Unhinged: The Trouble with Psychiatry—A Doctor's Revelations about a Profession in Crisis


Daniel J. Carlat - 2010
    As he did in his hard-hitting and widely read New York Times Magazine article "Dr. Drug Rep," and as he continues to do in his popular watchdog newsletter, The Carlat Psychiatry Report, he writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences. Psychiatrists have settled for treating symptoms rather than causes, embracing the apparent medical rigor of DSM diagnoses and prescription in place of learning the more challenging craft of therapeutic counseling, gaining only limited understanding of their patients’ lives. Talk therapy takes time, whereas the fifteen-minute "med check" allows for more patients and more insurance company reimbursement. Yet DSM diagnoses, he shows, are premised on a good deal less science than we would think. Writing from an insider’s perspective, with refreshing forthrightness about his own daily struggles as a practitioner, Dr. Carlat shares a wealth of stories from his own practice and those of others that demonstrate the glaring shortcomings of the standard fifteen-minute patient visit. He also reveals the dangers of rampant diagnoses of bipolar disorder, ADHD, and other "popular" psychiatric disorders, and exposes the risks of the cocktails of medications so many patients are put on. Especially disturbing are the terrible consequences of overprescription of drugs to children of ever younger ages. Taking us on a tour of the world of pharmaceutical marketing, he also reveals the inner workings of collusion between psychiatrists and drug companies. Concluding with a road map for exactly how the profession should be reformed, Unhinged is vital reading for all those in treatment or considering it, as well as a stirring call to action for the large community of psychiatrists themselves. As physicians and drug companies continue to work together in disquieting and harmful ways, and as diagnoses—and misdiagnoses—of mental disorders skyrocket, it’s essential that Dr. Carlat’s bold call for reform is heeded.

The Emperor's New Drugs: Exploding the Antidepressant Myth


Irving Kirsch - 2009
    Professor Irving Kirsch knew this as well as anyone. But, as he discovered during his research, there is a problem with what everyone knows about antidepressant drugs. It isn't true.How did antidepressant drugs gain their reputation as a magic bullet for depression? And why has it taken so long for the story to become public? Answering these questions takes us to the point where the lines between clinical research and marketing disappear altogether.Using the Freedom of Information Act, Kirsch accessed clinical trials that were withheld, by drug companies, from the public and from the doctors who prescribe antidepressants. What he found, and what he documents here, promises to bring revolutionary change to the way our society perceives, and consumes, antidepressants.The Emperor's New Drugs exposes what we have failed to see before: depression is not caused by a chemical imbalance in the brain; antidepressants are significantly more dangerous than other forms of treatment and are only marginally more effective than placebos; and, there are other ways to combat depression, treatments that don't only include the empty promise of the antidepressant prescription.This is not a book about alternative medicine and its outlandish claims. This is a book about fantasy and wishful thinking in the heart of clinical medicine, about the seductions of myth, and the final stubbornness of facts.

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America


Robert Whitaker - 2010
    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?


Richard P. Bentall - 2009
    It lay in biological solutions, focusing on mental illness as a problem of the brain, to be managed or improved through drugs. We entered the Prozac Age and believed we had moved far beyond the time of frontal lobotomies to an age of good and successful mental healthcare. Biological psychiatry had triumphed.Except maybe it hadn't. Starting with surprising evidence from the World Health Organization that suggests that people recover better from mental illness in a developing country than in the first world, Doctoring the Mind asks the question: how good are our mental healthcare services, really? Richard P. Bentall picks apart the science that underlies our current psychiatric practice. He puts the patient back at the heart of treatment for mental illness, making the case that a good relationship between patients and their doctors is the most important indicator of whether someone will recover.Arguing passionately for a future of mental health treatment that focuses as much on patients as individuals as on the brain itself, this is a book set to redefine our understanding of the treatment of madness in the twenty-first century.

The Shaking Woman, or A History of My Nerves


Siri Hustvedt - 2009
    Despite her flapping arms and shaking legs, she continued to speak clearly and was able to finish her speech. It was as if she had suddenly become two people: a calm orator and a shuddering wreck. Then the seizures happened again and again. The Shaking Woman tracks Hustvedt’s search for a diagnosis, one that takes her inside the thought processes of several scientific disciplines, each one of which offers a distinct perspective on her paroxysms but no ready solution. In the process, she finds herself entangled in fundamental questions: What is the relationship between brain and mind? How do we remember? What is the self?During her investigations, Hustvedt joins a discussion group in which neurologists, psychiatrists, psychoanalysts, and brain scientists trade ideas to develop a new field: neuropsychoanalysis. She volunteers as a writing teacher for psychiatric in-patients at the Payne Whitney clinic in New York City and unearths precedents in medical history that illuminate the origins of and shifts in our theories about the mind-body problem. In The Shaking Woman, Hustvedt synthesizes her experience and research into a compelling mystery: Who is the shaking woman? In the end, the story she tells becomes, in the words of George Makari, author of Revolution in Mind, “a brilliant illumination for us all.”

Crazy Like Us: The Globalization of the American Psyche


Ethan Watters - 2009
    But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In "Crazy Like Us," Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad. America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties." Crazy Like Us" documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

The Book of Woe: The DSM and the Unmaking of Psychiatry


Gary Greenberg - 2013
    An exposé of the psychiatric profession’s bible from a leading psychotherapist, The Book of Woe reveals the deeply flawed process by which mental disorders are invented and uninvented—and why increasing numbers of therapy patients are being declared mentally ill.

In the Realm of Hungry Ghosts: Close Encounters with Addiction


Gabor Maté - 2007
    Diligently treating the drug addicts of Vancouver's notorious Downtown Eastside with sympathy in his heart and legislative reform in mind can't be easy. But Maté never judges. His book is a powerful call-to-arms, both for the decriminalization of drugs and for a more sympathetic and informed view of addiction. As Maté observes, "Those whom we dismiss as 'junkies' are not creatures from a different world, only men and women mired at the extreme end of a continuum on which, here or there, all of us might well locate ourselves." In the Realm of Hungry Ghosts begins by introducing us to many of Dr. Maté's most dire patients who steal, cheat, sell sex, and otherwise harm themselves for their next hit. Maté looks to the root causes of addiction, applying a clinical and psychological view to the physical manifestation and offering some enlightening answers for why people inflict such catastrophe on themselves.Finally, he takes aim at the hugely ineffectual, largely U.S.-led War on Drugs (and its worldwide followers), challenging the wisdom of fighting drugs instead of aiding the addicts, and showing how controversial measures such as safe injection sites are measurably more successful at reducing drug-related crime and the spread of disease than anything most major governments have going. It's not easy reading, but we ignore his arguments at our peril. When it comes to combating the drug trade and the ravages of addiction, society can use all the help it can get. --Kim Hughes

Creatures of a Day: And Other Tales of Psychotherapy


Irvin D. Yalom - 2015
    Yalom describes his patients' struggles -- as well as his own -- to come to terms with the two great challenges of existence: how to have a meaningful life yet reckon with its inevitable end. We meet a nurse who must stifle the pain of losing her son in order to comfort her patients' pains, a newly minted psychologist whose studies damage her treasured memories of a lost friend, and a man whose rejection of psychological inquiry forces even Yalom himself into a crisis of confidence. Creatures of a Day is a radically honest statement about the difficulties of human life, but also a celebration of some of the finest fruits -- love, family, friendship -- it can offer. Marcus Aurelius has written that "we are all creatures of a day." With Yalom as our guide, we will find the means to make our own day not only bearable, but also meaningful and joyful.

The Myth of Mental Illness: Foundations of a Theory of Personal Conduct


Thomas Szasz - 1961
    "Bold and often brilliant.”—Science "It is no exaggeration to state that Szasz's work raises major social issues which deserve the attention of policy makers and indeed of all informed and socially conscious Americans...Quite probably he has done more than any other man to alert the American public to the potential dangers of an excessively psychiatrized society.”—Edwin M. Schur, Atlantic

Chasing the Scream: The First and Last Days of the War on Drugs


Johann Hari - 2015
    On the eve of this centenary, journalist Johann Hari set off on an epic three-year, thirty-thousand-mile journey into the war on drugs. What he found is that more and more people all over the world have begun to recognize three startling truths: Drugs are not what we think they are. Addiction is not what we think it is. And the drug war has very different motives to the ones we have seen on our TV screens for so long.In Chasing the Scream, Hari reveals his discoveries entirely through the stories of people across the world whose lives have been transformed by this war. They range from a transsexual crack dealer in Brooklyn searching for her mother, to a teenage hit-man in Mexico searching for a way out. It begins with Hari's discovery that at the birth of the drug war, Billie Holiday was stalked and killed by the man who launched this crusade--and it ends with the story of a brave doctor who has led his country to decriminalize every drug, from cannabis to crack, with remarkable results.Chasing the Scream lays bare what we really have been chasing in our century of drug war--in our hunger for drugs, and in our attempt to destroy them. This book will challenge and change how you think about one of the most controversial--and consequential--questions of our time.

The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder


Allan V. Horwitz - 2007
    Warnings that depressive disorder is a leading cause of worldwide disability have been accompanied by a massive upsurge in the consumption of antidepressant medication, widespread screening for depression in clinics and schools, and a push to diagnose depression early, on the basis of just a few symptoms, in order to prevent more severe conditions from developing.In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield argue that, while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic in fact reflects the way the psychiatric profession has understood and reclassified normal human sadness as largely an abnormal experience. With the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), mental health professionals began diagnosing depression based on symptoms—such as depressed mood, loss of appetite, and fatigue—that lasted for at least two weeks. This system is fundamentally flawed, the authors maintain, because it fails to take into account the context in which the symptoms occur. They stress the importance of distinguishing between abnormal reactions due to internal dysfunction and normal sadness brought on by external circumstances. Under the current DSM classification system, however, this distinction is impossible to make, so the expected emotional distress caused by upsetting events—for example, the loss of a job or the end of a relationship—could lead to a mistaken diagnosis of depressive disorder. Indeed, it is this very mistake that lies at the root of the presumed epidemic of major depression in our midst.

The Divided Self: An Existential Study in Sanity and Madness


R.D. Laing - 1960
    Laing explains how we all exist in the world as beings, defined by others who carry a model of us in their heads, just as we carry models of them in our heads. In later writings he often takes this to deeper levels, laboriously spelling out how "A knows that B knows that A knows that B knows..."! Our feelings and motivations derive very much from this condition of "being in the world" in the sense of existing for others, who exist for us. Without this we suffer "ontological insecurity", a condition often expressed in terms of "being dead" by people who are clearly still physically alive.This watershed work aimed to make madness comprehensible, and in doing so revolutionized the way we perceive mental illness. Using case studies of patients he had worked with, psychiatrist R. D. Laing argued that psychosis is not a medical condition, but an outcome of the 'divided self', or the tension between the two personas within us: one our authentic, private identity, and the other the false, 'sane' self that we present to the world. Laing's radical approach to insanity offered a rich existential analysis of personal alienation and made him a cult figure in the 1960s, yet his work was most significant for its humane attitude, which put the patient back at the centre of treatment. R.D. Laing (1927-1989), one of the best-known psychiatrists of modern times, was born in Glasgow, Scotland.This work is available on its own or as part of the 7 volume set iSelected Works of R. D. Laing

The Noonday Demon: An Atlas of Depression


Andrew Solomon - 2000
    His contribution to our understanding not only of mental illness but also of the human condition is truly stunning.The Noonday Demon examines depression in personal, cultural, and scientific terms. Drawing on his own struggles with the illness and interviews with fellow sufferers, doctors and scientists, policymakers and politicians, drug designers and philosophers, Solomon reveals the subtle complexities and sheer agony of the disease. He confronts the challenge of defining the illness and describes the vast range of available medications, the efficacy of alternative treatments, and the impact the malady has had on various demographic populations around the world and throughout history. He also explores the thorny patch of moral and ethical questions posed by emerging biological explanations for mental illness.The depth of human experience Solomon chronicles, the range of his intelligence, and his boundless curiosity and compassion will change the reader's view of the world.

Snakes in Suits: When Psychopaths Go to Work


Paul Babiak - 2006
    Now, Dr. Paul Babiak and Dr. Robert D. Hare return with a revised and updated edition of their essential guide.All of us at some point have—or will—come into contact with psychopathic individuals. The danger they present may not be readily apparent because of their ability to charm, deceive, and manipulate. Although not necessarily criminal, their self-serving nature frequently is destructive to the organizations that employ them. So how can we protect ourselves and our organizations in a business climate that offers the perfect conditions for psychopaths to thrive?In Snakes in Suits, Hare, an expert on the scientific study of psychopathy, and Babiak, an industrial and organizational psychologist and a leading authority on the corporate psychopath, examine the role of psychopaths in modern corporations and provide the tools employers can use to avoid and deal with them. Together, they have developed the B-Scan 360, a research tool designed specifically for business professionals.Dr. Babiak and Dr. Hare reveal the secret lives of psychopaths, explain the ways in which they manipulate and deceive, and help you to see through their games. The rapid pace of today’s corporate environment provides the perfect breeding ground for these "snakes in suits" and this newly revised and updated classic gives you the insight, information, and power to protect yourself and your company before it’s too late.