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Our Necessary Shadow: The Nature and Meaning of Psychiatry By Tom Burns. Allen Lane. 2013. £20.00 (hb). 384 pp. ISBN: 9781846144653

Published online by Cambridge University Press:  02 January 2018

Mariam Ali*
Affiliation:
FY2, Faculty of Medicine, Imperial College London, and Oxford University Hospitals NHS Trust, London, UK. Email: mariam.ali06@imperial.ac.uk
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Abstract

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Copyright © Royal College of Psychiatrists, 2014 

As an FY2 doctor hoping soon to enter into psychiatry training, Our Necessary Shadow was for me an eye-opening read. Having had first-hand experience of the day-to-day job of a psychiatrist, I now also have much greater understanding of and respect for clinical psychiatry.

The book is aimed at the general public in an attempt to provide greater understanding of ‘what psychiatry is, what it can and what it cannot do’. In the first section, the reader is taken on a tour through the history of psychiatry, including the way its development has been influenced by societal changes and international events such as wars. This historical background helps the reader to better understand past decisions, both good and bad. Current practice is described and challenged in a balanced and candid way. The future of psychiatry is honestly discussed, including areas and practices that could be improved.

For the general reader, psychiatry is explained in comprehensible terms. Many feared aspects, for example ECT, are demystified and their benefits clearly explained. Many readers will be from a generation accustomed to viewing psychiatry with a degree of suspicion. Much of the book is dedicated to giving a truthful account of the darker parts of psychiatry’s history, with fascinating insights into the character of the individuals involved. There are no excuses made for the darkest hours of psychiatry’s past. However, there is also plenty of material provided to challenge the views of the hardest cynic.

Throughout the book, Professor Burns uses professional and personal anecdotes and gives constructive opinions, which make this so much more than ‘just another textbook’. For early-career psychiatrists, this is an inspirational volume. For more experienced clinicians, it is a welcome refresher and reminder of psychiatry’s past and present, with a glimpse of what the future may hold. Most importantly of all, it is a chronicle of the impact of the profession on society, thinking and psychiatry itself - ‘that most human of medical disciplines’.

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