A History of Psychiatry: From the Era of the Asylum to the Age of Prozac

This book does not fool. It is a good work that presents the history of psychiatry in an interesting and clear way. It is worth buying.

Books by Edward Shorter have never disappointed me. This one however seems special. Mister Shorter has invested enormous amounts of research into every chapter of this book, and it really shows. Lots of details, lots of obscure litte specifics and minutiae.I have read other books on this topic, but I like this one the best.Summary: Wonderful book. Everyone interested in the history psychiatry MUST read this one!

Shorter does a remarkable job compressing over 200 years of medical history into a single, readable volume. Rather than attempting to provide the reader with an exhaustive chronology of psychiatry, Shorter tells a story which weaves seamlessly between intellectual movements, popular culture, and advances in drug therapy. The principle which guides this narrative-- and, indeed, psychiatry overall-- is the humanitarian impulse to help those who suffer from mental illness.What I found most surprising was the degree to which Freudian psychoanalysis has become thoroughly discredited:"All sciences have to pass through an ordeal by quackery," observed Hans Eysenck in 1985. "Chemistry had to slough off the fetters of alchemy, the brain sciences had to disengage themselves from the tenets of phrenology... Psychology and psychiatry, too will have to abandon the pseudo-science of psychoanalysis..."Far from taking psychological care down an aimless garden path, Freudian analysis is shown to have done real harm to those who suffer from psychological maladies by denying them other forms of care beyond the analyst's couch-- including drug therapy --which could have led to real improvement in patient's lives.Shorter's account begins with the early days of organized asylums, institutions which, despite today's negative associations with the word, were staffed by people who sought to bring relief to those who would have otherwise languished tied to wooden posts or locked in a room for years. The great failings of the asylum system resulted not from its intentions, but from an overwhelming crush of intake. An exponential increase in asylum patients led to substandard care and occasional depictions of gross negligence-- and these latter images are those most strongly associated today with the era, despite their relative infrequency.After the second world war, psychoanalysts in America insisted that mental problems could be cured by means of obtaining a deeper understanding of the primal drives which govern human action. It rejected other forms of treatment as purely palliative, and suggested that real treatment involved a self-discovery of the patient's unresolved psychosexual impulses. (This, despite significant evidence that patients undergoing psychotherapy actually experienced longer recovery periods than patients with similar conditions who received alternate forms of treatment.)Finally, advances in psychopharmacology in the last three decades of the twentieth century succeeded in dethroning Freud from the pinnacle of psychological care and allowed psychiatry to plant itself on firmer, scientific ground. New insights into the genetic origins of many forms of mental illness dispelled the notion that personal insight alone could lead to a full recovery in the majority of cases. The identification of specific drug treatments allowed many to live happy, public lives who would have earlier suffered lonliness and marginalization in the era of asylums.'A History of Psychiatry' is an excellent study of the major movements within psychiatric care over the past three centuries. Shorter has contributed a highly-readable story of a subject which, in less capable hands, would have been an unwieldy account.

19世紀以降の精神医療の流れが、多くの挿話をまじえて書かれています。精神分析について、批判的なのも今風といえるのでしょう。日本の医療の変革時期をふまえ関係者の方に一読を薦めたいと思います。

Very rich but a bit tiring. Very rich but a bit tiring. It is interesting to get a good notion of how people used to be treated and the mismatches between theory and practice. Maybe too descriptive for someone who does not work on the field.