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Philip Thomas, a Senior Psychiatrist and Research Fellow in the Department of Economic and Social Studies at the University of Bradford in England, states that his purpose in writing this book is “to examine the implications of the use of different languages in talking about Schizophrenia” (p. 79). His main thrust seems to be to illustrate how the very way in which physicians think about themselves and the mission of psychiatry and the way they talk about and to patients, especially how their personal values influence the treatments they choose to help people, in part create some of the difficulties patients experience. The book is very uneven. In many ways it appears to be written for intelligent laypersons rather than for clinicians. Large sections are devoted to simplified summaries of research on use of neuroleptic drugs and the nature of schizophrenia itself. I believe the author chose to write about schizophrenia because it is the most “alien” of all the mental illnesses and its victims are the type of patient from whom psychiatrists feel most different and therefore find most difficult to help.
At first blush I nearly returned this book as having minimal relevance to psychoanalysis. There are, in fact, only some 3 1/2 pages devoted to psychoanalytic approaches to schizophrenia. The way such approaches are described illustrates the corner the author has painted himself into. For example, on one hand, psychoanalytic approaches, compared with all other therapies, pay more attention to patients' individual experiences (an approach he thoroughly advocates); and yet as he says, “psychoanalysts have been loath to subject their treatment to the same criteria of effectiveness as pharmacological behavioral treatment” (p. 69). The author does not address the contradictions within his own writings, nor does he even seem to be aware of them to any great extent. This work is infused with a bibliography of largely British writings, illustrating