Desperate Remedies

Starred review from May 9, 2022
Sociologist Scull (Madness in Civilization) delivers a remarkable history of psychiatry in America. He begins in the “asylum era” of the early 19th century, when the popular view was that “insanity, when properly treated in appropriate physical and moral surroundings, was a readily curable condition”; a “cult of curability” took hold in which staff claimed to be able to improve up to “60, 70, even 80 percent of cases,” an estimate “wildly off the mark.” The book’s second section, “Disturbed Minds,” begins after WWI, when a wave of returning soldiers who suffered from “shell shock” shifted psychiatry’s focus so that “madness” began to be viewed as “not just a condition found among the biologically inferior who thronged the wards of the asylum.... it existed along a continuum.” The final section, “A Psychiatric Revolution,” is a devastatingly effective chronicle of the rise of psychopharmacology and its tendency to regard all mental illnesses as potentially treatable with the right medication; Scull issues a solid warning that “to deny that social factors play a major role in the genesis and course of mental illness is to blind oneself to an enormous volume of evidence... that teaches us that the environment powerfully matters.” This sweeping and comprehensive survey is an impressive feat.