Customer Reviews

Principles of Psychopathology: Two Worlds, Two Minds, Two Hemispheres

5 star:		(1)
4 star:		(0)
3 star:		(0)
2 star:		(0)
1 star:		(0)

 

 

This is a fat,strange book. Femi Oyebode, the eloquent British professor of psychiatry once compiled a list of ten foundational and influential books in the British Journal Psychiatry. Great novelists, thinkers and scientists are represented: Jorge Luis Borges, Gabriel Garcia Marquez, Camus,Elias Canetti, Norman Geschwind...... and even Immanuel Kant. To this list I would add John C. Cutting's tome "Principles of Psychopathology".
It is quite odd( maybe not) that fifteen years after its publication, I am the first one to review this book on Amazon. As a psychiatrist practicing in America, I am keenly aware of the conceptual crises that plague psychiatry in the new millenium. We are awaiting the next DSM whose publication is being perpetually pushed into the future because psychiatrists don't seem to agree on definitions. And probably here is where a work like this comes in handy. Dr. Cutting has written a book truly encyclopedic in scope. But don't be fooled, this is as much a book on methods as a compendium on various aberrations of the mind. The writer who is trained in philosophy and employs his command of German and French to access classical but neglected works in continental psychopathology has done the profession of psychiatry a huge favor by putting together a wealth of references mostly from the last hundred years or so. Perhaps that is why most psychiatrists have never heard of this book and why (to my good fortune) I was able to buy this book for 30 dollars- much less than its true worth. The book sometimes comes across as a philosophical work and less as a clinical text. In today's world where the average psychiatrist spends 20 mins with a given patient and most psychiatric residencies in the US have abolished their psychopathology courses- after the advent of the DSM- careful clinical definition of subjective experience is all but a preoccupation for psychiatric archeologists. It is now only in clinical psychology programs where one finds a dedicated effort to study psychopathology. But we ignore psychopathology at our own peril. It can effectively be argued that the knowledge base of the average psychiatrist has been shrinking over the past thirty years. Whatever the cause may be- the transmutation of the DSM into "the supreme and only book", the cruel economics of managed care, the supremacy of biological theories etc etc.- we are today much more vulnerable as professionals without methods than at any time in the past.
This book would be helpful to any student of psychopathology( clinical psychology, psychiatry even philosophy)by providing a critical outlook on most ideas of human experience we take for granted such as hallucinations, delusions, illusions, sense of self etc. For instance, Dr. Cutting provides a well thought counterpoint to the DSM conceptualization of delusions and how sometimes the latter is internally inconsistent. He also examines Jaspers original criteria for delusional thinking vis-a-vis the DSM which I found interesting. Some of the discussion may seem dry and academic, even pedantic but it is not. If one is going to spend half a life-time listening to and observing the human experience one might as well prepare for it in depth. I have seen many a psychiatrist who just ask patients "are you hearing voices?" and if the answer to that happens to be yes, diagnose psychosis. I think we all agree, including our patients, that things are not ok the way they are. It is at least in our power to make training more rigorous even if that means being exposed to difficult texts like "principles of psychopathology".