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The Rise and Fall of the Biopsychosocial Model: Reconciling Art and Science in Psychiatry 1st Edition

2.5 out of 5 stars 4 customer reviews
ISBN-13: 978-0801893902
ISBN-10: 0801893909
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Editorial Reviews

Review

Ghaemi's book is highly relevant. It is also very well written and appears meticulously researched, and it should be of interest to everyone with a professional relation to psychiatry. Hereby recommended.

(Anders Jørgensen Acta Psychiatrica Scandinavica)

Provocative... Ghaemi claims that one should leave muddled views behind and recognize that humanism in medicine is compatible with the bio-physiological model. The author offers William Osler's humanism and Karl Jasper's method-based existentialist psychiatry as exemplars. Essential.

(Choice)

This is a thoughtful and well-researched book. At minimum, it is an essential read for academic psychiatrists and residents involved in teaching and learning. More broadly, it is a good read for anyone interested in the historical and philosophical aspects of psychiatric theories.

(Hamid R. Tavakoli, MD Psychiatric Times)

Impassioned and thoughtful... Ghaemi has produced both a penetrating analysis of the ascent of the biopsychosocial model as a psychiatric theory-of-everything and a weapon designed to bring about its decline.

(Nicholas Kontos, M.D. Journal of Clinical Psychiatry)

A provocative and valuable piece of scholarship.

(Gerald N. Grob Bulletin of the History of Medicine)

This book is especially suited for those who want to ponder the direction of our field and who worry about the theoretical disorientation of modern psychiatry and our resulting need for deep organizing principles. Ghaemi's grasp is wide. His book will be as much disturbing as satisfying but will provide the reader a sense of where our field has been and where it may need to go.

(Kenneth S. Kendler, M.D. American Journal of Psychiatry)

It may become an influential, revolutionary book... Stimulating and thought provoking.

(Victor A. Colotla PsycCRITIQUES)

A psychiatrist criticizes the idea of psychiatric disease as a product of biological and social factors.

(Science News)

From the Back Cover

Outstanding Academic Title, Choice Magazine

Developed in the twentieth century as an outgrowth of psychosomatic medicine, the biopsychosocial model is seen as an antidote to the constraints of the medical model of psychiatry. In this critique of psychiatry's mainstream ideology, S. Nassir Ghaemi details the origins and evolution of the BPS model and explains how, where, and why it fails to live up to its promises. He makes the case for a new paradigm of medical humanism and method-based psychiatry that is consistent with modern science while incorporating humanistic aspects of the art of medicine.

"Impassioned and thoughtful... Ghaemi has produced both a penetrating analysis of the ascent of the biopsychosocial model as a psychiatric theory-of-everything and a weapon designed to bring about its decline."― Journal of Clinical Psychiatry

"Ghaemi's grasp is wide. His book will be as much disturbing as satisfying but will provide the reader a sense of where our field has been and where it may need to go."― American Journal of Psychiatry

"A thoughtful and well-researched book. At minimum, it is an essential read for academic psychiatrists and residents involved in teaching and learning. More broadly, it is a good read for anyone interested in the historical and philosophical aspects of psychiatric theories."― Psychiatric Times

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Product Details

  • Hardcover: 272 pages
  • Publisher: Johns Hopkins University Press; 1 edition (November 17, 2009)
  • Language: English
  • ISBN-10: 0801893909
  • ISBN-13: 978-0801893902
  • Product Dimensions: 6 x 0.9 x 9 inches
  • Shipping Weight: 1.3 pounds (View shipping rates and policies)
  • Average Customer Review: 2.5 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Best Sellers Rank: #2,316,320 in Books (See Top 100 in Books)

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Customer Reviews

Top Customer Reviews

Format: Hardcover Verified Purchase
The Rise and Fall of the Biopsychosocial Model is Dr. Ghaemi's brave and impassioned attempt to meaningfully distinguish the Biopsychosocial (BPS) Model from the Perspectives on historic and philosophical grounds. After my own Hopkins psychiatry residency training, having read McHugh & Slavney's book, "The Perspectives" cover-to-cover at least six times, it still remained unclear how the two diagnostic approaches differed in theory and in practice. Ghaemi's book succeeds, much like a 17th Century Rembrandt group portraiture, to put all those distinguished historic characters, seated or standing, in period costume within the same shadowy-lit room. Accordingly, the philosophical leanings, ulterior motives, and professed intentions of key contributors of each model are sketched and colored by Ghaemi's detailed interpretation of their work captured in it's timeframe. Still after this skillful exercise in argumentation, this reader felt the author had somehow missed the central dilemma and, consequently, the direction towards meaningful resolution.

The reality of psychiatry today is that individuals trained in either of these approaches are not meaningfully different appearing from each other in practice. Competent psychiatric practitioners from both camps compassionately collect similar data regarding the individual's life story, family history, disease history, and descriptions of recent behavior. Following from this process, neither the Biopsychosocial Model or the Perspectives offer a firm and reproducible methodology for connecting the dots or assigning value to those connections derive the essential 'meaning' or reframe a patient's view of themselves in the world in a manner that leads to greater personal effectiveness.
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Format: Hardcover
This is a hard review for me to write because the book in my mind succeeds on so many levels and was disappointing in some others. That said, I appreciate this book immensely and am inspired by the author's thoughtful approach to a profession that is considered by many to be in crisis.

As a Master's level therapist reading this book, and not a psychiatrist, I never felt talked down to as has been the case elsewhere personally and professionally, and I felt he critiqued his own colleagues with judiciousness. I learned a ton about the history of psychiatry and was captured by it's story-like feel. For professional counselors and psychotherapists, the book is recommended on that alone -- for nothing more than a kind of "who dunnit" approach to where our field came from and the bones on which its muscle is built today.

Ghaemi's presentation of the problem was excellent. He correctly notes the fallacy of "evidence-based medicine" saying that "facts never speak for themselves" -- that there is subjectivism that is inherent in our work and that we must keep a person's lived experience in the forefront as we work with them. I think he rightly criticizes the kind of "free for all" eclecticism that is rampant today. The field lacks any kind of unification and has become so big that it is being crushed under its own weight. He beautifully expresses the role of the arts, metaphor, and an ability to see the human in the body is central, not an extra, to our profession. I agree that if you have no understanding of the humanities, your abilities as a therapist in any regard, whether you do psychotherapy or just hand out pills, is seriously compromised.
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Format: Hardcover Verified Purchase
With the advance of technology in the form of machines such as those from Illumina and the rapid fall in the cost of computing the biomedical model will be the form of initial mental health treatment. On the intake the patient will be genotyped and given a whole body MRI providing a gadolinium enhanced lesion study, a report on white matter hyperintensities, and a report on atrophy evidenced in various brain regions and any evidence of non psychiatric diseases. A sample of CNS fluid will be examined and blood work done especially to determine substance abuse. Thyroid, liver and kidney function will be tested.

If there is no evidence of disease the clinician will interview the patient to see if sedatives or some other class of psychotropic medication can be suggested. If this does not seem to be of benefit the patient is handed an enormous reading list of literary classics and referred to Amazon or the local library. A list of various local self help groups might be given as well.

There is no possibility that the sort of literature driven psychotherapy will ever secure a public or corporate payer. No more than a handful of such people have ever been produced by society and given current trends even fewer will appear in the future. Karl Jaspers is a fine example of a fellow that did four years of clinical work, found it not to his liking and retreated to the academy where he spent the rest of his life expressing himself on paper. It seems Dilthey produced 17 + volumes of unorganized work also scribbling night and day. Existentialism is disappearing beneath the waves as well. When one has to resort to writing about human freedom... well, all is lost right at that point.
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