One of the great rebels of psychiatry, R. D. Laing challenged prevailing models of madness and the nature and limits of psychiatric authority. In this brief and lucid book, Laing’s widely praised biographer distills the essence of Laing’s vision, which was religious and philosophical as well as psychological.

The Crucible of Experience reveals Laing’s philosophical debts to existentialism and phenomenology in his theories of madness and sanity, family theory and family therapy. Daniel Burston offers the first detailed account of Laing’s practice as a therapist and of his relationships—often contentious—with his friends and sometime disciples. Burston carefully differentiates between Laing and “Laingians,” who were often clearer, more confident, and more simplistic than their teacher.

While he examines Laing’s theories of madness, Burston focuses most provocatively on Laing’s views of sanity and normality and on his recognition, toward the end of his life, of the essential place of holiness in human experience. In a powerful last chapter, Burston shows that Laing foresaw the present commercialization of medicine and asked pointed questions about what the meaning of sanity and the future of psychotherapy in such a world could be. In this, as in other matters, Laing’s questions of a generation ago remain questions for our time.

The advent of chemical or pharmacological therapies has had an enormous impact on the treatment of psychiatric illness. For the chemotherapy to be effective, however, the clinician must take into account many factors in addition to recognition of a syndrome and selection of an appropriate agent and dose. In this extensively revised and expanded edition of a widely used book, Ross Baldessarini concentrates on providing rational, scientific underpinnings for the treatment of patients. In doing so, he bridges the gap between biology, psychology, and clinical practice.

To provide the most up-to-date coverage of the actions and use of psychotropic agents, Professor Baldessarini has enlarged the text to nearly twice its original length and has added sixty-three new tables. More basic preclinical pharmacology is included to guide the thoughtful use of medication. In addition to summarizing this basic knowledge, the text reviews the indications for each drug, the kinds of patients most likely to respond, and side effects and contraindications, and provides summaries of clinical research findings on which rational clinical practice rests.

A chapter is devoted to each of the principal classes of psychotropic drugs: antipsychotic agents, lithium salts and other antimanic agents, antidepressant agents, and antianxiety drugs. Within each chapter is a new section that surveys the future of the field and examines new procedures, theories, and agents. A final chapter covers more general topics such as psychosocial, ethical, and legal aspects of practice in the administration of drugs, as well as the emerging topics of geriatric and pediatric psychopharmacology--material not readily available elsewhere.

To penetrate the opaque, to lift the weight and let the self escape its frozen image—this is the essence of psychotherapy, a process described with extraordinary grace and warmth in this book. In remarkably candid portraits of patients at odds with themselves, Leston Havens takes us through the wonders and rigors of psychological healing and shows us what it really means, in immediate, human terms, to come to life.

We are all captives of the images we carry with us—and those we inspire—and therapy seeks to expose the relation of these images to a deeper psychological life, to free the captive from labels and crippling assumptions. Havens views this process through the multiple lenses of literature, art, and psychiatry. In rich clinical portraits, short on jargon and rigid techniques and long on empathy and wisdom, we encounter ordinary people struggling with the trials of their own existence: marriage and divorce, sexual identity and fulfillment, illness and death. We meet a woman imprisoned by eager responses to her beauty and helpfulness, a proud lawyer in thrall to conventional expectations, a dying man becoming more and more alive as he approaches death.

Through these very personal stories, Havens explores the meaning of psychological health—how it can be recognized through the filter of images and ideas, protected from their distorting power, and encouraged to flourish. The result is a revealing and deeply moving explication of the process of self-discovery as it emerges from the life story that therapy can tell.

One of the major concerns about the changing U.S. health-care systems is whether they will improve or diminish the quality and cost-effectiveness of medical care. The shift from a fee-for-service to a prepaid method of reimbursement has greatly changed the incentives of patients to seek care as well as those of providers to supply it. This change poses a particular challenge for care of depressed patients, a vulnerable population that often does not advocate for its own care. This book documents the inefficiencies of our national systems--prepaid as well as fee-for-service--for treating depression and explores how they can be improved.

Although depression is a major illness affecting millions of people, it is seriously undertreated in the United States. The ongoing shift of mental-health care away from specialists and toward primary medical-care providers is causing fewer depressed patients to be appropriately diagnosed and treated. Depression is frequently more devastating than other major illnesses, such as arthritis and heart disease, because it often begins at a younger age, when people are at their productive peak and thus at risk of permanently damaging their careers. It also differs from many medical conditions in that its indirect costs are usually much higher than direct treatment costs.

The authors urge the integration of both medical and economic considerations in designing policies for the treatment of depression. They show that by spending more money efficiently on care, the nation will gain greater health improvements per dollar invested and a more productive population.

Meg Logan has not been farther than two miles from home in six years. She has agoraphobia, a debilitating anxiety disorder that entraps its sufferers in the fear of leaving safe havens such as home. Paradoxically, while at this safe haven, agoraphobics spend much of their time ruminating over past panic experiences and imagining similar hypothetical situations. In doing so, they create a narrative that both describes their experience and locks them into it.

Constructing Panic offers an unprecedented analysis of one patient's experience of agoraphobia. In this novel interdisciplinary collaboration between a clinical psychologist and a linguist, the authors probe Meg's stories for constructions of emotions, actions, and events. They illustrate how Meg uses grammar and narrative structure to create and recreate emotional experiences that maintain her agoraphobic identity.

In this work Capps and Ochs propose a startling new view of agoraphobia as a communicative disorder. Constructing Panic opens up the largely overlooked potential for linguistic and narrative analysis by revealing the roots of panic and by offering a unique framework for therapeutic intervention. Readers will find in these pages hope for managing panic through careful attention to how we tell the story of our lives.

It inspired written testimonials from William McKinley, Thomas Edison, and Sarah Bernhardt; merited a medal from Pope Leo XIII; produced "exhilaration and lasting euphoria" in Sigmund Freud. Once the stimulant of choice of the enlightened and the elite, cocaine has become, a century later, a plague, ravaging the lives of millions. This book is the first to draw together all the facts about this pervasive drug--from its natural occurrence in a tea-like native South American plant to its devastating appearance as crack in the inner cities of the United States.

Drawing on the latest work in medicine, psychiatry, neuroscience, pharmacology, epidemiology, social work, and sociology, the volume is a highly accessible reference on the history and use of cocaine, its physical and psychological effects, and the etiology and epidemiology of cocaine addiction. It also provides a critical evaluation of the pharmaceutical agents and psychosocial interventions that have been used to treat this addiction. Author Jerome J. Platt answers such basic questions as: What is cocaine? What forms does it come in? How is it administered? What does it do? What are the medical complications of cocaine addiction? What are the treatments, and how successful are they?

Uniquely comprehensive, Cocaine Addiction makes all the latest information on this urgent subject readily available to medical professionals and practitioners, social workers and scholars, and anyone who cares to know more about this perennially troubling drug.

The Concept of Heart Failure surveys the development of our ideas, both clinical and theoretical, on important aspects of cardiac and pulmonary disease, from the eleventh to the mid-eighteenth century. Before a unified and centralized concept of congestive heart failure was established, individual parts of the syndrome were regarded as discrete clinical entities. As a result, discussion of the syndrome is scattered throughout medieval and Renaissance literature.

Dr. Saul Jarcho, a noted clinician and medical historian, renders a great service in gathering together many little known sources and, with rich commentaries on each author, making them accessible to the modern reader. His translations of Latin, Arabic, and other texts are fluent and skillful. With its thorough documentation, concluding overview, and appendix on the relation between suffocative catarrh and pulmonary edema, The Concept of Heart Failure will be a rich resource for clinicians and historians alike.

You are old, ill, in pain, and your doctor asks you what you want to do about it. You may be uncertain but you're definitely not alone. By the year 2020, some 50 million Americans will be over sixty-five, and as the nation ages we must all ask what we ought to do about the health and medical care of our elderly. Our response will have profound consequences, not just for individuals and families, but for society as a whole. This book helps us start to form an answer.

To make decisions about medical care in old age, we need to know more about the reality of being elderly and sick, and Choosing Medical Care in Old Age gives us the opportunity. Muriel Gillick, a noted physician who specializes in the care of the elderly and in medical ethics, presents a panoply of stories drawn from her clinical experience. These encounters, with the robust and the frail, the demented and the dying, capture the texture of the experience of being old and faced with critical medical questions. From the stories of older people struggling to make choices in the face of acute illness, stories that are often poignant and sometimes tragic, Gillick develops broad guidelines for medical decision–making for the elderly. Within this framework, she confronts particular concerns and questions. When are certain procedures too burdensome to be justified? What are unacceptable risks? Should family members serve as exclusive spokespersons for relatives who can no longer speak for themselves? Gillick's bold and personal prescription for medical care for the elderly calls for a change in the way medicine is understood and practiced, as well as for changes in the institutions that serve the elderly, such as hospitals and nursing homes. An intelligent and deeply compassionate inquiry into the difficult issues and real–life dilemmas raised by current practices, her book offers a first step toward those changes.

This new book for students and professionals emphasizes a functional approach to aural rehabilitation refined during the past several years. It details the use of an integrated therapy strategy designed to meet a variety of needs for each client while simultaneously working on multiple communication skill areas. Particular care has been taken to address the different requirements of deaf and hard of hearing adolescents and adults, including information about the unique needs of the culturally Deaf population. Throughout this practical text, clinicians receive encouragement to learn American Sign Language to enhance communication with Deaf clients.

       Communication Therapy calls upon the expertise of various authorities well-versed in integrated therapy. They explain fully the state-of-the-art practices for all therapy areas, from global areas in communication therapy, to technology for aural rehabilitation, auditory skills, speechreading, speech and voice, pronunciation, and language skills, and telephone communication training. Case studies demonstrate the effectiveness of the integrated approach, making this book a significant advancement in communication therapy.

Cochlear Implants in Children: Ethics and Choices addresses every facet of the ongoing controversy about implanting cochlear hearing devices in children as young as 12 months old and in some cases, younger. Authors John B. Christiansen and Irene W. Leigh and contributors Jay Lucker and Patricia Elizabeth Spencer analyzed the sensitive issues connected with the procedure by reviewing 439 responses to a survey of parents with children who have cochlear implants. They followed up with interviews of the parents of children who have had a year's experience using their implants, and also the children themselves. Their findings shape the core of this useful and telling study.

       Cochlear Implants begins with a history of their development and an explanation of how implants convert sound into electric impulses that stimulate the brain. The second section focuses on pediatric implants, starting with the ways parents coped with the discovery that their child was deaf. Parents share how they learned about cochlear implants and how they chose an implant center. They also detail their children's experiences with the implants after surgery, and their progress with language acquisition and in school.

       The final part treats the controversy associated with cochlear implants, particularly the reaction of the Deaf community and the ethics of implanting young children without their consent. Cochlear Implants concludes with sage observations and recommendations for parents and professionals that complete it as the essential book on the pros and cons of this burgeoning technology.

Scientific breakthroughs have led us to a point where soon we will be able to make specific choices about the genetic makeup of our offspring. In fact, this reality has arrived—and it is only a matter of time before the technology becomes widespread.

Much like past arguments about stem-cell research, the coming debate over these reproductive genetic technologies (RGTs) will be both political and, for many people, religious. In order to understand how the debate will play out in the United States, John H. Evans conducted the first in-depth study of the claims made about RGTs by religious people from across the political spectrum, and Contested Reproduction is the stimulating result.

Some of the opinions Evans documents are familiar, but others—such as the idea that certain genetic conditions produce a “meaningful suffering” that is, ultimately, desirable—provide a fascinating glimpse of religious reactions to cutting-edge science. Not surprisingly, Evans discovers that for many people opinion on the issue closely relates to their feelings about abortion, but he also finds a shared moral language that offers a way around the unproductive polarization of the abortion debate and other culture-war concerns. Admirably evenhanded, Contested Reproduction is a prescient, profound look into the future of a hot-button issue.

John Riddle uncovers the obscure history of contraception and abortifacients from ancient Egypt to the seventeenth century with forays into Victorian England—a topic that until now has evaded the pens of able historians.

Riddle’s thesis is, quite simply, that the ancient world did indeed possess effective (and safe) contraceptives and abortifacients. The author maintains that this rich body of knowledge about fertility control—widely held in the ancient world—was gradually lost over the course of the Middle Ages, becoming nearly extinct by the early modern period. The reasons for this he suggests, stemmed from changes in the organization of medicine. As university medical training became increasingly important, physicians’ ties with folk traditions were broken. The study of birth control methods was just not part of the curriculum.

In an especially telling passage, Riddle reveals how Renaissance humanists were ill equipped to provide accurate translations of ancient texts concerning abortifacients due to their limited experience with women’s ailments. Much of the knowledge about contraception belonged to an oral culture—a distinctively female-centered culture. From ancient times until the seventeenth century, women held a monopoly on birthing and the treatment of related matters; information passed from midwife to mother, from mother to daughter. Riddle reflects on the difficulty of finding traces of oral culture and the fact that the little existing evidence is drawn from male writers who knew that culture only from a distance. Nevertheless, through extraordinary scholarly sleuthing, the author pieces together the clues and evaluates the scientific merit of these ancient remedies in language that is easily understood by the general reader. His findings will be useful to anyone interested in learning whether it was possible for premodern people to regulate their reproduction without resorting to the extremities of dangerous surgical abortions, the killing of infants, or the denial of biological urges.

Childbirth is a quintessential family event that simultaneously holds great promise and runs the risk of danger. By the late nineteenth century, the birthing room had become a place where the goals of the new scientific professional could be demonstrated, but where traditional female knowledge was in conflict with the new ways. Here the choice of attendants and their practices defined gender, ethnicity, class, and the role of the professional.

Using the methodology of social science theory, particularly quantitative statistical analysis and historical demography, Charlotte Borst examines the effect of gender, culture, and class on the transition to physician-attended childbirth. Earlier studies have focused on physician opposition to midwifery, devoting little attention to the training for and actual practice of midwifery. As a result, until now we knew little about the actual conditions of the midwife's education and practice.

Catching Babies is the first study to examine the move to physician-attended birth within the context of a particular community. It focuses on four representative counties in Wisconsin to study both midwives and physicians within the context of their community. Borst finds that midwives were not pushed out of practice by elitist or misogynist obstetricians. Instead, their traditional, artisanal skills ceased to be valued by a society that had come to embrace the model of disinterested, professional science. The community that had previously hired midwives turned to physicians who shared ethnic and cultural values with the very midwives they replaced.

This biography of one of the most prominent pediatricians of the twentieth century describes his illustrious medical family and his remarkable tenure of nearly three decades as Thomas Morgan Rotch Professor of Pediatrics at Harvard Medical School and head of the department of medicine at Children's Hospital, Boston. During this period Janeway built the first department of pediatrics in the nation with subspecialties based upon the new developments in basic sciences. Janeway and his colleagues defined the gamma globulin disorders that resulted in children's increased susceptibility to infections and associated arthritic disorders.

Janeway was the most visible U.S. pediatrician on the world scene in the last half of the 20th century. He traveled widely, taught modern pediatrics to thousands of physicians throughout the developing world, and brought many of them to the U.S. for further training. He was instrumental in starting teaching hospitals in Shiraz, Iran, and Cameroon.

Janeway believed that through teaching by example he might further the cause of peace in the world. His life is an inspiration to everyone in medicine, and serves as a model that all can seek to improve the health of the world's millions and promote a more peaceful future.

A century ago, a plump child was considered a healthy child. No longer. An overweight child is now known to be at risk for maladies ranging from asthma to cardiovascular disease, and obesity among American children has reached epidemic proportions. Childhood Obesity in America traces the changes in diagnosis and treatment, as well as popular understanding, of the most serious public health problem facing American children today.

Excess weight was once thought to be something children outgrew, or even a safeguard against infectious disease. But by the mid-twentieth century, researchers recognized early obesity as an indicator of lifelong troubles. Debates about its causes and proper treatment multiplied. Over the century, fat children were injected with animal glands, psychoanalyzed, given amphetamines, and sent to fat camp. In recent decades, an emphasis on taking personal responsibility for one’s health, combined with commercial interests, has affected the way the public health establishment has responded to childhood obesity—and the stigma fat children face. At variance with this personal emphasis is the realization that societal factors, including fast food, unsafe neighborhoods, and marketing targeted at children, are strongly implicated in weight gain. Activists and the courts are the most recent players in the obesity epidemic’s biography.

Today, obesity in this age group is seen as a complex condition, with metabolic, endocrine, genetic, psychological, and social elements. Laura Dawes makes a powerful case that understanding the cultural history of a disease is critical to developing effective health policy.

In the first extensive American study of child psychiatry in the Soviet Union, Dr. Nancy Rollins explains that her aim is two-fold: to expand knowledge of the theory, diagnosis, and treatment of psychiatric disorders of children and adolescents and to stimulate a professional dialogue. Her attainment of this goal is clearly evidenced here by means of her astute assessment of the findings of her four-month visit to Russia as an individual investigator on the Medical Cultural Exchange program. The author's basic concern about the relationship between a society's child-rearing practices, character formation, and psychiatric disorder propelled her to ponder such questions as: Is there a describable difference between the Soviet conscience and the American conscience, as it develops during the years of childhood and adolescence? What about the problems of sexual identity in the two societies? Identity crises? Why have Soviet psychiatrists and educators remained so consistently anti-Freudian?

In addressing herself to the various questions that intrigued her, Dr. Rollins first considers the history of Soviet psychiatric thought, with the major influences shaping the direction of Soviet child psychiatry and the social perspective with personal impressions of Soviet culture and society. Ensuing chapters, based upon first-hand observations and case material, take a close look at such topics as the organization of psychiatric services, diagnosis, general treatment methods, special psychotherapy, research, and psychiatric training programs. The author's reactions to the people she encountered in children's psychoneurological hospitals, polyclinics, sanatoria, and research institutions contributes a lively dimension to this impressive work.

The study points out some differences between Soviet and American treatment methods; for example, Soviet treatment aims at inducing peace and relaxation in the patient, whereas American methods encourage exposure to and mastery of conflicts and tolerance of anxiety. Dr. Rollins also offers suggestions for further study and reflects on the relation of psychiatry and culture in the two countries.

A window on the insular world of autism, this book offers a rare close look at the mysterious condition that afflicts approximately 350,000 Americans and affects millions more. As they make sense of the many features of autism at every level of intellectual functioning across the life span, Marian Sigman and Lisa Capps weave together clinical vignettes, research findings, methodological considerations, and historical accounts. The result is a compelling, comprehensive view of the disorder, as true to human experience as it is to scientific observation.

Children with Autism is unique in that it views autism through the lens of developmental psychopathology, a discipline grounded in the belief that studies of normal and abnormal development can inform and enhance one another. Sigman and Capps conduct readers through the course of development from infancy to adulthood, outlining the differences between normal and autistic individuals at each stage and highlighting the links between growth in cognitive, social, and emotional domains. In particular, Sigman and Capps suggest that deficits in social understanding emerge in the early infancy of autistic children, and they explore how these deficits organize the development of autistic individuals through the course of their lives. They also examine the effects certain characteristics can have on an autistic person's adjustment over time. Their book concludes with an overview of existing interventions and promising avenues for further research.

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory.

But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize.

Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

"The failure of the annual harvest is still an event of greater importance in the lives of the Russian people than...what happens to steel production."--from the Introduction

With over 540 million acres sown to crops the Soviet Union was one of the world's agricultural giants. Yet agriculture was the Achilles heel of the Soviet economy. Public pronouncements of Russian leaders--prerevolutionary and postrevolutionary alike--attested the crucial role of the agricultural problem, its economically and politically explosive nature, and its persistence over the years.

This is one of the most thorough studies ever made of Russian agriculture. Emphasizing the continuity of problems and policies too often dichotomized into tsarist and Soviet eras, Volin has created a monumental work--a sweeping panorama of the century between the emancipation of the serfs and the 1960s.

The author begins by recounting the development of serfdom and describing the emancipation and subsequent problem of land distribution. In the first part ofthe book he also explores the first agrarian revolution (1905) and the reforms that followed it, as well as the conditions during World War I that led to the Revolution of 1917.

In Part II he treats agricultural conditions during the Civil War, attempts made to restore the economy by means of the New Economic Policy, Stalin's programof forced collectivization and liquidation of the kulaks, agricultural conditions during World War II--including Nazi policies in occupied territory--and the policies of Stalin in the postwar recovery.

The longest section of the book is devoted to the Khrushchev era. It covers capital investment and expansion of sown acreage, incentives for the kolkhozniks, their income, and the supply of consumer goods, as well as mechanization and electrification programs, the state farms, rates of production, and administrative control and planning.

The final chapter summarizes the past century and comments on the outlook for the future.

In this innovative study of the rise of the conservation ethic in northern New England, Richard Judd shows that the movement that eventually took hold throughout America had its roots among the communitarian ethic of countrypeople rather than among urban intellectuals or politicians. Drawing on agricultural journals and archival sources such as legislative petitions, Judd demonstrates that debates over access to and use of forests and water, though couched in utilitarian terms, drew their strength and conviction from deeply held popular notions of properly ordered landscapes and common rights to nature.

Unlike earlier attempts to describe the conservation movement in its historical context, which have often assumed a crude dualism in attitudes toward nature--democracy versus monopoly, amateur versus professional, utilitarian versus aesthete--this study reveals a complex set of motives and inspirations behind the mid-nineteenth-century drive to conserve natural resources. Judd suggests that a more complex set of contending and complementary social forces was at work, including traditional folk values, an emerging science of resource management, and constantly shifting class interests.

Common Lands, Common People tells us that ordinary people, struggling to define and redefine the morality of land and resource use, contributed immensely to America's conservation legacy.

Schoolyards have come a long way from the barren playgrounds that many people remember. Today's school campuses often feature gardens in which students can learn about native plants and wildlife, grow vegetables and fruit, explore cultural traditions, practice reading and math skills, and use their imaginations to create fun play spaces. And for a growing number of urban students, these schoolyard gardens offer the best, if not the only, opportunity to experience the natural world firsthand and enjoy its many benefits.

This book is a practical, hands-on guide for creating a variety of learning environments in the arid Southwest. Filled with clear, easy-to-use information and illustrated with photographs, drawings, and plans, the book covers everything necessary to create schoolyard gardens:

• An introduction to schoolyards as outdoor classrooms and several types of habitats, including art gardens, cultural history gardens, ecological gardens, literacy gardens, and vegetable gardens
• Design theory, including a history of garden styles, and design principles and design elements
• Beginning the design process, including identifying participants and writing a design program that sets out goals and requirements
• Conducting site research and synthesizing design elements to arrive at a final design
• Design essentials, including project funding and design features, maintenance, accessibility, safety, and project evaluation and revision
• Wildlife ecology, including elements needed for survival such as food and shelter
• Creating gardens for pollinators and other wildlife, including hummingbirds, butterflies, bees, moths, bats, and flies, as well as pest control
• Lists of native plants for various kinds of habitats and nurseries that sell native plants, as well as books, web sites, and other resources for learning more about native plants and wildlife

This guide will be essential for landscape architects, school personnel, parents, and students. Indeed, its principles can be used in designing schoolyard habitats across the country, while its information on gardening with native plants and wildlife will be useful to homeowners across the Southwest.