An intelligent, encouraging survey of the psychiatric industry.

Though he considers the profession he’s dedicated his life to as the most “distrusted, feared, and denigrated of all medical specialties,” former American Psychiatric Association president Lieberman (Psychiatry/Columbia Univ. College of Physicians and Surgeons) writes with pride of his livelihood in this exuberant and comprehensive dissection of the trade. A profession once “clouded by ideology and dubious science,” the author applauds psychiatry’s grand advancements in the medical world and the progression of modern society’s impressions of it. Lieberman offers a broad historical perspective of how the mental health profession acquired its notoriously pseudoscientific reputation through chapters mining the processes of diagnosis and treatment, including a generous section highlighting the trailblazing career of Sigmund Freud, whose work as “CEO of the psychoanalytical movement” inspired the author to become a psychiatrist. Lieberman also discusses psychiatry’s historic role regarding issues of sexual orientation, the treatment of PTSD and the riddles involved in diagnosing schizophrenia (“sometimes schizophrenia skipped entire generations, only to re-emerge later in the family tree”). The author describes the documented barbarism of psychosurgical lobotomy treatments, insulin-induced comas, chloral sedation, progressive psychopharmacology and electroconvulsive therapy—though Lieberman also documents positive results with ECT performed on patients early in his career. The practice has dramatically outgrown its negative connotations, writes the author, with the implementation of a pluralistic viewpoint toward mental illness. Technological innovations like MRI neuroimaging and advanced genetic testing also paved the way toward a long overdue appreciation of psychiatric clinical practice. Furthermore, a complement of radical, renegade neuroscientists continues to revolutionize and destigmatize psychiatry throughout its modern-day renaissance. Lieberman’s exploration of what he dubs as psychiatry’s “dark comedy of fanciful missteps” optimistically concludes with Hollywood’s evolving interpretation of mental illness through films like The Silver Linings Playbook (2012).

Vastly edifying and vigorously written—a much-needed update on how far the psychiatric industry has come, both medically and from a public perception standpoint.

Kate Whittington