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The authors, one a preeminent American family therapist and the other an Israeli medical psychologist, attempt to extend family systems theory to a larger system, the social system. They believe that the troubled individual cannot be meaningfully addressed in vacuo, panicularly if that person is young or severely disturbed and in need of more extensive mental health or social resources. They introduce the book, which uses the case study approach to highlight their theses, by arguing that the mental health system is usually narrow and uneconomical in its approach to serious psychological problems. Madness may not lie only in the individual but in the structure in which the individual is embedded. Too often, for example, each individual in the family is treated by some form of individual therapy, and each therapist negotiates with the appropriate social agencies—hospitals, employers, schools, social welfare departments. For the authors, this is a kind of professional madness that compounds the madness of the identified patient.
The authors take an especially strong stand against the traditional psychiatric system: the medical model of diagnosis and treatment, the mental hospital, and the overuse of medications, ECT, and the like. They graphically illustrate, both independent of and by use of the case study, the disastrously iatrogenic effect of labeling someone as “ill” and using hospitals and excessive medication to control the situation. They effectively convey that this process initiates a social role for the identified patient wherein the illness takes on a life of its own. Further personality development takes the form of regression to an infirm individual and the loss of the opportunity to turn adversity into constructive growth. One especially strong chapter, written by Israeli psychiatrist Mordecai Kaffman, warns against hospitalization as setting a