Portrait of the Psychiatrist as a Young Man


Book Description

RD Laing remains one of the most famous psychiatrists of the last 50 years. In the 1960s he enjoyed enormous popularity and received much publicity for his controversial views challenging the psychiatric orthodoxy. He championed the rights of the patient, and challenged the often inhumane methods of treating the mentally ill. Based on a wealth of previously unexamined archives relating to his private papers and clinical notes, Portrait of the Psychiatrist as a Young Man sheds new light on RD Laing, and in particular his early formative years - a crucial but largely overlooked period in his life. The first half of the book considers Laing's intellectual journey through the world of ideas and his development as a psychiatric theorist. An analysis of his notebooks and personal library reveals Laing's engagement not only with psychiatric theory, but also with a wide range of other disciplines, such as philosophy, literature, and religion. This part of the book considers how this shaped Laing's writing about madness and his evolution as a clinician. The second half draws on a rich and completely unexplored collection of Laing's clinical notes, which detail his encounters with patients in his early years as a psychiatrist, firstly in the British Army, subsequently in the psychiatric hospitals of Glasgow, and finally in the Tavistock Clinic in London. These notes reveal what Laing was actually doing in clinical practice, and how theory interacted with therapy. The majority of patients who were to appear in Laing's first two books, The Divided Self and The Self and Others have been identified from these records, and this volume provides a fascinating account of how the published case histories compare to the original notes. There is a considerable mythology surrounding Laing, partly created by himself and partly by subsequent commentators. By a careful examination of primary sources, Allan Beveridge, both a psychiatrist and an historian, examines the many mythological narratives about Laing and provide a critical but not unsympathetic account of this colourful and contradictory thinker, who addressed questions about the nature of madness which are still being asked today. This book will be of interest to mental health workers and social historians alike as well as anybody interested in the philosophy of psychiatry.




Falling Into the Fire


Book Description

Falling Into the Fire is psychiatrist Christine Montross’s thoughtful investigation of the gripping patient encounters that have challenged and deepened her practice. The majority of the patients Montross treats in Falling Into the Fire are seen in the locked inpatient wards of a psychiatric hospital; all are in moments of profound crisis. We meet a young woman who habitually commits self-injury, having ingested light bulbs, a box of nails, and a steak knife, among other objects. Her repeated visits to the hospital incite the frustration of the staff, leading Montross to examine how emotion can interfere with proper care. A recent college graduate, dressed in a tunic and declaring that love emanates from everything around him, is brought to the ER by his concerned girlfriend. Is it ecstasy or psychosis? What legal ability do doctors have to hospitalize—and sometimes medicate—a patient against his will? A new mother is admitted with incessant visions of harming her child. Is she psychotic and a danger or does she suffer from obsessive thoughts? Her course of treatment—and her child’s future—depends upon whether she receives the correct diagnosis. Each case study presents its own line of inquiry, leading Montross to seek relevant psychiatric knowledge from diverse sources. A doctor of uncommon curiosity and compassion, Montross discovers lessons in medieval dancing plagues, in leading forensic and neurological research, and in moments from her own life. Beautifully written, deeply felt, Falling Into the Fire brings us inside the doctor’s mind, illuminating the grave human costs of mental illness as well as the challenges of diagnosis and treatment. Throughout, Montross confronts the larger question of psychiatry: What is to be done when a patient’s experiences cannot be accounted for, or helped, by what contemporary medicine knows about the brain? When all else fails, Montross finds, what remains is the capacity to abide, to sit with the desperate in their darkest moments. At once rigorous and meditative, Falling Into the Fire is an intimate portrait of psychiatry, allowing the reader to witness the humanity of the practice and the enduring mysteries of the mind




Essentials of Psychiatric Diagnosis, Revised Edition


Book Description

Grounded in author Allen Frances's extensive clinical experience, this comprehensive yet concise guide helps the busy clinician find the right psychiatric diagnosis and avoid the many pitfalls that lead to errors. Covering every disorder routinely encountered in clinical practice, Frances provides the ICD-9-CM and ICD-10-CM (where feasible) codes required for billing, a useful screening question, a colorful descriptive prototype, lucid diagnostic tips, and a discussion of other disorders that must be ruled out. The book closes with an index of the most common presenting symptoms, listing possible diagnoses that must be considered for each. Frances was instrumental in the development of past editions of the DSM and provides helpful cautions on questionable aspects of DSM-5. The revised edition features ICD-10-CM codes where feasible throughout the chapters, plus a Crosswalk to ICD-10-CM Codes in the Appendix. The Appendix, links to further coding resources, and periodic updates can also be accessed online (www.guilford.com/frances_updates).




The Man Who Closed the Asylums


Book Description

When the wind of the 1960s blew through the world of psychiatry In 1961, when Franco Basaglia arrived outside the grim walls of the Gorizia asylum, on the Italian border with Yugoslavia, it was a place of horror, a Bedlam for the mentally sick and excluded, redolent of Basaglia’s own wartime experience inside a fascist gaol. Patients were frequently restrained for long periods, and therapy was largely a matter of electric and insulin shocks. The corridors stank, and for many of the interned the doors were locked for life. This was a concentration camp, not a hospital. Basaglia, the new Director, was expected to practise all the skills of oppression in which he had been schooled, but he would have none of this. The place had to be closed down by opening it up from the inside, bringing freedom and democracy to the patients, the nurses and the psychiatrists working in that “total institution.” Inspired by the writings of authors such as Primo Levi, R.D. Laing, Erving Goffman, Michel Foucault and Frantz Fanon, and the practices of experimental therapeutic communities in the UK, Basaglia’s seminal work as a psychiatrist and campaigner in Gorizia, Parma and Trieste fed into and substantially contributed to the national and international movement of 1968. In 1978 a law was passed (the “Basaglia law”) which sanctioned the closure of the entire Italian asylum system. The first comprehensive study of this revolutionary approach to mental health care, The Man Who Closed the Asylums is a gripping account of one of the most influential movements in twentieth-century psychiatry, which helped to transform the way we see mental illness. Basaglia’s work saved countless people from a miserable existence, and his legacy persists, as an object lesson in the struggle against the brutality and ignorance that the establishment peddles to the public as common sense.




Continental Philosophy of Psychiatry


Book Description

This book explores how the continental philosophical tradition in the 20th century attempted to understand madness as madness. It traces the paradoxical endeavour of reason attempting to understand madness without dissolving the inherent strangeness and otherness of madness. It provides a comprehensive overview of the contributions of phenomenology, critical theory, psychoanalysis, post-structuralism and anti-psychiatry to continental philosophy and psychiatry. The book outlines an intellectual tradition of psychiatry that is both fascinated by and withdraws from madness. Madness is a lure for philosophy in two senses; as both trap and provocation. It is a trap because this philosophical tradition constructs an otherness of madness so profound, that it condemns madness to silence. However, the idea of madness as another world is also a fertile provocation because it respects the non-identity of madness to reason. The book concludes with some critical reflections on the role of madness in contemporary philosophical thought.




Vagueness in Psychiatry


Book Description

Blurred boundaries between the normal and the pathological are a recurrent theme in almost every publication concerned with the classification of mental disorders. Yet, systematic approaches that take into account discussions about vagueness are rare. This volume is the first in the psychiatry/philosophy literature to tackle this problem.




Psychiatry Reborn: Biopsychosocial psychiatry in modern medicine


Book Description

Psychiatry Reborn: Biopsychosocial Psychiatry in Modern Medicine is a comprehensive collection of essays by leading experts in the field, and provides a timely reassessment of the biopsychosocial approach in psychiatry. Spanning the sciences and philosophy of psychiatry, the essays offer complementary perspectives on the ever more urgent importance of the biopsychosocial approach to modern medicine. The collection brings together ideas from the series of Loebel Lectures by world leaders in the field of psychiatry and associated Workshops at the University of Oxford, including revised versions of the Lectures themselves, and a wide range of related commentaries and position pieces. With contributions from psychiatry, psychology, neuroscience, and philosophy, the book provides the most comprehensive account to date of the interplay between biological, psychological, and social factors in mental health and their ethical dimensions. The 23 chapters of this multi-authored book review the history and place of the biopsychosocial model in medicine, and explore its strengths and shortcomings. In particular, it considers how understanding this interplay might lead to more effective treatments for mental health disorders, as developments in genomic and neurobiological medicine challenge traditional conceptions and approaches to the research and treatment of mental health disorders. The book explores the challenges and rewards of developing diagnostic tools and clinical interventions that take account of the inextricably intertwined bio-psycho-social domains, and the ethical implications of the conceptualization. It concludes with chapters drawing together the book's range of expertise to propose a best conception of the model, and how it might be adopted going forward in an age of exponentially increasing technological advances and of integrated/collaborative care. The volume is intended to present the BPS model as it stands today in the academy, the lab, and the clinic, and to start to address the challenges and potential that the model has for each.




Philosophical Issues in Psychiatry


Book Description

The revisions of both DSM-IV and ICD-10 have again focused the interest of the field of psychiatry and clinical psychology on the questions of nosology. This work reviews issues within psychiatric nosology from clinical, historical and particularly philosophical perspectives. It brings together an interdisciplinary group of distinguished authors




The Virtue of Defiance and Psychiatric Engagement


Book Description

What is defiance, and when does defiant behaviour impede one's ability to aim at flourishing? People who are defiant can present perplexing challenges etiologically, diagnostically, and responsively. But in order to understand accurately when defiant behaviour is good, or bad, or neither (when it emerges out of mental illness), a fresh perspective on defiance is needed. This book offers a nuanced and complex look at defiance, taking seriously issues of dysfunction while also attending to social contexts in which defiant behaviour may arise. Those living in adverse conditions such as oppression, systematic disadvantages, and disability may act defiantly for good reasons. This perspective places defiance squarely within the moral domain; thus, it should not be assumed that when professionals come across defiant behaviour, it is a sign of mental dysfunction. Potter argues that defiance sometimes is a virtue, meaning that a disposition to be ready to be defiant when the situation calls for it is part of living a life with a realistic understanding of the aim of flourishing and its limits in our everyday world. Her work also offers theoretical work on problems in knowing that can impede understanding and responsiveness to those who are, or seem to be, defiant. Clinicians, teachers, social workers, nurses, and others working in helping professions are invited to engage in different ways with defiance so as to better understand and respond to people who express that defiance. Case studies, a framework for differentiating different forms of defiance, a realistic picture of phronesis-practical reasoning-and an explanation of how to give uptake well are some of the topics covered. The voices of service users strengthen the author's claims that defiance that is grounded in phronesis is just as much a part of moral life for those living with mental disabilities as for anyone else.




Philosophical issues in psychiatry III


Book Description

Psychiatry has long struggled with the nature of its diagnoses. The problems raised by questions about the nature of psychiatric illness are particularly fascinating because they sit at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. In being the only medical specialty that diagnoses and treats mental illness, psychiatry has been subject to major changes in the last 150 years. This book explores the forces that have shaped these changes and especially how substantial "internal" advances in our knowledge of the nature and causes of psychiatric illness have interacted with a plethora of external forces that have impacted on the psychiatric profession. It includes contributions from philosophers of science with an interest in psychiatry, psychiatrists and psychologists with expertise in the history of their field and historians of psychiatry. Each chapter is accompanied by an introduction and a commentary. The result is a dynamic discussion about the nature of psychiatric disorders, and a book that is compelling reading for those in the field of mental health, history of science and medicine, and philosophy.