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This remarkable book by Tom Burns, a British psychiatrist and professor of social psychiatry at Oxford, conveys much of the history of psychiatry, its triumphs and follies, its uses and abuses, its current strengths and weaknesses, and its prospects—all in 350 very readable, deeply informative pages. It seems at first to address the general intelligent reader, but then opens into brief thoughtful accounts that will interest, inform, and at times provoke anyone in the field of psychiatry. No one today can plausibly claim a scholarly knowledge of every part of the subject, and Burns relies heavily on secondary sources for psychoanalysis. The result is a timely and forceful reminder of how deeply misunderstood psychoanalysis and its development are, not only by the general public but even by a broadly informed, apparently well-disposed and humane academic psychiatrist.
Burns describes his adolescent and young adult experience of psychiatry, beginning with what would be his mother's twenty-year struggle with depression, and then smoothly shifts to what a new patient might experience in a first interview. He again draws on his own life, having once sought to join a group analytic treatment. The exposure and undefendedness he felt in a preliminary meeting with the therapist was followed by an absurd wave of confidence and idealization of the therapist. He proceeds to what he imagines the psychiatrist may have been thinking in that same initial interview. His narrative is an altogether remarkable account of the first psychiatric encounter. In the chapters that follow he discusses most branches of the field, and finally what makes it our “shadow,” in at least two senses: at its best, psychiatry draws on