REALITY THERAPY IN ACTION

The backlash may be on. Turn away from “organic psychiatry,” urges Glasser (Choice Theory, 1998, etc.); help patients with mental illness accept that they are responsible for their behavior; and drastically reduce our reliance on medications for treating mental illness. Joined by a growing crowd (Peter Breggin, for instance, and Schaler, below), Glasser reiterates his opposition to the theory that mental illness is caused by chemical imbalances in the brain. Instead, he insists that “what is labeled mental illness . . . are the hundreds of ways people choose to behave when they are unable to satisfy basic genetic needs, such as love and power.” He interprets brain scan research to show that as patients work in (non-drug) therapy, they begin to make better choices in life, and that as a result, brain chemistry changes. This collection of case histories and commentary ranges over marital discord, panic attacks, alcoholism, obsessive-compulsive disorder, and schizophrenia. Glasser demonstrates how he conducts therapy that helps patients take responsibility for their actions, gradually find better ways to meet their needs, and change inappropriate patterns of behavior. He is generally against “external control psychology,” arguing again that patients must learn to control themselves. Though his views are sometimes remote from the current mainstream (“A major purpose of all psychological symptoms is to get sympathy and attention”), he makes a cogent case for his dissent. For those looking for a new view of psychology and psychiatry, either for personal help or to follow the current state of the art.