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1 of 2 people found the following review helpful
4.0 out of 5 stars Great book:The rise, fall and rise of biological psychiatry
This book is a well written acount of the development of psychiatry through the ages. It shows in great detail (sometimes too much, hence only 4 stars) the rise, fall and rise of biological psychiatry. Especially the part of the second rise and the decline of psychoanalysis is a must read for everyone interested in this subject. After reading this book everyone should...
Published on Jan. 10 2000

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4 of 4 people found the following review helpful
1.0 out of 5 stars Confusing history with propaganda
Maybe I was wrong. When I reviewed Gemma Blok's history of anti-psychiatry in the Netherlands, I criticized her for interjecting her opinions, instead of sticking to reporting the facts. Perhaps that's not how historians see their role. Edward Shorter never even bothers to make a pretense of objectivity. I do admit that his unashamedly judgmental writing style makes for a...
Published on Aug. 8 2011 by Mira de Vries


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4 of 4 people found the following review helpful
1.0 out of 5 stars Confusing history with propaganda, Aug. 8 2011
By 
Mira de Vries - See all my reviews
(TOP 1000 REVIEWER)   
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
Maybe I was wrong. When I reviewed Gemma Blok's history of anti-psychiatry in the Netherlands, I criticized her for interjecting her opinions, instead of sticking to reporting the facts. Perhaps that's not how historians see their role. Edward Shorter never even bothers to make a pretense of objectivity. I do admit that his unashamedly judgmental writing style makes for a stirring read. Let me be equally unashamedly judgmental about him.

For one thing, Shorter loves psychiatry. That's clear. For another, there's no mistaking what his favored model of psychiatry is. He lavishes praise on early German psychiatry which was well-funded by the state, enabling plenty of experimentation, as "the triumphs of science" add to the national prestige. He even goes so far as describing the structure within which Kraepelin worked as "majesty." On France of the same period he pours scorn for being "a second-rate psychiatric power," whereas in pitiful England, where teaching hospitals were dependent on charity, there was little science at all, according to Shorter.

Shorter credits Kraepelin, a neurologist according to him, with being the inventor of psychotherapy, although it wasn't called that at the time of course. Wealthy people loathed asylums, so they avoided them by pretending their personal problems were neurological diseases. That's why they became known as neuroses. Neurologists soon recognized the role of placebo treatments (which worked) for these non-diseases, although neurology is actually, according to Shorter, the science of unusual and incurable diseases of the central nervous system. The nerve doctors, poor things, didn't have much choice but to go along with doing psychotherapy and running resorts, as that is where the money was at the time, and they couldn't cure any of their real patients anyway.

The irony is that Kraepelin, whatever his real job title was, worked in asylums where people were taken involuntarily. He is today considered the discoverer of "schizophrenia," a supposedly brain-based disease.

Freud, too, was a neurologist, Shorter points out (this time correctly), though he has no sympathy for psychoanalysis. He juicily describes a lecture given by a German émigré to the U.S., which was so well received that "it brought the house down." "Respected by all and understood by none," the émigré had spoken in broken English about "penis envoy." Psychiatrists in the U.S. welcomed psychoanalysis as a means to escape the asylums. Why they would want to leave all that majesty, Shorter doesn't say.

The early treatments for people brought into the asylums were geared at making them physically sick. Patients would be administered emetics (drugs to make them vomit) or injected with blood from people who were ill with malaria and tuberculosis. These treatments worked, according to Shorter, as did prolonged narcosis (keeping people asleep with drugs), a successful therapy that might still exist today had not some of the patients messed it up by dying. Alcohol was another treatment tried. Pharmaceutical treatments were promising, but unfortunately, Swiss psychiatrist Jakob Klaesi who was doing drug research at Hoffmann-La Roche, was subject to manic-depressive personality swings, says Shorter, and became a nazi sympathizer.

One would think that Shorter, writing in a period that the works of Healy (who is mentioned by him) and Breggin (who is not) are well-known in the psychiatric community, might have connected the term narcosis to the modern term narcotics, which is what all psychiatric drugs are. But no, to him they are medicines, and bear no relation to the early efforts to cure whatever ailed people by making them sick or drowsy. Nor does he express any skepticism of the bombastic claims for the success of any biological treatments, whether the ones mentioned above or ECT, opposition to which he labels "hostility." Only about the curative capacity of lobotomy is Shorter less confident.

For a book boldly named "A History of Psychiatry," reference to the psychiatric obscenities in Germany leading up to and during WWII is surprisingly brief. Not delving deeply into the facts, as though this were a minor sidestep in the history of psychiatry, Shorter condemns these events in no uncertain terms, manic-depressive personality swings or not. "Academic medicine in Germany on the whole stood waist-deep in the Nazi sewer" he asserts, suddenly forgetting about the glories of state funding and experimentation, which were the hallmarks of nazi medicine even more than of the earlier regime so praised by Shorter. Strangely, he ascribes the events under the nazis only to the theory of degeneration, not to the theory of heredity, even though degeneration rested on heredity.

Degeneration, Shorter laments, was seized upon by the eugenicists (so there was nothing wrong with the theory itself?). Later in the book Francis Galton is credited with proposing twin studies, about which Shorter is enthusiastic, without any mention of Galton being the founder of the eugenics movement, and twin children being the infamous Mengele's favorite victims. Mengele isn't mentioned in the book either. Instead, Shorter says defensively, "There was nothing intrinsically racist about the technique of twin studies in psychiatric genetics. ... Indeed, the next major contributions to the field came form Jewish scholars." Shorter misunderstands the meaning of the word racism in the nazi context, and implies that whatever any Jew does cannot be racist. He but regrets the influence of nazism on psychiatry because it imposed taboos on the discussion of biology and heredity in psychiatric disease for decades to come.

Advances in drug therapy were fortunately not held up too much by the nazi sewer, and by May 1952, Delay and Deniker's patients were all doing great on chlorpromazine, according to Shorter. It even cured "patient number one, Giovanni A., a 57-year-old laborer" of his propensity for "making improvised political speeches in cafés ... and ... preaching his love of liberty."

To his credit, although I'm not sure his heart is in it, Shorter isn't totally oblivious to the aggressive expansion of psychiatric territory. He notes regarding "Tom-Sawyer-esque enthusiasm ... the natural spirits of ladhood, [that] in the 1960s and after a whole series of psychological diagnoses arrived to define such behavior as pathological" and "[Such programs as] Mental Illness Awareness Week encourage doctors to diagnose depression. ... the ultimate effect is psychiatric empire-building against other kinds of care." He also mentions some of the various influence groups which affected the content of the DSM (apparently only in the past).

As I started this review with a reference to Gemma Blok, let me not leave out Shorter's section on antipsychiatry movements. They flourished, he claims, throughout the nineteenth century, then apparently mysteriously disappeared for a while. In the 1960s they were reborn, with books published by Michel Foucault, Thomas Szasz, and Erving Goffman. But what really caused the movement to flair up was a novel by Ken Kesey, One Flew Over the Cuckoo's Nest. The movie made from it swept the academy awards of that year, winning all five main Oscars, Shorter relates. That none of these authors considered themselves antipsychiatrists is apparently beside the point. Like Blok, he pronounces this movement a failure.

Shorter ends the book with a justification for the existence of psychiatry. "Whereas the average consultation in internal medicine or obstetrics lasts only around 10 minutes, the average in psychiatry lasts over 40. Within this 40 minutes, psychiatrists do essentially two things that their competitors on either side - the psychologists on the one side, the neurologists on the other - do not do. Psychiatrists offer psychotherapy, which the neurologists generally speaking do not... And psychiatrists prescribe medication, which the nonmedical competition is not permitted to do. This combination of psychotherapy plus medication represents the most effective of all approaches in dealing with disorders of the brain and mind."

Conspicuous by their absence from this justification for the existence of a field of medicine so hated by many of its supposed benefactors, are words like cure, improvement, and customer satisfaction.

There's a snapshot of Shorter on the dust cover. He's quite good looking. If you happen to see him somewhere - turn around and run!

Copyright © MeTZelf
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1 of 1 people found the following review helpful
3.0 out of 5 stars Mind Medicine -- Psychic or Somatic, Nov. 18 2000
By A Customer
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
Shorter's book is an important addition to the history of psychiatry. It falls short because of Shorter's "over kill" in his polemic against psychoanalysis. The Freudian perspective needs thoughtful criticism, but Shorter's attacks become carping. Psychoanalysis has made important cultural contributions, and many people have received benefit from the analyst's couch. Good history should have a direction, even a perspective. But Shorter's history would have been better served with a calmer and more balanced voice.
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1.0 out of 5 stars An Erratic Narrative Drowned by Useless, Dry Facts, Dec 7 2014
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
I picked up this book because of my keen and long-term interest in psychology, psychiatry and its history. I was incredibly excited when I started it, but by page 44 it became the first book in over 8 years I've decided not to finish. 1/7th of the book went by and I'd practically learned little more than what could have been told in two sentences. The writing style was chaotic; barely organized, it jumped from country to century to topic to create one of the most erratic narratives I've had the misfortune of reading. It's pages were filled with so many names, dates and places that it was difficult to pinpoint which ones were worth remembering. The detailed information lost its purpose - instead of communicating concepts, it focused on facts that after a while became empty in their recital. No doubt, this book is well researched and detailed - but it's also probably the driest account of one of the world's most interesting histories. It gave me no *practical* sense of the development of psychiatry. Perhaps if the author had stuck to a primary chronology, location or had created a clearer narrative it would have been the historical account the description claims it is. I personally found it to be a jumble of useless facts obscuring what it so interesting and lively about the topic itself. If one is only looking for fact fodder to find dates and names, this book would be helpful, but I'd steer clear of it as a historical narrative for the purpose of personal reading.

As an aside, the occassional sarcastic, almost judgemental comments the author threw didn't sit well with me. If they had been present within an otherwise amazing narrative, perhaps I wouldn't have minded as much. Regardless, it's my personal opinion that when recounting a history, one should remain as impartial and impersonal as possible. I found his commentary almost unprofessional. Of course, all authors have thier opinions and biases - but I think it would have been better had the author limited his to the introduction or a final chapter, instead of peppering the text itself with his personal opinions.

Considering it's the first book in years I refuse to finish and I intend to discard from my bookshelf, I would definitely not recommend "A History of Psychiatry" by Edward Shorter.
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3 of 4 people found the following review helpful
3.0 out of 5 stars Mind Medicine -- Psychic or Somatic, Nov. 18 2000
By A Customer
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
Shorter's book is an important addition to the history of psychiatry. It falls short because of Shorter's "over kill" in his polemic against psychoanalysis. The Freudian perspective needs thoughtful criticism, but Shorter's attacks become carping. Psychoanalysis has made important cultural contributions, and many people have received benefit from the analyst's couch. Good history should have a direction, even a perspective. But Shorter's history would have been better served with a calmer and more balanced voice.
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3 of 4 people found the following review helpful
2.0 out of 5 stars Shorter's opinion on the history of psychiatry, Sept. 2 2003
By 
G Marx (Wellington New Zealand) - See all my reviews
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
I really enjoyed the part of this book on the history of psychiatry. Unfortunately only about 60% of the book is on this topic and the rest consists of Shorter's unbalanced opinions. As a Psychiartic Registrar/resident slightly more simpathetic to the Biological approach, even I found this book extremely biased. Shorter's concrete style of reasoning makes him far more suitable to write a book on the history of surgery. The finer nuances and richness of the field of psychiatry is clearly outside his grasp.
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3 of 4 people found the following review helpful
2.0 out of 5 stars a one-sided polemic, May 24 1999
By A Customer
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
This book is a one-sided polemic. The author clearly believes that only the "biological" approach to psychiatry is worth anything, but instead of presenting his case as an honest argument, he gives us a weighted, colored, and biased view of history. I was very disappointed.
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2 of 3 people found the following review helpful
1.0 out of 5 stars Psychiatric hagiography, Nov. 14 2003
By 
Paul Gruchow (Duluth, Minnesota United States) - See all my reviews
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
This is an unbalanced, often inaccurate, and entirely adulatory history of psychiatry, masquerading as scholarship. Shorter finally lost me at the point where he describes ice-pick lobotomies, of which he is mildly diapproving, as an "adventure."
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1 of 2 people found the following review helpful
4.0 out of 5 stars Great book:The rise, fall and rise of biological psychiatry, Jan. 10 2000
By A Customer
This review is from: A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (Paperback)
This book is a well written acount of the development of psychiatry through the ages. It shows in great detail (sometimes too much, hence only 4 stars) the rise, fall and rise of biological psychiatry. Especially the part of the second rise and the decline of psychoanalysis is a must read for everyone interested in this subject. After reading this book everyone should understand that there is only one side to psychiatry and that is the biological side.
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1 of 3 people found the following review helpful
5.0 out of 5 stars Ah, so _that's_ what happened., Oct. 5 1997
By 
Daniel P. Smith "Daniel P. B. Smith" (Massachusetts, USA) - See all my reviews
(REAL NAME)   
I loved this book. Terrific. Over and over it tied together and made sense of things that had puzzled me.
To get personal: in the fifties, my father spent a small fortune on traditional Freudian psychoanalysis. And it did him a lot of good. For years, I believed Freudian psycyoanalysis was scientific. For one things, it just _had_ to be. No charlatan could go to the effort and expense of getting an MD, then board certification in psychiatry, then undergo psychoanalysis, just in order to con people.
Yet in some way that I didn't quite understand, I became aware than nowadays Freudian psychoanalysis is considered to be a pseudoscience, on about the same level as orgone boxes or homeopathy or Christian science.
How _could_ my parents have fallen for it? How _could_ the medical community?
Well, Shorter explains what happened in a way that makes sense, seems clear, and (to my mind) is really quite sympathetic to the psychoanalytic community and its clients.
Along the way he ties up a lot of loose ends. All through the book I kept saying to myself things like, "Oh, so _that's_ what 'neurasthenia' was" (people in novels written early in the century often had it). "Wow, so that's what the word 'degenerate' is really referring to."
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0 of 2 people found the following review helpful
5.0 out of 5 stars Intelligent, principled creitical review which informs, guid, March 1 1998
By A Customer
Highly intelligent, principled writing. Not opinionated, but has opinions, argues for them, convinces the reader. Informative but does not aequalize between imporatent and unimportant. Brilliant style, most amusing.
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