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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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Editorial Reviews 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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Product Details

  • Paperback: 368 pages
  • Publisher: Pocket; Reprint edition (May 1, 1995)
  • Language: English
  • ISBN-10: 0671796216
  • ISBN-13: 978-0671796211
  • Product Dimensions: 1 x 4.2 x 7 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: #709,147 in Books (See Top 100 in Books)

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Customer Reviews

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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4 of 6 people found the following review helpful By mitt stampler on October 17, 2010
Format: Paperback
Being something of an "insider" (my treating psychiatrist was also one of Dr. Bean's consultants, and we discussed the case at length) I feel that Dr. Bean was guilty primarily of the sin of hubris. She tried to do it all, she tried to do too much, and she tried to do it all alone. She should have reached out far sooner than she did for second opinions.
That said, she was working at cross-purposes with her patient, Paul lozano, whom even by Mcamara's lights was a difficult patient--maniulating, dependent, demanding, substance-abusing. There's blame aplentry in thhis tale. and not just for the doctor and patient. Why on earth did Harvard allow paul to go on his clinical rotations when he was oced uo in a psychiatric lockup getting ECT? Why was the Lozano family so smothering as to run up to Boston every time paul had a meltdown??? Clearly there was a certain amount of manipulation and passive-aggressoveness going on, and neither the doctor, nor the family,nor paul seemed motivated to discuss them.
Reparenting therapy, as MacNamanara is careful to point out, predates Freud. It has been known to work for certain patients--I underwent such therapy before entering analysis, and it helped immeasurably. But it has to be finite--after two years we acknowledged that we had taken it as far as we could, and I needed a "stricter" form of therapy. Dr. Bean-Bayog apparently didn't think in these terms (she certainly wasn't thinking when she wrote down her fantasies!) or Paul Lozano was so difficult to treat that she couldn't put borders on him.
As for the Lozano family,I find it a little hard to believe that the Lozano family was as saintly and close-knit as described.
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