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What distinguishes this well-documented critique of modern American psychiatry are the unusual credentials of its author and its use of his multiple proficiencies. Robitscher is a lawyer, a psychiatrist, and a psychoanalyst, and this professional configuration gives his inquiry added depth and special authority. He contends that psychiatry has overextended its boundaries, that its authority continues to grow despite the indifferent effects of its interventions, and that its functions--to help the individual and to help society run smoothly--are sometimes in conflict. Psychiatrists are now consulted as experts in areas foreign to their expertise; and when they stand up for a patient's therapeutic needs, they frequently jeopardize his civil rights. Moreover, the small fraction of psychiatrists who exploit patients flourishes because the majority of the APA ignore their transgressions. Robitscher reopens the familiar catalogue of the abuses and misuses of psychiatry--drug-experimentation policies, diagnostic imprecisions, commitment irregularities, mind-control technology, the proliferation of pay services; he surveys their sources; and he considers why they persist unchecked. At times his professional experience gives him an edge over psychiatry's earlier critics (Schrag; Chazkin; Scheflin & Opton), for he knows the importance of, say, transference or the prevalence of quickie consultations, and he is quite familiar with forensic psychiatry. His opinions on problem areas (such as sanity determinations in criminal cases) will be readily acceptable to many psychiatrists, even that majority he alludes to; his comments on hospitalization (most can be avoided) and on the economics of psychiatry are certain to be more controversial (""there is a difference between a patient being expected to pay his way and being expected to support an affluent life style or, more mercenarily, being expected to yield a profit""). A comprehensive, carefully mounted work which makes the most of the insider's access and the outsider's detachment.

Pub Date: May 8th, 1980
Publisher: Houghton Mifflin