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Lieberman Jeffrey A. - Shrinks : the untold story of psychiatry

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Shrinks : the untold story of psychiatry: summary, description and annotation

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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. Its a history full of fanciful theories--from Franz Mesmers 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. Its 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. Read more...
Abstract: 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. Its a history full of fanciful theories--from Franz Mesmers 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. Its 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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In accordance with the US Copyright Act of 1976 the scanning uploading and - photo 1

In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher constitute unlawful piracy and theft of the authors intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at permissions@hbgusa.com. Thank you for your support of the authors rights.

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Copyright 2015 by Jeffrey A. Lieberman

Cover design by Julianna Lee; photographs by iStockphoto and Shutterstock

Cover copyright 2015 by Hachette Book Group, Inc.

All rights reserved. In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher is unlawful piracy and theft of the authors intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at permissions@hbgusa.com. Thank you for your support of the authors rights.

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Text and illustration copyright acknowledgments appear .

ISBN 978-0-316-27884-3

E3

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.

They turned to naturopathic agents and meditation, and when those didnt help, they shelled out more money for hypnosis and acupuncture. In fact, they had done everything possible to avoid seeing a psychiatrist until the incident.

While traveling uptown on the New York subway to meet her mother for lunch, Elena was accosted by a balding middle-aged man in a grimy leather jacket who coaxed her off the subway car. Without informing her mother, Elena abandoned the lunch appointment and accompanied the man to his seedy basement apartment on the Lower East Side. The man was in the kitchen preparing something alcoholic for her to drink when Elena finally answered a call from her frantic mother on her cell phone.

When Mrs. Conway learned where Elena was, she speed-dialed the police, who swooped in and carted her back to her parents. Elena didnt protest her mothers abrupt intervention; in fact, Elena didnt seem fazed by the incident at all.

As the Conways narrated these events in my Manhattan office, it was apparent that they loved their daughter and were genuinely concerned for her welfare. Having two sons of my own, I could easily empathize with their distress over the possible fate that could have befallen their daughter. Despite their concern, they made plain their doubts about the need for my services. After he sat down, the first thing Mr. Conway said was, I gotta tell you, I really dont think she needs a shrink.

The profession to which I have dedicated my life remains the most distrusted, feared, and denigrated of all medical specialties. There is no anti-cardiology movement calling for the elimination of heart doctors. There is no anti-oncology movement protesting cancer treatment. But there is a large and vocal anti-psychiatry movement demanding that psychiatrists be downsized, reined in, or extirpated. As chairman of the psychiatry department at Columbia University, chief psychiatrist at the New York Presbyterian HospitalColumbia University Medical Center, and past president of the American Psychiatric Association, I receive emails each week expressing pointed criticisms like these:

Your bogus diagnoses exist merely to enrich Big Pharma.

You take perfectly normal behaviors and call them illnesses to justify your existence.

There is no such thing as mental disorders, only diverse mentalities.

You quacks dont know what the hell youre doing. But you should know this: Your drugs destroy peoples brains.

Such skeptics dont look to psychiatry to help solve mental health problems they claim psychiatry is the mental health problem. All around the world, people have an abiding suspicion of shrinksthe most common epithet for the self-important charlatans believed to populate my profession.

I ignored the Conways skepticism and began Elenas evaluation by taking her history, soliciting biographical and medical details from her parents. Elena, I learned, was the oldest and brightest of the Conways four children and the one who seemed to hold the greatest potential. Everything in her life had been going great, her parents confided wistfullyuntil her sophomore year at Yale.

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