A History of Psychiatry: From the Era of the Asylum to the Age of Prozac

Shorter cites recent research indicating that adult-onset schizophrenia is genetically influenced and often traceable to uterine trauma or difficult birth. In his view, brain biology and genetics underlie much mental illness, and biological psychiatry-combining drugs with psychotherapy-has replaced Freudian psychoanalysis as the dominant paradigm for explaining and treating a host of disorders. In this richly informative, iconoclastic, sure-to-be-controversial chronicle, Shorter, professor of the history of medicine at the University of Toronto, argues that Freud, by turning psychoanalysis into a movement instead of a method of objective inquiry, fostered a stifling orthodoxy, therapists' arrogance toward patients and scientific stagnation. He defends electroshock as a valuable tool in the treatment of depression; identifies German physician Emil Kraepelin, systematizer of diagnoses-rather than Freud-as the central figure in the history of psychiatry; and dismisses as unhistorical nonsense Michel Foucault's theory that psychiatry arose in a collusion between capitalism and the state as a means to control deviant individuals. While this study won't end the nature-versus-nurture debate, it mounts a formidable challenge to strict adherents of the talking therapies. Photos. (Jan.)