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LRO 162
19th June 2019

Getting the Fix on the Mind Fixers 
Thomas Svolos
 

We have many books on the history of psychiatry that are of interest to the psychoanalyst.  For the Francophile, of course, this would start with Michel Foucault’s Madness and Civilization. There are also some wonderful books on specialized subjects. I am fond of G. E. Berrios’ The History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth Century. Berrios treats a dozen psychopathological concepts to historical scrutiny, even incorporating Lacan’s doctoral thesis (Berrios wisely draws a line between psychiatry and psychoanalysis) into his description of the history of the use of the concept of delusions and of personality. Jack Pressman’s Last Resort: Psychosurgery and the Limits of Medicineis a definitive reading of the most aggressive of the biological treatments in psychiatry. And, David Healy has done great work on the history of psychopharmacology, including the interview series with leading researchers.

In the English language, Edward Shorter’s A History of Psychiatry has probably been the finest general history of psychiatry since its publication in 1997. But while there is much rich historical material in his survey, his celebratory and un-skeptical view of the turn of psychiatry recently to science contrasts with his harsh judgement of the turn of psychiatry a century ago to psychoanalysis in an unappealing way.

Along now comes a remarkable new book by Anne Harrington: Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness. While a bit less global and more American in its attention than Shorter and less focused on the history of asylums in the 19th century, I find Harrington’s read of history sharp and perspicacious. She has clear historical judgement on various turns and shifts in psychiatry that I find compelling. For example: an early hypothesis in the book is that Freud and psychoanalysis came to dominate psychiatry due to a failure of the first neuroscience project to deliver anything of value in treatment. She also advances the thesis that the place for psychoanalysis in psychiatry collapsed due to its internal self-destruction (over-reach, ambition, poor quality even–really desire for mastery I would say) and not the meds or new biological treatments, which I completely agree with. Indeed, her critique of American neo-Freudianism aligns well with Lacan’s. And, very convincingly, she argues that this second moment of biological dominance we are in now is much more about ideology (my word, not hers, using it in the Althusserian sense) than science—psychiatry has delivered no new real treatments in decades, in spite of all the research, theories, and promises made in the name of neuroscience. Furthermore, in addition to her clear awareness of the secondary literature, she documents her hypotheses with rich historical detail and contemporary evidence, and she delivers her work with the fine style of a gifted teacher.

For those inclined to take account of the psychiatric field in their work, Mind Fixers is a remarkable new addition to the literature.

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