The premise of Edward Shorter’s A History of Psychiatry is interesting. The brain remains the one piece of human anatomy whose inner workings we have not yet fully understood, and so an overview of our efforts to treat neurological illnesses seems like it would lead down some dark and intriguing alleyways. And so it does. Shorter provides a thorough chronicle of the different stages of psychiatric medicine, from the first efforts to house the mentally ill in asylums to the wonders of modern pharmaceuticals. The description of these phases was interesting, but strangely the least engaging aspect of Shorter’s chronicle was the human element. Shorter treats the book like a Who’s Who of psychiatric history, and the litany of names drone out paragraph after paragraph, each tagged with a brief description of the individual’s accomplishments before stepping aside to make room for the next shout out. Some names reappear pages later, vaguely attributed, leaving you scratching your head and wondering which of the 50 people you’ve just learned about this one is. I can’t fault Shorter for wanting to cite those responsible for psychiatry’s various accomplishments, but a more in-depth study of fewer players would have gone down a lot easier.
The cluttered prose is an inconvenience, but my biggest issue with the book was its editorializing. Shorter admits early on that he has a certain slant, which is admirable, but a history should strive for some level of objectivity. By contrast, Shorter’s preference for some schools of thought over others is apparent throughout the text—every figure associated with biological psychiatry, however slight their contribution, gets a solid 300 words, while major figures of psychotherapy are glossed over. Carl Jung is mentioned perhaps twice, both times in passing, and without any regard to his work or theories.
This editorializing by omission descends into something almost resembling a rant once it reaches the modern day. His dismisses patients with PTSD, anorexia, and moderate forms of depression, anxiety and OCD as little more than whiners who foisted their diagnoses on a hapless DSM committee through political strong-arming. There remains some validity to his criticisms of how the DSM was and is put together, but his cavalier dismissal of serious illnesses—some of which I’ve witnessed firsthand—was pretty gross. He walks this dismissal back in later pages, making it difficult to discern his exact stance on them, but either way the entire final chapter felt far too editorial in tone.