Review by Booklist Review
American psychiatry has excelled throughout the nation's history, but doctors and drug manufacturers have profited far more than psychiatric patients. When the World Health Organization compared schizophrenics' recovery rates in the U.S. and in nations too poor to afford the latest psychopharmaceuticals, it found that a Third World patient was exponentially likelier than an American one to regain sanity. Whitaker's articulate dissection of "mad medicine" in the U.S. explains why that dismaying contrast obtains. Assuming that insanity arises from identifiable physical causes, American psychiatry theorized about those causes and sought to find physical therapies and, later, drugs that attacked those causes. Accordingly, from being shocked with cold water and repeatedly nearly drowned, to suffering chemically and electronically induced grand mal seizures, to having the frontal lobes of their brains chopped off, to being drugged into parkinsonism (the preferred modus nowadays), the mad in America have suffered as essentially nonconsensual experimental subjects. Since World War II, drug companies have made continued testing increasingly worthwhile, despite the lack of encouraging results. This horrifying history is all the more discomfiting because another mode of treatment was successfully used from the late eighteenth century until the 1870s. Called moral treatment by its Quaker champions, it involved treating the mad with kindness and sympathetic companionship rather than drugs and machines. But it cost too much, and it wasn't professional. --Ray Olson
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
Tooth removal. Bloodletting. Spinning. Ice-water baths. Electroshock therapy. These are only a few of the horrifying treatments for mental illness readers encounter in this accessible history of Western attitudes toward insanity. Whitaker, a medical writer and Pulitzer Prize finalist, argues that mental asylums in the U.S. have been run largely as "places of confinement facilities that served to segregate the misfits from society rather than as hospitals that provided medical care." His evidence is at times frightening, especially when he compares U.S. physicians' treatments of the mentally ill to medical experiments and sterilizations in Nazi Germany. Eugenicist attitudes, Whitaker argues, profoundly shaped American medicine in the first half of the 20th century, resulting in forced sterilization and other cruel treatments. Between 1907 and 1927, roughly 8,000 eugenic sterilizations were performed, while 10,000 mentally ill Americans were lobotomized in the years 1950 and 1951 alone. As late as 1933, there were no states in which insane people could legally get married. Though it covers some of the same territory as Sander Gilman's Seeing the Insane and Elaine Showalter's The Female Malady, Whitaker's richer, more detailed book will appeal to those interested in medical history, as well as anyone fascinated by Western culture's obsessive need to define and subdue the mentally ill. Agent, Kevin Lang. (Feb.) (c) Copyright PWxyz, LLC. All rights reserved
(c) Copyright PWxyz, LLC. All rights reserved
Review by Kirkus Book Review
An absorbing, sometimes harrowing history of the medical treatment of the mentally ill in the US, from its roots in England-think Bedlam-to the present, and a scorching indictment of the status quo. Whitaker, a science reporter for the Boston Globe, does a bang-up job of showing how treatment of the mad has reflected society's changing political views and philosophical values. He recounts how the 18th-century European view that the mentally ill were beasts to be subdued and tamed led to fearfully harsh treatment, whereas in the early 19th century, the Quaker perspective that the mentally ill were fellow human beings deserving of empathy, resulted in humane therapy emphasizing gentle kindness and the comforts of a good home. In the 20th century, the eugenics movement in the US, which saw the mentally ill as hereditary defectives without rights, led to brain-damaging therapies-insulin coma, metrazol-induced seizure, electroshock, and prefrontal lobotomy-that were applied without the consent of patients and robbed them of the part of the mind that made them human. In the 1950s, chlorpromazine was introduced as a chemical lobotomy, useful for making disruptive patients sluggish and manageable. However, Whitaker points out, under the influence of pharmaceutical-industry marketing efforts, it and other neuroleptics came to be seen as safe and effective antischizophrenic drugs, a view that not only benefited drug companies financially but gave psychiatry the status of a scientific discipline and provided states a rationale for discharging medicated patients from overcrowded public mental hospitals. Whitaker argues that far from being effective, neuroleptics induce pathological conditions by causing irreversible brain damage. He cites World Health Organization studies showing that in countries where doctors do not keep their schizophrenic patients on neuroleptics-India, Niger, Colombia-recovery rates are dramatically higher than in the US. And according to the author, the hubris of the American medical community makes change unlikely. Sure packs a wallop. Author tour; radio satellite tour
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