November 1, 2022
A renowned psychiatrist explains the process and history of a debilitating, pervasive mental illness. Lieberman, a psychiatrist who has specialized in this field for 40 years and the author of Shrinks: The Untold Story of Psychiatry, argues persuasively that the public understanding of schizophrenia is limited. Affecting 3.3 million people in the U.S. and 78 million worldwide, it has little to do with split personalities, but it manifests with a range of psychotic behaviors and delusions. "Schizophrenia doesn't discriminate," writes the author. "It can strike the Ivy League-bound high school valedictorian as much as it can the impoverished kid from a broken home. Gender, race, ethnicity, affluence, education--none of these provides immunity." Tracking the history, Lieberman notes that ancient texts mention it, and for centuries, it was associated with demonic possession. Even after it was identified as an illness, effective treatment remained elusive. Eventually, researchers shifted their focus to chemical imbalances. The first therapeutic drug was chlorpromazine (thorazine), which led to a generation of antipsychotics. It also pointed the way to understanding that schizophrenia is tied to a malfunction of dopamine neurotransmission in the brain--although there is also a genetic element that makes some people vulnerable. Unfortunately, as the author shows, research was hampered by the emergence of syndromes that were not actually schizophrenia but looked much like it. The science has come a long way, however, and schizophrenia is now treatable--but it must be identified and addressed as early as possible. Schizophrenia is progressive, and once it reaches a certain stage, permanent brain damage is almost inevitable. Lieberman provides a list of symptoms to watch for, and a program that he has developed has had a good success rate. As he did in Shrinks, the author presents an informative, authoritative package. A compelling and engaging story that shines much-needed light into a dark corner of modern society.
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Starred review from December 5, 2022
Psychiatrist Lieberman (Shrinks) delivers an exceptional and wide-ranging study on schizophrenia’s history and treatments. He highlights how understanding of the condition has changed and notes that stigma has surrounded the illness since the Middle Ages, when it was seen as punishment for faithlessness. Treatments were often barbaric, he relates, explaining how patients were subjected to exorcisms, lobotomies, and a procedure that injected malaria-infested blood directly into the skull to provoke fever and reduce psychoses as recently as the 20th century. Today, antipsychotics and therapy are standard treatments, and advances in neuroscience have indicated that schizophrenia’s causes involve genetic predisposition and elevated levels of the neurotransmitters glutamate and dopamine. The history is first-rate, and Lieberman’s empathetic accounts of his patients’ stories drive home the toll the illness takes on patients, as when he remorsefully recalls his decision to end treatment for a 17-year-old girl whose symptoms resisted standard clinical analysis or reflects on the failures of psychiatric guidelines that inhibited the author from educating a young patient on the irreparable damage that would be done by going off of his medication. The result is a brilliant examination of a long-misunderstood disorder. Agent: Gail Ross, Ross Yoon Agency.
January 13, 2023
Lieberman (Shrinks: The Untold Story of Psychiatry), whose research led to the therapeutic strategy for the early detection and prevention of schizophrenia, describes moving to New York in 1975, when news outlets were covering the story of serial killer "Son of Sam," who eventually received a diagnosis of paranoid schizophrenia. Divided into four parts, this brilliant book describes the treatment of schizophrenia in the 18th and 19th centuries with the asylum movement and development of the first mental healthcare reformers. There's also a section that shows the birth of psychiatry, the rise of schizophrenia as a specialization, the development of psychoanalysis to discover the roots of mental illness in the brain, and the advances of science in understanding the brain itself. The author also spotlights today's methods of diagnosis and treatments for schizophrenia. Currently, anti-psychotic drugs can be used to control the psychotic manifestations that occur with this condition, such as hallucinations, delusions, and scrambled thoughts. Lieberman concludes that schizophrenia can be managed or treated through medication and therapy. VERDICT This book will likely be of interest to those in the medical profession and scholars. It belongs in social and behavioral sciences collections.--Claude Ury
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