn't entirely by choice -- psychiatrists are so rare on the ground that they don't have time to do much except talk to a patient for ten minutes and write a prescription. (Which raises the interesting question of why a person need an M.D. to prescribe such a small class of drugs. Psychiatrists don't use the vast majority of their medical training.) That lack of psychiatrists means immense suffering for patients who don't get the right drug but do get all the side effects. And the doctors still think that the patients should just ignore the side effects, because the pills are making them "better." So we we still have a problem.

And, for that matter, since psychiatrists don't actually consult with patients any more, why are they, and not the psychologists (who do deal with patients), writing the DSM -- which actually defines mental illnesses, and which is still more than a little controversial?

But those are not issues with psychiatry as such; they're issues with medicine in general. I think this book glosses over some of psychiatry's modern problems much too lightly. But if you belong to the class of people who think all psychiatry is wrong, it's worth remembering that the field is vastly improved. And this book is a very good description of why and how. Psychiatry still has a long way to go -- but it's made real and genuine and tremendous progress.

Send in the next patient, please! ( )
1 ääni waltzmn | Jul 29, 2016 |
Näyttää 1-5 (yhteensä 6) (seuraava | näytä kaikki)
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Tiedot englanninkielisestä Yhteisestä tiedosta. Muokkaa kotoistaaksesi se omalle kielellesi.
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who support me; and my patients, who guide me.
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Introduction
What's Wrong with Elena?
Anyone who goes to a psychiatrist ought to have his head examined.
       -- Samuel Goldwyn
A few years ago, a well-known celebrity -- let's call him Mr. Conway -- reluctantly brought his twenty-two-year-old daughter to see me.
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Englanninkielinen Wikipedia (1)

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, reveals, the path to legitimacy for "the black sheep of medicine" has been anything but smooth. Here, 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. It's a history full of fanciful theories--from Franz Mesmer's nineteenth-century notion of "animal magnetism" to the classification of homosexuality as a mental disorder as late as the 1970s--and reckless treatments, including "coma therapies" and ice-pick lobotomies. It's also the story of a field divided against itself, torn between mind-focused psychiatrists like Sigmund Freud, whose theory of psychoanalysis dominated American psychiatry for more than half a century, and brain-focused neuroscientists like Eric Kandel, whose pioneering research helped bring the reign of Freud, his hero, to a close. At its heart, Shrinks is a detective tale, propelled by the central questions, what is mental illness and how can it be treated? The true heroes of this tale are the men and women who dared to challenge the status quo in pursuit of answers.--From publisher description.

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