Changing American Psychiatry: A Personal Perspective

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Psychiatrists, psychoanalysts, other mental health workers, behavioral scientists, and university medical and neuroscience professionals will benefit from this articulate insider's view of post-World War II psychiatry in Changing American Psychiatry: A Personal Perspective by Melvin Sabshin, M.D. Dr. Sabshin served as Medical Director of the American Psychiatric Association (APA) for 23 years, from 1974 to 1997, during a period of perhaps the greatest change in psychiatry since the World War II produced a dramatic modification of practice.

The author describes in detail two extraordinary periods of change, the first stimulated by laudatory efforts to understand the high rate of psychiatric casualties among World War II veterans and to provide treatment for them. Psychiatry grew quickly during the postwar years, considerably influenced by the immigration of many Central European psychoanalysts. Gradually, however, psychiatry began to weaken its ties to medicine and lost much of its public respect. By the 1970s, postwar optimism had been replaced by widespread concern that psychiatric practice was being dominated by unsubstantiated formulations rather than reliable evidence. Psychiatry was dramatically impacted by enormous pressure for therapeutic accountability exerted by a managed care reimbursement system. The profession recognized the need for a new direction and resolved to change.

In the foreword to the book, current APA Medical Director James H. Scully Jr., M.D., notes that Dr. Sabshin has woven a personal journey of the history of the intellectual conflicts and changes in the field of psychiatry in the post-war era, culminating in the remedicalization of psychiatry and the development of the DSM-III.

Dr. Sabshin encourages psychiatric professionals to change the field so it can employ an empirically based "bio-psycho-social" model that has the potential to revitalize the next phase of American psychiatry. He details how the potential for the future of psychiatry can be enhanced by today's practicing professionals, stressing the: • Need to incorporate the rapid developments of neuroscience into a professional practice that is increasingly integrated with empirically demonstrated psychological and social influences upon mental illness.• Importance on continued research that is fed back into practice and keeps the professional evidence-based.• Need of psychoanalysis to make its beliefs explicit, formulating hypotheses that can be tested scientifically in order to be employed reliably in evidence-based practice.

This well-crafted historical account describes how the profession has become a more respected and accountable part of medicine and how it scientific credentials have risen as a result. Dr. Sabshin concludes that the use of psychological understanding and psychotherapies must play a major role combined with psychopharmacology in the treatment of psychiatric patients.

American Psychiatric Publishing

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Editorial Reviews


Changing American Psychiatry is a well-documented insider's view of the changing face of psychiatry during the past half century. It will interest anyone concerned with the history of psychiatry or who wants to understand the past as a guide to dealing with current challenges in mental health care. Consequently it will be of value to both mental health practitioners and public policy makers.

Doody's Review Service
Reviewer: Alyson Myers, MD (North Shore - LIJ Hofstra School of Medicine)
Description: The author interweaves his personal experience in the field of psychiatry with historical data in order to illustrate how psychiatry has evolved during the second half of the twentieth century.
Purpose: He successfully demonstrates the numerous changes in the leadership and ideologies of psychiatry. Some examples are the shift from a focus on psychoanalysis to biological psychiatry, or the increase in female and minority psychiatry residents. These events demonstrate how psychiatry has progressed since the 1950s. The author does a fine job of fulfilling his objective.
Audience: The audience includes anyone with an interest in psychiatric history. It is not written with a great deal of medical jargon, so nonmedical readers can easily understand this work. As a psychiatrist who practiced and held leadership positions in psychiatry for a majority of the time that the book encompasses, the author is a credible source.
Features: Initially, the author describes his childhood and eventual training as a physician. From this point on, he explores the different domains in which American psychiatry has progressed, such as research, diversity, international contributions, and overlap with neurology. The author's personal experience with these changes provides him with a unique perspective of these events. At times he interjects too much of his personal story, which detracts from his historical narrative. A key feature of this book is the thorough appendix which includes some of the author's publications, as well as the structure and leadership of the American Psychiatric Association (APA).
Assessment: In this book, the author takes readers on a journey through psychiatry from the mid to late 1900s by using personal accounts, humor, and historical facts. In doing so, he has created a unique historical perspective on psychiatry.
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Product Details

  • ISBN-13: 9781585623075
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 4/28/2008
  • Pages: 419
  • Product dimensions: 6.30 (w) x 9.10 (h) x 1.20 (d)

Meet the Author

Melvin Sabshin, M.D., was Medical Director of the American Psychiatric Association from 1974 to 1997. Dr. Sabshin studied medicine at Tulane University. After postgraduate training and a research post at Tulane's Department of Psychiatry, he received an appointment at the Michael Reese Hospital in Chicago, a center of psychiatric research and psychodynamically oriented practice, where he completed psychoanalytic training. In 1961 he was appointed Professor and Head of the Department of Psychiatry at the University of Illinois College of Medicine. Dr. Sabshin is an Honorary Fellow of the Royal College of Psychiatrists.

American Psychiatric Publishing

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Table of Contents

Preface. Introduction. Post World War II scene in American psychiatry. A pathway to psychiatry. Implicit preparations for leadership role in psychiatry. Reflections during the search. Clarifying the mission. En route to equity. International affairs. Psychoanalysis. Forensic psychiatry. Evidence-based diagnosis and treatment. Psychiatric research. Psychiatric education. A changing membership. Annual meetings. Publications. Governance and leadership. Organizational relationships. Social and community psychiatry. Conclusions. Appendices. Index.

American Psychiatric Publishing

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