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
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”
The powerful story of a father’s past and a son’s future.
Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”Pub Date: July 8, 2015
ISBN: 978-0-8129-9354-7
Page Count: 176
Publisher: Spiegel & Grau
Review Posted Online: May 5, 2015
Kirkus Reviews Issue: July 1, 2015
BOOK REVIEW
BOOK REVIEW
SEEN & HEARD
BOOK TO SCREEN
BOOK TO SCREEN
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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