Item description for Humanizing Madness: Psychiatry and the Cognitive Neurosciences by Niall McLaren M.D....
An application of the philosophy of science to psychiatry
Although it's been 140 years since Maudley's groundbreaking treatise, modern psychiatry is in a state of intellectual collapse. No psychiatrist practicing today can point to a universally agreed model of mental disorder which explains the common observations of mental disorder, dictates a research program and ordains a form of management.
This book, the result of thirty years research in the philosophy of science, takes each of the major theories in psychiatry and demonstrates conclusively that it is so flawed as to be beyond salvation. It goes further, in that the author outlines a model of mental function which both satisfies the essential requirements of any scientific model, and shows how the phenomena of mental disorder can be described in a parsimonious dualist model which leads directly to a humanist form of management of the most widespread form of disability in the world today.
"This book is a tour de force. It demonstrates a tremendous amount of erudition, intelligence and application in the writer. It advances an interesting and plausible mechanism for many forms of human distress. It is an important work that deserves to take its place among the classics in books about psychiatry." -Robert Rich, PhD, AnxietyAndDepression-Help.com
About the Author
Niall McLaren has been an M.D. and practicing psychiatrist since 1977. Since then, he has undertaken a far-reaching research program, some of which has previously been published. For six years, while working in the Kimberley Region of Western Australia, he was the world's most isolated psychiatrist. He is married with two children and lives in a tropical house hidden in the bush near Darwin, Australia.
From Future Psychiatry Press www.FuturePsychiatry.com an imprint of Loving Healing Press
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Est. Packaging Dimensions: Length: 9.92" Width: 7.24" Height: 0.87" Weight: 1.06 lbs.
Release Date Sep 6, 2007
Publisher Future Psychiatry Press
ISBN 1932690395 ISBN13 9781932690392
Reviews - What do customers think about Humanizing Madness: Psychiatry and the Cognitive Neurosciences?
very well written, but has some weaknesses ... Jun 20, 2008
I bought this book to read McLaren's views on the mind-body problem and to better understand the supposed flaws in the biopsychosocial model. While in general it is very well written and he has obviously put acknowledgeable effort into it, I believe that some of the content falls short in important areas. McLaren previously wrote a paper titled "Interactive dualism as a partial solution to the mind-brain problem for psychiatry" (N McLaren, Medical Hypotheses 2006:66:1165-1173), and the phrase "partial solution" is an accurate description of this book as well, as it is a partially successful attempt at reintroducing the mind back into mental illness but not a complete foundation for the entire "future of psychiatry".
McLaren does a good job at highlighting the major historical and current problems facing psychiatry and philosophy of mind, with concise descriptions of the essential issues. He delivers several major blows to the perceived intellectual status of the psychiatric profession; that is, a lack of underlying scientific theory of mind and therefore also for mental illness. He also raises other interesting and important points along the way (such as; over-biologising by psychiatrists of aberrant mental function, and problems with eclecticism in psychiatry). McLaren attacks the biopsychosocial model used in psychiatry, by exposing it's foundation and questioning it's scientific status (rather than by denying the role of psychological and social factors in mental illness). I had previously wondered what guides researchers and academics on the specific relevance of, or interaction between, each aspect to the biopsychosocial paradigm; now I suspect that there is little or none that isn't arbitrated by individual preference. McLaren outlines the importance of understanding automated processing of information in the brain, and then proposes a form of properties dualism. I'm not convinced that properties dualism will be the ultimate solution to the mind-body problem, but it suits the mentalistic view of psychiatry that McLaren endorses, and he presents a decent starting proposal that should interest some academic psychiatrists.
However, I think the application of this proposal needs more work. McLaren clearly dislikes biological psychiatry and (understandably) attempts to put the "mind" back into psychiatric illness; but although I'm not necessarily a biological reductionist, I think he over-stretches the mark. His account of psychiatric illness is too clean cut; he essentially attributes all mental illness to psychological causes, except perhaps in the case of brain disease, but even then its implied to be a psychological response to the limitations imposed by the brain disease. In general, it seems that he has taken a plausible contributing factor in each mental illness but inflated it to be the only main relevant factor in that illness. McLaren assumes that nearly all major psychiatric conditions are caused solely by an interaction between 3 themes: (i) abnormal personality factors or beliefs, (ii) chronic anxiety, and (iii) lack of insight on behalf of the patient. Although he presents a good understanding and plausible suggestions, he applies them too universally and in some cases too simplistically, which is probably the outcome of his interpretation of properties dualism. Here are some examples:
(a) He skilfully rips apart the current classification system of personality disorders employed in the DSM and explains personality as a set of psychologically acquired rules; this is a reasonable position, but there is a lack of discussion of the biological factors or variations between individuals which could influence their acquirement of rules. While he briefly mentions genetics and personality, he simply concludes that such discussion can't proceed without a more coherent definition of personality than what is currently used in research; this may be a valid point, but then the issue is essentially ignored rather than compensated for. I perceived a sort of hidden assumption that as long as there is no brain disease, everyone's "wetware" is potentially functionally identical.
(b) When describing anxiety-driven hypochondriac states, McLaren casually lumps in illnesses such as "benign meningoencephalomyelitis" (which I assume is benign myalgic encephalomyelitis) and chronic fatigue syndrome; however, anxiety isn't a defining characteristic or diagnostic criterion of these illnesses, and the research fails to demonstrate anxiety disorders in the majority of these patients; he is either unaware of this, or perhaps believes that the patients are denying their anxiety or they lack the insight to realise they are simply just anxious and/or depressed. It would also be problematic to associate post-exertional symptoms to phobias or the Yerkes-Dodson curve for similar reasons. Losing yet another supposed "psychosomatic" illness to other fields of medicine will only further reduce psychiatry's historically poor credibility in this area.
(c) When describing depression, McLaren starts off with a decent description but then rejects the notion of depression as a negative mood and simply attributes the state of depression to an acquired anhedonia. His explanation of depression (anhedonia caused by a loss of interest in life, sustained by personality factors and chronic anxiety) is too restrictive, mostly on grounds that depression and anhedonia aren't the same state and can occur without the other, and also on grounds that pleasure and interest aren't synonymous either (liking and wanting aren't the same). Furthermore, while he has a point that the relevance of anxiety is (potentially) being underestimated in depression, he is probably overestimating it by essentially blaming all depression on anxiety. This isn't to say all these aspects aren't interactive, or that McLaren's suggestion should be dismissed; but I don't think this is the best explanation of depression, the only mode of anhedonia, or the only theme in which depression can arise.
(d) McLaren's account of compulsion/addiction and drug withdrawal bizarrely implies that it is *purely* a self-fulfilling belief-based reverse placebo effect. Obviously the fear of withdrawal plays some role, but again, this is seemingly presented as the only relevant factor. Furthermore, when considering that the placebo effect itself may involve the brains opioid system, using saline injections to trick an opiate addicted patient into temporarily believing they've scored isn't conclusive evidence that withdrawal itself is simply a phobia.
Reading this book actually weakened my previous support for properties dualism and strengthened my support for John Searle's arguments against it, because in my opinion McLaren's practical application doesn't completely account for the "grey-area" within the mind-body problem and can lead to over-simplifications. I'm not saying the position, that the mind is an informational system dependent on but distinct from the brain, is unreasonable; on the contrary, it indeed deserves further consideration. The above criticism isn't meant to derail the overall merit of this book as a highly recommended read.
Groundbreaking Book on Psychiatry's Future! Jun 17, 2008
"Humanizing Madness" is an intriguing and insightful book into the nature of psychiatry, although it may not be aptly titled. The book does discuss psychiatry and the cognitive neurosciences, but more specifically its purpose is to discuss what is currently wrong with the major theories in psychiatry and to suggest a theory that will provide a future path for psychiatry to follow. This book may not be for the beginner in psychiatry, but students of psychiatry will find it a valuable alternative view on what they may otherwise be taught in university programs without questioning many of psychiatry's outdated and as McLaren expresses, ineffective and flawed theories which tend to disagree with each other anyway.
McLaren divides "Humanizing Madness" into three sections, the first giving an overview of psychiatry, its history and theories. Then he demonstrates what theories can be used to create a focused future path for psychiatry, and finally, he discusses mental disorders, such as anxiety, depression, and anorexia and how changes need to be made in their definitions and understanding to bring about more effective diagnoses.
Among the theories McLaren shows as severely flawed are behaviorist models, psychoanalysis, and eclectic models of psychiatry. Most importantly, McLaren states that no real foundational theory exists for psychiatry. While definitions of mental disorder exist, no real definition of mental order or normality has been determined. Until it is determined what a normal mental state is, psychiatry cannot accurately determine what is a mental disorder.
To determine what is the suitable definition of mental disorder and normality, the field must be narrowed down to being based on specific tenets. McLaren makes clear that psychiatry must focus on being rational, understanding that human behavior is not random, and that any theory of the mind must be able to account for mental disorder. He rejects simple ideas that mental disorders result from chemical imbalances, although he spends considerable time arguing that the mind can affect the body. (Whatever the mind is, the definition for which he also debates).
In the end, McLaren's thesis is that "human behavior is the outcome of a complex interaction between an emergent mind and the physical body." While psychiatry has focused on depression as the most popular mental disorder, McLaren believes the focus should be on anxiety, which is the result of the "fight or flight" instinct in most creatures; traumatic events that cause anxiety can lead to depression, so consequently anxiety deserves to be studied as a source of depression. McLaren emphasizes that the human mind does affect the human body, as in cases of mass hysteria, anxiety, and fear that create panic attacks.
Ultimately, McLaren says that any theory of the mind has to provide a rational explanation of mental disorder. He boldly speaks his mind throughout the book, backing up his points with multiple examples, and he is not afraid to cry "Humbug!" when necessary. McLaren has been practicing psychiatry since 1977 in Australia. His discussion of his own education and the shortcomings of the education system he went through as well as weaknesses in current psychiatric practices demonstrate that psychiatry has many more steps to take before it is a completely effective science. I believe "Humanizing Madness" may well lead to a new understanding of mental illness in future years as younger psychiatrists read his book and follow his example in rejecting the ineffective theories he derides.
For more information about Niall McLaren and "Humanizing Madness," readers may visit www.LovingHealing.com. While this book is academic and not light reading, anyone interested in the mind will benefit from reading "Humanizing Madness," and students of psychiatry will find it invaluable.
Tyler R. Tichelaar, Ph.D., author of The Marquette Trilogy
Fun, Thought-Provoking Prod at the Most Common Swallowed and Digestive Schools of Thought Dec 4, 2007
After recently completing quite a few psychology classes, only one thing remains a common thread across each: it seems no psychologist agrees with another. There are so many schools of thought and barely any common themes. Dr. McLaren outlines in this 30-year-research-result the flaws in some of the most popular and well accepted schools of thought and practice. Even though I do not sport an M.D. after my name, I understood and thoroughly enjoyed this frank and prod at what many professionals blindly accept as fact. Using the scientific model to grind down the frivolities of many schools of psychology, Dr. McLaren gets to the "nitty gritty" of modern psychology. The scientific model helps us understand some of the most common mental disabilities today without writing them off to Freudian fantasies. Dualism is an enlightening concept and to me, strikes as the most practical and rational approach one can have to a situation. Mind over matter sounds so cliché, but the relationship between mind and matter is a road to explore for most mental handicaps, not just an adage.
I'm Human Too Nov 25, 2007
This is an academic book about psychiatric methods. As a psychology graduate as well as a user of the various services, I find this a fascinating subject. It's not for a beginner, but for someone who has some experience of the mental health services, it's interesting and thought-provoking. I love the idea of Future Psychiatry anyway, we need to get over the stigma attached to mental health and see it on the same level as physical health issues. It's not a new theory, but more of an overview of what has gone before and where the future direction of psychiatry should lead.
Groundbreaking work Nov 18, 2007
In this book Niall McLaren sets out to explain what a scientific theory of psychiatry should look like. As a young student of psychiatry he began to wonder why there we so many different theories but no definite truths. He decided to start searching for the truth and after nearly thirty years of effort the first outline of that search is presented in this groundbreaking book.
Niall McLaren will talk about each current theory in psychiatry and show the they are all no good. These include the psychodynamic (using psychoanalysis as the model), the cognitive, behaviorism, biological psychiatry, dualism and the eclectic approach. He will show that they are all flawed beyond repair.
After showing that all current theories have serious problems, McLaren presents a completely new theory for psychiatry and shows how it can be applied to understanding human mental disorder.
Niall McLaren writes in clear and understandable way about the various theories. You don't need to be an expert in this field to understand and appreciate this book. Reading the book has been an eye opening experience for me. I had to keep reading until I reached the end to see what the new theory was all about. I cannot recommend this book enough.