Wednesday, March 25, 2015

Review of Jeffrey Lieberman's Shrinks: The Untold Story of Psychiatry

Excerpt from a great review by Gary Greenburg.

Book Forum
"I may be critical of psychiatry, but as a clinician, I would be thrilled if the portrait Lieberman paints of the mental health field bore a closer resemblance to reality. If a scientific medicine of the brain were truly available, I’d be glad to avail myself of it. At the very least, I’d be relieved not to worry that every time I sent a patient to a psychiatrist, she might return with a fistful of prescriptions, little idea of how the drugs work (for no one really knows) or what side effects she may suffer, and no guarantee that she will get better. Lieberman’s apologetics suffer from his cheerleading, from a tendency to gloss over history that would perhaps suggest a less sanguine conclusion than his.
But it’s not just the distant past that Lieberman leaves unrecounted. He minimizes or entirely overlooks such unsavory recent chapters as the widespread diagnosis, against the criteria of the DSM, of bipolar disorder in the very young and their subsequent treatment with powerful (and untested in children) antipsychotic drugs—an episode that occasioned Senate hearings and front-page exposés. He never acknowledges that the “serotonin imbalance” that antidepressants supposedly rectify does not exist—or if it does, it has yet to be discovered—and his lock-and-key image belies the much less certain clinical reality, in which antidepressants are routinely prescribed for anxiety disorders, antipsychotics for mood disorders, and anti-anxiety drugs for a wide range of complaints—and all on a trial-and-error basis. He fails to mention that no new psychiatric medications have been discovered in the past quarter century, or that none of the newer ones have proved more effective than the drugs discovered in the 1950s (although some of them do have fewer side effects). And he vastly overestimates the current state of neuroscience, which is only beginning to unravel the mysteries of how the billions of neurons and trillions of connections among them turn into consciousness."

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