Shrinks | Jeffrey A. Lieberman

Summary of: Shrinks: The Untold Story of Psychiatry
By: Jeffrey A. Lieberman

Shocking Therapy

The use of electroconvulsive therapy (ECT) to treat mental illness has come a long way since its inception in 1938. Before ECT, psychiatrists induced seizures with insulin, metrazol, and other drugs. While effective in relieving symptoms, these approaches came with significant side effects, including brain damage, obesity, and even death. ECT, on the other hand, delivers electric shocks to targeted areas of the brain under anesthesia and muscle relaxants, making it a safer and more effective treatment for severe cases of schizophrenia, depression, and mania. Though controversial, ECT continues to be a valuable tool in treating mental health conditions.

Introduction

Embark on a fascinating journey through the turbulent history of psychiatry as we explore ‘Shrinks: The Untold Story of Psychiatry’ by Jeffrey A. Lieberman. Dive deep into the often-horrifying history of asylums and examine the work of early reformers like Philippe Pinel and Benjamin Rush, who sought to humanize the treatment of mental illness. Discover the various questionable treatments and theories of the past, and witness the rise and influence of Sigmund Freud’s psychoanalysis. Be prepared to delve into the controversies surrounding psychiatry and the impact of technological advancements on the field.

The History of Humane Psychiatry

Mental health treatment was once appalling, with patients being locked up in tiny cells, beaten, and publicly displayed like freaks. Thankfully, reformers like Pinel and Rush led the charge in the 18th and 19th centuries to create a more humane approach, emphasizing clean housing, fair treatment, and manual tasks to promote self-mastery. Their efforts paved the way for modern psychiatry, although there remains much work to be done.

The Unfortunate History of Mental Health Practices

This summary explores the unique attempts of three psychiatrists to cure mental illness using circulation and energy flow theories, with disastrous results.

In the past, Benjamin Rush believed that the root of mental illness was disrupted blood circulation in the brain and attempted to address this by spinning schizophrenic patients in a ‘rotational chair’ until they became dizzy. Similarly, Franz Mesmer attempted to cure energy blockages that he thought caused mental illness by using hypnotism to uncover energy flow issues. This resulted in temporary cures and a following of patients. However, when examined by a scientific committee in Paris, his methods were denounced.

Later, Wilhelm Reich believed that mental illness resulted from an insufficient flow of cosmic energy. He called this energy ‘orgones’ and thought that the cure involved releasing orgone energy in the body. His methods involved spending time in a wooden box that supposedly collected cosmic energy to address this.

Overall these efforts resulted in dangerous and ineffective treatments. The history of mental health practices may have been rough, but we have since progressed to become better informed about mental health and to create more effective treatments.

Freud’s Revolutionary Theory

In the late nineteenth century, psychiatry lagged behind other fields of medicine, but Freud’s revolutionary theory changed everything. Freud’s approach to psychiatry placed the subconscious mind at the center, postulating that our subconscious has a life of its own hidden from our waking consciousness. He proposed that our mind has three components: the id, the source of selfish desires and instincts, the ego, which ensures that our impulses are expressed in an acceptable manner, and the superego, which incorporates moral standards we’ve learned. Freud’s ideas captivated many people, and his theory became the basis for modern psychoanalysis.

Freud’s theory of mental illness

Sigmund Freud believed that inner conflicts between the id, ego, and superego could lead to mental illness. While individuals normally cope with these conflicts through sublimation or denial, some may develop disorders when these mechanisms fail. Freud’s talking therapy, which involves patients discussing their innermost thoughts and dreams, helped them understand their conflicts and experience transference with their therapist.

The Rise of Psychoanalysis in America

Freud’s Psychoanalytic theory, which became popular in Europe, took some time to gain ground in the United States. By the 1930s, it had become a mass phenomenon. Psychoanalysts, including Adler, fleeing from Nazi Germany and Austria, established institutes and obtained professorships at leading US universities. Psychoanalytic theory suggested most people would benefit from therapy, leading to an increasing number of people seeking help in private practices. By the 1960s, almost every major psychiatric position was occupied by a psychoanalyst, with the core of all psychiatry training being psychoanalytic theory. The American Psychological Association (APA) played a vital role in promoting psychoanalysis in the United States, with the psychoanalytic section established in 1934 and most of the APA presidents being psychoanalysts for 48 years.

Psychoanalysis: An Unscientific Methodology

Freud’s psychoanalysis theory of psychiatric illness was not based on scientific evidence and was more faith-based. Later psychoanalysts also propounded unbacked theories that blamed parents for mental illnesses. However, these creative explanations were not enough to successfully treat severe mental illnesses, and patients continued to suffer.

Sigmund Freud’s theory of psychiatric illness provided a coherent explanation for mental illnesses and a new kind of therapy. However, psychoanalysis soon faced its own set of problems. Rather than being based on scientific evidence, psychoanalysis was more faith-based and dogmatic. Freud’s assumptions were not to be questioned, and scientific rigor was discouraged.

Later psychoanalysts continued to propound theories that were unsupported by significant scientific evidence. They blamed parents for various mental illnesses, including schizophrenia, autism, and psychosis. However, these creative explanations were inadequate in treating severe mental illnesses. In fact, Freud himself declared that psychoanalysis was unsuitable for treating psychosis.

Despite this, psychoanalytic hospitals opened, but they failed to remedy psychosis with talk therapy while patients continued to suffer. In summary, psychoanalysis has been shown to lack scientific rigor, and its theories were not based on significant scientific evidence.

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