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Index
Cover Title Page Dedication Copyright Page Contents List of Illustrations List of Figures Acknowledgements Preface: Rational Antipsychiatry
On the distinction between antipsychiatry and being against psychiatrists The purpose of this book
Doctoring the Mind
PART ONE: AN ILLUSION OF PROGRESS
1: A Smashing Success?
What is psychosis? The medical treatment of severe mental illness Has there been progress in the treatment of mental illness? The best psychiatry in the world? Doing without medical psychiatry Psychiatry is not working
2: The Appliance of Science: The Emergence of Psychiatry as a Medical Discipline
Building the intellectual foundations of psychiatry Life in the asylums Extreme remedies The absence of alternatives
3: Therapeutic Innovation at the End of the Asylum Era
The first drug that worked The clinical psychologist arrives The psychologist as engineer Harnessing the therapeutic relationship The two psychologies confront each other The impact of innovation Insane places
4: Dissent and Resolution: The Triumph of Biological Psychiatry
The new biological psychiatry The neo-Kraepelinian revolution The strange case of Rafael Osheroff Replicating Rosenhan
PART TWO: THREE MYTHS ABOUT MENTAL ILLNESS
5: People or Plants? The Myth that Psychiatric Diagnoses are Meaningful
The personal and political significance of psychiatric diagnoses How psychiatric diagnoses were invented The mass production of psychiatric diagnoses Spurious precision Multiplying diagnoses Correlations between symptoms The predictive validity of psychiatric diagnoses The boundary between the ‘normal’ and the ‘sick’ Are schizophrenia and bipolar disorder scientific delusions? Andrew
6: The Fundamental Error of Psychiatry: The Myth that Psychiatric Disorders are Genetic Diseases
The fundamental error of psychiatry Unpromising beginnings How genes cause disease The miscalculation of h2 The misinterpretation of h2 Hannah’s story The slings and arrows of outrageous fortune Victimization and powerlessness Expressions of emotion Vague communication Insecure attachment The era of molecular genetics The seductiveness of genetic myths Living with Mr Pinkerton
7: Brains, Minds and Psychosis: The Myth that Mental Illnesses are Brain Diseases
The significance of biology Brain structure and psychosis The neurochemistry of psychosis Cognitive functioning and psychosis How to explain psychosis The engine of paranoia The paranoid mind Hearing voices Psychiatric disorders are not simply brain diseases
PART THREE: MEDICINE FOR MADNESS
8: Science, Profit and Politics in the Conduct of Clinical Trials
We all need to understand randomized controlled trials What is a randomized controlled trial? There’s gold in them thar pills RCT wars The case of the SSRIs Can psychiatric trial data be trusted?
9: Less is Probably Better: The Benefits and Costs of Antipsychotics
The short-term therapeutic effects of antipsychotic medication Dose, side effects and the development of second-generation drugs There are more side effects than stiffness and shakes Do antipsychotics help in the long term? Could antipsychotics make patients more vulnerable to future episodes? Fooled again? First do no harm
10: The Virtue of Kindness: Is Psychotherapy Effective for Severe Mental Illness?
How can we find out if psychotherapy works? Is psychotherapy helpful to people with psychosis? The new insulin coma therapy? A universal therapeutic good?
11: What Kind of Psychiatry Do You Want?
Two visions of psychiatry Do as you are told Psychosis and violence Insight and psychosis The place of drugs in psychiatry Psychotherapy for the masses? Mental health tribalism Journey’s end
Notes Index Footnotes
Preface: Rational Antipsychiatry
Page xi
PART ONE: AN ILLUSION OF PROGRESS
1: A Smashing Success?
Page 11 Page 22
2: The Appliance of Science: The Emergence of Psychiatry as a Medical Discipline
Page 28 Page 31
3: Therapeutic Innovation at the End of the Asylum Era
Page 50 Page 52 Page 59 Page 62
4: Dissent and Resolution: The Triumph of Biological Psychiatry
Page 76 Page 83 Page 84
PART TWO: THREE MYTHS ABOUT MENTAL ILLNESS
5: People or Plants? The Myth that Psychiatric Diagnoses are Meaningful
Page 107
6: The Fundamental Error of Psychiatry: The Myth that Psychiatric Disorders are Genetic Diseases
Page 116 Page 125 Page 141 Page 145
7: Brains, Minds and Psychosis: The Myth that Mental Illnesses are Brain Diseases
Page 164 Page 173 Page 174
PART THREE: MEDICINE FOR MADNESS
8: Science, Profit and Politics in the Conduct of Clinical Trials
Page 193 Page 205
9: Less is Probably Better: The Benefits and Costs of Antipsychotics
Page 218 Page 226 Page 229 Page 233 Page 239
10: The Virtue of Kindness: Is Psychotherapy Effective for Severe Mental Illness?
Page 248
11: What Kind of Psychiatry Do You Want?
Page 266 Page 271 Page 274
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