Tolle Lege!.

Most of us today have a warped view of what psychiatry does based on its early history and the way it has been portrayed by popular media during earlier time periods. Psychoanalysis (think Freud) was pseudoscience. It thought that diseases of the mind and brain were caused by repressed memories and such, and that it had no empirical data to support it. The author really doesn't dance around the problems inherent within Psychoanalysis. Each psychoanalyst needed to be psychoanalyzed before becoming a psychoanalyst a perfect way to create a pseudoscience.

Psychoanalysts were arguing that all mental problems were behavioral problems and everybody suffered from some sort of mental problem. They had lost touch with reality. The media was right to mock the profession. Things started to change in the 1970s when Washington University in St. Louis, MO started emphasizing the role that data should play in diagnosis instead of tradition and intuition. They even started developing CBT (Cognitive Behavioral Therapy) as an antidote to the meaninglessness of blaming the patient for his neurosis. With data it was shown to work.

The first step in developing science is to first define categories. In this case, the DSM (Diagnostic Statistical Manual) III started insisting on scientific categories instead of the pseudo classifications that the psychiatrists (mostly psychoanalyst) had been using previously. The tenor of the times had tarnished the image of the psychiatrists and something needed to be done to put the profession back on a scientific basis.

The next step comes about through the realization that the mind and the brain both effect mental health. The first major step (early 1900s) was introducing malaria into patients who had severe mental problems due to advance syphilis. The ensuing fever cured the patients. Unfortunately, lobotomies started being performed, and had no data to support their efficacy. Ultimately, a whole slew of drugs are discovered which led to control of some mental related diseases.

The author shows how today the profession really does add value. Many people's perceptions about the profession were warped by what they saw in popular media while growing up, but the world has changed and so has the profession of psychiatry. For those who want to remain in the dark and only offer criticism they should skip this fine book, for all others who want to enter the 21st century and unlearn their misconceptions I would highly recommend this well written book.