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Psychiatryland's central thesis is that the world of modern psychiatry, with its commercial links to the big pharmaceutical companies, is not much different to the slick, hyper-reality theme parks which lure millions of Americans into a spending frenzy, leaving them simultaneously bereft of funds, and some would argue, a little more bereft of soul. The author, Dr Phillip Sinaikin, M.D, a board-certified psychiatrist with over 20 years of frontline experience, carefully, convincingly and systematically dissects the diagnostically-inadequate modern mental healthcare system and exposes the commercial imperative, which is destroying lives faster than the Prozac pills are pumping down the factory conveyor belt.
It's hard to know exactly how to pin this book down. It's a complex web of passionate truth-telling, searing intellectual wit and concrete, real world case analysis fuelled by direct experience with the most important people at the heart of this modern minefield – the little old consumer – me and you.
For a book whose title plays on the world of Disney, its own narrative structure is often very Hollywood-like, which is no bad thing; with such weighty, serious themes to get stuck into, the author clearly appreciates the need for a strong, powerful hook to lure the reader onto his enlightening rollercoaster ride. Dispel all fears of boredom before you step onto the car. Strap yourself in and get ready for the ride. Not only is this an intellectually challenging work, it is also highly accessible to the modern consumer. Sinaikin is catering primarily for people who want to make informed decisions about their own and their loved ones mental well-being, but he comes at the subject as an avid believer in Postmodern Philosophy. At times, the author steers a precarious path. This book could very easily have derailed itself and plunged headlong down a dead-end spur track littered with overcooked ideas. But the balance is perfectly struck. Admittedly, some passages will require a second reading, but that is not so much irksome, as it is mentally rewarding, as you will come to grips with philosophical concepts such as 'methodological individualism' and the 'technological attitude', which Sinaikan argues, are undermining a nation's mental wellbeing. This is heavyweight stuff, but the author never loses his intended audience, as he determinedly drags them towards the final destination, with a strong and wittily humanistic style, which at times verges on Coen-esque black humor.
Sinaikin likens his current role in the world of psychiatric medicine, to 'a pacifist working in a bullet factory'. His tone is never too quirky given the subject at hand, but the humour is pitch perfectly delivered. So how did we get from Hollywood opening to the barrage of Coen-esque-like one-liners which pepper this narrative?
It's a great opening, as good as the first five minutes of a superior Hollywood thriller.
Sinaikin slugs us straight in the gut as he recounts the unbelievably tragic story of a 4-year old child who died after overdosing on psychiatric medication prescribed for its own bipolar disorder….. 4 year olds….overdoses….bipolar disorder…. Psychiatric medication. If this had not come from the pen of an experienced psychiatrist with grave concerns about the state of modern mental healthcare, this would have smacked of pure fiction.
It's a brilliant set-up. It's going to be crystal clear to even the craziest of readers, that a world where a 4 year old can be diagnosed as bipolar and die from overdosing on powerful mind-bending drugs, has got some serious questions to answer. Such is the forcefulness of this setup, Sinaikin gives himself carte blanche to tear modern medical model psychiatry to pieces. And he willingly and successfully takes up the challenge, as he shows us how the science which underpins most mental health diagnoses, is precarious at best, and often downright speculative, with its insistence on chemical imbalances as an explanation for traumas which the author insists, are nothing more than normal life events – stress, grief, divorce, substance problems. He goes further and presents convincing evidence that psychiatry, in league with big Pharma, is actually inventing new 'illnesses' with the sole purpose of developing medications (based on speculative scientific, non-existent evidence of 'chemical imbalances'). More disturbingly, all these conditions are codified and passed out into the world through the medium of DSM-IV, giving them legitimacy and influencing mental healthcare practitioners around the globe. The world really has gone mad. Thankfully this book will empower the individual to regain and maintain their own sanity. As a frontline psychiatrist Sinaikin rejects many of the simplified diagnostic criteria presented in DSM. But he goes even further, and from his razor sharp postmodern perspective he shows how the formulation and codification of mental disorders is not only not an exact science, it is also very much a subjective enterprise, colored by individual belief systems. Thought leaders, discourse control…just a couple more concepts which come into play in this challenging book.
Qualifications should be made regarding the author's own perspective on the drive to medicate first and ask questions later. Sinaikin is by no means averse to prescribing medication; his contention is with the rise of polypharmacy and the commercial pressures exerting themselves on the psychiatric profession, which sometimes lead to gross overmedicating of simple reactive traumas to normal life events. As a knowledgeable and experienced mental health professional, Sinaikin understands the benefits of medications in alleviating the symptoms of the more extreme psychoses. He takes issue with a current landscape awash with a surfeit of tablets for every conceivable emotional difficulty, often the detriment of the consumer at the sharp end.
In the final analysis, what this book showcases is an impassioned battle between a mechanistic-technological-scientific interpretation of reality, and a more humanistic, holistic, rational one. No prizes for guessing which interpretation is currently dominating the arena of mental wellbeing. So does the author give us any alternatives to the current penchant for medicating anything that moves? He certainly does, and in the final stages of this book, the beautiful simplicity of it acts like an antidote to the over complexity of the modern world Sinaikan so abhors.
Ignorance about other available paths to mental wellbeing is an equally large concern for him. As a mental health practitioner who objects to the diagnosing of individuals in a vacuum, without any reference to societal pressures, stresses and economic factors, he is keen to promote alternative routes to wellness – psychotherapy and twelve-step programs feature strongly in the final stretch of this book. In fact, the twelve-step program gets a significant mention. It has strong connections with the profit-free origins of Alcoholics Anonymous – the antithesis of what currently seems to be going wrong as the pharmaceutical industry bombards TV screens and magazines with slick marketing designed to get you running to the nearest head doctor.
Psychiatryland is a bold, challenging, intellectual but highly accessible source of information for consumers, students and all mental health practitioners. It is compellingly structured and penned in a down-to-earth style by a concerned psychiatrist whose passion and wit shines through. It is absolutely essential reading.
© 2012 Alex Jenson
Alex Jenson writes about himself: "I have just successfully completed my training to teach English as a second Language. I am a published author and poet, a film school screenwriting graduate. I am working on my first feature length screenplay. I was born in the north of England. I am a big sports fan and I love running and playing football."