A lively exploration of mind and brain, conscious and unconscious, patient and client. In this companion volume to their widely acclaimed Perspectives of Psychiatry, Phillip R. Slavney, M.D., and Paul R. McHugh, M.D., argue that the discontinuity of brain and mind is the source of much of psychiatry’s discord, for it leads psychiatrists to think about their discipline in terms of polar opposites: conscious or unconscious; explanation or understanding; paternalism or autonomy. Psychiatric Polarities brings together the history of ideas and such clinical issues as suicide and bipolar disorder to identify, describe, and debate these and other polar oppositions that arise from psychiatry’s inherent ambiguity. There is no single conceptual perspective that is sufficient for all of psychiatry’s concerns, Slavney and McHugh observe, yet it is both possible and necessary to transcend the denominational conflicts that plague the field. In Psychiatric Polarities, their examination of these conflicts demonstrates how a methodological approach can help to resolve disagreements rooted in partisan commitments.

The Four Domains of Mental Illness presents an authentic and valid alternative to the DSM-5, which author René J. Muller argues has resulted in many patients being incorrectly diagnosed and wrongly medicated. Dr. Muller points out where the DSM-5 is mistaken and offers a guide to diagnosis based on the psychobiology of psychiatrist Adolf Meyer and the insights of existential philosophy and psychiatry. His model identifies the phenomena of the mental illnesses that clinicians most often see, which are characterized by identifying their structure, or partial structure. Using the FDMI approach, clinicians can grasp how each mental illness is an aberration of Martin Heidegger’s being-in-the-world.

One of the fascinations of psychiatry is that it is amenable to many different approaches. In seeking to account for mental disorder, for example, it is pos sible to explore the meaning and significance of symptoms in the psychody namic sense, to examine the social determinants of illness, or to adopt an es sentially biological viewpoint in investigating links between physiological and psychological dysfunction .. As a clinical discipline it may be practiced in the community, in the specialized clinic or hospital, or shoulder-to-shoulder with other medical practitioners in the general hospital. This richness and diversity are at once a strength and a weakness, attracting practitioners with a wide range of talents and interests, yet sometimes leading to polarizations and false an titheses. The so-called "medical model" of psychiatry has come under a good deal of attack, and deservedly so when claiming an exclusive provenance over all types and aspects of mental disorder. What cannot be gainsaid, however, is the central role of medicine in relation to many parts of the field, and the success in terms of understanding and therapy that has resulted from medicine's in volvement. Nor can it be doubted, after the most cursory acquaintance with the physically or mentally ill, that the relationship between these two forms of suffering is often so close and so mutually reinforcing that distinctions are drawn somewhat arbitrarily. This last is perhaps the cardinal reason for the alliance between medicine and psychiatry.

The Perspectives approach to psychiatry focuses on four aspects of psychiatric practice and research: disease, dimensional, behavior, and lifestory. In Systematic Psychiatric Evaluation, Drs. Margaret S. Chisolm and Constantine G. Lyketsos underscore the benefits of this approach, showing how it improves clinicians' abilities to evaluate, diagnose, and treat patients. Drs. Chisolm and Lyketsos use increasingly complex case histories to help the mental health provider evaluate patients demonstrating symptoms of bipolar disorder, psychosis, suicidal ideation, depression, eating disorders, and cutting, among other conditions. The book also includes an exercise that simulates the Perspectives approach side by side with traditional methods, revealing the advantages of a method that engages not one but four points of view. Featuring a foreword by Drs. Paul R. McHugh and Phillip R. Slavney, the originators of the Perspectives approach, this innovative book will be used in psychiatric training programs as well as by practicing mental health clinicians. -- Arnold E. Andersen, M.D., The University of Iowa College of Medicine

In this book, Johns Hopkins psychiatrist Phillip R. Slavney, M.D., offers a concise guide that will help primary-care physicians evaluate and treat patients who are delirious, demoralized, thinking of suicide, or refusing to follow medical advice. Although these patients exhibit emotional distress, cognitive disturbance, or maladaptive behavior, the cause of the problem is often their medical illness and treatment. For that reason, many such patients can receive excellent care from their own physicians—physicians who, given the resistance of managed care companies to specialist referrals, must now bear that responsibility in any event. After an introductory chapter on clinical assessment, Slavney discusses each of these common problems as it occurs in the clinical setting, with illustrative cases and specific advice about evaluation and treatment. "Dr. Slavney has written lucidly and carefully about these very important issues, clarifying his exposition through a series of case examples. This book should be enormously useful not only to students and house staff but also to practicing physicians and faculty, especially those making the rounds on clinical services. One wishes, in fact, that it were possible to have Dr. Slavney along on rounds; this volume is a useful move in that direction."—Jeremiah A. Barondess, M.D., from the foreword

Psychiatry in Law/Law in Psychiatry, 2nd Edition, is a sweeping, up-to-date examination of the infiltration of psychiatry into law and the growing intervention of law into psychiatry. Unmatched in breadth and coverage, and thoroughly updated from the first edition, this comprehensive text and reference is an essential resource for psychiatry residents, law students, and practitioners alike.

The controversies and dilemmas in contemporary psychiatry are so numerous and serious that they, to a great extent, define psychiatry. Yet most psychiatrists pay little attention to the field's controversies, maintaining that talking about controversies tarnishes psychiatry's reputation and them along with it. Critics of psychiatry use these controversies and dilemmas, along with psychiatrists' unwillingness to discuss them, to undermine psychiatry. They question the existence of mental disorder and the purpose of psychiatric therapy. Kecmanovic undertakes a major effort of resolving with science, not ideology, such dilemmas. Although psychiatrists give no thought to the mind-body relationship, their attitude towards this relationship determines their approach to the mentally ill, their understanding of the origin and nature of the mental disorder, and the therapy they think has priority. Sometimes psychiatrists implicitly or explicitly cite a specific school of philosophy in order to find conceptual support for their particular practice. As a result psychiatrists do not speak the same language about the same issues. Kecmanovic suggests that there can be no dialogue without common language; opposing views cannot converge without dialogue. The behavior of the mentally ill is socially jarring. This is a major reason why the mentally ill are considered to be a menace. They threaten prevailing manners of communicating, expressing one's thoughts and feelings, and the existing meaning of symbols in a given environment. Deviance of a person with a mental disorder is specific; socially perceived as incomprehensible, irrational, and unpredictable. What is common to all reactions to the disruptive nature of a mental disorder is the desire to be protected from those with illness; in other words, to put them under control and supervision.