Britain on the Couch and Staying Sane both proceed from the same starting point: as James's subtitle puts it, "Why we're unhappier than we were in the 1950s, despite being richer." Both blame "advanced capitalism" which, through drugs and other over-the-counter solaces, makes a profit on the ills it creates. Both call for government regulation of the therapy trade. As James points out, the state has hitherto refused, and "the result is an unregulated mishmash in which anybody can set up as a therapist." Persaud's indictment is more intemperate. He would remove therapy from the NHS, and keep it as a game for the rich. Tell that to the Dunblane survivors.
Reading Persaud's book, I kept having to remind myself that this is a man who, by virtue of his post at the Maudsley, wields considerable power in his corner of the NHS. His approach to illness seems more like that of a quack doctor. Feeling a touch depressed, or a shade paranoid? Follow my instructions, and you'll be right as rain.
After joining him in a perfunctory tour of psychological remedies, we are invited to fill in quizzes with titles like "Are you too nervous?" or "Are you a worrier?" Then, after a quick self-diagnosis, we are given a series of commands which include: "be productive at meaningful work", "develop an outgoing, social personality", plus other breezy injunctions. No problem: it's just a matter of applying the mind.
Oliver James, too, has an idea to sell but - though he beats us over the head with it - it's worth taking seriously. Depression, aggression and compulsion-disorder have been scientifically shown to correlate with low levels of a brain chemical called serotonin: there is literally a chemistry of despair. James charts the rise of "low-serotonin problems", and finds the cause in an interlocking series of dysfunctions: in schools, in relationships and at work. Moreover, by raising expectations, television induces chronic disappointment.
These are old ideas: what's new is the spin James puts on them, and the weight of research he considers. If James's political remedies are unrealistic, his medical ones are cogently argued. He advocates the use of pills like Prozac - which restore scrotonin levels without zombiedom - but in tandem with therapy. His survey of the hierarchy of therapies, from short-term counselling to full-blown psychoanalysis, is brilliantly clear. In one page, he offers more practical advice to those in trouble than Persaud does in the whole of his supposedly helpful primer.
We suffer, says James, from "pharmacological puritanism". We refuse to recognise the benign potential of drugs, and the most prescribed ones are not the best. This argument may be contentious - vast fortunes ride on its outcome - but it's one of many new thoughts I was left with on closing this uneven but fascinating book.Reuse content