Our Necessary Shadow: The Nature and Meaning of Psychiatry

Our Necessary Shadow: The Nature and Meaning of Psychiatry

by Tom Burns
     
 

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The first attempt in forty years to explain the full subject of psychiatry, from one of the world’s experts.

In what will be a tour de force in the field of psychiatry in all its complexity and depth, this important new volume explores the essential paradox of psychiatry—and offers a balanced understanding of its history and development in the

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Overview

The first attempt in forty years to explain the full subject of psychiatry, from one of the world’s experts.

In what will be a tour de force in the field of psychiatry in all its complexity and depth, this important new volume explores the essential paradox of psychiatry—and offers a balanced understanding of its history and development in the medical world. Much is written about psychiatry, but very little that describes psychiatry itself. Why should there be such a need? For good or ill, psychiatry is a polemical battleground, criticized on the one hand as an instrument of social control, while on the other the latest developments in neuroscience are trumpeted as lasting solutions to mental illness.

Which of these strikingly contrasting positions should we believe? This is the first attempt in a generation to explain the whole subject of psychiatry. In this deeply thoughtful, descriptive, and sympathetic book, Tom Burns reviews the historical development of psychiatry, throughout alert to where psychiatry helps, and where it is imperfect. What is clear is that mental illnesses are intimately tied to what makes us human in the first place, and the drive to relieve the suffering they cause is even more human.

Psychiatry, for all its flaws, currently represents our best attempt to discharge this most human of impulses. It is not something we can just ignore. It is our necessary shadow.

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Editorial Reviews

Library Journal
★ 06/01/2014
Burns (chair of social psychiatry, Oxford Univ.) learned about mental illness growing up with a seriously depressed mother who was helped by psychiatry. Initially opposed to pills and electroshock treatment, he came to appreciate their use in her case. Reflecting on his four decades in "medicine's most disputed discipline" in the United States, Britain, and elsewhere around the world, Burns illuminates its advances, controversies, and mistakes. A savvy clinician and historian, he covers diagnosis and treatment from ancient times to the present. For him psychotherapy is the key intervention, while medication is secondary. Psychiatric illnesses "are part of what we are, not things that just happen to us such as flu or a broken leg." There are fine chapters on neuroscience and pharmaceuticals (drug companies spend more on marketing than on research!), and Burns covers antipsychiatry movements, the insanity defense, and the impact of war. With the closing of large mental hospitals and our failure to create community mental health centers, U.S. jails and city streets have become lodging places for thousands of patients. VERDICT A compassionate healer and articulate scholar, Burns has written one of the best books ever on psychiatry: a comprehensive, engaging text for general readers and professionals.—E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC
Publishers Weekly
03/31/2014
Burns, professor of social psychiatry at Oxford and a practicing psychiatrist, looks at psychiatry and mental illness as a subjective phenomena, yet nonetheless “real” to its subjects and participants. By examining the shadow that psychiatry and psychotherapy cast on other aspects of culture, he reveals the practices to be historically contingent—part of, though frequently at odds with, other branches of medicine—as well as how they have come to define our concepts of personhood, daily life, our legal system, and our view of fate. The book begins as a history of the treatment of mental illness, from humors and asylums to the “discovery of the unconscious,” psychoanalysis and shell shock, and the early, grisly medical cures (insulin wards and malarial treatment of syphilis) of psychiatry. Burns puts forth no defense of psychiatry’s past sins, but is confident in the value of the newly open, evidence-based treatment of mental illness that typifies 21st-century care. While his early chapter on seeking psychological care seems misplaced, Burns’s focus on psychology’s operations in our larger culture is provocative, well-researched, and well-suited to interested lay readers looking for insight into medicine and the mind. Agent: Felicity Bryan (U.K.) (June)
Andrew Solomon
“Displaying the dignified passion of someone trying to construct a better world, Burns shows us psychiatry's triumphs and is frank about its pitfalls.”
The Times (London)
“Tom Burns is calm, sympathetic, and willing to listen to a wide variety of views. Just the person you would like to be in charge of your care if you were assailed by madness.”
The Financial Times
“In his cool and rational book Our Necessary Shadow, Burns makes a powerful case.”
The Washington Post
“[A] fascinating analysis of the scientific and medical exploration of the mind. Burns brings a carefully measured combination of personal and professional experience. Throughout this insightful and learned book, Burns poses questions, and offers some answers, that reveal the problematic nature of his profession and establish him as a thoughtful, erudite guide through a demanding landscape.”
Choice
“A readable overview of the history and development of psychiatry.”
Kirkus Reviews
2014-05-07
A comprehensive history and analysis of the practice of psychiatry.Burns (Social Psychiatry/Oxford Univ.) admits to developing a predilection for the craft of psychoanalysis after his mother suffered a nervous breakdown when he was a teenager and he observed the "enormous difference" her treatments made. Now a practicing psychiatrist, the author attempts a qualitative and personally reflective examination of his livelihood, a medical specialty that, he asserts, has long confused and confounded our culture. In the introduction, Burns pinpoints the main psychiatric illnesses affecting the adult population, and the first chapter, however oddly placed, forms a helpful preparatory primer for those seeking care. The author discusses the field's origins, from asylum care (the "essential precursors" to modern psychiatry) to the exploration of mental unconsciousness and theories of automatism, psychoanalysis and the fight-or-flight internal battle of soldiers with shell shock. Burns notes how early barbaric psychiatric treatments like insulin-induced comas, surgical leucotomies and aggressive electroconvulsive therapy have all contributed to a perpetually negative slant on the practice, but he remains optimistic about its future and displays and emphasizes the importance of psychiatry as a legitimate, trustworthy medical practice. "Deinstitutionalization" and the blooming popularity of antidepressants, along with advancements in neuroscience, collectively counteract these aspersions. Additionally, Burns shares his own frustrations regarding the "philosophical and ethical contradictions" of delivering professional psychiatric care and argues against the misconstrued belief that the practice is an outmoded hustle. He dexterously synthesizes all of this material into a broad-minded volume which may prove "more descriptive than explanatory" for some but that articulately grasps the past and present modalities of psychiatry. Writes Burns, "[psychiatry] is ‘our necessary shadow' in that it deals with illnesses that are a part of what we are, not things that just happen to us such as flu or a broken leg."A responsible, evenhanded exploration of a highly provocative medical industry.

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Product Details

ISBN-13:
9781605986005
Publisher:
Pegasus
Publication date:
06/15/2014
Sold by:
Barnes & Noble
Format:
NOOK Book
Pages:
384
File size:
1 MB

Meet the Author

Tom Burns is Professor of Social Psychiatry at Oxford University. In addition to his clinical and teaching work, he has produced nearly two hundred peer-reviewed scientific articles. He lives in England.

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