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Copyright 2015 by Jeffrey A. Lieberman, MD
Epilogue copyright 2016 by Jeffrey A. Lieberman, MD
Cover design by Julianna Lee; photographs by iStockphoto and Shutterstock
Author photograph by Eve Vagg
Cover copyright 2015 by Hachette Book Group, Inc.
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ISBN 978-0-316-27884-3
E3
Jeffrey Lieberman has produced a masterful behind-the-scenes examination of psychiatryand, by extension, the human condition. His epic narrative charts the unlikely ascent of the stepchild of medicine from the earliest parlor-room charlatans of animal magnetism to the contentious Digital Age rollout of the DSM-5, paralleling Liebermans own professional transformation from eager psychoanalytic student of Freud to neuroscience-minded president of a reformed American Psychiatric Association. A wise and gripping book that tackles one of the most important questions of our time: what is mental illness?
Andrew Solomon, author of Far from the Tree
Authoritative, scientifically scintillating, and anecdotally dazzling.
Elle
This is an astonishing book: honest, sober, exciting, and humane. Lieberman writes with the authority of an expert but with the humility of a doctor who has learned to treat the most profound and mysterious forms of mental illnesses. From Elenas story to the newest treatments in psychopharmacology and behavioral therapy, this book brings you to the very forefront of one of the most amazing medical journeys of our time.
Siddhartha Mukherjee, author of The Emperor of All Maladies
Shrinks is as thorough as it is lively.
Kay Redfield Jamison, author of An Unquiet Mind
An intelligent, encouraging survey of the psychiatric industry. Vastly edifying and vigorously writtena much-needed update on how far the psychiatric industry has come, both medically and from a public perception standpoint.
Kirkus Reviews
Shrinks is the most authoritative exploration I have read of the state of contemporary psychiatry and the paradox of the growing availability of effective treatments vs. the failure of the majority of those with severe mental illnesses to take advantage of those treatments. It is also the most hopeful. Jeffrey Liebermans extraordinary account of the scientific revolution in psychiatrya revolution that he both participated in and helped to fosteris compelling. But it is his candor, lack of dogmatism, and sensitivity to suffering that will linger in your mind long after youve turned the last page.
Sylvia Nasar, author of A Beautiful Mind
In the latter part of the twentieth century, cognitive psychology, the science of the mind, merged with neuroscience, the science of the brain. That merger, energized by molecular biology, has generated a new science of psychiatry that has roots in both modern psychological and biological research. Only someone such as Jeffrey Lieberman, who has led a great Department of Psychiatry on the one hand and headed the American Psychiatric Association on the other, and whose career reflects this synthesis, has both the clinical and scientific vision to write a modern history of the evolution of psychiatry, from its primitive origins to its current promise for the future. This highly readable and fully accessible book puts the history of psychiatry into a modern perspective for the general reader.
Eric R. Kandel, MD, winner of the Nobel Prize in Physiology or Medicine
For my parents, Howard and Ruth, who inspire me; my wife, Rosemarie, and sons, Jonathan and Jeremy, who support me; and my patients, who guide me.
Disclaimer: I have changed the names and identifying details of patients in this book to protect their privacy, and in some cases I have created composites of multiple patients. Many individuals have played seminal roles in the evolution of psychiatry. In the interest of readability, I have chosen to highlight certain key figures who seemed to me representative of their generation or their specialty. This should not be construed as ignoring or diminishing the achievements of other contemporaries who are not specifically mentioned by name. Finally, bucking the usual convention among academics, I have avoided using ellipses or brackets in quotations so as not to interrupt the narrative flow of the story, but I have made sure that any extra or missing words did not change the original meaning of the speaker or writer. The sources of the quotes are all listed in the Sources and Additional Reading section, and the original versions of the quotations are available at www.jeffreyliebermanmd.com.
The Brain is wider than the Sky,
For put them side by side
The one the other will contain
With easeand Youbeside.
The Brain is deeper than the sea,
For, hold them, Blue to Blue
The one the other will absorb
As Sponges, Buckets do.
The Brain is just the weight of God,
For, Heft them, Pound for Pound
And they will differif they do
As Syllable from Sound.
E MILY D ICKINSON
Anyone who goes to a psychiatrist ought to have his head examined.
S AMUEL G OLDWYN
A few years ago, a well-known celebritylets call him Mr. Conwayreluctantly brought his twenty-two-year-old daughter to see me. Elena had taken a leave of absence from Yale, Mr. Conway explained, because of issues surrounding a mysterious drop in her grades. Mrs. Conway nodded assent and added that Elenas slacking off stemmed from a lack of motivation and low self-confidence.
In response to their daughters perceived troubles, the Conways had hired a parade of motivational experts, life coaches, and tutors. Despite this pricey coterie of handlers, her behavior failed to improve. In fact, one tutor even volunteered (rather hesitantly, given Mr. Conways celebrity) that something is wrong with Elena. The Conways dismissed the tutors concern as an excuse for his own incompetence and continued to look for ways to help their daughter snap out of her funk.