John Clay
Shrinks on the Couch
The Growing Disorder in Psychiatry
By T M Luhrmann
Picador 338pp £20
Pain is nearly always indescribable. A psychiatrist interviewed in this book reckons it usually transmutes into anger, humour or wisdom. Psychiatry has to deal with pain on an everyday basis, and this very well–researched book shows how it tries to understand and treat it, and the difficulties that occur when patient meets doctor.
Most of the material for Of Two Minds has been gathered in the USA, where psychiatry at present divides into two schools — the biomedical school, relying heavily on pills, and the psychodynamic school, still seeking to understand the complex narratives behind human behaviour. The biomedical school is clearly in the ascendancy, partly thanks to pressure from pharmaceutical companies eager to try out new products, partly from medical insurance companies seeking the minimum cost for treatment, and partly as a result of the political requirement to achieve demonstrable result.
The author of this book, Tanya Luhrmann, is an anthropologist. Here she has turned her attention to the language and tribal customs of psychiatry. She sat in on classes for trainees and accompanied a spectrum of psychiatrists as they went on their daily rounds. She spent four years doing this
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