Doctoring the Mind: Why Psychiatric Treatments Fail
By Richard Bentall (Allen Lane, £25)
Uniquely difficult among medical disciplines, psychiatry has the task of conceptualising, studying and treating illnesses for which there may never be any objective physical evidence. There is no blood test, no brain scan, no genetic profile that a doctor can use to identify even acute schizophrenia, let alone any of the more minor conditions. The only diagnostic materials psychiatrists have at their disposal are a patient’s history, behaviour and language.
If psychiatric disorders are diseases at all, they are diseases of the mind rather than of the brain. This is what makes psychiatry so fascinating—and so confounding. For, in a profession with such a fragile diagnostic framework, there remains a very real possibility that its principal disease categories have been misconceived. No other orthodox medical discipline is so open to dispute at its very foundations. It’s hard to imagine a meaningful movement of anti-oncologists, say, who deny the very notion of cancer. “Anti-psychiatry,” however, is a serious minority activity.
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