Loved it and gave recommendations to several people.

Does anyone mention CBT and the success rate of VOLUNTARY and INVOLUNTARY participants?

Mental illness is not a character fault, then people talk about CBT like it isn't learning to think and act differently.

Philip Dawdy "My larger point here, just to be clear, is that getting clean of drugs requires will power and desire. Just tossing someone into treatment doesn't provide that."
LINK

Great review! I took a lot of undergrad psychology classes and always had weird feelings about its advocacy of pharmaceuticals and drugs. Barber's book looks like it is going in right direction - thanks.

I am in the final pages myself and agree with your review. I think it's a great book. I did hear some fellow psych survivor types trashing parts of it where he tries to make distinctions between depression with a little "d" and big "D" and "true" bipolar disorder as opposed to what? -- "false" I presume -- and pushing meds for these more serious examples but I wonder if they even read the whole book because by the end he is saying the alternatives (psychotherapy) work even for the most serious cases of mental disturbance and that in fact meds often don't. And yes, I am sure there are examples of where meds have to be used albeit I would hope not indefinitely. The most original part of the book and what distinguishes it I would say from the plethora of books out there right now trashing big pharma, the FDA and psychiatry is the treatment of psychotherapy and even neuroscience. He really explains it all clearly and presents history and evidence to support his points. Well worth reading.

P.S. If Warner read even the introduction before writing on the book I'd be surprised. What she read and absorbed lock, stock and barrel was her Brown buddy Peter Kramer's review. I'm sure she chatted with Kramer too and that was enough for her.

Glad to get a more balanced review of this book, I've been wondering about it.

What's not pointed out is that the largest efficacy study of therapies ever conducted (Consumer Reports) found no difference in effectiveness between different therapies. This has been borne out by research again and again. If anything makes a difference it is the patient and the clinician, not the therapy.

Thanks for this. I read Kramer's stupid, hateful review of the book at Slate. I'll read the book. It sounds important. As for Kramer, I guess I need to reread Listening to Prozac. I'll buy Comfortably Numb, but as for Kramer's book, I'll check it out from the library. I'm not giving Kramer any money. LtP was an important part of my decision to get off of ssri's and yet these days Kramer's a real shill for the biomedical model. Still be careful not to confuse psychosis induced by extended crack use and homelessness with schizophrenia; it's like confusing an alcohol addcition with Bipolar Disorder.

Wow. I just read Kramer's "review". It reads more like an argument than a book review. Then, in the penultimate paragraph, he seems to agree with Barber in a "throw the dog a bone" sort of way.

Very odd review. Now I'm going back to finish your posting. Just had to comment on Kramer's rant.
Sherry

I've worked with people who don't have homes too and I don't see them as different to anyone else with a psychiatric label in terms of degree of illness. Being homeless is a huge stressor for anyone, doesn't mean a person is more "sick" than someone else, just under much more stress and with lots less resources. And really crack addiction is not schizophrenia and it's impossible to figure out if someone has a mental illness while they are actively using.

I'm also not a CBT fan, if it works for folks, great, but it doesn't work for lots of folks with depression and other problems and we should have choices about what kind of therapy we get. Unfortunately because CBT is shorter and cheaper and easier, that's all a lot of folks can get these days. It is all about the relationship in psychotherapy, not some cookbook.

no disrespect alison, but where did i say smoking crack was the same thing as schizophrenia? as for the level of acuity you see amongst the homeless mentally ill, i can assure you that the cases tend be far more severe. not at every homeless shelter of course, but the one i worked at doesn't filter out the severe cases as do a lot of shelters.

as for the cbt is a cookbook business, i think you'll find that barber handles that pretty well in his book. it's a good point of course that not all therapists are created equally. and of course therapy doesn't work for everyone. but i don't think i said that.

When you said the guy with a crack addiction got better on Haldol, what I said, perhaps unclearly, is it's difficult to know if someone who is actively using crack actually does have a psychotic disorder or just a drug induced psychosis.

Have you worked with people with schizophrenia labels who are not in homeless shelters also Philip? Because I have and that's where my comparison that there is no significant difference in severity comes from. I was an outpatient therapist/case manager for years in a community mental health center.

I have no doubt that CBT does not work for everyone and that not all CBT therapists are equally good. As a person with MDD who has recently started CBT work, I have to say it seems better to/for me than traditional talk therapy. I've had depression long enough and have enough self-awareness to know the root cause of a lot of my negative self-talk and how my thoughts and actions feed into the depression. I can also see on my own how addressing weaknesses in physical and social health will help with the depression, but I need to have someone help me make goals to change my behavior and have someone to be accountable to other than myself. Is CBT a cure-all? Of course not, but it is more proactive and positive than therapy that involves sitting around talking about being depressed all the time. I can wallow on my own; doing something about it is what requires help.

I'm halfway through the book, just through the CBT chapter. Overall I agree with your review, but I do have a frustration with his constant reminders that you'll still need meds if you have "severe" mental illness, like bipolar/SZ/major "D"epression. I have the same frustration with several of the books of this ilk. Glenmullen comes to mind.

With so many people diagnosed as bipolar after a bad SSRI reaction, and the heavy marketing of the bipolar label, I worry folks who could benefit from his approaches won't realize he's talking to them, too. I had read several such books before it dawned on me that even though my label was "bipolar," I could make the same kind of progress with similar tools, and what do you know, I didn't need the meds either.