John Marzillier – To Hell and Back

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Book Review, John Marzillier, Psychiatry, Psychological Therapies, Psychology, Psychotherapy, PTSD, To Hell and Back, Trauma

A wise, thoughtful, compassionate and skillful book about PTSD revealed through the words of those who have experienced this.

It’s funny how synchronicity works. Because I read Noel Hawley’s highly recommended Before The Fall, which I highly recommend, and which features a small boy who suffers a profound traumatic event, and clearly would be diagnosed with PTSD, and because I have a professional interest in the subject, I was reminded that John Marzillier, a British clinical psychologist and later, psychotherapist had written a book on the subject.

I had been moved and beautifully taught much in another book by him, The Gossamer Thread, where he explored his wide journey of development as a practitioner, and the deep exploration, refining, and ambiguity in human relationships that happen throughout all our lives, within and without any kind of formal therapeutic setting, simply because human beings are complex, and so each and every encounter between self and other is fraught with – an endless possibility.

Duke and Duchess of Cambridge and Prince Harry: Promoting the charity Heads Together to open up discussion of mental health issues

So, I started to read the in some ways, more geared towards the practitioner, slightly more left brain, slightly less poetical/metaphorical To Hell and Back: Personal Experiences of Trauma and How We Recover and Move on. And during my reading and reflecting period, mental health, particularly linked to the experience of dealing with psychological trauma, suddenly became positive news, due to Prince Harry, and also Prince William, speaking openly about the deep, hidden effects caused by their mother’s death. Public figures speaking out in such a way, honestly, – particularly public figures who are, not being rude, part of the Establishment rather than famous for flashier, sex-and-drugs-and-rock-and-roll lifestyles, not to mention ‘reality TV’ famous only for being famous ‘stars’, will be listened to more seriously.

Expression of emotion is more common, and I would say, generally a good thing, with the exception of the artificial stimulation of emotion in reality TV shows!

But, he also cautions against those who assume it always IS the right approach to bare the suffering soul:

Is avoiding talking about feelings always wrong? I do not think that one can or should make such a categorical statement. So much depends on the context and the person, not to mention their relationships with family and close friends and on timing

Focusing on a wide range of traumatic single events – Marzillier in this book is exploring the kind of ‘out of a moderately clear blue sky’ unexpected and traumatic event, rather than, say the trauma of repeated brutal events from early childhood – the author looks both at the unpredictable horrors caused by acts of deliberate chosen malevolence, and the impersonal ‘being in the wrong place at the wrong time’ of major accidents like train crashes due to mechanical failures. Marzillier was, for many years, employed by Thames Valley Police, working with those who have to deal with traumatic events, which arise out of the nature of their work – police, firefighters, army personnel, ambulance personnel. The professionals have to maintain a distance from their own natural ‘alert! Danger! I am under threat! autonomic nervous system response of flight, fight, freeze or dissociation which is our physiological survival response. The fact that they are trained to do this, and have techniques to use, cannot ever completely over-ride that ancient animal response, and this kind of ‘trauma is my 9-5, day in-day out worker’ may well find health problems which arise out of the continual overriding of the normal response to danger – get out of here!

How people feel and behave once they are out of danger and the traumatic event is over is a product of the intensity of the experience itself, the nature of the person and the context – that is, what their life is after the event

As in his previous book, what most blazes out, necessarily and importantly, is Marzillier’s artistry, his compassion, his flexibility and his open-ness to meet each individual he interviews for this book, making space for a joint exploration of their stories. Time and again he cautions against the single fix-it approach to PTSD – and, indeed, to the single, fashionable diagnosis of the condition. There may be other mental and emotional health issues experienced by someone who has been in a ‘traumatic’ situation, and other approaches, other diagnoses may need to be made. Don’t jump to a PTSD conclusion, he cautions.

It is a mistake to sweep all post-trauma psychological reactions into one simple category, or to assume that if someone shows PTSD symptoms then nothing needs to be done but treat the person’s PTSD

At the heart of this book, is the often stated central idea that whatever ‘the diagnosis’ says, that it is a unique individual with all their individual personality, history, belief systems and social networks who is receiving the diagnosis, and there CAN be no ‘one way’ of treatment. As in Gossamer Thread, Marzillier stresses it is the relationship between practitioner/clinician and patient/client which actually matters MORE than any ‘specific’ method. Sure, the practitioner must have relevant skills which can work in this field, and preferably, the flexibility and skill to acknowledge that ‘their’ skillset may not be the right one for THIS client at this point. Marzillier even acknowledges that treatment approaches which lie outside his particular belief system and training, DO work for some people, – with the right practitioner. He is extremely open-minded, whilst being at the same time, a scientist by training.

This book has a lot, highly relevant, to say to both the clinical psychologist and the ‘energy worker’ working in this field.

It is a marvellous book, serious, analytical, warm, open minded and hearted – and, always important, beautifully written, and authentic – he has allowed the individual voices of the many people he interviewed in this book – those who had experienced events, and been diagnosed with PTSD – to recount their stories, and the different treatments and outcomes. These are not, in the main, ‘his clients or former clients’ . They are people who chose to respond to a general request made ‘public’ when he was planning on writing a book on this subject.

To Hell and Back Amazon UK
To Hell and Back Amazon USA

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Barbara Taylor – The Last Asylum: A Memoir of Madness in Our Times

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Barbara Taylor, Book Review, Medical History, Mental Health, Psychiatry, The Last Asylum: A Memoir of Madness in Our Times

Historical analysis of mental health care wedded to an almost unbearably painful warts and warts memoir.

Historian and writer Barbara Taylor’s The Last Asylum is partly an objective analysis of mental healthcare provision from the early provision of ‘places of asylum’ and/or places of incarceration, to the more recent dismantling of long stay psychiatric hospitals in favour of ‘Care In The Community’ . Asylum provision itself, which, at its best can provide a place of safety and community for the vulnerable, can at its worst also be a dumping ground for all kinds of people with mental, emotional or behavioural ‘difficulties’ which are perceived as outside society norms. And moreover can be a place where the lost, confused, furious, terrified or despairing can be treated brutally and abusively

History’s verdict has yet to be delivered, and it is possible that the judgment will be more favourable to the old asylums, at least in some respects, than psychiatric modernizers would like us to believe

Closing asylums, however, has been far from an unalloyed blessing. The change in the way psychological dis-ease has been dealt with was not a move done with completely pure, outcome driven intent. Cost was a huge driver. Like asylums themselves, and how patients fared within them, ‘Care In The Community’ as a concept is hugely variable on the ground, as Taylor, explains. At its best, people are supported back into community by skilled case workers, with provision for sheltered housing, day centres, and a wealth of trainings. Unfortunately the ‘at its best’ is a rare beast in times of austerity, and in the aftermath of Thatcher’s ‘There is no such thing as Society’ ethos, the vulnerable may find themselves with little care, and outside any community.

Anthony Bateman summarized the situation to me : “The relational, pastoral component of mental health care has been eliminated. All that is left now is a mechanistic, formulaic, depersonalised substitute for quality care”

The Last Asylum is not only objective and historical analysis. Taylor herself is/has been one of the vulnerable, from very young. She came from a high-achieving and materially successful Canadian background. Material well-being, as she acknowledges, was certainly helpful to her in one of her chosen routes towards recovery, but material well-being is not of course any guarantee that parents will be able to provide good, supportive, loving and unexploitative grounding for their children. Taylor suffered abuse as a child, the sexual dynamics in her family were disturbing, and the relational messages from both parents, remarkably creepy. Early signs of Taylor’s anxiety, depression and instability were ignored, and it seems there was a fair degree of undermining of her, as well as exploitation.

The lived past is never really past; it endures in us in more ways than we understand

More than half the book is about Taylor’s long experience of breakdown, rage, terror, despair, self abuse and alcoholism, and details her personal experience as a ‘service user’ of mental healthcare provision – including 3 spells as an inmate in ‘The Last Asylum’ –Colney Hatch Lunatic Asylum, which on its opening in 1851 represented progressive, enlightened treatment of mental health, but very quickly became associated with some of the worst excesses of institutions where the fragile were dumped, forgotten and incarcerated. At the time of Taylor’s 3 admissions there, in the late 1980s, the final one lasting 5 months, the now renamed ‘Friern Hospital’ was already scheduled for closure, under those changed ‘Care In The Community’ drives. But, as Taylor explains, the Hospital provided a place of safety, support and containment for many, and proper provisions for community care outside were often non-existent

‘Colney Hatch Pauper Lunatic Asylum 1851′

As well as support through hospitalisation, Taylor was also lucky in her NHS psychiatrist. She also took the decision to embark on psychoanalysis, privately paid for. Soon, she was seeing her analyst (including during her spells in Friern) 5 times a week. This went on for 21 years.

I know………it gave me pause for thought too.

Friern Hospital now converted as a prime location for luxury flats as Princess Park Manor

And a large part of this book recounts the circular conversations between Taylor and her analyst – she kept journals recording what she said, what he said, what she felt, what her dreams were. This makes for pretty depressing reading to be honest. And, it must be said at times extremely wearing. Taylor is, I think, very honest: there is little attempt to charm the reader, to get the reader to like her – she presents herself as grandiose, self-obsessed, manipulative and without empathy, compassion and understanding for others around her. Indeed these aspects of her nature and behaviour formed a major strand in her analysis However…….though all this meant that her personal story at times became utterly wearing, there had to be far more to her than that, as she also had a group of incredibly supportive friends over the decades, who clearly loved and cherished her, and did not wash their hands of someone who, on the face of it, in her account in this book, does not reveal just why those friends so clearly were and remain her loyal friends.

Poverty is a psychological catastrophe. Anyone who thinks that madness is down to defective brain chemistry needs to look harder at the overwhelming correlation between economic deprivation and mental illness

I value this book for the honesty and clarity which Taylor sometimes expresses about herself – she is well aware that the ‘luxury’ – in terms of how it helped her – of that 21 year journey of analysis was only available because of family funds – for a long, long, time she was too ill, too self-destructive, too drunk to work. And she also answers the questions which I think any reader must have about whether that 21 years was a waste of time and money, whether she could/would have got better without it, and faster, whether some of the ‘fast result’ approaches like CBT would have been a better option, whether, if long term stay in Friern had not been available, could she/would she have got better – or might she have killed herself without any or all of these supports. Indeed did some of the support (those 21 years) actually make her WORSE. As she shows, going into deep analysis is not some wonderfully self-indulgent place, it’s at times excruciatingly abrading, an endless delving for suppurating boils. Most of us find ways to plaster over and avoid our deepest pains, if at all possible.

Homeless feelings are boundless; they sweep all before them. Their violence is as all-engulfing as the primeval experiences – aloneness, helplessness, total vulnerability – that power them. Some memories never lose their potency; they live on in the heartbeat, the muscles, the breath

She is honest enough, in effect, to say she can’t really answer any of that – who knows? Nor is she crassly suggesting that any one approach is ‘the’ approach for the treatment of mental and emotional illness. What she cogently argues against is the taking away of choice. Some people needed the support of asylum; some people needed a longer, more relational safer space afforded by a psychotherapist – or even a psychiatrist who was more than just a quick dispenser of pills on a ten or twenty minute appointment. What we have now is, often, doing no more than placing a plaster over an infected wound, dispensing pills which cosh the symptoms of dis-ease, and create dependency. It’s a one size fits all.

A disturbing, thought provoking book, and a powerful one

The Last Asylum Amazon UK
The Last Asylum Amazon USA

Chris Mackey – Synchronicity

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Book Review, Chris Mackey, Positive Psychology, Psychiatry, Psychology, Synchronicity

An interesting book which might not quite reach its deserved audience

Chris Mackey’s Synchronicity is a fascinating look at this phenomenon, which is at the same time not completely satisfying, as, for this reader, its tone means it may well be more likely to appeal to the New Age converted (of which, to a large extent I can surely count myself a member) but fail to appeal to those who could or might be converted by the well argued theory and research to take this book as seriously as it deserves to be.

Some of the information, and, perhaps more, the at times ‘Wow!’ ‘Awesome!’ tone, makes the book appear to come from the scientific equivalent of what might be thought of as the ‘loony left of psychology’ When in fact, the focus is much more grounded and pertinent.

Mackey is clearly a respected and experienced psychologist and therapist. He is a Fellow of the Australian Psychology Society. Fellowships are an honour bestowed on those who are influential and have made positive contribution in their field. An honour, moreover, bestowed by one’s peers. He has worked within a public setting in hospitals, and has his own private psychology practice, and has been working in the field for over 35 years.

He is a passionate, thoughtful, persuasively articulate advocate of what might be called Positive Psychology. Mainstream pharmaceutically based psychology and psychiatry has increasingly become focused on what might be thought of as ‘lesion management’ rather than health recognition. In other words, the identification of the illness, the syndrome, the abnormality of dis-ease. And this generally means a reductionist and biochemical approach to management. The complex politics and organisation of this has been brilliantly explained in James Davies’ Cracked – Why Psychiatry Is Doing More Harm Than Good.

Holistic/Positive Psychology recognises that in every living organism forces of health/wholeness/stability – or the potential to achieve this always exists, as well as the opposite potential to entropy and disorganisation.

Western medicine has a focus around rectifying symptomatic dis-ease – and this is of course a very useful and productive paradigm, but it is not the only useful and productive approach. Other medical systems such as Ayurveda and Traditional Chinese Medicine focus less on the symptomatic analysis of the specific ‘wrong’ and more on what is the whole pattern of imbalance that symptoms are only a reflection of. This does represent a different approach as the pattern indicates the direction of ‘wholeness’ which still exists. A movement away from balance still indicates that relationship with the balance point. In TCM (Traditional Chinese Medicine) deficiency in flow of Qi has corresponding stagnation, excess, blockage.

In the field of Western psychology there are practitioners and theoreticians, and methods, where the emphasis is on understanding that the ‘lesion’, the wound, can be in fact the pointer to the direction in which health and wholeness lie, and that psychic wounds in fact show not only the potential for health and wholeness which is always present, but is the means by which healing manifests. This may sound barking, but, considered simply, it is the breaking of a bone, the wound to the skin, the being laid low by infection which galvanises the complex responses to repair and remodel tissue or to fight infection. Similarly those woundings to the psyche are also calls to where repair, remodelling and maintaining integrity will arise from. Unsurprisingly Mackey, an advocate of Positive psychology, explores the legacy of Jung, Maslow, Ken Wilbur and others, whose approaches have been around the psychology of health, individuation, peak experience and the like. Giving the psyche its weight and place.

Jung’s snappily titled (!) Synchronicity : An A-causal Connecting Principle, defined synchronicity as the connection of two or more, seemingly random occurrences, as not being ‘random’ or ‘chance’ but as meaningful, and common. These could vary from the experience many have, of having the thought of someone enter your head, someone you may not have thought about or had connection with, for some time, and an instant later, the phone rings, you pick up, and it is that person. Or it could be something more symbolic – Jung’s interest in the phenomenon initially being sparked from this direction – a patient told him about a dream in which she had been given a golden scarab (the dream was one which was a highly charged, meaningful one, full of symbols which were potent for the dreamer and the analyst) At the moment the analysand was describing her dream, came a tapping on the closed window in the room. Jung opened the window and an insect flew in – a scarab type of beetle, greeny gold in colour.

“Cetonia-aurata” by I, Chrumps. Licensed under CC BY-SA 3.0 via Commons.

Jung’s developing idea about synchronicity, which is seen as something of a pointer, something encouraging us towards a noticing, a kind of indication that you are in-the-flow, which Mackay describes as ‘ticks from the universe’ were formed in part out of discussions he had had with Einstein, and had encouragement from another ‘father of quantum theory’, Wolfgang Pauli.

Mackey also explores these connections, and provides some welcome, unflaky breaking the phenomenon away from the ‘spooky-woo’ dismissable. It is specifically ‘entanglement’ which interests him – on a quantum level:

The term ‘entanglement’ describes a relationship between two or more particles, or other objects, that have interacted with each other and then been separated. Bell’s Theorem (physicist John Stewart Bell) hypothesized that two or more such objects would somehow remain connected with each other, functioning as a single system. This mean that any induced change in one twinned particle, such as an electron, would lead to an instantaneous and complementary change in the other, regardless of how vast the distance that separated them

Easy-peasy, eh!

These kinds of ideas and reflections, though echoing many writings found in the New Age section of bookstores – or in long ago written texts on Eastern mystical thinking – are coming from that strange place called quantum physics, and from quantum physicists, trying to find ways to understand some of the phenomena happening at this level

And I must say, that describing all this through the perspectives of rationalising, without the kind of ‘Wow! Awesome!!’ wide-eyedness which often permeates ‘New Age’ books and makes the sceptical, unsurprisingly, dismiss the whole idea as something arising from the relicts of old hippies who dropped too much suspect chemistry in their dim and distant, is very very welcome indeed.

But……….there is ‘stuff’ in this book which troubles, however much I admire Mackay’s honesty about his own experiences. Which are thus : Synchronicity has been something which he has been aware of, in his own life, and usefully stayed open to. He has also, inevitably, in his professional life, attracted patients who noticed synchronicity, or synchronicity became a kind of tool which could be helpfully used in sessions. So there are examples and underlinings which Mackey gives, in clear, and understandable fashion.

What there also is, which increasingly creeps in, is precisely that tone of ‘Wow! Awesome!’ which begins to seem a little off-kilter, a little out-of-balance. And Mackey himself has had experience of ‘breakdown’ – a diagnosis of a hypomanic episode. During this, he was dizzyingly ‘synchronicitous’, and it is the reading of the chapters where he honestly recounts his ‘Wow!’ ‘Awesome’ and the recounting voice (to my mind) has a kind of ferociously over-bright, over-loud ‘Wow!’ ‘Wow!’ ‘Wow!’ quality to it that makes it a little hard to read. He is honest enough to let us know that during this period some of his colleagues thought (and told him) that he was psychotic.

Later, Mackey analyses his own experiences, and concludes he may have fallen into a kind of enlightenment trap – that of ‘psychic inflation’ a sense of grandiosity, specialness (which of course also happens in the ‘manic’ stages of bipolar disorder)

A writer Mackey met on a retreat, very broadly in sympathy with what Mackey has really spent his professional life involved in – furthering Positive Psychology, working with that impulse to wholeness within living organisms, embracing what might be called our spiritual nature, rather than reducing everything about a person to ‘dysfunctional chemistry’ and medication – warned Mackey not to get so focused and caught up in synchronicity. He felt Mackey had become so over-excited by it that he might overlook the ‘fundamental spiritual principles’

Translating that to my experience reading this book, it seems to me that however laudable his honesty about his own experience has been, that it is precisely the over-emphasis on his personal story, told in such a different voice from the rest of the book, which may end up side-lining what is surely an important book which has much to say about the ‘fundamental principles’ of bringing Positive Psychology, humanity, and meaningful, unreductionist ways of treating mental illness, and, perhaps more importantly, fostering and growing human wellness, into wider use. I do feel that it is the over-emphasised weight of that personal story which may lose Mackey a far more useful audience – the unconverted, the sceptical, than this book really deserves. It may not travel much beyond those New Age Shelves. Which will be a shame.

I do recommend it. The fully converted are unlikely to find it controversial, but I hope those less convinced might read it for the well-argued stuff.

I received this as an ARC for review from the publishers, Watkins, via NetGalley. It will be published in the UK next month, and in the States also, though with a much expanded title, which rather suggests its self-help market – nothing wrong with that, I just think it might have had a more professionally influential appeal. And perhaps some of the earlier, cooler stuff might not be sufficiently grab-able for those wanting more instructional self-help ‘how to’

Synchronicity Amazon UK
Synchronicity: Empower Your Life With The Gift Of Coincidence Amazon USA

James Davies – Cracked: Why Psychiatry Is Doing More Harm Than Good

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Big Pharma, Book Review, Cracked: Why Psychiatry Is Doing More Harm Than Good, James Davies, Medicine, Psychiatry, Soapbox

Wool Pulled Justifiable Rage Disorder

Why has the prescription of antidepressant medicine roughly tripled in less than 20 years? Is it that we are indeed becoming sicker, that we are all becoming more and more stressed and psychologically unwell, is it merely that doctors and psychiatrists are much more skilled at diagnosing psychiatric conditions than they used to be, or is it that we are now medicalising (drugging) what is normal about the variety of day to day human experiences, which at times can be sorrowful, challenging or confusing?

This briiliantly clear, cogently argued, shocking and timely book by psychotherapist and anthropologist James Davies rendered me almost incoherent with rage, exposing as it did something which many of us have been aware of, but maybe have not had the tools or ability to follow to a conclusion. James Davies has those tools and abilities; he thoughtfully, knowledgeably, skilfully connects all the dots together, uncovering the horrendous duplicity, collusion and sheer unscientific snake oil peddling visited upon us by Big Pharma, in the field of mental health.

I can’t urge the reading of this book strongly enough. Anyone who cares about what it means to be a fully human being, and especially anyone involved in any way in the caring professions needs to be aware of what Davies lays clear about the mental health industry. For industry it surely is.

With a carefully constructed series of explanations, revelations and arguments Davies delivers telling knock out punches to the House of Trick Cards of current mainstream psychiatry. The major punches involve

1)    The increasing categorisation of VIRTUALLY ANY EMOTIONAL STATE so that it falls within a category of disorder – thus opening the way to the development of chemical coshes. This categorisation – the ‘Bible’ used to denote syndromes, the DSM (currently DSM 5), is NOT the result of huge studies and research itself, yet it gets used as if it were the result of close scientific analyses. The result of the sort of sordid, limiting tickboxy thinking, turning us all into robots who can be managed out of our normal human pain is the crass thinking that says, for example, if after a bereavement, sleep appetite and general mood are affected for more than 2 weeks, anti-depressants may be helpfully prescribed. Crazy, insidious, crass. We have become so afraid of our suffering that the answer becomes ‘cosh it, flat line what it is to be in any way human’

1926 city scene, Fritz Lang Metroplis. Flicr Commons

2)    Trials – various meta analysis studies have shown that antidepressants are BARELY more effective, in mild to moderate depression, to placebo. Drug companies have disquietingly low bars to climb over, in order to ‘prove’ their products effectiveness. Davies uncovers the secrecy, the UNPUBLISHED drug trials that go against the findings Big Pharma wants and the manipulation of results. More than this, how drug companies positively USE that most powerful of tools – PLACEBO ITSELF to manipulate their own results higher – for example, the colour, the name, the advertising of the pharmaceutical – many of the effects that might be assumed to be the result of the chemistry of the drug ‘better than placebo’ – are in fact DUE to the use of placebo!

3)    There has been a change in thinking from the 60s and 70s, where psychiatric drugs were seen as altering mood (in the same way as any mind altering drug, including alcohol and street drugs alter moods) A shift occurred to thinking of psychiatric drugs as ‘curative’. This might not seem an important shift – however it goes along with the idea that much uncomfortable, difficult human emotion is now being seen as potentially aberrant and classifiable as a ‘disease’ – as in the DSM – shyness becomes ‘social phobia’.

Medical naming encourages thinking about human beings in all their complexity as broken, and needing mending – and opens the door to the over-prescription. In fact, as one astute expert (among the many) Davies consults, points out tersely, this thinking of these drugs as ‘cures’ is erroneous, as unlike most physiological disease there just is no hard evidence to support the biology of a lot of what is now being treated as ‘disease’ through these medications – which alter mood. They do not ‘cure’ shyness, (or, lets medicalise it as social phobia) any more than a glass of wine ‘cures’ shyness – both change ways of perceiving the world, that is all.

4)    Who bites the hand that feeds? There is a huge cover-up, smoke and mirrors going on in the world of funding ‘research’ into psychiatric medicine whether in academic institutions, or with clinicians. And, gentle reader, there is even less transparency over this in the UK than there is in the States, where under the Obama administration, spearheaded by a particularly truth-and-justice campaigning Senator, Senator Grassley, some efforts to bring the Pharma hyena under the spotlight are beginning to bear fruit. But not here, where there is murk a plenty. Perhaps though, the fact that fully 56% of the panel member luminaries involved in writing the DSM-IV  bible had 1 or more financial associations with the pharmaceutical industry, should begin to rip the wool from over our eyes.  And, for those writing/creating the diagnostic categories, which would of course be primarily treated by pharmaceuticals,  – 88% of DSM-IV panel members had drug company financial ties.from Big Pharma. And things don’t have appeared to have changed for the better in terms of ‘arms length’ involvement with the writing of the now current DSM-V.

I am not saying (nor is Davies) that all these senior clinicians and medical academicians are corrupt, merely that neutrality becomes hard to achieve when your income is dependent on a particular company who are hoping your findings will support the excellence of their product, and even to demonstrate a need for their product

I received this book as an ARC – of course, given what I have said in point 4, you may feel that my judgement is compromised. I would argue that a lowly amateur reviewer lucky enough to get offered bookie freebies through third parties does not in any way equate to some stars of the psychiatric industry who receive millions for the sterling work they do in supporting the claims of specific drugs and manufacturers.  A look at some of my reviews on Amazon will show that if I think a particular book is poor I will indeed say so.

This one though gets my gold standard bookie trial award. Properly researched, properly cited, free from duplicitous cover-up. Unlike the industry is exposes.It deserves to be a best seller – indeed, needs to be so – its material is provocative, prescient, and vital to know.

I have one cavil – my ARC was a digital copy, from the publisher via NetGalley. Now I don’t know if this will be any different than the standard digitise prepared for sale, but the digitisation on my ARC was poor – a lot of the useful charts and graphs do not appear and footnotes get chopped and inexplicably appear in the middle of other pages.  If I were buying this book, I would definitely choose hard, over digitised, copy.

Available now in the UK, paper and digital; not in the USA in paper until August but available as digital
Cracked: Why Psychiatry Is Doing More Harm Than Good UK
Cracked: Why Psychiatry Is Doing More Harm Than Good USA