Desperate Remedies: Psychiatry's Turbulent Quest to Cure Mental Illness by Andrew Scull (review)

Reviewed by: Desperate Remedies: Psychiatry's Turbulent Quest to Cure Mental Illness by Andrew Scull Dillon J. Carroll (bio) Desperate Remedies: Psychiatry's Turbulent Quest to Cure Mental Illness. By Andrew Scull. (Cambridge, Mass.: Belknap Press of Harvard University Press, 2022. Pp. 512. Cloth, 35. 00; paper, 18. 95. ) "Few of us escape the ravages of mental illness. We may not suffer from it ourselves, but even then we feel the pain it inflicts on friends or family. And no one escapes its social burdens. Psychiatry seeks to lessen these End Page 284 afflictions, but too often it has increased them, " writes Andrew Scull in the opening paragraph of his new book Desperate Remedies (ix). Scull, who teaches in the Sociology Department at the University of California, San Diego, has written numerous books and articles about the history of mental illness, its treatment and its professional practitioners. Scull's new book focuses on mental illness in the United States. His scholarly gaze is "on the therapeutics of mental illness and on the professionals who advanced them. " The patients of these practitioners and their theories are not the focus but instead "are the constant subtext" (x). Desperate Remedies is a broad survey of American psychiatry from the mid- to late nineteenth century up to the late twentieth and early twenty-first century. The content explored is vast, from asylums, to Freud, to pharmacology, to PTSD, to the DSM-V. While the focus is on American psychiatry, European practitioners are also large players in the story, as American psychiatry was very much part of the Atlantic world and a beneficiary of European advancements. The book is divided into three parts. Part 1, "The Asylum Era, " traces psychiatry from the birth of the insane asylum up to the era of electroshock therapy and lobotomies. Part 2, "Disturbed Minds, " examines the rise of Freudian talk therapy as well as cognitive behavioral therapy and its eventual decline. Part 3, "A Psychiatric Revolution, " delves into the psychopharmacological revolution, exploring its successes as well as its stark limits. By Scull's own accord, Desperate Remedies "will strike many, quite correctly, as a deeply critical account of the psychiatric enterprise" (xiii). Scull is intensely critical, at times scathing, of psychiatry. He writes admiringly of some figures, such as Adolf Meyer, William Menninger, and Robert Spitzer. But, overall, Scull expresses withering critiques of psychiatric theories and therapeutics, often concluding that many practices did much more harm than good. Scull briefly charts the rise of the asylum movement in the opening pages of the first chapter, before turning to neurologists. Surprisingly, the American Civil War is barely mentioned at all. This may strike some as a graduate student complaint, but given that the Civil War, in part, resulted in the birth of American neurology, one would think it would play a larger part in the early chapters. Scull's early chapters on the asylum movement deftly analyze the rise of the anti-immigrant eugenics movement, as well as the racism of asylum psychiatry. Scull really hits his stride in chapter 3, which mines psychobiology, and uses Adolf Meyer as a case study. Meyer, a Swiss-German immigrant, would try to drag American asylum psychiatry into the twentieth century. Devoted to research rather than patient interaction, Meyer was disappointed by the corrupt, patronage politics of the United States, and the inefficient bureaucracy of American asylums. End Page 285 At his first appointment in Kankakee, Illinois, Meyer standardized case records, creating a comprehensive history of each patient. In 1896, Meyer spent several weeks training in Heidelberg at the clinic of Emil Kraepelin, who discovered Alzheimer's disease. He then received an appointment as a clinic director in Estonia (then part of Russia). He returned to the United States, where in a few years he invented his own system of "psychobiology" (49). Finding inspiration from the bacteriological revolution, students of Meyer carried out serious clinical and pathological research, as well as learning German and French, to stay current with European innovations. Meyer believed that "mental illness represented a failure of functional adaptation to the demands of modern life" (52). Psychobiology recorded everything that might affect a patient's mental state—"biology, medical history. . .