Of Two Minds: An Anthropologist Looks at American Psychiatry

by T.M. Luhrmann

Book Overview

With sharp and soulful insight, T. M. Luhrmann examines the world of psychiatry, a profession which today is facing some of its greatest challenges from within and without, as it continues to offer hope to many. At a time when mood-altering drugs have revolutionized the treatment of the mentally ill and HMO's are forcing caregivers to take the pharmacological route over the talking cure, Luhrmann places us at the heart of the matter and allows us...

• Format: Paperback
• Language: English
• ISBN: 0679744932
• ISBN13: 9780679744931
• Release Date: August 2001
• Publisher: Vintage
• Length: 352 Pages
• Weight: 0.66 lbs.
• Dimensions: 0.8" x 5.2" x 8.0"

Customer Reviews

An Intellectual's Journey Through the Field of Psychiatry

This is a book by an intellectual written for other intellectuals. It weaves its way into the two great divides in the field of psychiatry today, and addresses many of the problems inherent in both views. During the next century, many of the questions the book brings to mind will hopefully be answered. My greatest disappointment with the book is the lack of mention of some of the key players in the basic scientific revolution of psychiatry. None of the future Nobel prize winners in neuroscience were mentioned, nor a future winner of the National Medal of Science (given for her work in psychiatry).The influence on psychiatric researchers of the National Alliance for Research on Schizophrenia and Depression was not discussed either.Other than these omissions the book is an excellent read by someone not directly in the field. I would highly recommend it for any public or private library.

History and Critique of the state of Modern Psychiatry

This is a terrific history and critique of the state of modern psychiatry.The author writes with clarity, precision and enthusiasm about her topic. It is an insightful look at the crisis of "brain-as-mind" thinking, and the idea that the "whole" is greater the sum of its percieved parts. Luhmann is about as even handed as a writer can hope to be, but ultimately seems to conclude that the whole person approach to psychiatry is probably best for the individual and the larger culture. The book works equally well as a piece of cultural criticism depicting the competing points of view among the schools of psychiatry as a thought provoking paradigm used to portray "kinds of mind" and the ways we think about ourselves and each other. There are, to be sure, many more than TWO MINDS, but there does seem to be Two Dominat Camps. One that thinks we are little more than a collection of our symptoms and one that thinks we are much more imaginative and capable than the limitations of our physical selves. Great piece of social history!

Thoughtful and thought-provoking

Am I my mind? Am I my illness? In a fascinating new book, T.M. Luhrmann makes a clear, concise argument that we cannot look upon the diseases of the mind in the same way that we look upon diseases of the body. This view is too simplistic, and allows healthcare companies to undertreat mental illness by paying for medication treatment, but discouraging talk therapy.Luhrmann used her experience as an anthropologist and four years of field work to observe first-hand the training of mental health professionals. This part of the book is of interest to any patient who is affected by how their doctor's attitude toward patients was developed.Lurhmann observes the situation and treatment of the mentally ill with a clear vision. The concerns she raises about the emphasis of the biomedical (chemical) model of mental illness over the psychodynamic (talk therapy) model are on target and worth serious consideration.

Highly recommended reading.

Of 2 Minds focuses on American psychiatry observes training programs, how psychiatrists are successful, and how the many ambiguities in the field affect patients. How do psychiatrists learn their profession, and how do they treat their patients? Of 2 Minds outlines the activities and controversies of the profession and provides lay readers with the latest details on psychiatry.

Freud, Prozac, and managed care

This most recent book by T. M. Luhrmann distills the results of four years' observation, interviewing and experiencing the theory and practice of American psychiatry, in venues ranging from one of the last private psychoanalytic residential centers to neuroscience labs, psychiatric conferences, and elite biomedically oriented hospitals. Her previous books dealt with how people make sense of their worlds: Persuasions of the Witch's Craft showed how witches in modern England come to believe in astrology and magic; and _The Good Parsi_ examined the Parsis' reaction to their fall from grace as India's colonial elite. Now she turns her attentions to some of the great existential questions of modern society: what is mental health? how can we intervene in people's lives when we only have imperfect knowledge? and what does it mean to be a person?Luhrmann began by following the training process of a group of new psychiatric residents, to see how medical students become psychiatrists, and how they negotiate between the two, often antagonistic, models of psychiatry: biomedical and psychodynamic. The book contains great descriptions of patients and residents, of the quirks of different kinds of programs, and of how neither the psychoanalysts nor the biomedical specialists really believe in most of the DSM categories per se, but use them empirically and pragmatically as a means to treating the problems they represent. Luhrmann is sympathetic to the position of psychiatrists, but fair. She makes the point quite strongly that both biomedicine and analysis have their down sides, that both have internal theoretical and practical problems, but that they're addressing an absolutely real need. The dichotomy between the two, according to Luhrmann, is a false one which grew out of historical differences (namely the near-monopoly of psychoanalysis in the 1950s and 1960s) and which has been prevented from a reconciliation by the perceptions and policies of managed care, probably to the detriment of both patients and of the financial bottom line.The book is extremely readable, which is welcome in the field of medical writing, which is often either thinly disguised politics or thickly layered jargon. Luhrmann manages to range from William Styron's autobiography to budget cuts in a state psychiatric clinic to debates between Hume and Kant over the nature of personhood without once losing her readers. She also has written a book which would be almost impossible for one of the insiders to write, because most psychiatric professionals are thoroughly socialized into the assumptions and habits of medicine long before they come to psychiatry. And so she does what a good anthropologist is supposed to do -- to give us a new perspective on our own lives. I highly recommend this book to anyone interested in American psychiatry, the effects of managed care, or the profound challenges posed by the paradoxes of mental illness.