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Of Two Minds: An Anthropologist Looks at American Psychiatry [Kindle Edition]

T.M. Luhrmann
4.4 out of 5 stars  See all reviews (9 customer reviews)

Print List Price: $17.95
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Book Description

In this groundbreaking book, Tanya Luhrmann -- among the most admired of young American anthropologists -- brings her acute intelligence and her sophisticated powers of observation to bear on the world of psychiatry. On the basis of extensive interviews with patients and doctors, as well as day-to-day investigative fieldwork in residency programs, private psychiatric hospitals, and state hospitals, Luhrmann shows us how psychiatrists are trained, how they develop their particular way of seeing and listening to their patients, what makes a psychiatrist successful, and how the enormous ambiguities in the field affect its practitioners and patients.

How do psychiatrists learn to do what they do? What is it like for psychiatrists to deal with people who are in emotional extremity? How does the choice between drug therapy and talk therapy, each of which requires very different skills, affect the way psychiatrists understand their patients?  Boldly and with sharp insight, Luhrmann takes the reader into the world of young doctors in training.

At a time when mood-altering drugs have revolutionized the treatment of the mentally ill and HMOs are forcing caregivers to take the pharmacological route, Luhrmann places us at the heart of the struggle -- do we treat people's brains or their minds? -- and allows us to see exactly what is at stake.

From the Hardcover edition.

Editorial Reviews


“Clear-eyed intellectual analysis...shrewd, witty, refreshing.”–The New York Times

“[A]stute and fascinating.... [V]ividly portrays the fierce and often unnecessary wars between those representing the interests of the mind and the brain.”–Kay Redfield Jamison

“A more nuanced treatment of the moral and philosophical issues than any previous discussion”–The New Yorker

From the Trade Paperback edition.

From the Inside Flap

With sharp and soulful insight, T. R. Luhrmann examines the world of psychiatry, a profession which today is facing some of its greatest challenges from within and without, as it continues to offer hope to many.

At a time when mood-altering drugs have revolutionized the treatment of the mentally ill and HMO's are forcing caregivers to take the pharmocological route over the talking cure, Luhrmann places us at the heart of the matter and allows us to see exactly what is at stake. Based on extensive interviews with patients and doctors, as well as investigative fieldwork in residence programs, private psychiatric hospitals, and state hospitals, Luhrmann's groundbreaking book shows us how psychiatrists develop and how the enormous ambiguities in the field affect its practitioners and patients.

Product Details

  • File Size: 657 KB
  • Print Length: 353 pages
  • Page Numbers Source ISBN: 0679744932
  • Publisher: Vintage; 1 edition (April 6, 2011)
  • Sold by: Random House LLC
  • Language: English
  • Text-to-Speech: Enabled
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  • Lending: Not Enabled
  • Amazon Best Sellers Rank: #217,485 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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Customer Reviews

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17 of 21 people found the following review helpful
4.0 out of 5 stars History and Critique of the state of Modern Psychiatry October 24, 2001
By Nagel
This is a terrific history and critique of the state of modern psychiatry.The author writes with clarity, precision and enthusiasm about her topic. It is an insightful look at the crisis of "brain-as-mind" thinking, and the idea that the "whole" is greater the sum of its percieved parts. Luhmann is about as even handed as a writer can hope to be, but ultimately seems to conclude that the whole person approach to psychiatry is probably best for the individual and the larger culture.
The book works equally well as a piece of cultural criticism depicting the competing points of view among the schools of psychiatry as a thought provoking paradigm used to portray "kinds of mind" and the ways we think about ourselves and each other. There are, to be sure, many more than TWO MINDS, but there does seem to be Two Dominat Camps. One that thinks we are little more than a collection of our symptoms and one that thinks we are much more imaginative and capable than the limitations of our physical selves.
Great piece of social history!
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5 of 5 people found the following review helpful
5.0 out of 5 stars Amazing! January 27, 2010
Format:Paperback|Verified Purchase
A bit outdated now, but still very very relevant to modern day psychiatry. It does a good job of looking at the historical forces that have brought psychiatry into being both political and economic and ultimately does a service to the profession by helping to expose some of the harmful contradictions found in its internal culture. Very good read! The author is a pleasure to read and her metaphors and descriptive language can't be beat... enjoy!
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43 of 60 people found the following review helpful
2.0 out of 5 stars A major disappointment January 28, 2002
Format:Paperback|Verified Purchase
I read this book based on the glowing reviews it had received. It seemed to promise to be an outsider critique of psychiatry in the same lague as such classics as "Asylums". Instead, I found the book to be superficial on a number of different levels and rather unfair to both the psychoanalytic and biological approaches to psychiatric treatment. As a clinical psychologist, I have had alot of exposure to psychiatric training, psychoanalytic therapy, and the scienitific foundations, as well as practice of biological psychiatry. It is from this background, that I found the book lacking on so many fronts.
Luhrmann never provides a satisfactory definition of what she means by psychoanalytic psychotherapy. What she does is proceed to rule out many contemporary forms of this treatment (e.g., interpersonal psychotherapy), without opeartionalizing what's left. She further confuses writings about different forms of psychoanalytically-oriented treatment, for example misattributing Roy Shafer's opinions from "The Analytic Attitude" to psychoanalysis, when in fact he was talking about psychotherapy. The treatment of biological approaches is even worse. She reduces an evolving area of science into opinion-ridden discourse. Indeed, it appears that she simply has made little effort to understand the biology and pharmacology of psychiatric disorders. Any number of undergraduate or graduate courses in phyisological psychology, pharmacology, etc. could have made this relatively accessible to her. Instead she dismisses science as "just jargon". The shortcomings in this analysis are, unfortunately, obvious for someone with a basic foundation in these biological areas.
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1 of 1 people found the following review helpful
Format:Paperback|Verified Purchase
I am a psychiatry resident in the US but I am British and read this book prior to starting my psychiatric training. In this ethnography of American Psychiatry in the 1990s, anthropologist T.M. Lurhmann explores the tensions between psychodynamic and biomedical approaches to psychiatry during a time of tremendous change in the practice of psychiatry, largely under the growing influence of managed care. She essentially followed psychiatric residents, interviewed psychiatric researchers, psychoanalysts, patients, psychiatric survivors, attended conferences, had her own psychotherapy, and trained to provide psychotherapy in order to illuminate the process of becoming a psychiatrist. And she does a fantastic job. She really captures the joys, frustrations, fears, anger, regret, and insecurities of psychiatrists in training and more senior psychiatrists, and the curious melding of psychopharmacological and biological approaches to mental distress with psychodynamic (psychoanalytic) approaches which were taught side-by-side.

Lurhmann confesses her own father was a psychiatrist, and this text does not descend into an impassioned critique of the failures of psychiatry. She really gives a balanced account of the successes and limits to both biological and psychodynamic approaches to psychopathology, and concludes that psychiatry can be neither mindless nor brainless and must combine both approaches. This, unfortunately, is a rather dull conclusion, and I am not convinced it is true either. She portrays her subject matter with such sympathy, one wonders whether she has "gone native" and lost her objective, critical anthropological eye in the process.
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1 of 1 people found the following review helpful
5.0 out of 5 stars Hours of fascinating reading June 2, 2012
Format:Kindle Edition|Verified Purchase
How many psychiatrists does it take to change a light bulb? Only one, but the light bulb has to want to change.

This is the one of the best books I have found on psychoanalysis, therapy, legal drugs, medical education, and so much more, including a look at personal interactions among bright, educated, dedicated people. The author, an anthropologist on the Stanford faculty, brings a lot of information and observations to the pages and paragraphs. Her experience convinced her that drug therapy and talk therapy are best when used together.

Dr. Luhrmann uses clear language that flows almost conversationally, with precise terminology only where needed. Her book moves along in a lively and enjoyable way.
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