Volume 196 - Issue 11
A contrarian’s view of psychiatry
Author: Rebecca E Adams
Med J Aust 2012; 196 (11): 711. || doi: 10.5694/mja12.10428
Published online: 18 June 2012
Published online: 18 June 2012
GORDON PARKER describes himself as a “contrarian”. He admits that he’s difficult, combative, impatient with received wisdoms in psychiatry that he thinks don’t work, and dogged - even aggressive - in tackling problems, clinical and conceptual. And it’s clear in this intellectual autobiography that these personal qualities, combined with his enormous energy and brilliance, have been central to his enormous contributions to the field. Professor ...
A piece of my mind: a psychiatrist on the couch.
Gordon Parker. Sydney: Pan Macmillan Australia, 2011 (viii + 352 pp, $32.99). ISBN 9781742610740.
GORDON PARKER describes himself as a “contrarian”. He admits that he’s difficult, combative, impatient with received wisdoms in psychiatry that he thinks don’t work, and dogged — even aggressive — in tackling problems, clinical and conceptual. And it’s clear in this intellectual autobiography that these personal qualities, combined with his enormous energy and brilliance, have been central to his enormous contributions to the field. Professor of Psychiatry at the University of New South Wales, Sydney, for 25 years; a leading and prolific researcher; and founder of the Black Dog Institute, which offers specialist expertise in mood disorders in Australia; Parker’s contributions to psychiatry are extraordinary, and he is an international leader in the field. But he didn’t get there without a fight.
Parker’s central research and clinical passion has been in understanding and reconceptualising mood disorders, especially depression. Surveying the field of “major depression” — a unitary category he views as more politically than biologically or psychologically defined — he saw conceptual muddiness, consequent misdirection of research into eddies of self-referential tautologies and, ultimately, too many misdirected treatments of suffering patients. Parker insists — against the mainstream and the Diagnostic and statistical manual of mental disorders — that depression is not a single entity, with severity providing the only variation, but that it is at least a two-headed beast, with melancholia (depression marked by psychomotor disturbance) and non-melancholic depressions being distinct, and having different implications for treatment approaches. The field has been and remains deeply divided by this challenge. But this psychiatrist has found Parker’s work powerful, persuasive and profoundly, clinically useful. And, as I’m sure Parker would agree, the latter is the only bottom line that matters.
Parker examines his journey into psychiatry through the lens of his childhood and development, a putting-oneself-on-the-couch that is brave and rare in psychiatric writing. I find myself grateful to the loving but overprotective mother (against whose ministrations Parker felt compelled to rebel) and to the father who believed in hard work above all else, for helping to shape this extraordinary personality — who has done so much to tame the black dog that stalks so many of us. A challenging book; an inspiring life.