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68 of 71 people found the following review helpful:
4.0 out of 5 stars
Psychiatrists - Do not be afraid!, 16 Feb 2007
Confession 1:I am a Psychiatrist.
Confession 2: Before I started this book I was expecting a deeply negative perception of modern psychiatry and little in the way of concrete evidence to support any alternative hypothesis. I anticipated this book to he read mainly by other psychologists, anti-psychiatrists and disgruntled patients.
However, I rapidly discovered that this is not the start of a new anti-psychiatry movement but in fact a fascinating, open-minded review of the current thinking about madness.
The first third of this book should be read by everyone involved in or interested in psychiatry, psychology, or just madness. It is a brilliant and genuinely gripping synthesis of the journey from dark age beliefs about madness to the current concepts. The author makes this potentially dreary history lesson vibrant, relevant and insightful and brings alive many of the key players whose legacies have outlived them, whether deservedly or not.
After this the author then goes on to explore in quite significant detail, the psychological and biological research into psychosis and related conditions. This is predictably heavier going but worth persevering with for the exciting and occasionally startling revelations.
As a result, he fairly comprehensively dismantles the traditional model of psychiatric classification but manages to bring even the most sceptical reader with him through this process.I did not find this as controversial as I expected, as most practising psychiatrists are already aware of the significant overlap in diagnoses and symptoms of these disorders. Richard Bentall then formulates draft models for approaching particular psychiatric symptoms.
There is much less controversial material in this book than I expected. The research discussed is reasonably balanced and the conclusions are tentative and never fundamentalist.
However, although interesting, evidence-based and realistic, the practical applications of the symptom-directed approach are not at all clear. Abandoning traditional psychiatric diagnoses altogether would at present leave patients, carers and health professionals with even less framework for approaching treatment, suggesting aetiology or predicting prognosis. This book may encourage us to be more flexible and patient-centred but I cannot yet see it changing frontline mental health care.
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109 of 115 people found the following review helpful:
5.0 out of 5 stars
The new synthesis?, 7 Oct 2003
By A Customer
Writing as someone who lives with a son labelled 'schizophrenic', I am immensely grateful for this new and authoritative account of madness. Bentall refuses the Cartesian divide, which requires it to be seen either as a brain disease or as 'all in the mind'. He cites a vast array of evidence drawn from neurology, psychiatry, psychotherapy, psychoanalysis and cognitive psychology to show that brain and mind are two aspects of a single system, and that madness and sanity are two ends of a continuum. He also demolishes the century-old myth that there are two distict illnesses, schizophrenia and manic/depressive disorder. Bentall has a hopeful message to sufferers and their friends and families, though you have to work through a long book to reach it: family therapy and cognitive behaviour therapy do have the potential to help people back towards sanity. The earlier in life these methods are used, the better the chances of returning to normality. Wider public awareness of the early signs of madness and increased investment in providing these therapies could greatly improve mental health. It would be misleading to compare Bentall with R D Laing, who asserted a great deal without evidence. However, the book would have benefited by reference to Gregory Bateson's 'ecology of mind'. Bentall only once mentions 'Geoffrey' Bateson, whom he dismisses for blaming the family, though Bateson himself thought in terms not of blame but of two-sided breakdowns in communication. Bateson had the misfortune to write about madness in the 1950s, just at the time when effective drug treatments were found, and psychiatry began fifty years of obsession with pills. It is to be hoped that the new excitement over atypical drugs will not prevent Bentall's message from being heard.
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53 of 56 people found the following review helpful:
5.0 out of 5 stars
How Psychology is finding the answers Psychiatry have missed, 10 Aug 2003
By A Customer
A superb review of how Psychiatry has been getting psychosis wrong for the last hundred years: by focussing on flawed reductionist concepts of diagnosis rather than on seeing psychosis as a complex and heterogenous group of presentations and symptoms. By identifying these fundamental flaws of the medical model Bentall is able to demonstrate both how traditional approachs to research are bound to fail, and how a more psychological approach is developing greater understanding and more helpful treatment. Up to date, erudite, but also fascinating for the lay reader. Should be prescribed reading for all trainee psychiatrists, and for any psychologists working with psychosis who need to challenge the assumptions of their medical colleagues.
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