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Tanya Luhrman, Of Two Minds
Tanya Luhrmann is my favorite anthropologist (not that I've got many anthropologists). Her writing is like a good novel: it puts me in people's shoes that I'd never imagined before. This book of hers is about psychiatric training and practice, focusing on the split between "talk" and "pill". It is both a rich description (based on years of interviewing and immersion) and a polemic. Luhrmann believes that the displacement of therapy by pharmaceuticals -- in reaction to the delusory arrogance psychoanalysis had twenty years ago, and under the pressure of managed care -- is bad for the profession and bad for the patient, and that it risks losing beyond recall an entire way of thinking.
A few bits: How it is that politically liberal graduates who go into Lawrence Livermore Labs evolve into ardent weapons scientists. What it is like to be in a psychiatric residency program, where "If you do not talk about your feelings and their sources in one-on-one social interaction, you are substandard." How the process of becoming a psychiatrist -- the unlearning of social interaction instincts -- changes the way you relate to people. The different ways that traning in talk therapy and in drug therapy cause students to think about patients and their own interaction with patients: narratives versus classification. John Hood, a high-functioning schizophrenic who sits on the California Mental Health Planning Council, and his explanation of why he can't consider schizophrenia a disease, why he has to own it as part of himself.
Part of why I read books like this is that I feel I tend too often to assume that people are basically like me; it's easier to use myself as a model than to realize how alien someone else is. I was thinking about this off and on as I read, so it was amusing to run across this quote:
A few bits: How it is that politically liberal graduates who go into Lawrence Livermore Labs evolve into ardent weapons scientists. What it is like to be in a psychiatric residency program, where "If you do not talk about your feelings and their sources in one-on-one social interaction, you are substandard." How the process of becoming a psychiatrist -- the unlearning of social interaction instincts -- changes the way you relate to people. The different ways that traning in talk therapy and in drug therapy cause students to think about patients and their own interaction with patients: narratives versus classification. John Hood, a high-functioning schizophrenic who sits on the California Mental Health Planning Council, and his explanation of why he can't consider schizophrenia a disease, why he has to own it as part of himself.
Part of why I read books like this is that I feel I tend too often to assume that people are basically like me; it's easier to use myself as a model than to realize how alien someone else is. I was thinking about this off and on as I read, so it was amusing to run across this quote:
The more psychodynamic psychiatrists tended to assume that other people thought that psychiatric patients were strange and different. They were likely to tell me to tell people how similar we all were. [...] "This taught me," the psychodynamic director said, "that psychiatric illness is merely a powerful magnification of the emotional current in all of our lives."
By contrast, on this biomedical unit the staff were more likely to assume that other people thought the patients are like all of us and that the problem was that the public did not properly understand how different they were, that they were far more sick than most people imagined, and that this sickness was a terrible, terrible accident in their lives. [...] "No one conceives of the severity. You ought to write about that."