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Trouble in Mind

, 352 pages

6 b&w illus.

December 2010



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Trouble in Mind

An Unorthodox Introduction to Psychiatry

Orthodox psychiatric texts are often rich in facts, but thin in concept. Depression may be defined as a dysfunction of mood, but of what use is a mood? How can anxiety be both symptom and adaptation to stress? What links the disparate disabilities of perception and reasoning in schizophrenia? Why does the same situation push one person into drink, drugs, danger, or despair and bounce harmlessly off another?

Trouble in Mind is unorthodox because it models adaptive mental function along with mental illness to answer questions like these. From experience as a Johns Hopkins clinician, educator, and researcher, Dean F. MacKinnon offers a unique perspective on the nature of human anguish, unreason, disability, and self-destruction. He shows what mental illness can teach about the mind, from molecules to memory to motivation to meaning.

MacKinnon’s fascinating model of the mind as a vital function will enlighten anyone intrigued by the mysteries of thought, feeling, and behavior. Clinicians in training will especially appreciate the way mental illness can illuminate normal mental processes, as medical illness in general teaches about normal body functions. For students, the book also includes useful guides to psychiatric assessment and diagnosis.

Dean F. MacKinnon, M.D., is an associate professor in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine.

"Written for the medical student and the psychiatric resident and the psychology and social work intern. For those readers, it is a masterly summary of what we know about the normal brain, and how it goes awry."

"Dean MacKinnon has written an ambitious book for psychiatrists and psychologists, and indeed for the interested general reader. Most texts that address normal brain function keep it compartmentalized in separate chapters (often written by separate authors) from theories of psychopathology. Such texts almost never take on the risky project of connecting neurobiology with concepts of mind. MacKinnon has made rich connections that will fire the imagination of clinicians, giving them a way to situate human experience in the function and malfunction of our brains."

"Dr. MacKinnon's thoughtful and provocative book begins with the premise that 'psychiatry has no coherent concept of mind' and that the orthodox approach to psychiatric diagnosis neglects the nature of mind and mental illness. As an alternative to the superficial symptom checklists of the DSMs, MacKinnon provides a richly detailed model for understanding both our mental life and its breakdown in various forms of mental illness. By conceptualizing 'mind' as a function of brain, MacKinnon is able to present a compelling and systematic account of our mental life, in both health and disease. He gives due weight to both biological and humanistic modes of explaining psychiatric illness, and his book will greatly enrich the understanding of trainees and seasoned clinicians alike."

"A masterly summary of what we know about the normal brain, and how it goes awry."

" Trouble in Mind is rich with ideas and I think that it will become a classic of non-mainstream psychiatric thinking."

"MacKinnon is a wonderful guide and interpreter... an excellent resource for new trainees, and experienced clinicians."

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