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Breakdown: Sex, Suicide and the Harvard Psychiatrist: Breakdown: Sex, Suicide and the Harvard Psychiatrist Paperback – May 1, 1995


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Product Details

  • Paperback: 368 pages
  • Publisher: Pocket; Reprint edition (May 1, 1995)
  • Language: English
  • ISBN-10: 0671796216
  • ISBN-13: 978-0671796211
  • Product Dimensions: 6.7 x 4.2 x 1.1 inches
  • Shipping Weight: 6.4 ounces
  • Average Customer Review: 3.5 out of 5 stars  See all reviews (6 customer reviews)
  • Amazon Best Sellers Rank: #2,610,920 in Books (See Top 100 in Books)

Editorial Reviews

Amazon.com Review

Paul Lozano was a beloved son of a Mexican American family in El Paso, Texas. In his first year at Harvard Medical School, he had a difficult time adjusting to the loneliness and the strange environment. He sought psychotherapy with Dr. Bean-Bayog, a member of the Harvard psychiatry faculty. She told him to think of himself as a 3-year-old, and gave him flash cards with messages such as "I'm your Mom--I'll always be your Mom." Paul regressed, and his mental functioning deteriorated. As their relationship grew more peculiar, Dr. Bean-Bayog apparently gave Paul more than 50 pages of her handwritten sadomasochistic sexual fantasies about the two of them. Then she stopped seeing him, because she was adopting a baby boy. Paul killed himself. It's a distressing, suspenseful story. As the New York Times writes, "Breakdown: Sex, Suicide, and the Harvard Psychiatrist, its lurid title notwithstanding, makes a serious attempt to arrive at the truth in this strange case." Author Eileen McNamara also uses the case as a springboard for discussing broader issues such as the need for professional standards and accountability in psychotherapy.

From Publishers Weekly

McNamara's disturbing and impressive investigation into the case of Harvard Medical School student Paul Lozano, who committed suicide in 1991, nine months after Harvard psychiatrist Margaret Bean-Bayog severed her ties to him, reaches conclusions diametrically opposed to those of the author's Boston Globe colleague Gary S. Chafetz in Obsession (reviewed above). McNamara charges that Bean-Bayog erred badly in using an untested role-playing therapy that cast her as the "mother" and Lozano as her "son." By passing along to her patient sexually explicit notes, letters, inscriptions in baby books and flash cards ("You can too feel like a three-year-old when you're twenty-five . . . You can breast feed and be cozy," wrote the psychiatrist on one card), Bean-Bayog, McNamara contends, reduced her patient to an infantile, dependent state. This "mothering technique" was also in conflict with Lozano's insistent sexual attraction toward Bean-Bayog, according to McNamara. She is highly skeptical of the portrayal by the former psychiatrist (Bean-Bayog has resigned her medical license) of Lozano's boyhood as one of mental torture, instability and possible sexual abuse by his mother.
Copyright 1994 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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Customer Reviews

3.5 out of 5 stars
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See all 6 customer reviews
If the subject matter appeals, I highly recommend this book.
Dan Bogaty
'The initial stuff was, I would say, critical to the point of being abusive, and I feel sorry if anybody gets that,' he said, in explaining his call.
Deanne R. Peterson
Dr. Bean-Bayog apparently didn't think in these terms (she certainly wasn't thinking when she wrote down her fantasies!)
mitt stampler

Most Helpful Customer Reviews

5 of 6 people found the following review helpful By A Customer on March 11, 2000
Format: Hardcover
Alarming story of how a noted psychiatrist (who was obviously very sick herself, read the notes she kept on the case) was able to turn her own demons lose on an already disturbed patient. The psychiatrist was obviously baby obsessed and serverly neurotic after nine miscarriages in four years. Her treatment of the patient reads like something from the journal of a madwoman, in my opinion. the only complaint i have (i took this book out of the library) is the pacing is way too slow, the author painstakingly goes over the patients childhood and his sister's conversations etc etc, and the final outcome is only dealt with in the last few chapters or so. i think the writer could have written a much more engrossing story if she had paced it better and gotten to the heart of the matter quicker, after all the doctors' notes are the basis of the treatment. anyway i think the story itself worked well, and i enjoyed reading it.
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2 of 2 people found the following review helpful By Sue on February 10, 2011
Format: Paperback Verified Purchase
This is an important book, not simply in its illustration of a respected doctor who seemingly became unmoored, but in some of her colleagues' hustling to spin the embarrassing news.

It is the tragic story of psychiatry gone-haywire, a depressed Mexican-American Harvard medical student, Paul Lozano, unfortunately drawn into an infantilizing, eroticized treatment at the hands Dr. Margaret Bean-Bayog in the late 80s and early 90s. Author Eileen McNamara carefully traces the tragic path toward Lozano's suicide and its highly publicized aftermath.

Many questions will never be answered: did patient and psychiatrist actually have sex? Could this depressed patient have been saved under more ethical, skilled care? Was the treatment the cure, or did it provoke the disease? There was large evidence of an out-of-control therapist who damaged her patient through a distorted and sexually-provocative Mom-Boy relationship and mutual over-dependence.

Beyond this specific case are the larger issues. Aspects of harmful therapy are offered at its source: a depiction of a doctor's rescue complex, her bunker mentality and her fantasy universe. This book also is a cautionary tale about the irresponsible side of mental health profession. For not only did this doctor rationalize her bizarre methodology and its mountains of artifacts, but many in her community rushed to defend her, hailing Bean-Bayog their victimized hero.

Therapists sometimes can be so strangled by their own theory that they're myopic to the common sense. Study the photo of Bean-Bayog in semi-recline, slipped hips low on her chair, tenderly holding Dr. Bean Bear teddy to her breast. Her "professional" defenders even have a rationalization for that one.
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5 of 7 people found the following review helpful By Dan Bogaty on April 7, 2010
Format: Paperback
A Boston psychiatrist in her 40's, Dr. Margaret Bean-Bayog begins treating Paul Lozano, an intelligent and driven but also mentally ill Harvard medical student who's in his early 20's. She decides that he displays all the symptoms of an abused child, though he has no memories of being abused, never told her was abused, and by all accounts (Except Dr. Bean's) was not abused. Bean then proceeds to subject this guy to four years of deranged therapy. She regresses him back to being a three year old during appointments which occur up to 5 times a week, and tells him she's his "Mom", and she'll keep him safe. She reads baby books to him (Goodnight Moon, etc.) and gives him stuffed toys. She refuses to meet with any of his family to the point that once when Paul's sister, Pilar, saw Bean in a hospital lobby and called out to her, Bean refused to acknowledge her and simply kept on walking. The Lozanos are presented as good people who are just sick about what's happening to their son and brother, but Bean tells Lozano that since his family is responsible for his condition, he should not contact them. However, Bean is not only his "Mom", she is also a sexual presence in his life, writing him EXTREMELY graphic letters, with highly sado-masochistic overtones, about her fantasized encounters with him. Fifty-five of those letters were found among Paul's possessons. And Bean openly masturbates during their sessions.
Paul Lozano, the patient knows she isn't really his Mom, but, due in large part to Bean's "therapy", he deteriorates to the point that he fades in and out between fantasy and reality and comes to "love" her, though what it actually is is just total dependence and sexual desire. There are basically no boundaries between Doc and patient. Dr.
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