Our Necessary Shadow: The Nature and Meaning of Psychiatry

Burns, professor of social psychiatry at Oxford and a practicing psychiatrist, looks at psychiatry and mental illness as a subjective phenomena, yet nonetheless “real” to its subjects and participants. By examining the shadow that psychiatry and psychotherapy cast on other aspects of culture, he reveals the practices to be historically contingent—part of, though frequently at odds with, other branches of medicine—as well as how they have come to define our concepts of personhood, daily life, our legal system, and our view of fate. The book begins as a history of the treatment of mental illness, from humors and asylums to the “discovery of the unconscious,” psychoanalysis and shell shock, and the early, grisly medical cures (insulin wards and malarial treatment of syphilis) of psychiatry. Burns puts forth no defense of psychiatry’s past sins, but is confident in the value of the newly open, evidence-based treatment of mental illness that typifies 21st-century care. While his early chapter on seeking psychological care seems misplaced, Burns’s focus on psychology’s operations in our larger culture is provocative, well-researched, and well-suited to interested lay readers looking for insight into medicine and the mind. Agent: Felicity Bryan (U.K.) (June)