Our Necessary Shadow

June 1, 2014

Burns (chair of social psychiatry, Oxford Univ.) learned about mental illness growing up with a seriously depressed mother who was helped by psychiatry. Initially opposed to pills and electroshock treatment, he came to appreciate their use in her case. Reflecting on his four decades in "medicine's most disputed discipline" in the United States, Britain, and elsewhere around the world, Burns illuminates its advances, controversies, and mistakes. A savvy clinician and historian, he covers diagnosis and treatment from ancient times to the present. For him psychotherapy is the key intervention, while medication is secondary. Psychiatric illnesses "are part of what we are, not things that just happen to us such as flu or a broken leg." There are fine chapters on neuroscience and pharmaceuticals (drug companies spend more on marketing than on research!), and Burns covers antipsychiatry movements, the insanity defense, and the impact of war. With the closing of large mental hospitals and our failure to create community mental health centers, U.S. jails and city streets have become lodging places for thousands of patients. VERDICT A compassionate healer and articulate scholar, Burns has written one of the best books ever on psychiatry: a comprehensive, engaging text for general readers and professionals.--E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC

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