MIND FIXERS

A thorough and well-researched account of the ongoing attempts to find biological bases for mental illness.

In a surprisingly suspenseful narrative, Harrington (History of Science/Harvard Univ.; The Cure Within: A History of Mind-Body Medicine, 2008, etc.) traces the conflict between those who believed it would be possible to find biological causes and cures for mental illness and those who suspected that the current scientific tools were too crude to do so and that such illness could only be treated with a series of dialogues between patient and physician. In the late 19th and early 20th centuries, the author suggests, the biologists had a few victories, such as making the connection between the physical effects of syphilis and its effect on the mind, but they focused primarily on unproductive autopsies of the brains of patients. Meanwhile, the newly popular Freudians won the approval of patients with less severe mental illnesses as well as those attempting to ameliorate their symptoms. Later in the 20th century, as new drugs and techniques such as electroconvulsive therapy were discovered and heavily marketed, the balance swung temporarily toward the biologists—at least until it became clear that these drugs and techniques didn't produce the miracles their proponents initially claimed. After considering this struggle as a whole, Harrington moves on to examining it in the context of several specific forms of mental illness, including schizophrenia, depression, and manic depression. Beneath the author’s firm, stately prose, which never becomes alarmist or provocative, lies a bleak assessment of the mental health profession. Its practitioners come across as hampered by the current, insufficient state of understanding of how the mind functions and malfunctions as well as prompted by jealousy, fear, greed, and a desire to one-up those they see as their competitors. Can psychiatry, Harrington asks, “acknowledge and firmly turn away from its ethical lapses—and especially the willingness of so many of its practitioners in recent decades to follow the money instead of the suffering?”

A measured, insightful survey of the limits of contemporary treatment for mental illness.