Why I wrote this book

My principal goal in writing this book was to address the gap between what mental health care providers, patients and the public want, and what the conventional model of care and institutions that perpetuate the current dogma permit. The book is not an attack on mainstream psychiatry nor is it intended as a wholesale endorsement of complementary and alternative medicine (CAM). I’ve tried to chart a ‘middle way’ between Western biomedicine and CAM keeping in mind advantages and limitations of different domains of medical knowledge and clinical practice.

Psychiatry as presently conceptualized and practiced fails to adequately address the core causes and meanings of mental illness. The reasons for this are complex and include the following:

  • Current scientific theories do not adequately explain the causes of mental illness
  • Available mainstream treatments often fail to alleviate symptoms of mental illness
  • Academic and government institutions that promulgate psychiatry are, with few exceptions, conservative in ideology and resist new ideas
  • Post-graduate training programs in psychiatry are narrowly focused on psychopharmacology and do not cover non-pharmacologic interventions and non-allopathic models of mental illness causation
  • The pharmaceutical industry heavily influences ideology and clinical practices in academic institutions, the American Psychiatric Association (APA), and among psychiatrists broadly. As a result, most non-pharmacologic interventions are marginalized in academic institutions, APA-sponsored conferences, and professional journals

A large grassroots movement has emerged in the U.S. and other industrialized countries in response to what is widely regarded as a growing crisis in mental health care. But there is a disconnect between a highly vocal popular movement to reform mental health care and the American Psychiatric Association (APA), and institutions that shape the policies, practices and research agenda of psychiatry.

At the same time, growing numbers of mental health professionals who find the status quo unacceptable are educating themselves about a variety of non-pharmacologic treatment choices and recommending these to their patients.

Many CAM modalities have been investigated in sophisticated research studies and have been found to be both safe and effective treatments of specific psychiatric disorders. Hence, the real bottleneck delaying progress in psychiatry toward a more eclectic paradigm and more effective, safer modalities is not a paucity of evidence for CAM, but negative biases in biomedical psychiatry against CAM based on an entrenched ideology that equates the practice of psychiatry to prescribing psychotropic medications.

Mental health care practitioners who want to learn about evidence-based CAM approaches may encounter problems finding reliable, up-to-date information on a particular treatment modality. Another problem that is delaying progress toward a truly integrative psychiatry is the absence of a methodology for integrating disparate Western biomedical and CAM modalities into a coherent treatment plan.

This book addresses these problems by offering a conceptual framework for solving practical problems in integrative mental health care. It covers resources and methods that will help mental health practitioners find reliable information on a range of CAM modalities, and know how to use such information in day to day clinical decision making. The book is not a compendium of research findings on CAM though select CAM modalities are mentioned as examples. The reader seeking comprehensive reviews of research findings on CAM is referred to resources on a wide range of topics.

I feel strongly that a critique of mental health care as currently conceptualized and practiced is both a legitimate and necessary prologue to reconceptualizing and reinvigorating this important domain of knowledge and praxis in light of promising new ideas. I hope this book will provide a useful framework for dialog and debate on urgently needed changes in the way mental health providers practice, in the way academic institutions use information, and most of all, in the way patients receive care.

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