In a book sure to inspire controversy, Gene Heyman argues that conventional wisdom about addiction—that it is a disease, a compulsion beyond conscious control—is wrong.

Drawing on psychiatric epidemiology, addicts’ autobiographies, treatment studies, and advances in behavioral economics, Heyman makes a powerful case that addiction is voluntary. He shows that drug use, like all choices, is influenced by preferences and goals. But just as there are successful dieters, there are successful ex-addicts. In fact, addiction is the psychiatric disorder with the highest rate of recovery. But what ends an addiction?

At the heart of Heyman’s analysis is a startling view of choice and motivation that applies to all choices, not just the choice to use drugs. The conditions that promote quitting a drug addiction include new information, cultural values, and, of course, the costs and benefits of further drug use. Most of us avoid becoming drug dependent, not because we are especially rational, but because we loathe the idea of being an addict.

Heyman’s analysis of well-established but frequently ignored research leads to unexpected insights into how we make choices—from obesity to McMansionization—all rooted in our deep-seated tendency to consume too much of whatever we like best. As wealth increases and technology advances, the dilemma posed by addictive drugs spreads to new products. However, this remarkable and radical book points to a solution. If drug addicts typically beat addiction, then non-addicts can learn to control their natural tendency to take too much.

From August 29 to September 21, 1909, Sigmund Freud visited the United States, where he gave five lectures at Clark University in Worcester, Massachusetts. This volume brings together a stunning gallery of leading historians of psychoanalysis and of American culture to consider the broad history of psychoanalysis in America and to reflect on what has happened to Freud’s legacy in the United States in the century since his visit.        

We have made huge progress in understanding the biology of mental illnesses, but comparatively little in interpreting them at the psychological level. The eminent philosopher Jonathan Glover believes that there is real hope of progress in the human interpretation of disordered minds.

The challenge is that the inner worlds of people with psychiatric disorders can seem strange, like alien landscapes, and this strangeness can deter attempts at understanding. Do people with disorders share enough psychology with other people to make interpretation possible? To explore this question, Glover tackles the hard cases—the inner worlds of hospitalized violent criminals, of people with delusions, and of those diagnosed with autism or schizophrenia. Their first-person accounts offer glimpses of inner worlds behind apparently bizarre psychiatric conditions and allow us to begin to learn the “language” used to express psychiatric disturbance. Art by psychiatric patients, or by such complex figures as van Gogh and William Blake, give insight when interpreted from Glover’s unique perspective. He also draws on dark chapters in psychiatry’s past to show the importance of not medicalizing behavior that merely transgresses social norms. And finally, Glover suggests values, especially those linked with agency and identity, to guide how the boundaries of psychiatry should be drawn.

Seamlessly blending philosophy, science, literature, and art, Alien Landscapes? is both a sustained defense of humanistic psychological interpretation and a compelling example of the rich and generous approach to mental life for which it argues.

In 1895 there was not a single case of dementia praecox reported in the United States. By 1912 there were tens of thousands of people with this diagnosis locked up in asylums, hospitals, and jails. By 1927 it was fading away . How could such a terrible disease be discovered, affect so many lives, and then turn out to be something else?

In vivid detail, Richard Noll describes how the discovery of this mysterious disorder gave hope to the overworked asylum doctors that they could at last explain—though they could not cure—the miserable patients surrounding them. The story of dementia praecox, and its eventual replacement by the new concept of schizophrenia, also reveals how asylum physicians fought for their own respectability. If what they were observing was a disease, then this biological reality was amenable to scientific research. In the early twentieth century, dementia praecox was psychiatry’s key into an increasingly science-focused medical profession.

But for the moment, nothing could be done to help the sufferers. When the concept of schizophrenia offered a fresh understanding of this disorder, and hope for a cure, psychiatry abandoned the old disease for the new. In this dramatic story of a vanished diagnosis, Noll shows the co-dependency between a disease and the scientific status of the profession that treats it. The ghost of dementia praecox haunts today’s debates about the latest generation of psychiatric disorders.

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory.

But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize.

Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

A Washington Post Notable Work of Nonfiction
A Telegraph Book of the Year

A sweeping history of American psychiatry—from the mental hospital to the brain lab—that reveals the devastating treatments doctors have inflicted on their patients (especially women) in the name of science and questions our massive reliance on meds.

For more than two hundred years, disturbances of the mind—the sorts of things that were once called “madness”—have been studied and treated by the medical profession. Mental illness, some insist, is a disease like any other, whose origins can be identified and from which one can be cured. But is this true?

In this masterful account of America’s quest to understand and treat everything from anxiety to psychosis, one of the most provocative thinkers writing about psychiatry today sheds light on its tumultuous past. Desperate Remedies brings together a galaxy of mind doctors working in and out of institutional settings: psychologists and psychoanalysts, neuroscientists, and cognitive behavioral therapists, social reformers and advocates of mental hygiene, as well as patients and their families desperate for relief.

Andrew Scull begins with the birth of the asylum in the reformist zeal of the 1830s and carries us through to the latest drug trials and genetic studies. He carefully reconstructs the rise and fall of state-run mental hospitals to explain why so many of the mentally ill are now on the street and why so many of those whose bodies were experimented on were women. In his compelling closing chapters, he reveals how drug companies expanded their reach to treat a growing catalog of ills, leading to an epidemic of over-prescribing while deliberately concealing debilitating side effects.

Carefully researched and compulsively readable, Desperate Remedies is a definitive account of America’s long battle with mental illness that challenges us to rethink our deepest assumptions about who we are and how we think and feel.

“The Emmanuel Movement” was a name given by the contemporary press to a combined method of group and individual psychotherapy introduced in 1906 by the Rev. Elwood Worcester, Rector of the Emmanuel Church in Boston. This treatment method for the common neuroses, offered to the public free of charge and open to all social classes and religious denominations, was first welcomed with great popular acclaim but later ravaged by the widespread newspaper publicity it attracted. The movement continued its stormy existence for a decade beyond Worcester’s retirement in 1929. His successors applied his methods—including group treatment, the first to be employed in psychotherapy anywhere—to the treatment of alcoholics.

In The Emmanuel Movement, Sanford Gifford presents the definitive statement on this unique movement. He examines its position during a critical phase of American psychotherapy, and discusses the methods and personalities—both champions and detractors—associated with it.

No other book in the field so fully combines vivid clinical examples, specific details of technique, and mature perspectives on both effectively functioning families and those seeking therapy. The views and strategies of a master clinician are presented here in such clear and precise form that readers can proceed directly from the book with comparisons and modifications to suit their own styles and working situations.

Salvador Minuchin presents six chapter-length transcripts of actual family sessions—two devoted to ordinary families who are meeting their problems with relative success; four concerned with families seeking help. Accompanying each transcript is the author’s running interpretation of what is taking place, laying particular stress on the therapist’s tactics and maneuvers.

These lively sessions are interpreted in a brilliant theoretical analysis of why families develop problems and what it takes to set them right. The author constructs a model of an effectively functioning family and defines the boundaries around its different subsystems, whether parental, spouse, or sibling. He discusses ways in which families adapt to stress from within and without, as they seek to survive and grow.

Dr. Minuchin describes methods of diagnosing or “mapping” problems of the troubled family and determining appropriate therapeutic goals and strategies. Different situations, such as the extended family, the family with a parental child, and the family in transition through death or divorce, are examined. Finally, the author explores the dynamics of change, examining the variety of restructuring operations that can be employed to challenge a family and to change its basic patterns.

Most psychologists claim that we begin to develop a “theory of mind”—some basic ideas about other people’s minds—at age two or three, by inference, deduction, and logical reasoning.

But does this mean that small babies are unaware of minds? That they see other people simply as another (rather dynamic and noisy) kind of object? This is a common view in developmental psychology. Yet, as this book explains, there is compelling evidence that babies in the first year of life can tease, pretend, feel self-conscious, and joke with people. Using observations from infants’ everyday interactions with their families, Vasudevi Reddy argues that such early emotional engagements show infants’ growing awareness of other people’s attention, expectations, and intentions.

Reddy deals with the persistent problem of “other minds” by proposing a “second-person” solution: we know other minds if we can respond to them. And we respond most richly in engagement with them. She challenges psychology’s traditional “detached” stance toward understanding people, arguing that the most fundamental way of knowing minds—both for babies and for adults—is through engagement with them. According to this argument the starting point for understanding other minds is not isolation and ignorance but emotional relation.

Jacques Lacan, one of the most influential and controversial French thinkers of the twentieth century, was a practicing and teaching psychoanalyst in Paris, but his revolutionary seminars on Freud reached out far beyond professional circles: they were enthusiastically attended by writers, artists, scientists, philosophers, and intellectuals from many disciplines.

Shoshana Felman elucidates the power and originality of Lacan’s work. She brilliantly analyzes Lacan’s investigation of psychoanalysis not as dogma but as an ongoing self-critical process of discovery. By focusing on Lacan’s singular way of making Freud’s thought new again—and of thus enabling us to participate in the very moment of intellectual struggle and insight—Felman shows how this moment of illumination has become crucial to contemporary thinking and has redefined insight as such. This book is a groundbreaking statement not only on Lacan but on psychoanalysis in general.

Felman argues that, contrary to popular opinion, Lacan’s preoccupation is with psychoanalytic practice rather than with theory for its own sake. His true clinical originality consists not in the incidental innovations that separate his theory from other psychoanalytic schools, but in the insight he gives us into the structural foundations of what is common to the practice of all schools: the transference action and the psychoanalytic dialogue. In chapters on Poe’s tale “The Purloined Letter”; Sophocles’s Oedipus plays, a case report by Melanie Klein, and Freud’s writings, Felman demonstrates Lacan’s rediscovery of these texts as renewed and renewable intellectual adventures and as parables of the psychoanalytic encounter. The book explores these questions: How and why does psychoanalytic practice work? What accounts for clinical success? What did Freud learn from the literary Oedipus, and how does Freud text take us beyond Oedipus? How does psychoanalysis inform, and radically displace, our conception of what learning is and of what reading is?

This book will be an intellectual event not only for clinicians and literary critics, but also for the broader audience of readers interested in contemporary thought.

Since 1955, moving from early work in psychopharmacology to studies of clinical method and the psychiatric schools, Leston Havens has been working toward a general theory of therapy. It often seems that twentieth-century psychiatry, sect-ridden, is a Tower of Babel, as Havens once characterized it. This book is the distillation of long years of thought and practice, a bold yet modest attempt to delineate an “integrated psychotherapy.”

The boldness of this effort lies in its author’s willingness to recognize the best that each school has to offer, to describe it cogently, and to integrate it into a full response to today’s new kind of patient. Descriptive or medical psychiatry, psychoanalysis, interpersonal or behavioristic psychiatry, empathic or existential therapy-viewed in metaphors, respectively, of perceiving, thinking, managing, feeling-all have useful contributions to make to contemporary methods of treatment. But how? Havens’s modest answer is through appropriate language, and he demonstrates exactly what he means: when to ask questions, when to direct or draw back, when to sympathize.

Practitioners now must deal with less dramatic, but more stubborn, problems of character and situation; lack of purpose, isolation, submissiveness, invasiveness, deep yet vague dissatisfaction. Some kind of human presence must be discovered in the patient, and Havens gives concrete, absorbing examples of ways of “speaking to absence,” of making contact. The emphasis is on verbal technique, but the underlying broad, humane intent is everywhere evident. It is no less than to transform passivity, by means of disciplined therapeutic concern, into a state of being Human.

Russian psychologist A. R. Luria presents a compelling portrait of a man’s heroic struggle to regain his mental faculties. A soldier named Zasetsky, wounded in the head at the battle of Smolensk in 1943, suddenly found himself in a frightening world: he could recall his childhood but not his recent past; half his field of vision had been destroyed; he had great difficulty speaking, reading, and writing.

Much of the book consists of excerpts from Zasetsky’s own diaries. Laboriously, he records his memories in order to reestablish his past and to affirm his existence as an intelligent being. Luria’s comments and interpolations provide a valuable distillation of the theory and techniques that guided all of his research. His “digressions” are excellent brief introductions to the topic of brain structure and its relation to higher mental functions.

It’s the American dream—unfettered freedom to follow our ambitions, to forge our identities, to become self-made. But what if our culture of limitless self-fulfillment is actually making millions desperately ill? One of our leading interpreters of modernity and nationalism, Liah Greenfeld argues that we have overlooked the connection between egalitarian society and mental illness. Intellectually fearless, encompassing philosophy, psychology, and history, Mind, Modernity, Madness challenges the most cherished assumptions about the blessings of living in a land of the free.

Modern nationalism, says Greenfeld, rests on bedrock principles of popular sovereignty, equality, and secularism. Citizens of the twenty-first century enjoy unprecedented freedom to become the authors of their personal destinies. Empowering as this is, it also places them under enormous psychic strain. They must constantly appraise their identities, manage their desires, and calibrate their place within society. For vulnerable individuals, this pressure is too much. Training her analytic eye on extensive case histories in manic depression and schizophrenia, Greenfeld contends that these illnesses are dysfunctions of selfhood caused by society’s overburdening demands for self-realization. In her rigorous diagnosis, madness is a culturally constituted malady.

The culminating volume of Greenfeld’s nationalism trilogy, Mind, Modernity, Madness is a tour de force in the classic tradition of Émile Durkheim—and a bold foray into uncharted territory. Often counter-intuitive, always illuminating, Mind, Modernity, Madness presents a many-sided view of humanity, one that enriches our deepest understanding of who we are and what we aspire to be.

With all the intrigue and twists of a mystery, Questions for Freud uncovers the paradoxes that riddle psychoanalysis today and traces them to Freud's vacillation at key points in his work--and from there to a traumatic event in Freud's life.

What role did censored family history play in shaping Freud's psychological inquiries, promoting and impeding them by turns? With this question in mind, Nicholas Rand and Maria Torok develop a new biographical and conceptual approach to psychoanalysis, one that outlines Freud's contradictory theories of mental functioning against the backdrop of his permanent lack of insight into crucial and traumatic aspects of his immediate family's life. Taking us through previously unpublished documents and Freud's dreams, his clinical work and institutional organization, the authors show how a shameful event in 1865 that shook Freud and his family can help explain the internal clashes that later beset his work--on the origins of neurosis, reality, trauma, fantasy, sexual repression, the psychoanalytic study of literature, and dream interpretation.

Steeped in the history, theory, and practice of psychoanalysis, this book offers a guide to the wary, a way of understanding the flaws and contradictions of Freud's thought without losing sight of its significance. This book will alter the terms of the current debate about the standing of psychoanalysis and Freud.

There are more psychoanalytic theories today than anyone knows what to do with, and the heterogeneity and complexity of the entire body of psychoanalytic though have become staggering. In Relational Concepts in Psychoanalysis, Stephen A. Mitchell weaves strands from the principal relational-model traditions (interpersonal psychoanalysis, British school object-relations theories, self psychology, and existential psychoanalysis) into a comprehensive approach to many of the knottiest problems and controversies in theoretical and clinical psychoanalysis.

Mitchell’s earlier book, Object Relations in Psychoanalytic Theory, co-authored with Jay Greenberg, set the stage for this current integration by providing a broad comparative analysis of important thinking on the nature of human relationships. In that classic study Greenberg and Mitchell distinguished between two basic paradigms: the drive model, in which relations with others are generated and shaped by the need for drive gratifications, and various relational models, in which relations themselves are taken as primary and irreducible. In Relational Concepts in Psychoanalysis, Mitchell argues that the drive model has since outlived its usefulness. The relational model, on the other hand, has been developed piecemeal by different authors who rarely acknowledge and explore the commonality of their assumptions or the rich complementarity of their perspectives.

In this bold effort at integrative theorizing, Mitchell draws together major lines of relational-model traditions into a unified framework for psychoanalytic thought, more economical than the anachronistic drive model and more inclusive than any of the singular relational approaches to the core significance of sexuality, the impact of early experience, the relation of the past to the present, the interpenetration of illusion and actuality, the centrality of the will, the repetition of painful experience, the nature of analytic situation, and the process of analytic change. As such, his book will be required reading for psychoanalytic scholars, practitioners, candidates in psychoanalysis, and students in the field.

What do we mean when we refer to our “identity,” and how do we represent it in the stories we tell about our lives? Is “identity” a sustained private core, or does it change as circumstances and relationships shift? In this thoughtful and learned book, a recognized master of research interviewing explores these questions through analyses of in-depth interviews with five craftartists, who reflect on their lives and their efforts to sustain their form of work as committed artists in a world of mass production and standardization.

The artists describe their families of origin and the families they have created, and the conscious decisions, chance events, and life experiences that entered into the ways they achieved their adult artistic identities. Exploring these continuities, discontinuities, and unresolvable tensions in an analysis that brings new sophistication to a much-used term, Elliot Mishler suggests that “identity” is always dialogic and relational, a complex of partial subidentities rather than a unitary monad. More a verb than a noun, it reflects an individual’s modes of adaptation, appropriation, and resistance to sociocultural plots and roles.

With its critical review of narrative research methods, model of analysis for the systematic study of life stories and identity, and vision of how narrative studies may contribute to theory and research in the social sciences, Storylines is an eloquent and important book for narrative psychology and lifespan development.

Waiting lists in psychiatric clinics and increasing numbers of patients in long-term psychotherapy have highlighted the need for shorter methods of treatment. Existing forms of short-term psychotherapy tend to be vague and uncertain, lacking as they do a clearly formulated rationale and methodology.

The bold and challenging technique for brief psychotherapy designed around the factor of time itself, which James Mann introduces here, is a method he hopes will revolutionize current practice. The significance of time in human life is examined in terms of the development of time sense as well as its unconscious meaning and the ways these are experienced in both the categorical and existential senses. The author shows how the interplay between the regressive pressures of the child’s sense of infinite time and the adult reality of categorical time determine the patient’s unconscious expectations of psychotherapy.

According to the poet Elias Canetti, "All the things one has forgotten / scream for help in dreams." To the ancient Egyptians they were prophecies, and in world folklore they have often marked visitations from the dead. For Freud they were expressions of "wish fulfillment," and for Jung, symbolic representations of mythical archetypes. Although there is still much disagreement about the significance and function of dreams, they seem to serve as a barometer of current mind and body states.

In this volume, Deirdre Barrett brings together the study of dreams and the psychology of trauma. She has called on a distinguished group of psychiatrists, psychologists, and social workers--among them Rosalind Cartwright, Robert J. Lifton, and Oliver Sacks--to consider how trauma shapes dreaming and what the dreaming mind might reveal about trauma. The book focuses on catastrophic events, such as combat, political torture, natural disasters, and rape. The lasting effects of childhood trauma, such as sexual abuse or severe burns, on personality formation, the nature of memories of early trauma, and the development of defenses related to amnesia and dissociation are all considered. The book also takes up trauma and adult dreams, including Vietnam veterans and Post-Traumatic Stress Disorder, Holocaust survivors and perpetrators, rape victims, and firestorm survivors. Finally, this volume concludes with a look at the potential "traumas of normal life," such as divorce, bereavement, and life-threatening illness, and the role of dreams in working through normal grief and loss.

Taken together, these diverse perspectives illuminate the universal and the particular effects of traumatic experience. For physicians and clinicians, determining the etiology of nightmares offers valuable diagnostic and therapeutic insights for individual treatment. This book provides a way of juxtaposing the research in the separate fields of trauma and dreams, and learning from their discoveries.

Torture is banned because it is cruel and inhumane. But as Shane O’Mara writes in this account of the human brain under stress, another reason torture should never be condoned is because it does not work the way torturers assume it does.

In countless films and TV shows such as Homeland and 24, torture is portrayed as a harsh necessity. If cruelty can extract secrets that will save lives, so be it. CIA officers and others conducted torture using precisely this justification. But does torture accomplish what its defenders say it does? For ethical reasons, there are no scientific studies of torture. But neuroscientists know a lot about how the brain reacts to fear, extreme temperatures, starvation, thirst, sleep deprivation, and immersion in freezing water, all tools of the torturer’s trade. These stressors create problems for memory, mood, and thinking, and sufferers predictably produce information that is deeply unreliable—and, for intelligence purposes, even counterproductive. As O’Mara guides us through the neuroscience of suffering, he reveals the brain to be much more complex than the brute calculations of torturers have allowed, and he points the way to a humane approach to interrogation, founded in the science of brain and behavior.

Torture may be effective in forcing confessions, as in Stalin’s Russia. But if we want information that we can depend on to save lives, O’Mara writes, our model should be Napoleon: “It has always been recognized that this way of interrogating men, by putting them to torture, produces nothing worthwhile.”