Of two minds: The growing disorder in American psychiatry (2000) by T. M. Luhrmann

The book in question – Of two minds (2000) – is by the anthropologist T. M. Luhrmann.

Anthropology offers a particular frame of reference for viewing the world. There’s value, I believe, in looking at things from a variety of frames of reference.

By the early 1970s, the community mental health movement was characterized as a “visible failure”

T. M. Luhrmann remarks that what was known at the time as the “community mental health movement” was by the early 1970s being characterized as a “visible failure” (p. 222). She adds (p. 223):

“The money never materialized, but many of the hospitalized were released from hospitals despite the lack of local community care. This was called the ‘deinstitutionalization.’

“Because the infrastructure of community mental health care was never established, homelessness became the only option for many of the former patients. The profound chronicity of much mental illness became evident to the public, particularly in the next decade, when the real estate market skyrocketed and much formerly affordable housing was converted into more profitable investment.”

A sadly troubled history: The meanings of suicide in the modern age (2009)

The reference to deinstitutionalization brings to mind two passages from A sadly troubled history (2009). In the latter study, John C. Weaver remarks (p. 342) that “The management of others is offensive to liberal sensibilities.”

In his study devoted to the history of suicide in New Zealand and Queensland, Weaver also remarks (p. 341) regarding the history of public mental hospitals:

“In the 1940s, if not earlier, the public mental hospitals were no longer alone as places of treatments and training. As the refuge of the poor and the holding facility for difficult cases, the public mental hospitals persisted and expanded after World War II, until pharmacological developments completed a process of deinstitutionalization in the 1970s. The groundwork for that monumental shift  had been prepared with the growth of psychoanalysis after World War I, a rush toward physical treatments in of the late 1930s, and the expansion of barbiturates in the 1940s.”

Recession medicine

In Of two minds (2000), Luhrmann notes (p. 157) that “Psychiatric illness, like all medical problems but more so, is mired in the ugly realities of the American class structure. That is one reason psychiatric illness presents our society with moral choices.”

The comment is of relevance with regard to a May 15, 2012 Guardian article regarding “recession medicine.”

According to the article, based on a recently published study by David Stuckler and Sanjay Basu (The body economic 2013), poorer public health is not an inevitable consequence of economic downturns but amounts, instead, to a political choice.

A March 26, 2015 New York Times article is entitled: “Inside America’s Toughest Federal Prison: For years, conditions inside the United States’ only federal supermax facility were largely a mystery. But a landmark lawsuit is finally revealing the harsh world within.”

Shrinks (2015)

A March 26, 2015 New York Times article is entitled: “‘Shrinks,’ by Jeffrey A. Lieberman with Ogi Ogas.”

A blurb for Shrinks (2015) at the Toronto Public Library website notes:

“The fascinating story of psychiatry’s origins, demise, and redemption, by the former President of the American Psychiatric Association.

“Psychiatry has come a long way since the days of chaining ‘lunatics’ in cold cells and parading them as freakish marvels before a gaping public. But, as Jeffrey Lieberman, MD, reveals in his extraordinary and eye-opening book, the path to legitimacy for “the black sheep of medicine” has been anything but smooth.

“In Shrinks, Dr. Lieberman traces the field from its birth as a mystic pseudo-science through its adolescence as a cult of ‘shrinks’ to its late blooming maturity – beginning after World War II – as a science-driven profession that saves lives. With fascinating case studies and portraits of the luminaries of the field – from Sigmund Freud to Eric Kandel – Shrinks is a gripping and illuminating read, and an urgent call-to-arms to dispel the stigma of mental illnesses by treating them as diseases rather than unfortunate states of mind.”

 

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