Psychology/Psychiatry

Is Psychiatry All Better Now?

Gary Greenberg argues just throwing out Freud doesn't cure psychiatry of its ills.

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Gary Greenberg, author of a great 2013 feature for Reason called "Overselling Psychiatry" on the fight over the latest Diagnostic and Statistical Manual of Mental Disorders, has an interesting review essay at Bookforum about the book Shrinks: The Untold Story of Psychiatry by Jeffrey A Lieberman, M.D.

Greenberg's own writings contain very apt and corrosive critiques of the actual practice of psychiatry, though in this review he says he doesn't want to be lumped in with the late Reason contributing editor Thomas Szasz and the larger group of "anti-psychiatrists" as he says Lieberman does.

Szasz himself rejected that label. He was not anti-psychiatry; he was anti- what he saw as coercion and often lies in the existing field of psychiatry. But it's understandable why those who only looked at the title of his most famous (but not best) book The Myth of Mental Illness might loosely conclude that.

In this review, Greenberg sums up some of the problems with psychiatry as a scientific discipline and social/medical practice against author Lieberman, who just blames Freud for everything.

Greenberg notes that Lieberman's very old psychiatrist trick of copping to the problems of the bad old days and blaming them on outmoded and mistaken practices or ideas we are now totally beyond, doesn't really work:

Psychiatry, in [Lieberman's] view, isn't in need of rethinking, or at least it hasn't been since it dumped its Freudian baggage. What it needs now is only better public relations. His book is an attempt to let the world know that the bad old days are over, that the profession has transcended its past and entered a "pluralistic" era in which doctors use "the latest techniques of neuroscience and the latest psychodynamic theories of mental function." This anodyne summary discounts the possibility that we will never know how brain produces mind, that indeed the two realms are incommensurable, and it overlooks the continued unsatisfactory performance of even these latest techniques. Lieberman wants us to think that the story of psychiatry's progress is one we have never heard, but it's not nearly so untold as he would have us believe. It's the story that every defender of tradition likes to tell, the one in which we are on a march, led by quiet heroes like him, from the slime to the light, a parade whose leaders we disregard or overthrow only at risk of losing our way entirely.

Greenberg's essay, and his great 2013 Reason article, help explain why some intelligent observers of psychiatric theory and practice might not be as optimistic as Lieberman.

I reviewed an earlier work about the scary and repressive history of mental health practices in the United States back in 2002, Robert Whitaker's Mad in America. 

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  1. “the latest techniques of neuroscience and the latest psychodynamic theories of mental function.”

    The “neuroscience” catch-all offers cover for a lot of quackery

    1. At least they’ve got the psychodynamic theorizing down pat!

      1. That, at least, sounds like a big pile of steaming bullshit to anyone who doesn’t fucking love science.

  2. Fun game. How many words do you need to substitute in the Greenberg excerpt to come up with any Leftist’s defense of collectivism?

  3. Catatafish, I’ll bite:

    Change:
    psychaitry – socialism
    Freudian – Marxist
    Doctors – Economists
    Brains – Markets
    Minds – Wealth

    Presto.

  4. That was a nice article, I didn’t see it the first time.

  5. If only we will give MOAH POWAH to all the shrinks and those who will medicalize everything, then EVIL ITSELF can be cured! Hitler and Stalin and Mao Tse Tung? They just needed to “lay down on the couch” and pop a few pills, and conservatively 136,000 people might not have had to have been killed to feed the egos of those who were “ethically challenged”, although I am QUITE sure that the shrinks can come up with MUCH more comprehensive psycho-babble to describe the ailments of these 3 gentlemen…

    1. They have delusions of grandeur.

      They think they’re Hitler, Stalin, and Mao.

  6. I’m more worried about the SJWs and the AGW cultists who insist that the involuntary committment laws be used on anyone who disagrees with them.

  7. Is Psychiatry All Better Now?

    Bitch, please. That’s just crazy talk.

  8. Why is there a Picture of Eric Kandel in this post? He may be at Columbia and talk a lot, but he works with marine invertebrates for the most part, not people.

  9. oh jeez somethig that libertarians cant understand and disagree with even i the inlikely event that they could just happens to be the secret dealings of the evil commies/ will wonders never cease? its seems youre over due for another “rachel carson banned ddt and hates black people (ie one of the most easily debunked lies you dingbats peddle) here on reason.

    1. NEEDS MOAR CAPZ

      1. It’s either all or nothing with these guys.

    2. “rachel carson banned ddt and hates black people (ie one of the most easily debunked lies you dingbats peddle) here on reason.

      Uh-huh.

  10. As an Operating Thetan VIII, I have no need for your quackery.

    1. I see your Scientology and raise you a Scienfoology… Scienfoology is where it’s REALLY at, see http://www.churchofSQRLS.com

  11. It is still so amusing to me that so many people are worried about what’s in the DSM such as Greenberg. The DSM is a billing manual, like the Chilton manual on how to price auto repairs. It is not a ‘bible’ of psychiatry or anything remotely resembling it. No one, at least not anyone doing adult psychiatry, bases their psychiatric practice on it.

    Greenberg is a “therapist” and many of his ilk resent psychiatrists, who are physicians and thus may prescribe meds, do physical examinations, and use imaging to continue to build the scientifically-based treatments of psychiatry. There are therapists who want to believe all mental illness can be treated in psychotherapy, but it just isn’t the case, any more than you could treat diabetes in psychotherapy.

    The genetic and biologic bases of serious psychiatric illnesses are becoming better and better understood each day, and just about all of the major improvements come from the biologic, not the psychotherapeutic domains. You can talk all you want to people with schizophrenia and it won’t make their hallucinations go away, but there are now fairly benign meds who allow people with serious mental illnesses to lead much more fulfilling lives.

    There’s plenty of room for psychotherapists to work with people on improving their neuroses and relationships. There’s no need for them to resent the fact that psychiatry has moved farther and farther away from talking and into a more purely medical field.

    1. I had to read this three times to make sure you weren’t joking.

      What planet do you live on? I can’t even respond without asking if you live in some kind of alternate reality first, where everything is upside down.

      The biggest improvements do come from psychotherapy. Ever heard of Hearing Voices Network? Open Dialogue? These are very effective at helping people with psychosis. And yes, most of these people come to a point where they don’t hear voices anymore.

      On the other hand, meds actually have the long-term effect of making things worse.

  12. wow — this new comment format bites. You can’t even put a space between paragraphs?

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  14. Greenberg is a “therapist” and many of his ilk resent psychiatrists, who are physicians and thus may prescribe meds, do physical examinations, and use imaging to continue to build the scientifically-based treatments of psychiatry. There are therapists who want to believe all mental illness can be treated in psychotherapy, but it just isn’t the case, any more than you could treat diabetes in psychotherapy.

    ???? ??? ???? ??????????? ?????? ????? ???????
    The genetic and biologic bases of serious psychiatric illnesses are becoming better and better understood each day, and just about all of the major improvements come from the biologic, not the psychotherapeutic domains. You can talk all you want to people with schizophrenia and it won’t make their hallucinations go away, but there are now fairly benign meds who allow people with serious mental illnesses to lead much more fulfilling lives.

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