The end of the 20th century saw powerful indictments of the way we treat people with mental-health problems, not from those in the psychiatric profession but from those on the receiving end. Psychiatry's increasing reliance on pharmaceuticals was coming under attack, and a more caring, less drug-dependent way was being advocated by the newer strand of mental-health specialists: clinical psychologists.
One of the many fascinating things that Richard P Bentall's excellent book flags up is the lack of progress we seem to have made in the past 200 years. Ironically, knowing far more about how the brain works than, say, the 18th-century's William Cullen, or even Freud, seems barely to have improved our ability to treat mental problems. If anything, neuroscience, in emphasising the brain's failures, has advocated a more simplistic approach: a chemical imbalance in the brain? Here, pop a pill. We may no longer chain "mad" people to walls or apply leeches to their skin, but the moment in the early 19th century when more holistic methods were advocated was quickly eclipsed when the emerging study of psychiatry sought to establish itself as a science, and did so by becoming as authoritative as possible.
Many of us may not know about the opposition between psychiatry and clinical psychology, but, given that mental illness is apparently on the increase – "the lifetime risk of suffering from any kind of psychotic disorder may be as high as 3 per cent, [which] means as many as 1.8 million British citizens" – we had perhaps better start becoming educated about them. Bentall, a professor of clinical psychology himself, can hardly be the most disinterested commentator on these arguments, but he has produced a lucid and accessible account of a tricky but endlessly absorbing subject.Reuse content