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Ten Years Which Changed the Face of Mental Illness. By Jean Thuillier. Trans. By Gordon Hickish. London: Martin Dunitz. 1999. 225 pp. £24.95 (pb). ISBN 1-85317-886-1

Published online by Cambridge University Press:  02 January 2018

Allan Beveridge*
Affiliation:
Fife Primary Care NHS Trust, Mental Health Services, Queen Margaret Hospital, Whitefield Road, Dunfermline KY12 0SU
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Abstract

Type
Columns
Copyright
Copyright © 2000 The Royal College of Psychiatrists 

The title of this book alludes to John Reed's classic account of the Russian Revolution, Ten Days that Shook the World (Read, 1990). Instead of the overthrow of capitalism, it focuses on the decade during which the introduction of antipsychotics transformed psychiatric practice. The author, Jean Thuillier, is well placed to discuss this period, having worked alongside Jean Delay and Pierre Deniker, the French clinicians who were among the first to use chlorpromazine. Trained in both psychiatry and pharmacology, Thuillier was a Chef de Clinique at the Faculty of Medicine in Paris and played a pioneering role in the early days of psychopharmacology.

In similar fashion to Edward Shorter in his recent A History of Psychiatry (Reference ShorterShorter, 1996), Thuillier contrasts the dark ages before the advent of effective medication with the post-chlorpromazine era, which he portrays as liberating the mentally ill from the asylums. Advances were made by heroic clinical scientists, toiling in laboratories and at the bedside. The end of this happy tale sees psychiatry rescued from the professional wilderness and restored to its rightful place beside general medicine. In Thuillier's view the discovery of the neuroleptics has brought psychiatry back into the medical mainstream.

There are, of course, other readings of this key episode in the evolution of modern psychiatry. Some have pointed to the fact that the asylums were starting to empty before the development of the antipsychotics, demonstrating the importance of social factors. Some may also feel that the author, in his somewhat evangelical account of the benefits of medication, rather downplays the severity of side-effects.

However, this is an ‘insider’ account of recent events, rather than an ‘outsider’ overview by an academic historian. Thus, what it loses in its lack of engagement with other interpretations of the period, it gains in the personal detail that Thuillier is able to provide by virtue of the fact that he lived through the time. He takes us into the Parisian psychiatric wards of 50 years ago, to ground-breaking international conferences and to eavesdrop on the discussions of the leading psychopharmacologists of the day. Thuillier emerges as a humane clinician, with an enquiring mind, forever trying to find novel pharmacological remedies for mental distress.

The book ends with an imagined picture of what psychiatry will look like in the year 2080. The millennial issues of the Journal and Bulletin also contained essays attempting to predict the future of psychiatry (Reference Davies and McGuireDavies & McGuire, 2000; Reference KendellKendell, 2000; Reference PersaudPersaud, 2000). Thuillier was writing in 1980, but, like these more recent authors, he conjures up a vision in which pharmacology and computers combine to create a brave new world of mind manipulation and control. And, like current prophets, he voices his unease that the human dimension to clinical care may thus be eroded.

Unfortunately, the book is overlong and given to lengthy digressions. By aiming to cater for both lay and professional audiences, it veers between simplistic accounts of psychiatric theory and more technical discussions of pharmacology. Clinicians may wish to perform their own editing as they read the book, and by doing so, they will discover passages that convey the excitement of the decade that shook the psychiatric world.

References

Davies, T. & McGuire, P. (2000) Teaching medical students in the new millennium. Psychiatric Bulletin, 24, 45.Google Scholar
Kendell, R. E. (2000) The next 25 years. British Journal of Psychiatry, 176, 69.Google Scholar
Persaud, R. (2000) Psychiatry in the new millennium. Psychiatric Bulletin, 24, 1619.Google Scholar
Reed, J. (1990) Ten Days That Shook the World. Harmondsworth: Penguin Books.Google Scholar
Shorter, E. (1996) A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons.Google Scholar
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