Customer Reviews

Cultures Of Healing: Correcting The Image Of American Mental Health Care

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Okay, I wrote this, so of course I like it--and since I have to give it "stars" in order to post, I give it five.

But the point of this "review" is to say that the book will be back in print this Fall (2003), from Transaction Publishers/Rutgers, with a new intro and a new title--"Health and Suffering in America: The Context and Content of Mental Health Care."

The hype about mental health care in the last five years or so has grown more and more outrageously false. I'm glad Transaction wants to keep this book in print, as a corrective to the nonsense that those who profit from mental health care would have you believe.

I am a psychologist, and have been reading actively in the field of psychology since 1960. I have never encountered a book nearly as good as this one that deal with the same subject matter. If you are interested in psychopathology, psychotherapy, mental health and its care, there is no better book than this one. Fancher writes with great clarity, with a philosopher's analytic ability, but also with great heart, with wisdom and compassion. And much of what he has to say is very hard to find anywhere else. The book presents a perspective that is not well known to the general public, that cuts against the grain of much of our popular understanding. It is a very tightly argued book. His arguments, which require real effort and concentration to follow, are detailed, scientifically and philosophically sophisticated, informed with clinical experience and with real wisdom. My favorite chapter is "The Middlebrow Land of Cognitive Therapy." There are penetrating insights in this chapter that were entirely new to me, although I have taught this material in two different courses for years. I will never look at cogntive therapy the same way again. As far as I know most of the contents of this chapter are original insights of Fancher, and can be found nowhere else. My second favorite chapter is "Biological Psychiatry's Confusion of Tongues." For me there was little new in this chapter, but it is by far the best summary of the problems with biological psychiatry that I have ever read. The critical analysis he presents in this chapter is not only brilliantly done, it is also an analysis that is quite hard to find elsewhere, and of absolutely fundamental importance in understanding biological psychiatry. This is an extremely powerful book, and most of its major arguments are so sharply and compellingly developed that I think most open-minded readers will have to admit that Fancher is pretty much right in most of his major conclusions. Of all of the psychology books I have read in the last ten years or so, this is the one I would have been most proud to have written myself.

This is the best book on comparative clinical psychology/psychiatry I've ever read.

If psychotherapists/psychiatrists were considered faith healers (which this book makes clear they are), this book would qualify as a book on comparative religion, and it would make one question their faith.

Psychoanalysis, Behaviorism, Cognitive Therapy, and Biological Psychiatry are all analyzed, with their core beliefs and assumptions described in detail. Each school's standing with the scientific facts is mentioned.

Cultural reasons why Americans accept certain therapies, or come to accept them in spite of their unscientific bases, are also given.

The most noticable omission is the lack of any discussion of Albert Ellis' Rational Emotive Therapy, although many of the comments about Beck's therapy apply to RET too.

The chapter on biological psychiatry could have provided more background on its history, as well as mention more specific psychiatrists' and pharmaceutical companies' influences. For biological psychiatry, "Blaming the Brain" by Elliot Valenstein (mentioned in this text's acknowledgements) is also recommended.

Without coming out too strongly (which could create a backlash), the book does an excellent job of pointing out how biological psychiatry's illness model is used to justify prescribing psychoactive drugs with no proven specificity in treating "illnesses", in a culture which otherwise wages war on psychoactive drugs.

The only noticable editorial error was a major misspelling of "renaissance".

This book changed my life. I took a class taught by Dr. Fancher my last semester of college, in which we studied this book and half a dozen others. As a psychology major, I wished I had taken this class first, rather than last, in my major. Most books on mental health either push a particular ideology or denounce psychotherapy completely. This is the only book I know that both reveals the exagerrated claims of various schools, and respectfully makes sense of what clinicians actually do. In class, and I believe in the book, it was clear that Dr. Fancher cares very deeply that people in pain get help. Equally important, he cares that they not be sold a bill of goods. After studying this book, I see psychotherapy as a way of trying to do the best we can with difficult lives, not a personal course in The Truth. This book empowers all of us to look at therapy as a source of ideas and support, not an authority.

I was amazed at the clarity this book sheds on psychological schools of thought. It does an excellent job of explicating the values of each school of thought, giving the reader information by which to evaluate them.

I would highly recommend Cultures of Healing to anyone interested in therapy to help them understand what types of therapists do what, and what they believe in. I would also recommend Cultures of Healing to any psychology student who wishes to make some sense out of the morass of contradictory beliefs.

Definitely buy this book.

Dr. Fancher makes many excellent points in this book. There is a lot more reform that needs to happen in psychology and psychiatry. It's good that there are courageous people like Fancher who will raise these crucial issues.

If there were still hippies, this book would not have to be written. Thinking back to those days, I recall my friend Alex coming from therapy one day and saying, "Psychologists basically want you to conform." He was right then, but in our age of conformity, common sense statements like that will not be enough to educate a public inundated with data showing the efficacy of therapy. This book fills that vaccuum and reveals the hidden ideology of each of the contemporary schools of psychotherapeutic schools so cogently, succinctly, and logically that it would probably be blacklisted by most graduate Psychology departments. It is equivalent to Galileo's revelation that the Church had a vision of the solar system, not based on study but on wish-fulfillment. Taking on the psychoanalytic enterprise, behaviorists, Beck's cognitive psychology, and psychopharmacology in one fell swoop, he demonstrates effectively that that the theorists and practitioners of these various "methods" have molded their views in the same way pre-Columbian map makers designed atlases: through conjecture, impressionism, and powerful cultural biases. Regardless of the implied assertions by many that psychotherapy is rising to the level of a science, Fancher shows this to be far from the case. This is of particular importance today as there is a strong move toward defining evidence based or empirically based therapies that work--probably an artifact of pressures from HMO's rather than greater sophistication of understanding the nature of mental illness. Fancher presents two major problems: one is that in dealing with what is a "healthy individual," one must have an ideological basis; and second, the "subjects" are not reliable. Ever take an employment test with a question "Have you ever stolen from an employer?" How would YOU answer? This is a rather crude example, but you get the point. But if you think about the claims therapies make, and think rationally, it seems fairly obvious psychologists are either poorly trained in logic, poorly educated in the nature of human culture, value, and imagination. One gets the feeling from reading the anayses of the reasoning behind what makes therapy work that most psychologists/psychiatrists don't even read the newspaper. One salient example is the popular Beck Cognitive Therapy industry. Your thinking determines how you feel; change your mind, change your emotions--all in 12 easy sessions. I can imagine Doestoevsky or even John Steinbeck in these sessions. "See, John, when you THINK people are poor and exploited and powerless, you will feel sorry for them and write those pessimistic books of yours. Now, just look around, do you see anyone starving to death in my office?" That might be a bit of hyperbole, but not far from the truth. But it is certainly the truth that such methods--if taken at face value--have the potential of converting the search for the end of psychological suffering and the search for meaning to a reductionist level that approaches the quest for mental health on the same level of taking dance lessons to get dates. Fancher hits home when he challenges each of the popular forms of therapeutic schools, showing even psychopharmocology is an enterprise based on Nielson ratings, figuring out what therapists want their patients to feel, then trying to get the chemistry right. At times the author uses a bit more ammunition than he needs. Having hit the nail on the head, he will occasionaly add a few swings of the hammer. Also, while psychopharmocology does have its ideology, it does appear to relieve some suffering at least some of the time, so I'd be hesitant to throw the baby out with the bathwater. Rather than provide more summary, I'd make the point that if you are interested in the field of therapy or counseling--either as a professional or consumer--if you don't read this book, it would be like trying to play chess without knowing what any of the pieces do or how the game is played.

I am giving up half-way through. The outline of this book is great, and the points made are valid. But it is not written well. Specifically, it is very wordy and repetitive. The author makes a point, discusses the point, then makes the point again a page or two later. I got it the first time.

I am toward the end of the section on the Behaviorists, and have just decided it is not worth finishing. I would give an example of the wandering wordiness, but it would take too much text to convey this oft-repeated problem. An editor needs to get hold of this and fix it up.

That's a shame - the author does a very good job of defining the theory and the scientific basis of the major schools of psychotherapy, and then noting how far the theory is from its scientific claim. For the intellectual content, I agree with other reviewers that this is one of the best books to do this. However, it is a lot of work to slog through all this writing to cover the wide but discrete range of theses presented.

The author makes profound statements about the human condition, normalcy, and pathology, including as understood by the schools of therapy. But he presents this elliptically. His case could be stronger if he simply stated his counter-arguments, supported them, then went on to the next chapter. The counter-arguments actually add up to a nice profile of what it means to be human, whether disturbed or not!

I was excited to get this book. I have read a lot on this topic. Like the author, I am also trained as a psychotherapist, and like the author, I am quite concerned about the way that therapeutic training ignores the truth that most of what we do is based on philosophy and belief and only to a small (but increasing) degree on science.

I was surprised at the quality of writing when I began reading. I then figured out my mistake: I picked this used book up for a good price, thinking it was written by Raymond Fancher, who wrote the marvelous book, Pioneers in Psychology. That also covers historical and philosophical bases of psychology. When the writing proved annoying, I looked closer and realized it was a different Fancher!

If you conduct research in this area and want a good account of the premises of the major schools of psychotherapy, and you want a good account of their criticisms, this is a valuable book. for example, an ambitious undergrad could write a strong paper with guidance from these arguments. But you will have to work at it -they are not clearly presented.