Most Helpful Customer Reviews
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16 of 16 people found the following review helpful:
5.0 out of 5 stars
A challenging text, 23 Jul 2009
This is, in my opinion, an important book. Bentall reviews a number of areas related to contemporary psychiatry and clinical psychology, and he highlights some of the major areas of controversy between practitioners in these disciplines. It is beyond my competence to assess whether all his conclusions are correct. Indeed, given the diversity of topics covered, I doubt whether many readers will feel competent to draw definitive conclusions.
The central issue arising from this book relates to the validity or otherwise of reductionist accounts of both normal and abnormal behaviour, i.e. the extent to which behaviour can or cannot be explained in terms of the detailed analysis of brain functioning at the neuronal level. Over the last 40 years mainstream psychology has undergone a "paradigm shift' in which reductionist accounts of behaviour have become less influential. Bentall's book reflects this change, and it represents a considerable challenge to conventional psychiatrists, who typically adopt a more reductionist philosophical approach, focussed in particular on drug treatment.
Since the 1970s there have not really been major advances in psychopharmacology, and some of the major ones such as the development of the clozapine-like "atypical/second generation" antipsychotics seem to be progressively disappearing, after much hype, in a cloud of smoke, leaving some puzzled and confused. In part, as Bentall documents, this is due to the malign influence of the pharmaceutical industry which has done itself no favours at all by e.g. i) Rigging clinical trials by the use of inappropriate (high) comparator doses of older drugs in trials investigating the actions of novel drugs, and ii) Lack of attention to serious adverse side effects such as weight gain and diabetes. A strong case can be made for the psychiatric profession and psychopharmacologists in general paying much more attention to what we often do NOT know about many psychoactive drugs - most efficacious doses, mechanisms of action involved in their therapeutic and side effects, consequences of co-administration of two or often more drugs, effects of drug withdrawal, abuse of antipsychotics when administered at high doses to the elderly, interactions of drugs with psychological therapies et alia. Such studies will clearly not be conducted by the pharmaceutical industry and thus will have to be state funded. The best psychiatrists do address the issues described above, and they attempt to deal with the problem of reductionism by marrying neuronal ideas to functional psychological concepts, although they are relatively few and far between. Ideally, Bentall's book would lead to a rapprochement between psychiatrists and clinical psychologists, although given its rather strident tone this appears highly unlikely to happen at present! In the meantime it is probably essential reading for all trainee clinical psychologists and psychiatrists, for interested lay readers as well as individuals in receipt of therapy.
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4 of 4 people found the following review helpful:
5.0 out of 5 stars
A vitally important and accessible assessment of psychiatry., 27 Aug 2009
Richard Bentall pieces together evidence from an impressive array of sources to provide a critical yet accessible evaluation of the current state of psychiatry. This book is not a scathing anti-psychiatry rant. Bentall lucidly examines the mental health literature, before concluding that a) mental health practitioners often fail their patients - he is self-critical and modest about his own treatment successes and failures and b) this failure is often borne out of rigid adherence to the neo-kraeplinian, biomedical school of psychopathology; an approach which is underpinned by pharmaceutical companies and their marketing strategies. Psychiatric diagnosis is a difficult process, the author - who favours a symptom-focused model - believes these difficulites arise from the inefficiencies, limitations and unsuitability of the disorder-based, biomedical paradigm of mental health. The efficacy of both pharmacological and psychosocial treatments is also comprehensively challenged - alongside the chapters on psychiatric diagnosis, these topics form large sections of the book.
In essence, the book provides a basic framework for an holistic approach to the treatment of mental illness. Bentall seeks to educate, empower and treat the psychiatric patient, perceiving them as individuals with diverse and often distressing life experiences who are deserved of fundamental human rights, rather than as deviants lacking the cognitive prowess to make decisions relating to their treatment who cannot/shouldn't be trusted to tell the truth about their symptoms and life experiences. A nurturing, trusting, compassionate, patient/client-centred approach is promoted as a key component of treatment success, regardless of the treatment modality. Adopting the author's approach is likely to be beneficial to the patient-practitioner relationship because it engenders a sense of mutual trust and respect which would probably improve treatment compliance, appointment attendance, the patient's self-esteem and perhaps even treatment outcome.
It is impossible to do justice to this book in such a short review because the diversity and depth of the subject matter, as well as the author's warm and humane tone cannot be reviewed nor conveyed. This book is a must for the psychiatrist, the psychologist, the psychiatric patient and anybody else who is interested in psychopathology. Doctoring the Mind is an important text which asks probing questions about mental health practices, that could also be used as a springboard to improved policies. This book is suitable for the layperson.
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3 of 3 people found the following review helpful:
5.0 out of 5 stars
Quake in your boots psychiatry, 28 Aug 2009
Excellent follow up to Madness Explained (which was a bit of a chore in the second half of the book, truth be told). This is much clearer and and easier more accessable read. It give alternatives to the "accepted wisdom" of psychiatry. It also draws attention to the massive amount of guesswork that psychiatrist use to try and get things right.
Richard Bentall writes in a blanced yet compelling way. The arguments are very interesting and really make the reader think. I would heartily recommend this book to anyone who is working in mental health services. It would also be a useful resource for service users who find themselves unhappy with the treatment or diagnosis they have recieved from their doctor. As a prelude to reading this book it might be fun and useful to read the article "A wake up call for British Psychiatry" to get a feel for the current thinking from an opposite position.
Having alternatives is more useful to aid recovery than a life sentence of a diagnosis. read this book and empower yourself as therapists and service users alike.
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