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.
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Book Description
An application of the philosophy of science to psychiatry
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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.
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23 of 25 people found the following review helpful
By biophusion
Format: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.
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.
6 of 7 people found the following review helpful
Format:Hardcover
Calling for the need of a sound theory of mind, Dr. Niall McLaren presents a strong and sharp criticism of the reductionist framework of psychiatric practices that exist today. In Humanizing Madness, he raises serious doubts over the legitimacy of mainstream psychiatry that stands on weak scientific grounds and loosely defined concepts relating mind and mental disorders. As he attempts to prove with his logical analysis of mental theories, we still are very much in need of a plausible theory of mind.
Not only does Niall McLaren point out the various shortcomings of the established views of psychology/psychiatry, and of some other scientific disciplines, but he also proposes the most cogent model of mind that does not violate fundamental scientific laws and is also compatible with the norms of common sense and logic.
Humanizing Madness is undoubtedly a groundbreaking work of scholarly caliber. Dr. McLaren's knowledge of psychiatry and philosophy, his insight in the epistemological value of scientific and philosophical concepts, and his command of creating illustrative analogies do not anywhere fall short of being impressive. Most remarkable is his attention to detail.
There is a lot to digest in Humanizing Madness-chunks of intellectual goodies; and despite all the lucidity of the book's language, it will be recommended only for the egg-headed, and those having a penchant for a philosophical discussion of science.
Not only does Niall McLaren point out the various shortcomings of the established views of psychology/psychiatry, and of some other scientific disciplines, but he also proposes the most cogent model of mind that does not violate fundamental scientific laws and is also compatible with the norms of common sense and logic.
Humanizing Madness is undoubtedly a groundbreaking work of scholarly caliber. Dr. McLaren's knowledge of psychiatry and philosophy, his insight in the epistemological value of scientific and philosophical concepts, and his command of creating illustrative analogies do not anywhere fall short of being impressive. Most remarkable is his attention to detail.
There is a lot to digest in Humanizing Madness-chunks of intellectual goodies; and despite all the lucidity of the book's language, it will be recommended only for the egg-headed, and those having a penchant for a philosophical discussion of science.
6 of 7 people found the following review helpful
5.0 out of 5 stars
Fun, Thought-Provoking Prod at the Most Common Swallowed and Digestive Schools of Thought
December 3, 2007
Format:Hardcover
After recently completing quite a few psychology classes, only one thing remains a common thread across each: it seems no psychologist agrees with another. There are so many schools of thought and barely any common themes.
Dr. McLaren outlines in this 30-year-research-result the flaws in some of the most popular and well accepted schools of thought and practice.
Even though I do not sport an M.D. after my name, I understood and thoroughly enjoyed this frank and prod at what many professionals blindly accept as fact. Using the scientific model to grind down the frivolities of many schools of psychology, Dr. McLaren gets to the "nitty gritty" of modern psychology. The scientific model helps us understand some of the most common mental disabilities today without writing them off to Freudian fantasies. Dualism is an enlightening concept and to me, strikes as the most practical and rational approach one can have to a situation. Mind over matter sounds so cliché, but the relationship between mind and matter is a road to explore for most mental handicaps, not just an adage.
Dr. McLaren outlines in this 30-year-research-result the flaws in some of the most popular and well accepted schools of thought and practice.
Even though I do not sport an M.D. after my name, I understood and thoroughly enjoyed this frank and prod at what many professionals blindly accept as fact. Using the scientific model to grind down the frivolities of many schools of psychology, Dr. McLaren gets to the "nitty gritty" of modern psychology. The scientific model helps us understand some of the most common mental disabilities today without writing them off to Freudian fantasies. Dualism is an enlightening concept and to me, strikes as the most practical and rational approach one can have to a situation. Mind over matter sounds so cliché, but the relationship between mind and matter is a road to explore for most mental handicaps, not just an adage.
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