Paul McHugh, The Mind Has Mountains: Reflections on Society and Psychiatry, h/b, Baltimore, The Johns Hopkins University Press, 2006
Paul McHugh is an outstanding American psychiatrist of the C20th and early C21st. Now in the nineties he was for many years the Director of the Department of Psychiatry and Behavioural Sciences at the Johns Hopkins University School of Medicine and later the Henry Phipps Professor of Psychiatry Emeritus.
Mc Hugh was a spirited defender of a psychiatric methodology based on epidemiology, genetics and neuro-pharmacology as against the C20th explosion of nonmedical, fashionable and over simplified ideas about psychiatry and mental illnesses promoted by the so-called antipsychiatrists (p.4) including Thomas Szasz, R.D. Laing, Erving Goffmann and Michel Foucalt amongst others. A measure of the explosion of under researched and purely theoretical psychiatric disorders can be traced by the growth of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official tome of the American Psychiatric Association. What began in 1968 as a psychiatric disease identification of 119 pages became an explosion of 886 pages in the latest edition. Many of these identifications based on descriptive appearance of individual cases have little basis in medical evidence and some are purely the inventions of their proponents. (p.51) One dangerous motivation for this sudden explosion of new ailments is the extravagant retainers from pharmaceutical companies plugging their medications and the healthy returns from some insurance companies!
McHugh’s book is a series of essays based on a wide range of topics including the demise of early C20th Freudian ideas (including the Oedipal complex, castration anxiety, and penis envy); the important work of Dr. Jerome Frank in helping patients master problems in their present life rather than searching for problems in early life conflicts; misunderstandings about the nature of depression; the imprisonment of Dr Kevorkian for murder; the development of overvalued ideas in society (someone who has taken up an idea shared by others in his or her milieu or culture and transformed it into a ruling passion or “monomania”); the importance of the work of Karl Jaspers in opposing Freudian nihilism and his fight against eugenics, fascism and racism in medicine; the scandal of “repressed memories”; the over-reach and oversimplification of PSTD cases for a false motivation; Multiple Personality Disorder as a socially constructed artifact; the cultic character of psycho-analysis and its continuation until “the money runs out”; the de-institutionalisaton of the severely mentally ill; the failures of contemporary bioethics and its rush to become a culture of death; William Osler’s contribution to modern medicine; Shakespeare and psychiatry; the development of the distinction between sex and gender and the accompanying explosion and under determined value of sex-change surgery; the ethical use of embyronic cells and psychiatric insights into terrorism.
Not all will agree with every idea in McHugh’s analysis of a better path for psychiatry. On the other hand McHugh’s logic, common sense, clinical expertise and scientific sophistication based on factual cases will provide significant food for thought for anyone interested in mental health issues and the best way forward in dealing with them successfully. Five stars.
James Joyce, The Dubliners, [The corrected text with an Explanatory Note by Robert Scholes and Photography by Dr. J. J. Clarke of the period between 1897 and 1904], h/b, London, Folio, 2003 (1914)
A collection of fourteen short cameos and one extended narrative of the lives of ordinary Dubliners published in 1914.
The first three are written in the first person and tell of (i) the death of a somewhat tiresome old man whose life and story had made a deep impact on a young boy. (ii) Two boys wagging school and being approached by a perverted old man (iii) a boy’s love for a girl in his street and his unsuccessful attempt to buy her a present at the market.
The other eleven stories are written in the third person and describe:
– a young woman torn between her love for family and town and a romance with a wandering sailor who wished to marry her.
– four well healed young men with a fast car and their escapades around town.
– a young man in a boarding house who gets the landlady’s daughter pregnant and is challenged by the mother as to his intentions.
` – a young man somewhat bored with his ordinary life catches up with an old friend who is single and has had good success in London as a journalist and is living the high life.
– a married man with children is in trouble at work and soothes his mind by pawning his watch and getting drunk with the boys. Coming home in a bad way, his wife is at church and his tea is cold; he pays out on the children.
– a busy single matron takes her day off and goes to visit her married brother and his family. – a lonely unmarried business man takes up a friendship with a married woman who is unhappy in her marriage. When she wishes to go further he retreats and the woman turns to drink.
– a group of political committee members get together for a drink after a hard day’s campaigning.
– a woman with a talented daughter is upset when her daughter is not paid appropriately for a series of concerts.
– a group of faithful church goers try to rehabilitate a drunkard and try to sort out their religious differences in the process.
The final somewhat longer narrative is entitled The Dead and describes a sumptuous annual dance and dinner but on my the Misses Morkans which they have hosted for over thirty years. The narrative focuses down on the thought processes of the regular speech maker, a deep thinking literary and caring man who sees their quiet world changing, key people dying and begins to ponder his own life and coming death. The narrative turns from trivial description of a host of characters to a powerful and deep private meditation.
Joyce had trouble publishing this work due to the strict moral standards of 1914 Britain. A number of these characters reappear in his amazing Ulysses, the story of one day in the life of Dublin. The Dubliners makes for thoughtful and entertaining reading. 5 stars.
Colm Tóibín: The Magician: p/b, Sydney, Picador/Pan Macmillan, 2021
Exceptional biography of distinguished C20th German writer Thomas Mann (wrote Magic Mountain/Death in Venice/Tristan/ Tonio Kröger/Doctor Faustus) amongst other novels. Tóibín is an exceptional Irish writer who has also written biographies of Henry James and Mary the mother of Jesus along with The Master and Brooklyn.
This is a deeply researched novel written in a fictionalised style by Tóibín which takes the reader deeply into Thomas Mann’s innermost thoughts as well as describing intimate family and other conversations in precise detail. The reader is guaranteed a reasonable sense of Tóibín’s accuracy by the list of over fifty major works of analyses of Mann’s life during the rise and fall of Hitler and the rise of Stalin on p. 435 of this work. Married into the wealthy Jewish Pringsheim family Thomas and his impressive wife Katia had six children whose upbringing was largely Katia’s responsibility as Mann spent pretty well every morning of his life in his study writing and thinking. His brother Heinrich was also a writer but much more to the left and their fraught relationship was a major tension in his life.
Thomas Mann felt strongly about the need for a restored Germany after the Great War and was very late to recognise the vast danger of German fascism. Equally he was so involved in the creation of his novel Magic Mountain (for which he won the Nobel prize), that he was caught unawares by the rapid rise of the Third Reich and in the end had to leave behind his house in Munich and flee to Switzerland, then southern France, finally becoming a citizen of the USA. His first son Klaus and first daughter Erika played significant roles in the fight against Nazism and his at times strained relationship with them is a key component of his story. Mann was also completely blind to the horror of the Nazi genocidal program and the magnitude of this racial destruction had to be spelt out to him while he was living comfortably in the USA and when it was far too late for him to use his considerable wealth and contacts to help Jewish refugees.
Alongside his writing, his wife, his six child family and his fame Mann did not hide his erotic interest in beautiful young men and Tóbín delicately describes Katia’s negotiation of these two sides of Mann’s nature carefully and elegantly.
Ironically Mann, who was a European heroic ally for talking up the need for America to join the war against Hitler, became himself an enemy of the American people after the war due to his equivocal approach to the rise of Stalin and the division of Germany. He and his family were effectively encouraged to leave the USA and returned to
Europe spending their final years in Switzerland.
This beautifully written biographical novel is an absolute masterpiece. 5 stars and rising.
Bev Aisbett: Panic Attacks: A Survivor’s Guide to Panic Attacks, p/b, Sydney, Angus & Robertson, 1996
Bev Aisbett has written a very helpful introduction and overview to coping with and living with panic attacks, a phenomenon that makes simply living a misery for a vast number of sufferers around the world. Supported by Dr D Jeffries, Aisbett uses a helpful descriptive approach using clever line drawings and diagrams. Aisbett does not simplify or minimise the difficulty of dealing with panic attacks and underlines that professional help and often supportive medication is essential for full recovery.
A strength of this book is a chapter on those living with sufferers of panic attacks. This chapter underlines the dangers of well-meaning advice such as “get over it” or “you look all right to me or simply feelings of frustration, helplessness, or even anger.
This is a positive and helpful book that will surprise and assist both sufferers and helpers. 5 stars.