Louis Menand on Psychiatry

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4.7 • 4.3K Ratings

🗓️ 31 May 2010

⏱️ 59 minutes

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Summary

Louis Menand of Harvard University talks with EconTalk host Russ Roberts about the state of psychiatry. Drawing on a recent article of his in the New Yorker, Menand talks about the state of knowledge in psychiatry and the scientific basis for making conclusions about mental illness and various therapies. Menand argues that the research record shows little difference between the effectiveness of psychopharmacology and talk therapies of various kinds in fighting depression. Neither is particularly successful in any one case. Other topics that are discussed include the parallels between economics and psychiatry in assessing causation, the diminished role of Freudianism in modern psychiatry, and the range of issues involved in using medication to avoid pain and hardship.

Transcript

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0:00.0	Welcome to Econ Talk, part of the Library of Economics and Liberty. I'm your host Russ Roberts
0:13.9	of George Mason University and Stanford University's Hoover Institution. Our website is econtalk.org
0:21.2	where you can subscribe, find other episodes, comment on this podcast, and find links to
0:26.5	other information related to today's conversation. Our email address is mailadicontalk.org. We'd
0:33.6	love to hear from you. Today is May 26, 2010 and my guest is Lewis Manand, the NT and Robert
0:44.8	M. Bass professor of English at Harvard University. Mr. Benand, welcome to Econ Talk.
0:49.7	Thank you. Nice to be here. Our subject for today is an article you wrote for the New Yorker
0:54.0	on the State of Modern Psychiatry. The title of the article is Headcase and the subtitle was,
1:00.6	can psychiatry be a science? I spend a lot of time thinking about whether economics can be a science,
1:05.9	so the article resonated deeply with me. You looked at a couple of recent books on psychiatry,
1:12.1	one by Gary Greenberg, the other by Irving Kirsch. Both authors argue that psychiatry is in
1:17.4	disarray, but totally disagree with reasons for that. But I want to start with a basic question,
1:24.1	which is, do we know what depression is? Is it different as you raised the issue in the
1:30.1	beginning of your article? Is it different from being really sad in response to a life challenge?
1:35.2	Is there such a thing as clinical depression? Well, that's sort of the question at the center
1:41.6	of a lot of these debates about contemporary psychiatry and in particular about the use of the
1:48.6	diagnostic and statistical manual of mental disorders, the DSM, which has been criticized
1:54.0	really ever since it was created back in 1952, but particularly in its most recent edition,
1:58.6	the fourth edition. And the problem is that it's impossible to distinguish empirically sadness
2:08.4	over some life event death or divorce or losing your job. And what you're calling clinical
2:16.5	depression, that is depression that doesn't seem to have an exogenous reason. And if you look
2:24.6	at the brains of people who have been laid off or have some other kind of life event that makes
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