In this companion volume to their widely acclaimed Perspectives of Psychiatry, Phillip R. Slavney, M.D., and Paul R. McHugh, M.D., argue that the discontinuity of brain and mind is the source of much of psychiatry's discord, for it leads psychiatrists to think about their discipline in terms of polar opposites: conscious or unconscious; explanation or understanding; paternalism or autonomy. Psychiatric Polarities brings together the history of ideas and such clinical issues as suicide and bipolar disorder to identify, describe, and debate these and other polar oppositions that arise from psychiatry's inherent ambiguity. There is no single conceptual perspective that is sufficient for all of psychiatry's concerns, Slavney and McHugh observe, yet it is both possible and necessary to transcend the denominational conflicts that plague the field. In Psychiatric Polarities, their examination of these conflicts demonstrates how a methodological approach can help to resolve disagreements rooted in partisan commitments.

From strenuous opposition to physician-assisted suicide to a conviction that sex-correction surgery for newborns is cruel and misguided, Dr. Paul R. McHugh's opinions are strong and often controversial. In this collection of essays, McHugh demonstrates why he is one of the most thought-provoking figures in the academic world.

These pieces argue for a realistic appraisal of just what psychiatrists know and how they know it, with the aim of indicating how such knowledge can best be used not only for better patient care but also to reflect on and influence public issues and social movements. His essays will stimulate professional and popular discussion about the goals and effectiveness of current psychiatric practice.

McHugh sorts through the layers of what he terms the "culturally driven misdirection of psychiatry and psychotherapy" to explain concepts often misunderstood by nonscholars and the intellectual community alike. America's leading psychiatrist may inspire you or offend you, but he will certainly make you think.

Substantially revised to include a wealth of new material, the second edition of this highly acclaimed work provides a concise, coherent introduction that brings structure to an increasingly fragmented and amorphous discipline. Paul R. McHugh and Phillip R. Slavney offer an approach that emphasizes psychiatry's unifying concepts while accommodating its diversity. Recognizing that there may never be a single, all-encompassing theory, the book distills psychiatric practice into four explanatory methods: diseases, dimensions of personality, goal-directed behaviors, and life stories. These perspectives, argue the authors, underlie the principles and practice of all psychiatry. With an understanding of these fundamental methods, readers will be equipped to organize and evaluate psychiatric information and to develop a confident approach to practice and research.

stematiker apostrophiert, deren Leistungen bestenfalls als uberholt angese- hen werden, nicht selten jedoch auch als Hemmschuh fur die neuen Seh- weisen einer psychodynamischen Psychiatrie mit tiefen psychologischen Theorien, Lehranalysen, Selbsterfahrungsgruppen u. a. m. Unberucksichtigt bleibt dabei meist, dass viele der neuen Lehren trotz der Betonung von Be- griffen wie "Seele" oder "psychisch" im Grunde nur maskierte Formen einer modischen identitatstheoretischen Philosophie materialistischer Couleur darstellen (Koehler 1984). Gewiss ist gegen eine psychodynamische Ausbildung des psychiatri- schen Nachwuchses wenig einzuwenden, sofern eine Verabsolutierung des gewahlten Standpunktes vermieden wird. Leider stellen die zweifellos erfor- derlichen tiefen psychologischen Aspekte noch keinen selbstverstandlichen Teil einer integralen psychiatrischen Ausbildung an den deutschen Klini- ken dar, in denen der junge Assistenzarzt sein diagnostisches und therapeu- tisches Wissen erwirbt (Mombour 1984). Deshalb sieht er sich fast uberall gezwungen, unter zum Teil erheblichen Schwierigkeiten seinen Zusatztitel fur Psychotherapie "ausser Haus" zu erwerben. Dessen schwere Zugang- lichkeit, die vor allem institutionell bedingt ist, mag zur Tendenz beitragen, dass die psychodynamische Sehweise eine herausgehobene Position erhalt und in der Vorstellung gerade der psychiatrischen Anfanger leicht zum do- minierenden Denkansatz gerat.