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What Is Mental Illness? 1st Edition

4.5 out of 5 stars 10 customer reviews
ISBN-13: 978-0674046498
ISBN-10: 0674046498
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Editorial Reviews

From Publishers Weekly

"The boundary between mental distress and mental illness will never be neat and clean," says Harvard professor McNally (Remembering Trauma) in this dense and well-researched scholarly work. He explores changes in society and science that influence how we distinguish disorder from distress. Though McNally serves as an advisor to the DSM (psychiatry's diagnostic bible), he warns against its over application and asks if we should look at mental illness as a spectrum, as we do physical illness; mild expressions would count (and, perhaps, their treatment would be reimbursed for by insurance companies) as much as severe cases. Alternately, the expansion of a disorder's definition, which would include more and more people, does a disservice to patients as well. McNally explores the genetic components of mental illness and looks to evolutionary psychology to explain its persistence. A standout chapter examines the social construction of mental disorders, comparing, for example, the ways that depression sufferers in China and the United States describe their symptoms. This is no pop psychology handbook and will not appeal to the casual reader, but those involved or interested in the field will find it useful.
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The meaning of madness has confounded us for centuries. Now, we learn that half the population meets criteria for mental disorders. In this lucid and erudite book, Richard McNally tackles the difficult questions of science, philosophy, and politics that bear on this issue. His answers will have a great impact on the study of psychopathology. (David H. Barlow, Boston University)

Richard McNally's book is the definitive description of the cultural impact of DSM-style empiricism in psychiatry, and the mostly rational but ultimately unsatisfactory approaches that have led to the state of confusion over the nature of mental maladies and mental health we have today. Although our present chaos will probably last at least a decade past the publication of the DSM-V in 2012, all who long for the replacement of this strange and primitive answer to the question 'What is Mental Illness?' will find some hope in McNally's analysis of new ways of thinking about caring for patients and understanding the mind. (Paul R. McHugh, M.D., Johns Hopkins School of Medicine)

Compassionate and insightful. (Kirkus Reviews 2010-10-01)

McNally, an adviser on the Diagnostic and Statistical Manual of Mental Disorders, calls himself a "friendly critic" of psychiatry. In eight compact, well-written chapters, he points out the high prevalence of mental disorder in the United States, the tendency to create diagnoses to fit with new pharmaceuticals, and the blurred line between distress and disorder that allows grief to be labeled depression and high spirits [labeled] mania. McNally explains how homosexuality was removed from the list of disorders, how posttraumatic stress disorder was added, how the "recovered memory" phenomenon rose and fell, and much more. Together, biology, culture, politics, economics, and religion determine what is and isn't normal. Essential for mental-health professionals, this remarkable book will give diligent lay readers a grasp of genetics, evolutionary psychology, and diagnostic controversies. (E. James Lieberman Library Journal (starred review) 2010-11-15)

McNally's book is essentially an extended critique of the DSM, for which he serves as an advisor...[He] begins by asking if we are pathologizing everyday life...One thing that I particularly appreciated about this book is that McNally doesn't take any sides when describing...hypotheses about the origins of mental illness, allowing the reader to draw his or her own conclusions. Those conclusions will probably be mixed and inconsistent, and that's okay. You get the real sense that he is truly committed to the alleviation of mental suffering...It's a clear, thorough, and lively accounting of the problems facing mental health and its practitioners today, and will prove a fascinating read to scientist and layperson alike. (Jason Goldman Wired blog 2011-05-18)

McNally's wide-ranging and extremely readable book is quite sane, and vastly illuminating...Perhaps the most profound insight in What Is Mental Illness? has to do with the role of culture. McNally presents a clinically nuanced, historically rich, and anthropologically informed discussion of how mental illnesses are expressed...The next DSM edition, the fifth, is now in the works. To judge by the heated controversy within academic and advocacy circles generated by interim progress reports, its unveiling in 2013 will doubtless shine an uncomfortable spotlight on the psychiatric profession and spark plenty of debate. McNally's masterful synthesis will help us understand the discussion, and thereby help us to understand ourselves. (Sally Satel New Republic 2011-05-12)

Product Details

  • Hardcover: 288 pages
  • Publisher: Belknap Press; 1 edition (January 15, 2011)
  • Language: English
  • ISBN-10: 0674046498
  • ISBN-13: 978-0674046498
  • Product Dimensions: 8.5 x 5.9 x 1 inches
  • Shipping Weight: 13.6 ounces
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (10 customer reviews)
  • Amazon Best Sellers Rank: #756,595 in Books (See Top 100 in Books)

More About the Author

Richard J. McNally received his B.S. in psychology from Wayne State University in 1976, and his Ph.D. in clinical psychology from the University of Illinois at Chicago in 1982. He completed his clinical internship and postdoctoral fellowship at the Behavior Therapy Unit, Department of Psychiatry, Temple University School of Medicine. In 1984 he was appointed Assistant Professor in the Department of Psychology at the University of Health Sciences/The Chicago Medical School where he established the Anxiety Disorders Clinic and directed the university counseling center. He moved to the Department of Psychology at Harvard University in 1991 where he is now Professor and Director of Clinical Training. He has more than 330 publications, most concerning anxiety disorders (e.g., posttraumatic stress disorder, panic disorder, phobias, obsessive-compulsive disorder), including the books Panic Disorder: A Critical Analysis (Guilford Press, 1994), Remembering Trauma (Belknap Press/Harvard University Press, 2003), and What is Mental Illness? (Belknap Press/Harvard University Press, 2011). He has conducted laboratory studies concerning cognitive functioning in adults reporting histories of childhood sexual abuse, including those reporting recovered memories of abuse. His research has been supported by the National Institute of Mental Health. He served on the American Psychiatric Association's DSM-IV PTSD and specific phobia committees, and he is an advisor to the DSM-V Anxiety Disorders Sub-Workgroup. He is a Licensed Clinical Psychologist, a Fellow of the Association for Psychological Science, winner of the 2005 Distinguished Scientist Award from the Society for the Science of Clinical Psychology, winner of the 2010 Outstanding Mentor Award from the Association for Behavioral and Cognitive Therapies, and he is on the Institute for Scientific Information's "Highly Cited" list for psychology and psychiatry [top 0.5% of published authors worldwide in terms of citation impact].

Customer Reviews

Top Customer Reviews

Format: Hardcover Verified Purchase
This is a very informed and sympathetic assessment of psychiatry (and other mental health professions) and the many problems that come with understanding mental illness. To what extent are mental disorders genetic? Socially caused? Socially constructed, even? Is the current state of psychiatry scientific? Is the DSM purely political and subject to the whims of culture?

McNally, who has served in various roles as an adviser to the DSM review committees, addresses all of these concerns, and more, and does so without pointing fingers and laying blame. He highlights the difficulties psychiatrists face on the ground not only with trying to help patients who are suffering, but also when dealing with insurance companies. In fact, he emphasizes the role that insurance coding and the need for patient benefits has played in the significant growth of the DSM and its myriad disorders over the past decades.

Regarding the DSM more generally, McNally provides a bit of history of the motivations behind the symptoms-only focus of DSM III, discussing how this was (deemed) necessary and how this both helped and hindered psychiatry ever since. He also discusses a number of ongoing debates within the field (along with psychology) about how DSM 5 ought to be restructured, focusing more on psychopathology and perhaps adjusting diagnoses to reflect degrees of mental illness rather than distinct kinds.

Perhaps one of the weak points of the book is the time he sets aside to discuss differing ideas about the role mental disorders might have played in -- and the problems they may present for -- human evolution. The fault is not so much his as that of the proponents of many of the ideas that, frankly, aren't worthy of much consideration.
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Just a warning to those with a low attention span: there are no car chases or titillating stories here, just good hard, thorough science that is going to require you to stay awake and pay attention. But if you can manage to do that, you will really learn something about the myriad theories about what is and isn't mental illness and how it should be judged when invoking a diagnosis of such. McNally gives us all the theories and then points to the most sensible viewpoint, and his analysis and evaluation of these theories is well thought-out scientifically and given to good old fashioned common sense.
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Format: Hardcover Verified Purchase
McNally writes clearly about complex and nuanced issues ranging from the inner politics of the APA to the theoretical approaches that inform treatments and research. His account of the "recovered memory syndrome" fad alone is worth the price of the book! His candid discussion of issues and assumptions, and their implications for policy and treatment are a refreshing look at the fuzzy lines and gray areas which we often fail to acknowledge in the advocacy or advertising propaganda which dominates most discourse about this topic.
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Format: Paperback Verified Purchase
I thought I understood what mental illness was. Then Dr McNally showed me up. In a series of elegant and well-cited chapters, McNally points out exactly where the strengths and limits of the current diagnostic system are. Eminently readable and enlightening.
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This book arrived in great condition and was exactly what I expected. I would recommend this seller to others and revisit for future purchases. The book was based on the authors opinion regarding the topics throughout the book.
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