Darian Leader is a Lacanian psychoanalyst, and this alone may dissuade many psychologists from reading this fascinating book. It would be their loss. This is a truly important book, not least because, first and foremost, Leader seeks to understand the psychology of people who are labelled mad. This contrasts with the medical model where ‘illnesses’ are presumed to be the causes of psychotic behaviour and drug treatments seen as the treatment of choice. In his book Madness Explained (2003) Richard Bentall showed how inadequate this system is. Leader takes a similar stance, pointing out that a diagnostic approach that merely lists symptoms without reference to cause or meaning fails to do justice to the psychology of madness. It is the individual’s relationship to their symptoms that counts, and only by understanding that can we begin to understand what madness is. Leader has researched deeply into what he calls, the ‘old psychiatry’ (19th and early 20th century). He shows how the phenomenological investigations of the time revealed far more of the individual’s psychology than the symptom check-lists of today.
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