Desperate Remedies

Psychiatry’s Turbulent Quest to Cure Mental Illness

By: Andrew Scull

Narrated by: Jonathan Keeble

For more than two hundred years, disturbances of the mind—the sorts of things that were once called "madness"—have been studied and treated by the medical profession. Mental illness, some insist, is a disease like any other, whose origins can be identified and from which one can be cured. But is this true?

In this masterful account of America's quest to understand and treat everything from anxiety to psychosis, one of the most provocative thinkers writing about psychiatry today sheds light on its tumultuous past. Desperate Remedies brings together a galaxy of mind doctors working in and out of institutional settings.

Andrew Scull begins with the birth of the asylum in the reformist zeal of the 1830s and carries us through to the latest drug trials and genetic studies. He carefully reconstructs the rise and fall of state-run mental hospitals to explain why so many of the mentally ill are now on the street and why so many of those whose bodies were experimented on were women.

Carefully researched, Desperate Remedies is a definitive account of America's long battle with mental illness that challenges us to rethink our deepest assumptions about who we are and how we think and feel.

©2022 Andrew Scull (P)2022 Tantor

Fair if dismal history of psychiatry.

Scull has made a good career as a historian of psychiatry and this book seems to be his crowning achievement. Although the chapters are written to stand alone causing some repetition, his account rings true to my experience as a practicing psychiatrist.

Provocative evidence based.

Evidence based. I would have enjoyed seeing an epilogue that included a colloquy between defenders of the psychiatric faith and the author. Some point counter point! Excellent summary of the apparent situation. A book that prompts me to google for counter arguments to see if I can find holes in the thesis. But seemingly very strong. Well done!

Excellent

Every sentence in this hefty tome deserves a careful listen. The best history and current state of the discipline I’ve read.

A Chilling Reminder that Doctors are not Saints

This book is timely. I got here by way of Jonathan Haidt's recommendation in his book "The Righteous Mind". This book is a chilling reminder that "cures" are not always cures and doctors are not solely motivated by care for their patients. And that this is especially true when sickness is resistant to known cures. Reading this book, I was struck by the abuse we tacitly approved of people already suffering.

This book is a timely reminder with a backdrop of a certain virus that shall remain unnamed in this review so as not to upset our tech overlords. Fortunately, modern medicine is impervious to the character flaws of the previous generations of doctors and would never latch onto desperate remedies of their own.

Comment on Performance

Once in a while there is a different man narrating, It is almost like a second person went through and fixed some errors in the original recording, the first man couldn't fix the errors due to scheduling, and this new man tried do an impression of the original narrator. It is subtle but I had to stop a couple times and think if I had been hearing the voice wrong. Not a major issue. Good story and lots and lots to take in with all the facts and what not.

Responsible

Broad view without bias. Excellent narration. Accessible to the lay person. A must listen for anyone touched by mental illness which is basically everyone. If anyone in the street ever asked you for a handout...tag.

The continuing failure of psychiatry

A depressing but sobering read on the desperate remedies to treat maladies of the mind over the past 150 years in America. As of 2023, psychiatry is still in the medical dark ages. No one has a clue how to treat the severely mentally ill. The drugs currently in vogue, the talk therapy—none of it seems to work or the positive effects are paltry, and the drugs have profound side effects. If you don’t want the drugs, you can still get zapped with electroshocks to the brain, because no on one has come up with anything better. At least lobotomies have discontinued, though many in the psychiatry community once embraced them. For those burdened with severe mental disorders and their loved ones, it seems there’s little hope. Scull unfortunately doesn’t discuss LSD or magic mushroom therapy. Maybe AI could provide an answer. In the meantime, thanks to this book, I have a more clear-eyed view of the past and present state of mental health treatment. After reading it, you wonder why anyone would want to enter psychiatry as a profession. You might as well choose alchemy.

A Great History but I Have One Big Reservation

This book is enlightening and, for the most part, engaging. The author, a sociologist who specializes in the history of medicine and psychiatry, really seems to know his stuff. I have one quibble however, and it's a pretty big one. When he recounts the history of deinstitutionalization in the 1980s the author paints it as a purely social and political move. States emptied mental hospitals to save money, or because of the stigma the hospitals had acquired. While that may have been true of the first wave of deinstitutionalization beginning in the 1950s, by the 1970s mental illness advocacy groups had won a number of court victories in America that gave the mentally ill new legal rights including right to refuse their medication and to not be involuntarily committed unless they were found to be a danger to themselves or others. Whether one agrees or disagrees with them these and a few other court decisions forced the deinstitutionalization of the 1980s onto the states. How states treated their severely mentally ill was now almost entirely out of their hands.

Also, toward the end of the book, Dr. Scull gives a rough outline of how he feels America should deal with our mentally ill citizens. And, while I agree with just about everything he says here, much of what he prescribes would be impossible given the court cases that I mentioned above. Does he not realize this?

The fact that Dr. Scull doesn't include these court cases in this history, but chooses instead to paint the deinstitutionalization of the 1980s as simply the product of hard-hearted policies created by an uncaring society gives me pause. Does this historian of psychiatry not know about the rulings of the 1970s that radically transformed how America has cared for its severely mentally ill for the past half-century? That seems like an awfully large gap in his education. Or did the author intentionally leave them out because it didn't fit a narrative he was creating? I don't know. Either way, the fact that he misrepresented this era that I happen to know something about makes me wonder if he did the something similar with eras about which I know less.

So, overall, four stars. Would have been five except for the above issue.

Interesting

Mr Scull presents an excellent history of psychiatric treatments. It should remind us that jumping on the bandwagon for such unproven remedies for a transgender diagnosis without scientific backing is horrendous and wrong.
He seems a bit biased against drug companies, though their ethics is definitely questionable.

Insightful, highly detailed, and scathing analysis of the history of psychiatry

This book is a meticulously, detailed and thorough accounts of the origins of psychiatry and psychological analysis. It puts on full display, the sordid and tragic history of the profession whose reputation is marred by decades of unconscionable, immoral, and barbaric treatment practices that were and are still enacted by the desperate, egotistical, greedy, ideologically, and intellectually blind. This book is in essential read for anyone who is serious in their pursuit of understanding our current sociological predicament and who is looking desperately for remedies to address the ever expanding blight of mental illnesses across the world.