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A History of Psychiatry


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Table of Contents

The Birth of Psychiatry. The Asylum Era. The First Biological Psychiatry. Nerves. The Psychoanalytic Hiatus. Alternatives. The Second Biological Psychiatry. From Freud to Prozac. Notes. Index.

About 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.


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, LJ 11/1/93) 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, making this a good choice for academic libraries and larger public libraries with a clientele interested in social history.‘Mary Ann Hughes, Neill P.L., Pullman, Wash.

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. Photos. (Jan.)

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