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Over the past several decades, psychiatry has undergone radical changes. After its midcentury heyday, psychoanalysis gave way to a worldview guided by the Diagnostic and Statistical Manual, which precisely defined mental disorders and their treatments; more recently, this too has been displaced by a model inspired by neuroscience. Each of these three dominant models overturned the previous era’s assumptions, methods, treatment options, and goals. Each has its own definitions of health and disease, its own concepts of the mind. And each has offered clinicians and patients new possibilities as well as pitfalls.
The Couch, the Clinic, and the Scanner is an insightful first-person account of psychiatry’s evolution. David Hellerstein—a psychiatrist who has practiced in New York City since the early 1980s, working with patients, doing research, and helping run clinics and hospitals—provides a window into how the profession has transformed. In vivid stories and essays, he explores the lived experience of psychiatric work and the daunting challenges of healing the mind amid ever-changing theoretical models. Recounting his intellectual, clinical, and personal adventures, Hellerstein finds unexpected poetry in hallways and waiting rooms; encounters with patients who are by turns baffling, frustrating, and inspiring; and the advances of science. Drawing on narrative-medicine approaches, The Couch, the Clinic, and the Scanner offers a perceptive and eloquent portrayal of the practice of psychiatry as it has struggled to define and redefine itself.
Preface
Part I. The Couch, 1980–1994
1. The Work: Learning to Do Psychoanalytic Psychotherapy, 1980–1984
2. Tigers in the Night: A Therapist’s Own Therapy, 1981–1988
3. The Enchanted Garden: Psychoanalysis in the Psychiatry Marketplace, 1985
4. Dreams of the Insane Help Greatly in Their Cure: Demolition of the Psychoanalytic Mothership, 1994
Part II. The Clinic, 1985–2000
5. Treating the City: DSM Psychiatry in the Real World of the City Hospital, 1989
6. Reinventing the Egg: Translating the DSM Across Cultures and Languages, 1990–1994
7. The Red Box: Digging Deep Into the DSM, Late 1990s
8. Call: Testing the DSM Off Hours, 1998
9. Less with Less: Stripping the DSM to the Essentials or Beyond, 1998–2000
Part III. The Scanner, 1997–2023
10. Flights Into Health: Learned Safety and the New Neuropsychiatry, 2000–2007
11. Curing Families: Genes, Circuits, and the Frontiers of Treatment, 2005–2009
12. Off Label: Revisioning Drugs in the Age of Neuroscience, 1997–2023
13. Mind Wandering, Then and Now: New Views Over Three Eras, 2005–2023
14. Floating Brains and Magic Mushrooms: Ancient Psychedelics Test the Progress of Psychiatry, 2019 to Today
Afterword
References
Index
Description
Over the past several decades, psychiatry has undergone radical changes. After its midcentury heyday, psychoanalysis gave way to a worldview guided by the Diagnostic and Statistical Manual, which precisely defined mental disorders and their treatments; more recently, this too has been displaced by a model inspired by neuroscience. Each of these three dominant models overturned the previous era’s assumptions, methods, treatment options, and goals. Each has its own definitions of health and disease, its own concepts of the mind. And each has offered clinicians and patients new possibilities as well as pitfalls.
The Couch, the Clinic, and the Scanner is an insightful first-person account of psychiatry’s evolution. David Hellerstein—a psychiatrist who has practiced in New York City since the early 1980s, working with patients, doing research, and helping run clinics and hospitals—provides a window into how the profession has transformed. In vivid stories and essays, he explores the lived experience of psychiatric work and the daunting challenges of healing the mind amid ever-changing theoretical models. Recounting his intellectual, clinical, and personal adventures, Hellerstein finds unexpected poetry in hallways and waiting rooms; encounters with patients who are by turns baffling, frustrating, and inspiring; and the advances of science. Drawing on narrative-medicine approaches, The Couch, the Clinic, and the Scanner offers a perceptive and eloquent portrayal of the practice of psychiatry as it has struggled to define and redefine itself.
