A History of Psychiatry: From the Era of the Asylum to the Age of Prozac / Edition 1

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Overview

In A History of Psychiatry, Edward Shorter shows us the harsh, farcical, and inspiring realities of society's changing attitudes toward and attempts to deal with its mentally ill and the efforts of generations of scientists and physicians to ease their suffering. He paints vivid portraits of psychiatry's leading historical figures and pulls no punches in assessing their roles in advancing or side-tracking our understanding of the origins of mental illness. Shorter also identifies the scientific and cultural factors that shaped the development of psychiatry. He reveals the forces behind the unparalleled sophistication of psychiatry in Germany during the 18th and 19th centuries as well as the emergence of the U.S.as the world capital of psychoanalysis.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: William F. Gabrielli, Jr., MD, PhD (University of Kansas Medical Center)
Description: This book reviews psychiatry's evolution from its beginning as a medical specialty with therapeutic asylums, through the early biological era, the descriptive period, the psychoanalytic era, and finally the medical era.
Purpose: With the previous major chronicles of psychiatry more than 30 years old, the author sought to update the historical perspective. Despite contrary popular media references, the psychoanalytic era — championed for years by the psychoanalytic societies and institutions — is ended. Beginning in the 1950s, medical advances, improved diagnosis, and later, managed care sealed the transition. The author captures the changing discipline's character, presenting his perspective with eloquence, style, and riveting novel-like quality.
Audience: This book chronicles psychiatry for the student and updates professionals and others who may incompletely appreciate the field's paradigmatic shifts. Neither a psychiatrist nor a clinical psychiatry expert, the historian author objectively and credibly develops the story.
Features: Photographs of some historical characters are included, but some expected images are absent. Although the book describes a timeline, no figures, tables, or other graphs depict the paradigmatic shifts. Adequate references add to the excellent appearance, feel, and prose.
Assessment: Previously, no single source clearly and concisely captured psychiatry's evolutionary essence. The book identifies the asylum physicians' efforts to develop therapeutic interventions. It chronicles the ambitious hopes of those who sought to explain psychiatric illness with anatomy, pathology, and genetics. Documented is the descriptive era with development of a psychiatric illness nosology. The book fairly describes the psychoanalytic era and the analysts' motivations and contributions. According to the author, this period was a hiatus for the understanding and treatment of true psychiatric illness. The modern era, built upon the descriptive one, utilizes empirically sound pharmacologic and other therapies. If the book has weaknesses, they are partial appreciation for community psychiatry, incomplete acknowledgment of the impact of the rapidly evolving psychopharmacology, and minimal conjecture about the next era. Overall, this excellent book is for anyone seeking insight into modern psychiatry.
William F. Gabrielli
This book reviews psychiatry's evolution from its beginning as a medical specialty with therapeutic asylums, through the early biological era, the descriptive period, the psychoanalytic era, and finally the medical era. With the previous major chronicles of psychiatry more than 30 years old, the author sought to update the historical perspective. Despite contrary popular media references, the psychoanalytic era—championed for years by the psychoanalytic societies and institutions—is ended. Beginning in the 1950s, medical advances, improved diagnosis, and later, managed care sealed the transition. The author captures the changing discipline's character, presenting his perspective with eloquence, style, and riveting novel-like quality. This book chronicles psychiatry for the student and updates professionals and others who may incompletely appreciate the field's paradigmatic shifts. Neither a psychiatrist nor a clinical psychiatry expert, the historian author objectively and credibly develops the story. Photographs of some historical characters are included, but some expected images are absent. Although the book describes a timeline, no figures, tables, or other graphs depict the paradigmatic shifts. Adequate references add to the excellent appearance, feel, and prose. Previously, no single source clearly and concisely captured psychiatry's evolutionary essence. The book identifies the asylum physicians' efforts to develop therapeutic interventions. It chronicles the ambitious hopes of those who sought to explain psychiatric illness with anatomy, pathology, and genetics. Documented is the descriptive era with development of a psychiatric illness nosology. The bookfairly describes the psychoanalytic era and the analysts' motivations and contributions. According to the author, this period was a hiatus for the understanding and treatment of true psychiatric illness. The modern era, built upon the descriptive one, utilizes empirically sound pharmacologic and other therapies. If the book has weaknesses, they are partial appreciation for community psychiatry, incomplete acknowledgment of the impact of the rapidly evolving psychopharmacology, and minimal conjecture about the next era. Overall, this excellent book is for anyone seeking insight into modern psychiatry.
Publishers Weekly - Cahners\\Publishers_Weekly
Shorter cites recent research indicating that adult-onset schizophrenia is genetically influenced and often traceable to uterine trauma or difficult birth. In his view, brain biology and genetics underlie much mental illness, and biological psychiatry-combining drugs with psychotherapy-has replaced Freudian psychoanalysis as the dominant paradigm for explaining and treating a host of disorders. In this richly informative, iconoclastic, sure-to-be-controversial chronicle, Shorter, professor of the history of medicine at the University of Toronto, argues that Freud, by turning psychoanalysis into a movement instead of a method of objective inquiry, fostered a stifling orthodoxy, therapists' arrogance toward patients and scientific stagnation. He defends electroshock as a valuable tool in the treatment of depression; identifies German physician Emil Kraepelin, systematizer of diagnoses-rather than Freud-as the central figure in the history of psychiatry; and dismisses as unhistorical nonsense Michel Foucault's theory that psychiatry arose in a collusion between capitalism and the state as a means to control deviant individuals. While this study won't end the nature-versus-nurture debate, it mounts a formidable challenge to strict adherents of the talking therapies.
Library Journal
The view of psychiatry held by both insiders and the general public has changed considerably in the past few decades, in ways that Shorter (From the Mind into the Body) both acknowledges and celebrates. For the most part, psychiatrists have moved from what Shorter calls the "Freudian Interlude" to a role as gatekeepers of psychopharmaceuticals. Shorter covers psychiatry's birth as an attempt to create "mental asylums" as places of refuge. This attempt, argues the author, capsized because new major psychiatric illnesses (notably neurosyphilis and schizophrenia) arose in the 19th century, deluging the asylums. Young psychiatrists turned to Freudian analysis to earn a living by treating less sick and more financially secure patients. This "interlude" ended because analysis has become too expensive at the very time that psychiatric drugs have become available. While the book is a bit dry in places, it covers a great deal of fascinating material. -- Mary Ann Hughes, Neill Public Library, Pullman, Washington
Library Journal
The view of psychiatry held by both insiders and the general public has changed considerably in the past few decades, in ways that Shorter From the Mind into the Body both acknowledges and celebrates. For the most part, psychiatrists have moved from what Shorter calls the "Freudian Interlude" to a role as gatekeepers of psychopharmaceuticals. Shorter covers psychiatry's birth as an attempt to create "mental asylums" as places of refuge. This attempt, argues the author, capsized because new major psychiatric illnesses notably neurosyphilis and schizophrenia arose in the 19th century, deluging the asylums. Young psychiatrists turned to Freudian analysis to earn a living by treating less sick and more financially secure patients. This "interlude" ended because analysis has become too expensive at the very time that psychiatric drugs have become available. While the book is a bit dry in places, it covers a great deal of fascinating material. -- Mary Ann Hughes, Neill Public Library, Pullman, Washington
Booknews
A social history outlining the major scientific and cultural forces that shaped the development of psychiatry. Shorter history of medicine, University of Toronto traces the evolution of psychiatry with an elegant writing style, portraying 18th century madhouses, the nervous disorder spas of the Victorian elite, the "snake pits" of early 20th century public mental hospitals, the cool decorum of psychoanalytical therapies, and the modern agendas of pharmaceutical cartels. Along the way, the author describes the leading figures in the field and astutely assesses their contributions to understanding mental illness or sidetracking its advancement into pseudoscience and metaphysics.
Books & Culture: A Christian Review
...[C]oncise, well-organized, well-documented...
Kirkus Reviews
An opinionated, anecdote-rich history of a branch of medicine strongly shaped by culture. Canadian physician and medical historian Shorter (University of Toronto) begins his lively account by describing the horrific treatment of the mentally ill before the advent of the custodial asylum. It was, he says, the discovery that asylums could have a therapeutic role that led to the birth of psychiatry at the end of the 18th century. Shorter examines the failure of the therapeutic asylum movement, attributing it largely to an overwhelming number of inmates in the 19th century. Always divided by two visions of mental illness, one finding its origins in the biology of the brain and the other looking to psychosocial factors, psychiatry was dominated by the biological view throughout the 19th century. Shorter presents the German physician Emil Kraepelin, who revolutionized the approach to categorizing and diagnosing mental illnesses, as the central figure in ending the sway of biological psychiatry. As for Freud, says Shorter, "His doctrine of psychoanalysis, based on intuitive leaps of fantasy, did not stand the test of time." Citing studies indicating that the majority of American psychoanalysts and their patients were Jewish, the author links the growing social assimilation of Jews (and their abandonment of their "encapsulated little subculture") with the post-'60s decline in popularity of psychoanalysis—a theory sure to arouse controversy. Shorter chronicles the discovery of the various drugs that formed the pharmacological basis of the new biological psychiatry and hails the alliance of psychiatrists with geneticists, biochemists, and other scientists that has brought the scientificmethod to the investigation of mental illness. Where does psychiatry go from here? Shorter predicts a combination of the neuroscientific and the psychotherapeutic, that is, a blend of "neurochem" and "neurochat."

While psychiatrists may quibble and Freudians and other psychoanalysts will surely squawk, those without a vested interest will be thoroughly entertained and certainly enlightened.


3 Stars from Doody
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Product Details

  • ISBN-13: 9780471157496
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 12/28/1996
  • Edition number: 1
  • Pages: 448
  • Product dimensions: 6.44 (w) x 9.63 (h) x 1.43 (d)

Meet the Author

EDWARD SHORTER, PhD, is Hannah Professor in the History of Medicine at the University of Toronto. He is the author of ten books, including the international bestseller The Making of the Modern Family and a two-volume history of psychosomatic illness.

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Table of Contents

Preface
1 The Birth of Psychiatry 1
2 The Asylum Era 33
3 The First Biological Psychiatry 69
4 Nerves 113
5 The Psychoanalytic Hiatus 145
6 Alternatives 190
7 The Second Biological Psychiatry 239
8 From Freud to Prozac 288
Notes 329
Index 421
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