Humanizing Madness: Psychiatry and the Cognitive Neurosciences [Paperback]

Niall McLaren M.D. (Author)

Book Description

Publication Date: September 6, 2007

An application of the philosophy of science to psychiatry

Although it's been 140 years since Maudley's groundbreaking treatise, modern psychiatry is in a state of intellectual collapse. No psychiatrist practicing today can point to a universally agreed model of mental disorder which explains the common observations of mental disorder, dictates a research program and ordains a form of management.

This book, the result of thirty years research in the philosophy of science, takes each of the major theories in psychiatry and demonstrates conclusively that it is so flawed as to be beyond salvation. It goes further, in that the author outlines a model of mental function which both satisfies the essential requirements of any scientific model, and shows how the phenomena of mental disorder can be described in a parsimonious dualist model which leads directly to a humanist form of management of the most widespread form of disability in the world today.

"This book is a tour de force. It demonstrates a tremendous amount of erudition, intelligence and application in the writer. It advances an interesting and plausible mechanism for many forms of human distress. It is an important work that deserves to take its place among the classics in books about psychiatry." -Robert Rich, PhD, AnxietyAndDepression-Help.com

About the Author

Niall McLaren has been an M.D. and practicing psychiatrist since 1977. Since then, he has undertaken a far-reaching research program, some of which has previously been published. For six years, while working in the Kimberley Region of Western Australia, he was the world's most isolated psychiatrist. He is married with two children and lives in a tropical house hidden in the bush near Darwin, Australia.

From Future Psychiatry Press www.FuturePsychiatry.com
an imprint of Loving Healing Press

Product Details

• Paperback: 268 pages
• Publisher: Future Psychiatry Press; 1 edition (September 6, 2007)
• Language: English
• ISBN-10: 1932690395
• ISBN-13: 978-1932690392
• Product Dimensions: 7 x 10 x 0.6 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 3.2 out of 5 stars  See all reviews (20 customer reviews)
• Amazon Best Sellers Rank: #1,556,560 in Books (See Top 100 in Books)

More About the Author

Niall (Jock) McLaren is a psychiatrist in Darwin, in Australia's steamy Northern Territory. He graduated in medicine in Western Australia and then completed his training in psychiatry. Almost from the beginning, he was interested in the idea of a rational psychotherapy, which led him to study the philosophy of mind and of science. Since then, he has written extensively in the area of rational psychiatry, publishing two books on the topic. This is in addition to working in some of the most isolated parts of Australia where he often had no contact with other psychiatrists for years on end. He lives with his family in the bush outside Darwin and leaves occasionally to undertake lecture tours in the US.

Customer Reviews

Most Helpful Customer Reviews

14 of 14 people found the following review helpful:

1.0 out of 5 stars RUBBISH!!!, December 1, 2011

By 

J R Frederiksen - See all my reviews

This review is from: Humanizing Madness: Psychiatry and the Cognitive Neurosciences (Paperback)

Inaccurate on ME ("CFS"). ME is a severe neuro-immune disease. Pls correct this. Refer to 2011 ME International Consensus Criteria and 2003 ME/CFS Canadian Consensus Criteria. Neuro-immune diseases are not Madness and the author's approach is dehumanizing.

21 of 23 people found the following review helpful:

4.0 out of 5 stars very well written, but has some weaknesses ..., June 19, 2008

By 

biophusion - See all my reviews

This review is from: Humanizing Madness: Psychiatry and the Cognitive Neurosciences (Hardcover)

I bought this book to read McLaren's views on the mind-body problem and to better understand the supposed flaws in the biopsychosocial model. While in general it is very well written and he has obviously put acknowledgeable effort into it, I believe that some of the content falls short in important areas. McLaren previously wrote a paper titled "Interactive dualism as a partial solution to the mind-brain problem for psychiatry" (N McLaren, Medical Hypotheses 2006:66:1165-1173), and the phrase "partial solution" is an accurate description of this book as well, as it is a partially successful attempt at reintroducing the mind back into mental illness but not a complete foundation for the entire "future of psychiatry".

McLaren does a good job at highlighting the major historical and current problems facing psychiatry and philosophy of mind, with concise descriptions of the essential issues. He delivers several major blows to the perceived intellectual status of the psychiatric profession; that is, a lack of underlying scientific theory of mind and therefore also for mental illness. He also raises other interesting and important points along the way (such as; over-biologising by psychiatrists of aberrant mental function, and problems with eclecticism in psychiatry). McLaren attacks the biopsychosocial model used in psychiatry, by exposing it's foundation and questioning it's scientific status (rather than by denying the role of psychological and social factors in mental illness). I had previously wondered what guides researchers and academics on the specific relevance of, or interaction between, each aspect to the biopsychosocial paradigm; now I suspect that there is little or none that isn't arbitrated by individual preference. McLaren outlines the importance of understanding automated processing of information in the brain, and then proposes a form of properties dualism. I'm not convinced that properties dualism will be the ultimate solution to the mind-body problem, but it suits the mentalistic view of psychiatry that McLaren endorses, and he presents a decent starting proposal that should interest some academic psychiatrists.

However, I think the application of this proposal needs more work. McLaren clearly dislikes biological psychiatry and (understandably) attempts to put the "mind" back into psychiatric illness; but although I'm not necessarily a biological reductionist, I think he over-stretches the mark. His account of psychiatric illness is too clean cut; he essentially attributes all mental illness to psychological causes, except perhaps in the case of brain disease, but even then its implied to be a psychological response to the limitations imposed by the brain disease. In general, it seems that he has taken a plausible contributing factor in each mental illness but inflated it to be the only main relevant factor in that illness. McLaren assumes that nearly all major psychiatric conditions are caused solely by an interaction between 3 themes: (i) abnormal personality factors or beliefs, (ii) chronic anxiety, and (iii) lack of insight on behalf of the patient. Although he presents a good understanding and plausible suggestions, he applies them too universally and in some cases too simplistically, which is probably the outcome of his interpretation of properties dualism. Here are some examples:

(a) He skilfully rips apart the current classification system of personality disorders employed in the DSM and explains personality as a set of psychologically acquired rules; this is a reasonable position, but there is a lack of discussion of the biological factors or variations between individuals which could influence their acquirement of rules. While he briefly mentions genetics and personality, he simply concludes that such discussion can't proceed without a more coherent definition of personality than what is currently used in research; this may be a valid point, but then the issue is essentially ignored rather than compensated for. I perceived a sort of hidden assumption that as long as there is no brain disease, everyone's "wetware" is potentially functionally identical.

(b) When describing anxiety-driven hypochondriac states, McLaren casually lumps in illnesses such as "benign meningoencephalomyelitis" (which I assume is benign myalgic encephalomyelitis) and chronic fatigue syndrome; however, anxiety isn't a defining characteristic or diagnostic criterion of these illnesses, and the research fails to demonstrate anxiety disorders in the majority of these patients; he is either unaware of this, or perhaps believes that the patients are denying their anxiety or they lack the insight to realise they are simply just anxious and/or depressed. It would also be problematic to associate post-exertional symptoms to phobias or the Yerkes-Dodson curve for similar reasons. Losing yet another supposed "psychosomatic" illness to other fields of medicine will only further reduce psychiatry's historically poor credibility in this area.

(c) When describing depression, McLaren starts off with a decent description but then rejects the notion of depression as a negative mood and simply attributes the state of depression to an acquired anhedonia. His explanation of depression (anhedonia caused by a loss of interest in life, sustained by personality factors and chronic anxiety) is too restrictive, mostly on grounds that depression and anhedonia aren't the same state and can occur without the other, and also on grounds that pleasure and interest aren't synonymous either (liking and wanting aren't the same). Furthermore, while he has a point that the relevance of anxiety is (potentially) being underestimated in depression, he is probably overestimating it by essentially blaming all depression on anxiety. This isn't to say all these aspects aren't interactive, or that McLaren's suggestion should be dismissed; but I don't think this is the best explanation of depression, the only mode of anhedonia, or the only theme in which depression can arise.

(d) McLaren's account of compulsion/addiction and drug withdrawal bizarrely implies that it is *purely* a self-fulfilling belief-based reverse placebo effect. Obviously the fear of withdrawal plays some role, but again, this is seemingly presented as the only relevant factor. Furthermore, when considering that the placebo effect itself may involve the brains opioid system, using saline injections to trick an opiate addicted patient into temporarily believing they've scored isn't conclusive evidence that withdrawal itself is simply a phobia.

Reading this book actually weakened my previous support for properties dualism and strengthened my support for John Searle's arguments against it, because in my opinion McLaren's practical application doesn't completely account for the "grey-area" within the mind-body problem and can lead to over-simplifications. I'm not saying the position, that the mind is an informational system dependent on but distinct from the brain, is unreasonable; on the contrary, it indeed deserves further consideration. The above criticism isn't meant to derail the overall merit of this book as a highly recommended read.

13 of 13 people found the following review helpful:

1.0 out of 5 stars Innacurate, December 1, 2011

By 

Vulpus Vupus - See all my reviews

This review is from: Humanizing Madness: Psychiatry and the Cognitive Neurosciences (Paperback)

from p.192:

"Hypochondriacal States
...The term indicates a person with an unhealthy preoccupation with matters of health, illness, etc., who is convinced he has an illness, but who has no evidence at all of physical illness...However, in dealing with these patients, we have to be very careful because if the psychiatrist doesn't take a patient's complaints of illness seriously, then the next person to do so may be the pathologist...
The same cycle of self-reinforcing panic can be seen in opiate addicts... Simply giving them an injection causes them immediate relief for which they are often pathetically grateful...
Some of the names for it are benign meningoencephalomyelitis (which is more benign than it sounds), total allergy syndrome or twentieth century allergy, chronic fatigue syndrome, adrenal exhaustion and a huge range of poisonings and toxicities not forgetting effort syndrome, Agent Orange and Gulf War Syndrome.
The symptoms of these protean disorders just are the symptoms of anxiety and the grumbling depression caused by chronic anxiety. The same symptoms are up for grabs for anybody who needs a label to conceal the fact that he is anxious."

There are several thousand studies which show immune system abnormalities, cardiac insufficiency, grey and white matter reductions in the brain, and many other multi-system physiological issues.

The author needs to research the subject matter more thoroughly before making such sweeping and inaccurate statements about disease processes he obviously knows nothing about.

This viewpoint on ME/CFS is decades out of date and is rather analogous to how MS patients were labeled in the earlier part of the last century with "Malingerers Syndrome"