Conversations in Critical Psychiatry - Updates
The volume is now scheduled for print release in North America
Conversations in Critical Psychiatry (Oxford University Press, 2024), edited by me, brings together a selection of interviews published in the Psychiatric Times from 2019 to 2022, updated with new and previously unpublished material, including a foreword by Sir Robin Murray, a detailed introductory chapter on psychiatry and the critical landscape, exclusive interviews, and my interview by Richard Gipps and Nev Jones.
The print book has a release date of December 20, 2024 in North America, and is available for pre-orders. It’s already available as an eBook globally and in print in the UK and Europe.
Purchase via OUP website
Purchase via Amazon (US)
Purchase via Amazon (UK)
For those with academic affiliations, Conversations in Critical Psychiatry is also available digitally through OUP’s Oxford Medicine Online collection.
Excerpt from Sir Robin Murray’s Foreword
“Psychiatry must continually reassess its practices and remain open to constructive criticism, but crucially Aftab also argues that any critical psychiatry movement worth its name must also be self-critical. Sadly, neither orthodox psychiatry nor its critics live up to this injunction. Aftab outlines a number of scientific and philosophical areas where such self-critique has been deficient in the critical psychiatry movement, and suggests a remedy in the form of a critical and integrative pluralism. A common theme among many psychiatric critics is the profession’s reliance on the so-called ‘brain disease model’. Much progress will be made here if the psychiatrists respond to such criticisms by open acknowledgement that we are just emerging from a period dominated by reductionistic tendencies, particularly in the USA, and critics recognize and move beyond a simplistic or outmoded caricature of the medical model.
I have previously written about how I ignored how social factors could contribute to the aetiology of psychosis for the first two decades of my research career, and how I dismissed iatrogenic phenomena such as antipsychotic-induced dopamine supersensitivity (Murray, 2017). These were consequences of following the fashion of the herd and adhering to the prevailing orthodoxies. I have benefitted from engagement with colleagues who took novel and non-conformist approaches to the study of mental illness. Well-meaning critics force us to reevaluate our preconceptions and play a vital role in scientific progress. Increasingly, though late in the day, our patients are given space to also contribute (Murray, 2020).”
Excerpt from my Preface
“Jacques Derrida often pointed out the artificiality of the interview genre and responded once to a straightforward interview question with: ‘I should not have to reply right away to such fully elaborated and serious questions—and by improvising no less. Our agreement for this exchange is that I should try to improvise a response even when I am not sure that I can do so adequately’ (as quoted in Peter Salmon’s biography of Derrida, An Event, Perhaps).
The interviews in this volume bring their own form of artificiality but in the opposite direction. There may be an appearance of improvision and spontaneity in response to elaborate and serious questions, but the responses are products of thoughtful and unhurried reflection. Most of these interviews were conducted as an exchange of questions and answers via email, over a span of several weeks. A few were conducted virtually and then transcripts were prepared, edited, and revised. It was so by design, as I was not interested in what the interviewees had to say on the spot about complicated issues but rather in what they had to say after careful consideration. The strategy has been successful from my perspective, as the interviews seem to offer something of enduring value. In particular, their frequent use for academic and educational purposes is heartening and provided a motivation for this book adaptation as well.
The interviews in the series ‘Conversations in Critical Psychiatry’ were conducted over a period of 3 years from 2019 to 2021 for Psychiatric Times. My own intellectual development and professional trajectory has been significantly influenced by this undertaking. I have discovered new ideas, pre-existing ideas have matured in unexpected ways, and I have had the privilege to collaborate with many of the individuals interviewed. When I started this series in 2019, I was still a trainee. I was completing my geriatric psychiatry fellowship in San Diego, California, USA. Geographical opportunity and intellectual affinity converged on Allen Frances as the first interviewee. He was gracious and welcoming when I approached him, and I have benefitted from his support and encouragement ever since. Starting the series with Frances was symbolic, because he had been one of the architects of the modern DSM and yet had emerged as one of DSM-5’s most prominent critics, while speaking openly about conceptual and metaphysical issues that surround psychiatric classification. Starting with Frances signalled that the series was grounded within the psychiatric tradition, but also honest in genuine exploration of the critical space. This spirit has persisted throughout this undertaking.”
The first review of Conversations in Critical Psychiatry by Mark L. Ruffalo is out in Psychology Today.
My gratitude to Ruffalo for the favorable review!
“Both Dr. Aftab and I “came of age” professionally at a time when psychiatry was recovering from a decades-long recess into biological reductionism, encapsulated by the 1990s slogan, “the Decade of the Brain.” Both of us followed along as the DSM system was being revised in the late 2000s and early 2010s and took note of the significant controversy that developed during this process. Both of us were fortunate to connect with Allen Frances, whose work on these issues inspired our own writing and ideas.
In a way, it would have been easy to look at what was happening within psychiatry at that time and simply conclude that it was a failed experiment. Maybe Thomas Szasz was right after all; maybe there is no mental illness and all of it is just “made up,” an attempt to control people who simply deviate from normal. Maybe the drugs are toxins. Maybe psychotherapy is hogwash. Maybe psychiatrists and psychotherapists should just “pack it in” and admit that their whole venture has ultimately proven to be a disastrous failure…
Dr. Aftab and I agree on many things, but perhaps what we agree on most is the need for pluralism in psychiatry. That is, a field as vast as psychiatry (and, by extension, psychology, psychotherapy, psychoanalysis, etc.) demands a plethora of ideas, for no single approach could possibly capture the intricacies and nuances of a field that contains such diverse territory. As Seymour Kety wrote in 1960, “A truer picture of the nervous system and of behavior will emerge only from its study by a variety of disciplines and techniques, each with its own virtues and its own peculiar limitations.”
It is in this spirit that Conversations in Critical Psychiatry emerged. Whether you're a clinician, a student, or someone with a keen interest in the philosophy of psychiatry, this book is essential reading for anyone who seeks a deeper understanding of the sheer complexity, and beauty, of some of the most important issues of our day.”
Comments by Duncan Double
The British psychiatrist Duncan Double, a founding member of the Critical Psychiatry Network and one of the interviewees in the OUP volume, has commented on the volume in a post on his personal blog. He touches on some of our disagreements and asserts, “I’m not so convinced that critical psychiatry is lacking in self-criticism. It's more Awais saying he can’t accept at least part of its critique.”
“In the same way that Anthony Clare did for a previous generation by emphasising psychiatry’s eclecticism (see eg. previous post), mainstream psychiatry seems to be defending itself against the message of critical/relational psychiatry by promoting integrative and critical pluralism. The publication of Awais’ book is welcome. The trouble is that although it engages with the critique of psychiatry, it does not properly take its message on board because psychiatry does not want to change.”
I have talked about my disagreements with the Critical Psychiatry Network in my chapter in the book (see a summary here) and I will leave it up to the readers to judge whether my efforts are, as Double thinks, representative of psychiatry’s resistance to change and critique, or whether, as I think, critical psychiatry has genuine conceptual shortcomings that need to be remedied via a shift towards pluralism. (I’m flattered to be compared to Anthony Clare regardless!)
There is more to the Psychiatric Times series than this volume (and vice versa)
I regret that due to limited print space I could not include all the interviews from the Psychiatric Times series in this book. Only 2/3rds of the interviews were included in the OUP volume, and some of my favorite interviews are not in the book. I am hopeful that many of the remaining interviews will be published in a future volume, perhaps along with a selection of interviews from Psychiatry at the Margins.
If you are a commissioning editor for a press and interested in publishing a follow-up volume of interviews, reach out to me!
You can see a full list of the interviews from the Psychiatric Times series here.
I want to acknowledge and thank the Psychiatric Times interviewees whose interviews could not be included in this volume due to considerations of space and thematic coherence: Niall McLaren, Susannah Cahalan, Lucy Johnstone, George Dawson, Marvin Goldfried, Joseph Pierre, Jonathan Sadowsky, Kathleen Flaherty, Janice Haaken, Wouter Kusters, Jim Gottstein, and Judith Beck.
If you’d like to review the volume for a publication and need help in obtaining a review copy, you are welcome to contact me.
If you purchase the book through Amazon, I hope you’ll consider leaving a review. (I am grateful to the folks who have already reviewed.)
Dr. Aftab, this is such an inspiring project to see you complete and continue to nurture. Keep doing what you do. Medical students such as myself will be greatly helped by these kinds of works.
So many congratulations to you! I do not work in this field but have an interest in psychology, psychiatry, mental health diagnoses, etc. from a non professional point of view. Do you think the book is accessible for someone like me?