This is a thoughtful assessment of modern-day psychiatry. In essence it is a plea for a balance between biological psychiatry and psychotherapeutic approaches. Paris emphasises the limitations of current knowledge about the brain, presenting the failure to find genetic markers for psychiatric conditions, the non-specificity of neuroanatomical abnormalities and the inconsistency of biochemical research. His analysis of psychiatric diagnosis is particularly interesting. In the absence of biological markers of disease, Paris suggests, psychiatric diagnoses are simply pragmatic constructs, and he criticises the tendency to view them as real entities. He explores the difficulty of distinguishing disorder from normality and the tendency to pathologise more and more aspects of everyday life. He repeatedly criticises the tendency to over-diagnose mental disorders and over-prescribe psychiatric drugs. In particular, he highlights what he believes to be the misuse of the diagnosis of bipolar disorder in adults and children. He even suggests that the use of this diagnosis to justify the widespread initiation of long-term therapy with atypical antipsychotics and mood stabilisers could be ‘one of the worst scandals in the history of psychiatry’ (p. 82).

Paris also critically analyses research on psychotherapy. He recognises that the benefits of therapy are not specific to any theoretical orientation, but emanate from good empathy and interpersonal skills, skills that psychiatrists are in danger of losing with the current emphasis on biomedical approaches.

However, for all his concern to restore the humanity to psychiatry, Paris still believes that neuroscience will unlock the secrets of psychiatric disorders eventually, at least the severe ones. He holds out for a foolproof system of diagnosis based on biological markers of underlying diseases. It is difficult to know how this vision is compatible with his opposition to reductionism in psychiatry. If psychiatric problems can be traced to specific abnormalities in brain function, psychiatry is surely right to focus on biological interventions, and other approaches are simply cosmetic. If Paris wants to restore attention to the whole person, a more fundamental critique of the view of mental illness as a form of brain disease is required.