Psychiatry is now a highly visible activity - care in the community, compulsion, suicide, drug and alcohol abuse mean that few people are not touched by it. Indeed one in four of us will consult a psychiatrist in our life time. This book explains what psychiatry is, and what it is not. It starts with the identification of the major mental illnesses and why they are no longer considered just variations of 'normality'. It charts the rise of the Asylum and its demise with the developments of Care in the Community, and the flourishing of psychoanalysis and its later transformation into more accessible psychotherapies. More than any other branch of medicine psychiatry has been attacked and criticised. There is a long catalogue of abuses - from mundane neglect and bizarre treatments through to political abuse by totalitarian regimes. Modern psychiatry too brings with it new controversies such as the medicalization of normal life, the power of the drug companies and the use of psychiatry as an agent of social control. The book does not shy away from outlining these issues but provides the reader with a clear understanding of what psychiatry is capable of, and what it is not capable of, so that they can draw their own conclusions.
[...]... pleasure in all, or almost all, activities most of the day, nearly every day (subjective Psychiatry account or observation) Significant weight loss or weight gain (more than 5% of body weight in a month), or decrease or increase in appetite nearly every day Insomnia or hypersomnia nearly every day Agitation or retardation nearly every day (observable by others) Fatigue or loss of energy nearly every day... hate a world where everyone had the same personality, where there were no sensitive individuals, no moody individuals, no brave brash ones, etc Similarly life without emotional variation would be intolerable Aldous Huxley’s book Brave New World (where everyone was able to remain constantly content by taking a drug called ‘Soma’) was a nightmare scenario, not a utopia Normal 7 What is psychiatry? Diagnoses... and is making Psychiatry and the neurosciences are making remarkable strides xi Preface I have devoted so much space to the controversial aspects of psychiatry for two reasons First, because there are real philosophical and ethical differences between mental and physical illnesses that won’t go away simply because we want them to Nor will technological advances obliterate these tensions; rather, as explored... usually starts in early adulthood (during the 20s) although it can occur as early as adolescence While it affects men and women in equal numbers, men often become ill earlier and fare worse The prominent features are hallucinations, delusions, thought disorder, social withdrawal, and self-neglect Hallucinations are ‘sensory experiences without stimuli’ Far and away the most common are auditory hallucinations... of patients alternated through several periods of profound disturbances – sometimes agitated and sometimes withdrawn and 15 What is psychiatry? Kraepelin was very gloomy about schizophrenia and believed that virtually no patients really got better, but Bleuler was more positive and the truth lies closer to him It is a fluctuating illness and most patients have several bouts About a quarter probably... not that simple – you can find the same bacteria that cause pneumonia in lots of perfectly healthy people The diagnosis is not made just by finding the bacteria but by finding them in the presence of a fever and cough Even objective, verifiable data don’t always resolve the issue What is considered ‘pathological’ will change depending on changing knowledge about diseases and available treatments Just as improved... psychologists are essential members of all modern mental health (‘psychiatric’) services Psychiatry Although Freud was a doctor there is no requirement for psychoanalysts to be medically trained In America (where psychoanalysis has always had its most powerful presence) analysts were usually also psychiatrists but this is now increasingly the exception Even when medically trained, analysts rarely use... illnesses in exactly the same way that a dermatologist would train by treating patients with skin disorders or an obstetrician by delivering babies Within medicine, psychiatry is simply defined as that branch which deals with ‘mental illnesses’ (nowadays often called ‘psychiatric disorders’) Medicine is fundamentally a pragmatic endeavour While drawing heavily on the basic biological sciences and scientific... external event, fully awake in broad daylight; there is no ‘as if’ quality to them and the patient believes they are entirely real The world is now a very culturally mixed place and a judgement often has to be made about whether ideas are really that odd for any particular individual For example, two quite different patients described to me their conviction that there were invisible forcefields traversing... determine what a psychiatrist is, and what he or she does What is a mental illness? There is a marked circularity about this ( a psychiatrist is someone who diagnoses and treats psychiatric disorders’, ‘psychiatric disorders are those conditions which are diagnosed and treated by psychiatrists’) There has been endless controversy about the reliability of psychiatric diagnoses and even whether or not mental . AGE John Blair ANIMAL RIGHTS David DeGrazia ARCHAEOLOGY Paul Bahn ARCHITECTURE Andrew Ballantyne ARISTOTLE Jonathan Barnes ART HISTORY Dana Arnold ART THEORY. now: ANARCHISM Colin Ward ANCIENT EGYPT Ian Shaw ANCIENT PHILOSOPHY Julia Annas ANCIENT WARFARE Harry Sidebottom ANGLICANISM Mark Chapman THE ANGLO-SAXON AGE John