Shrinks

Starred review from February 23, 2015
Lieberman (co-author of Essentials of Schizophrenia), former president of the American Psychiatric Association, does a stellar job of recounting the history of his profession, warts and all, in a way that is easily accessible to lay readers and full of surprising facts. While people are "more likely to need services from psychiatry than any other medical specialty," the stigma attached to mental illness means that most sufferers "consciously avoid the very treatments now proven to relieve their symptoms." But the path from defining a mental illness to finding a consistently effective treatment for it is far from linear, and Lieberman pulls no punches while demonstrating how many psychiatrists, including Freud, made serious missteps that harmed patients and discredited the field in the eyes of the general public. He ends on an upbeat note, however, convincingly arguing that the shame of admitting to mental illness may become a thing of the past, because sufferers can be "diagnosed and treated very effectively," although he notes that the public still needs to be educated about recent advances.

Starred review from January 1, 2015
An intelligent, encouraging survey of the psychiatric industry. Though he considers the profession he's dedicated his life to as the most "distrusted, feared, and denigrated of all medical specialties," former American Psychiatric Association president Lieberman (Psychiatry/Columbia Univ. College of Physicians and Surgeons) writes with pride of his livelihood in this exuberant and comprehensive dissection of the trade. A profession once "clouded by ideology and dubious science," the author applauds psychiatry's grand advancements in the medical world and the progression of modern society's impressions of it. Lieberman offers a broad historical perspective of how the mental health profession acquired its notoriously pseudoscientific reputation through chapters mining the processes of diagnosis and treatment, including a generous section highlighting the trailblazing career of Sigmund Freud, whose work as "CEO of the psychoanalytical movement" inspired the author to become a psychiatrist. Lieberman also discusses psychiatry's historic role regarding issues of sexual orientation, the treatment of PTSD and the riddles involved in diagnosing schizophrenia ("sometimes schizophrenia skipped entire generations, only to re-emerge later in the family tree"). The author describes the documented barbarism of psychosurgical lobotomy treatments, insulin-induced comas, chloral sedation, progressive psychopharmacology and electroconvulsive therapy-though Lieberman also documents positive results with ECT performed on patients early in his career. The practice has dramatically outgrown its negative connotations, writes the author, with the implementation of a pluralistic viewpoint toward mental illness. Technological innovations like MRI neuroimaging and advanced genetic testing also paved the way toward a long overdue appreciation of psychiatric clinical practice. Furthermore, a complement of radical, renegade neuroscientists continues to revolutionize and destigmatize psychiatry throughout its modern-day renaissance. Lieberman's exploration of what he dubs as psychiatry's "dark comedy of fanciful missteps" optimistically concludes with Hollywood's evolving interpretation of mental illness through films like The Silver Linings Playbook (2012). Vastly edifying and vigorously written-a much-needed update on how far the psychiatric industry has come, both medically and from a public perception standpoint.

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March 1, 2015

Lieberman (Lawrence C. Kolb Professor and Chairman of Psychiatry, Columbia Univ.; former president, American Psychiatric Assoc. [APA]), no relation to this reviewer, starts his historical review with Franz Mesmer and hypnosis, then attacks Sigmund Freud and psychoanalysis and endorses cognitive behavior therapy. With enthusiasm Lieberman, with coauthor Ogas (coauthor, A Billion Wicked Thoughts), recounts developments in neuroscience and pharmacy that distinguish psychiatry from psychology and other nonmedical approaches to mental illness. He deplores the emptying of U.S. mental hospitals that led to the present situation: thousands of seriously mentally ill people in prison or homeless. He describes the evolution of the APA's Diagnostic and Statistical Manual (DSM-5), a "triumph of pluralism," and writes enthusiastically about the "brain revolution" and the end of stigma. Lieberman animates the text with stories of a home invasion and--worse--nearly causing a fatal accident. VERDICT A lively defense of psychiatry that extols brain science and pharmaceutical treatment. A contrasting approach is found in Philip Thomas's Psychiatry in Context; critical of routine overuse of pharmaceuticals, Thomas makes a case for understanding the unique experience of each patient, even in schizophrenia. [See Prepub Alert, 9/29/14.]--E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC

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March 1, 2015
With the word psychiatry literally meaning medical treatment of the soul, note Lieberman and Ogas, how can past treatments not have encompassed the wacky, the useless, the harmful, and the harebrained? In this history of the practitioners and the practices, Lieberman and Ogas outline them allthe lobotomies, the orgone machines, the animal magnetismand how psychiatry may have once deserved the opprobrium it is now moving past, for how does one treat what cannot be seen (and how much blame can parents be expected to take?)? Today, with the newest DSM offering standardized diagnoses and understanding of a variety of ills, and with psychoanalysis not the primary mode of treatment available (and then, often, only for the well-heeled worried well, not those suffering from schizophrenia, bipolar disorders, and other illnesses not receptive to Freudian methods), most people with mental illness, if properly diagnosed and treated, can expect to lead a relatively normal and enjoyable life instead of wasting away inside the decrepit walls of an asylum. An enlightening, entertaining, and sometimes spooky history.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)