Civil Liberties

Is Psychiatry All Better Now?

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


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.