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The author of this book graduated from McGill Medical School in 1964, a time when the influence of psychoanalysis on psychiatry was at its height. He was “happy to enter a specialty that kept its distance from medicine.” Doctors were busy balancing body fluids and had no time to talk to patients. “Psychiatry, on the other hand, was about life” (p. 161). Of the students in Paris's medical school class, 15 per cent specialized in psychiatry. In the United States, the choice “reached an all-time high of 12.5 percent in 1954” (p. 26). Today, the number never goes higher than 5 per cent, and usually hovers around 2 to 3 per cent (p. 17). In spite of these figures, the author believes that “the only stance that has any hope of retaining a place for psychoanalysis within psychiatry is a rapprochement with science” (p. 156).
Paris tells us that “in the 1960s many physicians expressed contempt for psychiatry because they saw it as more or less synonymous with psychoanalysis.” How is this to be reconciled with the attractiveness of the field for medical students, and with the fact that Bond (Cleveland), Gauthier (Université de Montréal), Lowy (Toronto), Michels (Cornell), and Pardes (Columbia)—all psychiatrists who became deans of medical schools—were analysts?
The author has two explanations for the low recruitment of medical students into psychiatry: “When there was only one way to become a doctor who cared about the mind and soul, medical students turned to psychiatry. Now there is an alternative in family medicine … The problem is that medical students still see psychiatry as insufficiently scientific” (p. 162).
Would it not be scientific to consider the possibility that, since this decline coincided with a lesser role of psychoanalysis in academic psychiatry, correlation might imply causation?
One of the reasons given for the fact that psychoanalysis is not scientific is that “the discipline has never developed a way to discard old ideas” (p. 157). But earlier in the book, w