A provocative new perspective on the diagnosis, and therefore treatment, of mental illness.
Brothers Joel Gold (Psychiatry/NYU School of Medicine) and Ian Gold (Philosophy and Psychiatry/McGill Univ.) suggest that to treat delusions simply as manifestations of psychosis, without regard to their cognitive function, is insufficient.
The authors examine the possibility that delusions are symptomatic of a malfunctioning cognitive system whose positive evolutionary function has been protection against social threats. This leads them to conclude that it is necessary to view delusions as a malfunctioning response to “social environment on its own terms and not as an illusion waiting to be reduced to biology.” Their content can be traced to a need to deal with environmental stresses and are, in part, a reflection of the culture. Turning to the field of evolutionary psychology, the Golds suggest the existence of a hypothesized brain system, the “Suspicion System,” whose purpose is to protect the individual from threats; this would have served a useful purpose in alerting our ancestors to danger. It is when these threats are misperceived without corrective cognitive input that delusion follows. Joel Gold cites case histories from his practice as an attending psychiatrist at Bellevue Hospital Center; the cases show how such malfunctioning might occur when “[d]elusional thoughts and their linguistic expression are…cognitively isolated and not integrated with other thinking.” These delusions may be due to neurological malfunction, but biological theories of mental illness need not exclude their social component. “In taking account of the role of the social world in mental illness,” write the authors, “it may be necessary to hang on to notions like threat, discrimination, exploitation and status, and there may be no way to understand these concepts other than by theories far removed from neurons….Reductionism in psychiatry constrains theory to operate within the skull or the skin. Our bet is that the outside world is going to matter as well.”
A provocative new perspective on the diagnosis, and therefore treatment, of mental illness.Pub Date: July 8, 2014
ISBN: 978-1-4391-8155-3
Page Count: 288
Publisher: Free Press
Review Posted Online: May 17, 2014
Kirkus Reviews Issue: June 1, 2014
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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