It is questionable whether psychiatry as a whole does, or has done throughout its history, more good than harm. Certainly there are some patients who benefit from its ministrations; but there are many others who have been harmed by the wrongful administration of noxious drugs or other therapies. A less tangible, but nevertheless potentially serious, harm is that it persuades people with the difficulties in living that are inseparable from human existence that they are ill, and therefore disguises from them that the best remedy, if one there be, lies in their own hands. Indeed, psychiatry seems to have persuaded whole societies that all forms of mental distress are illnesses, for which there is a technical medical solution.

I confess to having approached Lisa Appignianesi’s book with something like dread. I thought it would be a simple-minded catalogue of wrongs committed by male psychiatrists against women, but I was quite wrong. The author recognises the inherent ambiguities and difficulties of the field, which speaks to her honesty; she weaves a seamless robe from individual case histories (often of murderesses or suicides), literature and the theoretical writings of psychiatrists. She has a good measure of what in fact is not very common, namely common sense, and this lends an exemplary clarity to her prose. Her range of reference is very large, and although her book concentrates on the treatment of women, it does so in no sectarian spirit, and can be recommended to anyone interested in the history of psychiatry. Indeed, I would say that it is the most readable and elegant history of the last two centuries of psychiatry that I have read.

The Loss of Sadness is one of the most important books in the field of psychiatry published in the last few years. The authors are two American professors of sociology, but (I almost said nevertheless) they present a powerful argument that is so good that they do not have to obscure it with convoluted prose.

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