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The writer of this volume believes that the theories and practices of psychoanalytic therapy have been superseded by treating mental disorders with a precise medical diagnosis followed by the correct somatic treatment. Andreasen
replaces the idealization of Freud by the figure of Kraepelin, the 19th-century psychiatrist who is said to have “identified … specific diseases.” She asserts, “In every country except the United States, Kraepelin, not Freud, is regarded as the founding father of modern psychiatry.”
In point of fact, the most authoritative of psychiatric volumes on diagnosis, the DSM-III, has replaced the concept of disease with that of disorder, and even here states that “there is no satisfactory definition that specifies precise boundaries for the concept ‘mental disorder’. … For most of the DSM-III disorders … the etiology is unknown.” It follows that Andreasen's reliance upon the definitive medical diagnosis of disease and a consequently clear mandate for somatic therapy is open to serious question, and this vitiates the major thrust of her book.
Aside from her determined medical bias, Andreasen has produced a worthwhile volume, intended for the general reader, that describes current biological trends in psychiatry. She provides vivid case histories of mental disorders, clear descriptions of brain anatomy and function, and also furnishes precise descriptions, histories, and applications of all the major drugs used by psychiatrists today. There are lucid explanations of such diagnostic instruments as the CT (or CAT) scan and the NMR (nuclear magnetic resonance) scan and also a glossary.
The writer makes efforts to be fair to psychoanalysis, and in some ways she succeeds. Her descriptions of psychoanalytic therapy are generally accurate, and she concedes that there are therapies other than the somatic ones which are helpful. Her effort to be fair is illustrated by a comment on the Little Hans case: “Depending on one's point of view, it is either an intellec