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American Therapy: The Rise of Psychotherapy in the United States

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From Freud to Zoloft, the first comprehensive history of American Psychotherapy

Fifty percent of Americans will undergo some form of psychotherapy in their lifetimes, but the origins of the field are rarely known to patients. Yet the story of psychotherapy in America brims with colorful characters, intriguing experimental treatments, and intense debates within this community of healers.

American Therapy begins, as psychotherapy itself does, with the monumental figure of Sigmund Freud. The book outlines the basics of Freudian theory and discusses the peculiarly powerful influence of Freud on the world of American mental health. The book moves through the emergence of group therapy, the rise of psychosurgery, the evolution of uniquely American therapies such as Gestalt, rebirthing, and primal scream therapy, and concludes with the modern world of psychopharmacology, cognitive-behavioral therapy, and highly targeted short-term therapies.

For a counseled nation that freely uses terms such as “emotional baggage” and no longer stigmatizes mental health care, American Therapy is a remarkable history of an extraordinary enterprise.

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Editorial Reviews

Publishers Weekly

Since 50% of Americans will reportedly undergo some form of psychotherapy in their lifetimes, Engel, a professor of health care policy and management at Seton Hall University, presents a complete survey of the 100-year-old history of American mental health practitioners. Tracing the rise and decline of psychoanalysis in America (including the pioneering theories of homegrown talents Harry Stack Sullivan and Karen Horney), and its replacement by other, more targeted forms of therapy, this book notes that mental health treatment has become intensely consumer-oriented, tailored to finicky patients and leading to a variety of therapies such as Gestalt, rebirthing, primal scream therapy and medications like Prozac and Zoloft (though the discussion of medications fails to do justice to their complexities). Engel (The Epidemic: A Global History of AIDS) touts community mental health facilities and new progress in treatments and drugs to control addictions and mental instability. Highly informative, if a bit textbookish in tone, this is a capable introduction to the ever-changing American mental health industry and its practitioners. 8 pages of b&w photos. (Nov.)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
The New York Times Book Review
Studded with fascinating tidbits [ . . . ] The story Engel does tell is plenty interesting and his conflicting view of Freudianism well worth absorbing.
Library Journal

Medical historian Engel (public & health-care administration, Seton Hall Univ.; Poor People's Medicine: Medicaid and American Charity Care Since 1965; Doctors and Reformers: Discussion and Debate over Health Policy, 1925-1950) writes a blunt epitaph for psychoanalysis in a plainspoken survey of mental health care in the United States over the last century. Among the special topics are child guidance, alcohol, narcotics, and narcissism (therapy as self-indulgence). To make a living, psychiatrists, who are physicians first, have increasingly focused on medication, leaving psychotherapy to psychologists and social workers. Engel explains the need for and the methods of outcome research: it shows that brief cognitive-behavioral treatment with comfortably engaged therapists, along with medication when indicated, wins the laurels. Although Engel discusses religious attitudes to therapy, he gives short shrift to family and couples therapy and pastoral counseling. An authoritative, readable book, this is highly recommended for large general libraries and collections in health and social science.
—E. James Lieberman

Kirkus Reviews
Thorough yet concise history of the talking cure. "Of course you have to start with Freud," writes Engel (Health Care Policy and Management/Seton Hall Univ.; The Epidemic: A Global History of AIDS, 2006, etc.). No matter how modern psychology may attempt to distance itself from its out-of-fashion master, there is no escaping Freud's work in psychoanalysis. For better or for worse, it indelibly shaped not only the enterprise of psychotherapy but also the ways in which people think about themselves and the workings of their inner lives. Engel quickly moves on with an outline of the extended turf wars over who had the better claim to the promotion of sanity and mental health: The medically trained psychoanalysts with their biological understanding of psychopathology? The research-trained doctorates whose field had its roots in psychological testing? The social workers who brought with them an emphasis on understanding the context in which mental illness occurred? Half a century after these questions were first raised, many of them are still debated. Engel also walks the reader through such subjects as the growing recognition of alcoholism as a disease and the foundation of organizations like Alcoholics Anonymous as extra-therapeutic means of dealing with it; lobotomies and other surgical interventions; the development of vastly different schools of psychological thought, from cognitive-behavioral therapy and humanistic therapy to the current trend in "eclectic" therapies. The book closes with the rise of pharmacotherapy and the decline of traditional psychoanalysis. In the final chapter, Engel describes the frightening impact of managed care, which effectively bars psychoanalysis for all butthe wealthiest patients and pushes those suffering from a variety of maladies to try less time-consuming and costly pharmacological remedies first. This despite the fact, he notes, that multiple studies have shown psychotherapy-of many different kinds-to be as effective or more effective than pills alone. A capable explanation of a complicated field.
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Product Details

  • ISBN-13: 9781592404919
  • Publisher: Penguin Group (USA) Incorporated
  • Publication date: 11/3/2009
  • Pages: 368
  • Product dimensions: 5.20 (w) x 7.90 (h) x 0.90 (d)

Meet the Author

Jonathan Engel holds a Ph.D. in the history of science and medicine from Yale, and has written extensively about the historical development of U.S. medicine and health policy. His previous books are Doctors and Reformers: Discussion and Debate Over Health Policy 1925-1950, Poor People’s Medicine: Medicaid and American Charity Care Since 1965, and The Epidemic: A Global History of AIDS. A professor of health care policy and management at Seton Hall University, he lives in New Jersey.

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Table of Contents

1 Freud 1

2 Orthodoxy and Pragmatism 19

3 A Crying Need 43

4 Thinking 76

5 Alcohol 109

6 Psychological Society 132

7 Narcissism 167

8 Narcotics 195

9 Psychoanalysis in Decline 218

10 Biology 240

Afterword 255

Acknowledgments 263

Notes 265

Bibliography 307

Index 341

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