Fri Tanke, 2015.
Reviewed by Anna Paterson in SBR 2016:1
Review Section: Non-fiction
Den stökiga psykiatrin sets out to explain to the lay reader how research in psychiatry should progress to best effect. Of course, that qualification begs more questions than even this urbane, readable and well-informed compilation can begin to answer: ‘compilation’, not only because of its wealth of sources, but also because the assembled texts do not add up to a sustained personal argument. This is perfectly proper, given that Jersild was a member of a group that reported to the Swedish Academy of Sciences on how to improve the internationally poor ratings for Swedish mental health research. With the report (completed in 2011) as a framework, Jersild reminisces, introduces new and old interviews with colleagues, reflects on the history of psychiatry, explains concepts and practices, and ponders on the usefulness of portraits of disturbed minds in fiction and in other non-professional works.
Jersild, who is both a novelist and a doctor, is a wonderfully articulate if sometimes self-indulgent guide to developments in modern psychiatry – that is, starting in the mid-1950s, when he was a medical student. The many short chapters allow him to move swiftly from past issues to current ones: from asylums, lobotomies and the first scary generation of anti-psychotic drugs, via psychotherapies and anti-psychiatry, to the present-day fascination with brain imaging and molecular biology. He returns again and again to the arguments for and against a mind/brain split, an intellectually fruitful idea, though he concedes that it has largely given way to the biological insistence on a continuum. The term ‘liaison psychiatry’ (psychological medicine) defines the borderline area where reductionist medicine meets value-laden psychiatry, and our guide leaves us in that territory. However, Jersild reminds us that methodologies can still be radically different and outlines the incompatibilities between what he defines as mental health care seen from the first-person perspective (observational, case-focused, social) and the third-person perspective (empirical, cohort-oriented, controlled) respectively.
Finally, Jersild, the self-confessed cool-headed materialist, examines people’s attitudes and the role of artists, notably writers. Who but an artist could better interpret for the rest of us just what it is like to be mentally ill? He tries to answer the question in a series of fascinating asides, quoting from works by leading Swedish authors who have told the world about their pain. It is his easy skill in moving from the personal and the felt to the professional and factual that makes Jersild’s examination of the evidence about modern mental health care such a fascinating book.