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the most stupendous confidence-trick of the 20th century.

The American consumer appears to have rumbled what Sir Peter Medawar has termed the most stupendous confidence-trick of the 20th century, PSYCHIATRY.

In our Western societies  the numbers of mentally sick and worried well have not diminished. They are still in search of help, but they are turning more and more to drugs, to biofeedback, towards new ways of living and away from the one-to-one, let’s-talk-about-me psychotherapy which was so much in vogue during the fat years of the Fifties and Sixties. A seemingly limitless demand to pay 100 bucks per hour wasthen met by the extended palm of the modern day Witch Doctor.

And the glitzy Hollywood stereotype of the attentive ear, with Woody Allen as its comic champion (and look how his personal life developed in the real world after 30 years on the couch),

For many, our views are determined by watching 'soaps'. The resulting stereotype of the psychiatrist has become all too familiar, both in the fantasy world inhabited by the Hollywood shrink and in the fictional characters of American writers from Scott Fitzgerald onwards. It is an image manifestly different from the one with which the millions of British television viewers, glued weekly to soap-operatic events are presenedt with a psyhciatrist: as an amiably bummpling shabby figure, fallible but well-meaning, doing his troubled best to help, counsel and advise his patients.

Now the American consumer appears to have rumbled, as some would have it,  the most stupendous confidence-trick of the 20th century. To be sure, the numbers of mentally sick and worried well have not diminished. They are still in search of help, but they are turning more and more to drugs, to biofeedback, towards new ways of living and away from the one-to-one, let’s-talk-about-me psychotherapy which was so much in vogue during the fat years of the Fifties and Sixties. A seemingly limitless demand for psychiatry was met.

This is an early statement of a truth which has since been widely acknowledged and much elaborated by observers within and, increasingly, outside the medical orbit, not least by last year’s Reith Lecturer, who exaggerated its force by describing medicine as an essentially political enterprise, with psychiatry as a prime example.

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