A comprehensive history and analysis of the practice of psychiatry.
Burns (Social Psychiatry/Oxford Univ.) admits to developing a predilection for the craft of psychoanalysis after his mother suffered a nervous breakdown when he was a teenager and he observed the “enormous difference” her treatments made. Now a practicing psychiatrist, the author attempts a qualitative and personally reflective examination of his livelihood, a medical specialty that, he asserts, has long confused and confounded our culture. In the introduction, Burns pinpoints the main psychiatric illnesses affecting the adult population, and the first chapter, however oddly placed, forms a helpful preparatory primer for those seeking care. The author discusses the field’s origins, from asylum care (the “essential precursors” to modern psychiatry) to the exploration of mental unconsciousness and theories of automatism, psychoanalysis and the fight-or-flight internal battle of soldiers with shell shock. Burns notes how early barbaric psychiatric treatments like insulin-induced comas, surgical leucotomies and aggressive electroconvulsive therapy have all contributed to a perpetually negative slant on the practice, but he remains optimistic about its future and displays and emphasizes the importance of psychiatry as a legitimate, trustworthy medical practice. “Deinstitutionalization” and the blooming popularity of antidepressants, along with advancements in neuroscience, collectively counteract these aspersions. Additionally, Burns shares his own frustrations regarding the “philosophical and ethical contradictions” of delivering professional psychiatric care and argues against the misconstrued belief that the practice is an outmoded hustle. He dexterously synthesizes all of this material into a broad-minded volume which may prove “more descriptive than explanatory” for some but that articulately grasps the past and present modalities of psychiatry. Writes Burns, “[psychiatry] is ‘our necessary shadow’ in that it deals with illnesses that are a part of what we are, not things that just happen to us such as flu or a broken leg.”
A responsible, evenhanded exploration of a highly provocative medical industry.