Shrinks

by Jeffrey A. Lieberman

  Acknowledgments

  I am fortunate to have received much guidance and support in the course of my life and career. Writing this book was no exception. My greatest debt is to my parents, Howard and Ruth, whose love and influence formed my values, moral posture, and view of the world, and to my wife, Rosemarie, and sons, Jonathan and Jeremy, who have enriched my life immeasurably, supported my efforts, and graciously tolerated my many absences from them and family life as a result of my chronic overinvolvement with my professional activities (otherwise known as “workaholism”).

  When I first thought seriously about writing this book, Jim Shinn, a dear friend and professor of political economy and international relations at Princeton, helped me to crystallize the nub of the story from an inchoate conglomeration of ideas. He also pointed me in the direction of oncologist and fellow Columbia faculty member Siddhartha Mukherjee, who was kind enough to spend an illuminating hour with me. I have looked to Sid’s Pulitzer Prize–winning book, The Emperor of All Maladies, as a model and a source of inspiration.

  With a plan in mind, I sought advice from friends who also happen to be brilliant writers. Kay Jamison, Oliver Sacks, and Andrew Solomon offered encouragement, guided my formative thinking about the content, and helped me to navigate the publishing landscape and process. Peter Kramer gave helpful advice as a psychiatrist writing for the general public.

  I owe thanks to my friend and neighbor Jennifer Weis, an editor at St. Martin’s Press, who introduced me to my agent, Gail Ross of the Ross-Yoon Agency. Gail took the idea I pitched to her, expertly fashioned it into something more accessible, and connected me to Ogi Ogas, a skilled writer and neuroscientist. Ogi and I bonded and became virtual Siamese twins for the next eighteen months while developing the story and creating the manuscript. His invaluable contributions and unwavering dedication to the project were apparent throughout, but never more dramatically than when he convinced his fiancée to postpone their honeymoon so that he could finish the book with me on time.

  Numerous colleagues generously gave me their time and provided valuable information during the research process, including Nancy Andreasen, the eminent researcher and professor of psychiatry at the University of Iowa; Aaron Beck, inventor of cognitive-behavioral therapy (CBT) and emeritus professor of psychiatry at the University of Pennsylvania; Bob Spitzer, the chair of DSM-III and emeritus professor of psychiatry at Columbia University, who, along with his wife and DSM-III Task Force member Janet Williams, recounted their experience with DSM and the evolution of psychiatry; Jean Endicott and Michael First, Columbia University faculty who worked with Spitzer and on various DSMs; Robert Innis, eminent scientist and chief of molecular imaging at the National Institute of Mental Health, who advised on the impact of imaging on psychiatry; Robert Lifton, psychiatrist-activist-author and Columbia University faculty member, who described his Vietnam-era experience and collaboration with Chaim Shatan; Bob Michels, the former dean of Cornell Medical College and eminent psychiatrist and psychoanalytic scholar, who, in erudite fashion, recounted the trajectory of psychoanalysis in American psychiatry; Roger Peele, the iconoclastic former chair of psychiatry at St. Elizabeths Hospital, in Washington, DC, and longstanding leader in the American Psychiatric Association, who shared his firsthand experience with the passage of DSM-III; Harold Pincus, former director of research of the APA and vice chair of DSM-IV, who provided an informative perspective on the APA and DSM; Myrna Weissman, the eminent psychiatric epidemiologist and professor of psychiatry at Columbia University, who described how she and her late husband, Gerry Klerman, developed Interpersonal Psychotherapy. Tim Walsh and Paul Appelbaum, eminent psychiatrists and Columbia professors, provided feedback on selected portions of the manuscript. Glenn Martin was the APA Assembly liaison to the DSM-5 Task Force and helped me recall the chronology of events in the development process. Brigitt Rok, a friend and clinical psychologist, provided feedback on sections of the manuscript from the practitioner’s perspective. My friend and colleague Wolfgang Fleischhacker, chair of biological psychiatry at the University of Innsbruck, enlightened me about historical developments in German and Austrian psychiatry, and translated key documents from German to English.

  Hannah Decker’s scholarly book The Making of DSM-III: A Diagnostic Manual’s Conquest of American Psychiatry provided an invaluable source of information.

  Four luminaries generously took the time to review large sections of the manuscript in various drafts and provide detailed comments. Andrew Solomon offered wise but bracing feedback in his review of an early version that got us started on the right track. Eric Kandel, the celebrated scientist, author, and Nobel laureate who is a university professor at Columbia, engaged in several discussions with me about psychiatry, past and present, and gave me relevant materials and valuable comments on sections of the manuscript. Both Fuller Torrey, the researcher, author, and public commentator and advocate for the mentally ill, and Ken Kendler, the renowned geneticist, scholar, and professor of psychiatry at Virginia Commonwealth University, spent lengthy periods reviewing near complete drafts of the manuscript and providing detailed feedback.

  I also want to recognize Peter Zheutlin, a science writer who helped me on an earlier project that contributed to this book, and the journalist Stephen Fried, a member of the Columbia Journalism School faculty, who offered sage advice on effective writing for nonprofessional audiences.

  Thanks to Michael Avedon, Annette Swanstrom, and Eve Vagg for taking and providing photos for the book. Yvonne Cole and Jordan DeVylder provided research assistance, and Yvonne and Monica Gallegos obtained permissions for photos and quotes used in the book. And, perhaps most important, Susan Palma and Monica Gallegos actively managed my schedule to block time for me to write the book.

  When my agent and I first approached potential publishers, Tracy Behar, now my editor, responded with unabashed enthusiasm (along with the publisher Reagan Arthur) and preemptively engaged us with Little, Brown. Over the course of the book’s development, Tracy, with the help of her associate Jean Garnett, guided us with skill and experience. Their timely and incisive comments and suggestions helped craft the book into its final form and length.

  Finally, I want to acknowledge and express my gratitude to my teachers, mentors, psychiatric and scientific colleagues, and mental health care providers for what they have taught me, and the experiences I have enjoyed, and for their efforts to advance our knowledge of, and care for, people with mental illness. Like everything that we collectively do, this book is motivated by the desire to improve the lives of people with mental illness. I am grateful to my patients for the lessons that they have imparted to me, and the purpose that they have given to my life.

  Copyright Acknowledgments

  “The Brain is wider than the Sky” reprinted by permission of the publishers and the Trustees of Amherst College from The Poems of Emily Dickinson, edited by Thomas H. Johnson, Cambridge, Mass.: The Belknap Press of Harvard University Press, Copyright © 1951, 1955 by the President and Fellows of Harvard College. Copyright © renewed 1979, 1983 by the President and Fellows of Harvard College. Copyright © 1914, 1918, 1919, 1924, 1929, 1930, 1932, 1935, 1937, 1942, by Martha Dickinson Bianchi. Copyright © 1952, 1957, 1958, 1963, 1965, by Mary L. Hampson; “Gee, Officer Krupke” (from West Side Story) by Leonard Bernstein and Stephen Sondheim © 1956, 1957, 1958, 1959 by Amberson Holdings LLC and Stephen Sondheim. Copyright renewed. Leonard Bernstein Music Publishing Company LLC, publisher. Boosey & Hawkes, agent for rental. International copyright secured. Reprinted by permission; excerpt from Notebooks by Tennessee Williams reprinted by permission of Georges Borchardt, Inc. for the University of the South. Copyright © 2006 by the University of the South; “Mother’s Little Helper” Written by Mick Jagger and Keith Richards. Published by ABKCO Music, Inc. Used by permission. All rights reserved; CBT dialogue republished with permission of Taylor and Francis Group LLC Books, from Cognitive Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach,
J. Russell Ramsay and Anthony L. Rostain, 2007; permission conveyed through Copyright Clearance Center, Inc.

  About the Author

  Jeffrey A. Lieberman, MD, has spent his career of over thirty years caring for patients and studying the nature and treatment of mental illness. Dr. Lieberman is the Lawrence C. Kolb Professor and Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons and Director of the New York State Psychiatric Institute. He also holds the Lieber Chair for Schizophrenia Research in the Department of Psychiatry at Columbia and serves as Psychiatrist in Chief at New York Presbyterian Hospital–Columbia University Medical Center. His work has advanced our knowledge of the history and treatment of psychotic disorders and has fundamentally contributed to the current standards of care as well as the development of novel therapeutic medications and transformative strategies for the early detection and prevention of schizophrenia.

  Dr. Lieberman has authored more than five hundred articles published in the scientific literature and has edited or coedited twelve books on mental illness and psychiatry. He is the recipient of many honors and awards, including the Lieber Prize for Schizophrenia Research from the Brain and Behavior Research Association, the Adolph Meyer Award from the American Psychiatric Association, the Stanley R. Dean Award for Schizophrenia Research from the American College of Psychiatry, the Research Award from the National Alliance on Mental Illness, and the Neuroscience Award from the International College of Neuropsychopharmacology. Formerly the president of the American Psychiatric Association, he is a member of numerous scientific organizations and in 2000 was elected to the National Academy of Sciences Institute of Medicine.

  He lives with his wife in New York City.

  Sources and Additional Reading

  Adler, A. The Neurotic Constitution. Translated by J. E. Lind and B. Glueck. New York: Moffat, Yard and Company, 1917.

  Amen, D. G. Change Your Brain, Change Your Life: The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness. New York: Three Rivers Press, 1998.

  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th Edition. Washington, DC: American Psychiatric Publishing, 2013.

  ______. The Statistical Manual for the Use of Institutions for the Insane, 1918. New York: State Hospitals Press, 1942.

  Beck, J. S., and A. T. Beck. Cognitive Behavior Therapy, Second Edition: Basics and Beyond. New York: The Guilford Press, 2011.

  Boller, F., and G. D. Barba. “The Evolution of Psychiatry and Neurology: Two Disciplines Divided by a Common Goal?” In Current Clinical Neurology: Psychiatry for Neurologists, edited by D. V. Jeste and J. H. Friedman, 11–15. Totowa, NJ: Humana Press, 2006.

  Brown, H. G. Sex and the Single Girl: The Unmarried Woman’s Guide to Men, 1962. New York: Open Road Media, 2012.

  Campbell, J. The Hero with a Thousand Faces. 3rd edition. Novato, CA: New World Library, 2008.

  Castaneda, C. The Teachings of Don Juan: A Yaqui Way of Knowledge. Berkeley, CA: University of California Press, 1998.

  Centonze, D., A. Siracusano, P. Calabresi, and G. Bernardi. “The ‘Project for a Scientific Psychology’ (1895): A Freudian Anticipation of LTP-Memory Connection Theory.” Brain Research Reviews 46 (2004): 310–14.

  Clarke, C. A., and P. M. Sheppard. “Lessons of the ‘Pink Spots.’ ” British Medical Journal 1 (1967): 382–83.

  Darwin, C. On the Origin of Species by Means of Natural Selection. London: John Murray Albemarle Street Publishers, 1859.

  Decker, H. S. The Making of DSM-III: A Diagnostic Manual’s Conquest of American Psychiatry. New York: Oxford University Press, 2013.

  Diagnostic and Statistical Manual of Mental Illness. American Psychiatric Association Task Force on Nomenclature and Statistics. Washington, DC: American Psychiatric Publishing, 1952.

  Dickstein, L. J., M. B. Riba, and J. M. Oldham, eds. American Psychiatric Press Review of Psychiatry. Washington, DC: American Psychiatric Press, 1997.

  Dukakis, K. D. Shock: The Healing Power of Electroconvulsive Therapy. New York: Avery Publishing Group, 2006.

  Ellenberger, H. The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. New York: Basic Books, Perseus Books Group, 1970.

  Ellman, G. L., R. T. Jones, and R. C. Rychert. “Mauve Spot and Schizophrenia.” American Journal of Psychiatry 125 (1968): 849–51.

  Endler, J. A. “Gene Flow and Population Differentiation.” Science 179 (1973): 243–50.

  Feighner, J. P., E. Robins, S. B. Guze, A. Woodruff Jr., G. Winokur, and R. Munoz. “Diagnostic Criteria from the Saint Louis School (Missouri-USA).” Archives of General Psychiatry 26, no. 1 (1972): 57–63.

  Feuchtersleben, E. von. Principles of Medical Psychology. London: Sydenham Society, 1847.

  Frances, A. Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the Medicalization of Ordinary Life. New York: HarperCollins, 2013.

  Freedman, A. M., and H. I. Kaplan. The Comprehensive Textbook of Psychiatry. Baltimore, MD: Williams and Wilkins, 1967.

  Freud, S. Introductory Lectures on Psychoanalysis. New York: Edward L. Bernays, Inc., 1920.

  ______. Project for a Scientific Psychology. In The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904. Edited and translated by J. M. Masson. Cambridge, MA: Belknap Press of Harvard University Press, 1985.

  ______. The Future of an Illusion. Translated by G. C. Richter. Peterborough, Ontario, Canada: Broadview Press, 2012.

  ______. The Interpretation of Dreams. New York: The Macmillan Company, 1913.

  ______. Totem and Taboo. Translated by A. A. Brill. New York: Moffat, Yard and Company, 1918.

  Gay, Peter. Freud: A Life for Our Time. New York: W. W. Norton and Company, 1988.

  Goffman E. Asylums. New York: Doubleday and Company, 1961.

  Gorwitz, K. “Census Enumeration of the Mentally Ill and the Mentally Retarded in the Nineteenth Century.” Health Service Report 89, no. 2 (1974): 180–87.

  Houts, A. C. “Fifty Years of Psychiatric Nomenclature: Reflections on the 1943 War Department Technical Bulletin, Medical 203.” Journal of Clinical Psychology 56, no. 7 (2000): 953–67.

  Hurn, J. D. “The History of General Paralysis of the Insane in Britain, 1830 to 1950.” PhD diss., University of London, 1998.

  Huxley, A. The Doors of Perception: And Heaven and Hell. New York: Vintage Classic, 2004.

  Hyman, S. E., and E. J. Nestler. The Molecular Foundations of Psychiatry. Washington DC: American Psychiatric Press, 1993.

  James, W. The Varieties of Religious Experience. Rockville, MD: Manor, 2008.

  Jamison, K. R. An Unquiet Mind: A Memoir of Moods and Madness. New York: Vintage Books, 1996.

  Jones, E., and S. Wessely. Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War, Maudsley Monographs #47. Hove, UK, and New York: Psychology Press, 2005.

  Jung, C. G. Studies in Word-Association. Translated by M. D. Eder. New York: Moffat, Yard and Company, 1919.

  Kandel, E. R. “Psychotherapy and the Single Synapse: The Impact of Psychiatric Thought on Neurobiological Research.” New England Journal of Medicine 301, no. 19 (1979):1028–37.

  ______. The Molecular Biology of Memory Storage: A Dialogue Between Genes and Synapses. Monograph Reprint. Les Prix Nobel 2000. Stockholm, Sweden: Norstedts Tryckeri, 2001.

  ______. Psychiatry, Psychoanalysis, and the New Biology of Mind. Washington, DC: American Psychiatric Publishing, 2005.

  ______. In Search of Memory: The Emergence of a New Science Mind. New York: W. W. Norton & Company, 2006.

  Kendler, K. S. “The Structure of Psychiatric Science.” American Journal of Psychiatry 171, no. 9 (September 2014): 931–38.

  Kraepelin, E. Compendium der Psychiatrie. Leipzig, Germany: Verlag von Ambr. Abel, 1983.

  Kramer, P. D. Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self. New York: Viking
Penguin, 1993.

  Lidz, T. The Origin and Treatment of Schizophrenic Disorders. New York: Basic Books, 1973.

  Lifton, R. J. Death in Life: Survivors of Hiroshima. New York: Random House, 1968.

  Linehan, M. M. Skills Training Manual for Treating Borderline Personality Disorder. New York: The Guilford Press, 1993.

  Makari, G. Revolution in Mind: The Creation of Psychoanalysis. New York: HarperCollins, 2008.

  Menninger, K. A. The Vital Balance: The Life Process in Mental Health and Illness, 1963. New York: Penguin Books, 1977.

  ______. “War Department Bulletin, Medical 203—Office of the Surgeon General, Army Service Forces: Nomenclature of Psychiatric Disorders and Reactions, 1943.” Journal of Clinical Psychology 56, no. 7 (2000): 925–34.

  Mesmer, F. A. Dissertation on the Discovery of Animal Magnetism, 1779. Mesmerism: Being the Discovery of Animal Magnetism. Translated by J. Bouleur. Lynnwood, WA: Holmes Publishing Group, 2005 (rev. ed.).

  Michels, R. “Giants of Psychiatry.” American Board of Psychiatry and Neurology 75th Anniversary Celebration. Lecture presented to the American Board of Psychiatry and Neurology (ABPN), September 26, 2009.

  ______. “Psychiatry and Psychoanalysis in the United States.” Philosophical Issues in Psychiatry III: The Nature and Sources of Historical Change. Lecture conducted from University of Copenhagen, Denmark, May 10, 2013.