Author | Richard Bentall |
---|---|
Language | English |
Subject | Psychiatry |
Publisher | Allen Lane |
Publication date | 2009 |
Publication place | United Kingdom |
Media type | Print (Hardcover and Paperback) |
Pages | 304 |
ISBN | 9780713998894 |
OCLC | 317748917 |
616.891 | |
LC Class | RC454 .B452 2009 |
Doctoring the Mind: Why psychiatric treatments fail is a 2009 book by Richard Bentall, his thesis is critical of contemporary Western psychiatry. Bentall, a professor of clinical psychology, argues that recent scientific research shows that the medical approach to mental illness is fatally flawed. [1] According to Bentall, it seems there is no "evidence that psychiatry has made a positive impact on human welfare" [2] and "patients are doing no better today than they did a hundred years ago". [3]
The book focuses on psychotic disorders, especially those diagnosed as schizophrenia and bipolar disorder.
Richard Bentall, a professor of clinical psychology, has edited and written several books, most notably Madness Explained. A review by Paul Broks in The Sunday Times summarized its position as: "Like Szasz, Bentall is firmly opposed to the biomedical model, but he also takes issue with extreme social relativists who would deny the reality of madness." In the book, Bentall also argues that no clear distinction exists between those diagnosed with mental illnesses and the "well". While this notion is more widely accepted in psychiatry when it comes to anxiety and depression, Bentall insists that schizotypal experiences are also common. [4] Bentall has also been significantly influenced by the writings of R.D. Laing. [5]
According to reviewer Carolyn Quadrio, Doctoring The Mind: Is Our Current Treatment Of Mental Illness Really Any Good? is an easy to read "shorter and more accessible version" of Madness Explained. [6] A review of this book by neuro-scientist Roy Sugarman found that it allied itself with the anti-psychiatry movement in its critiques of biological psychiatry. [7] The review in PsycCRITIQUES was more nuanced, pointing out that Bentall did not reject psycho-pharmacology, but that he was concerned over its overuse. [8]
In the preface, Bentall writes that "conventional psychiatry might reasonably be criticized, not on hard-to-define humanistic grounds (although these are important) but because it has been profoundly unscientific and at the same time unsuccessful at helping some of the most distressed and vulnerable people in our society". [9]
The book features a short history of psychiatry, also covering anti-psychiatry and clinical psychology.
Bentall argues that the psychiatric diagnoses of schizophrenia and bipolar disorder are not meaningful classifications. [10] As an alternative to neo-Kraepelinian classification systems such as DSM and ICD-10 Chapter V employing these diagnostic labels, Bentall proposes to focus on symptoms ("complaints"), such as paranoia or auditory hallucinations. [11]
He also argues that psychiatric researchers have overestimated the extent to which serious mental illness is genetically inherited while underestimating environmental influences. [12] According to Bentall, psychiatric diseases are not isolated diseases of the brain, but occur in a social context. [3] He presents theoretical models for paranoia and auditory hallucinations involving psychological and biological mechanisms. [13]
According to Bentall, the pharmaceutical industry, as a profit-oriented industry, has been successful in exaggerating the potency of some psychotropic drugs through "ruthless manipulation of the clinical trial data" [14] (he mentions SSRIs as an example [15] ). Bentall states that the pharmaceutical industry also increases sales through sponsoring and bonus payments. [16] The author discerns that antipsychotics (psychotropic drugs used primarily in the treatment of psychotic disorders) can be effective, but are frequently misused, despite their heavy side-effects. According to Bentall:
Bentall claims that "despite [...] serious limitations [antipsychotics'] use has become almost synonymous with psychiatric treatment" and that "weaning services from this dangerous addiction will necessitate completely rethinking the values and goals of psychiatric care". [20]
According to Bentall, psychotherapy, as currently practiced, can already achieve modest effects in treating people with psychosis. [21] He supposes that not all patients will benefit from psychotherapy. [22] With regard to psychotherapy, the book focuses on cognitive-behavioral therapy, [23] but Bentall leaves room for the Dodo bird conjecture. [24]
More generally, Bentall sees the therapeutic relationship at the center of clinical practice. [25] He argues that psychiatric professionals have been blind "to the fact that distress in human beings is usually caused by unsatisfactory relationships with other human beings" and that they have ignored that "warmth and kindness are necessary to promote psychological healing". [25]
Bentall claims that "coercion [of patients] has been become so universally accepted amongst mental health professionals that many no longer see it as ethically troubling". [26] But, according to Bentall, coercion should be avoided for multiple "utilitarian and practical" reasons. [27] Bentall compares a "paternalistic-medical" and an "autonomy-promoting" vision of future psychiatric care. [28] While the former has the treatment goals of "management of mental illness by symptom reduction", the latter pursues a recovery approach, where the treatment goals are "whatever the patient thinks is most important, but especially improvement in self-esteem, self-efficacy, relationships with others and quality of life". [28] The latter approach also refutes a claim to leadership by doctors. [29] This vision also entails relinquishing authority to patients, especially through consumer movements. [30] Bentall claims that "the engagement of patients in the design and development of services [...] is most likely to lead to lasting improvements". [31]
The book was reviewed in scientific journals including Psychiatric Services , [33] Psychological Medicine , [34] New Scientist , [35] Psychosis , [6] Journal of Mental Health , [36] Disability & Society, [37] Acta Medica Academica, [38] PsycCRITIQUES , [8] Cognitive Neuropsychiatry, [39] Journal of the History of the Behavioral Sciences, [40] The Psychologist, [41] Metascience. [42]
The book was also reviewed in such newspapers as The Observer , [43] The Guardian , [44] The Daily Telegraph , [45] Scientific American Mind . [46]
Born in Sheffield, Bentall attended the University College of North Wales, Bangor as an undergraduate before registering for a Ph.D. in Experimental Psychology at the same institution. After being awarded his doctorate, he moved to the University of Liverpool to undertake professional training as a Clinical Psychologist. He later returned to his alma mater of Liverpool to work as a lecturer, after a brief stint working for the National Health Service as a Forensic Clinical Psychologist. In later years, he studied an MA in Philosophy Applied to Healthcare from University of Wales, Swansea. He was eventually promoted to Professor of Clinical Psychology at University of Liverpool. In 1999, he accepted a position at the University of Manchester, collaborating with the numerous researchers working in understanding the psychology and treatment of psychotic experiences. Bentall is currently a professor of clinical psychology at Bangor University, in Wales. [47]
Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Schizophrenia is a mental disorder characterized by hallucinations, delusions, disorganized thinking and behavior, and flat or inappropriate affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially mood disorders, anxiety disorders, and obsessive–compulsive disorder.
Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment can be often more damaging than helpful to patients. The term anti-psychiatry was coined in 1912, and the movement emerged in the 1960s, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historical critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive therapy and insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of whom agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.
A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. These medications are typically made of synthetic chemical compounds and are usually prescribed in psychiatric settings, potentially involuntarily during commitment. Since the mid-20th century, such medications have been leading treatments for a broad range of mental disorders and have decreased the need for long-term hospitalization, thereby lowering the cost of mental health care. The recidivism or rehospitalization of the mentally ill is at a high rate in many countries, and the reasons for the relapses are under research.
Richard Bentall is a Professor of Clinical Psychology at the University of Sheffield in the UK.
The Hearing Voices Movement (HVM) is the name used by organizations and individuals advocating the "hearing voices approach", an alternative way of understanding the experience of those people who "hear voices". In the medical professional literature, ‘voices’ are most often referred to as auditory verbal hallucinations. The movement uses the term ‘hearing voices’, which it feels is a more accurate and 'user-friendly' term.
Biological psychiatry or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics, epigenetics and physiology to investigate the biological bases of behavior and psychopathology. Biopsychiatry is the branch of medicine which deals with the study of the biological function of the nervous system in mental disorders.
Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill is a 2002 book by medical journalist Robert Whitaker, in which the author examines and questions the efficacy, safety, and ethics of past and present psychiatric interventions for severe mental illnesses, particularly antipsychotics. The book is organized as a historical timeline of treatment development in the United States.
The Soteria model is a milieu-therapeutic approach developed to treat acute schizophrenia, usually implemented in Soteria houses.
Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.
The trauma model of mental disorders, or trauma model of psychopathology, emphasises the effects of physical, sexual and psychological trauma as key causal factors in the development of psychiatric disorders, including depression and anxiety as well as psychosis, whether the trauma is experienced in childhood or adulthood. It conceptualises people as having understandable reactions to traumatic events rather than suffering from mental illness.
Loren Richard Mosher was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health (1968–1980). Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons.
Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions. These include various matters related to mood, behaviour, cognition, perceptions, and emotions.
Folie à deux, also known as shared psychosis or shared delusional disorder (SDD), is a psychiatric syndrome in which symptoms of a delusional belief are "transmitted" from one individual to another.
A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders.
Rufus May is a British clinical psychologist best known for using his own experiences of being a psychiatric patient to promote alternative recovery approaches for those experiencing psychotic symptoms. After formally qualifying as a clinical psychologist, he then disclosed that he had been previously detained in hospital with a diagnosis of schizophrenia.
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is a book by Robert Whitaker published in 2010 by Crown. Whitaker asks why the number of Americans who receive government disability for mental illness approximately doubled since 1987.
Allen J. Frances is an American psychiatrist. He is currently Professor and Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. He is best known for serving as chair of the American Psychiatric Association task force overseeing the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Frances is the founding editor of two well-known psychiatric journals: the Journal of Personality Disorders and the Journal of Psychiatric Practice.
John Read is a psychologist and mental health researcher from England. He is professor of clinical psychology in the University of East London's School of Psychology.
Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States.