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Trouble in Mind: An Unorthodox Introduction to Psychiatry Review

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As a third-year psychiatry resident, I am in the midst of training, constantly trying to acquire clinical experience and to better understand my patients, as well as the field of psychiatry.
I found "Trouble in Mind" thought-provoking and extremely well-written. I would certainly recommend the book to any student or resident looking for an in-depth inquiry into psychiatry and psychopathology. Anyone who is concerned about the epistemological roots of psychiatry, or thinking about the underlying "edifice" of psychiatry, in this age of emerging and revisionary DSM classifications and evolving nosology, would be very well-served by this book.
In "Trouble in Mind", Dr. MacKinnon seems to have deftly woven a new potential paradigm for approaching patients afflicted with mental illness, by depicting the mind and mental life, on different explanatory levels. For each progressive level of the mind portrayed in the book, he articulates a description of function, as well as an associated pathologic disruption that may be seen in a patient presenting with a mental illness.
Beginning with the "elementary mind", Dr. MacKinnon reviews basic biological "input and output functions" of the mind, such as arousal, appetite, and perception, and then describes their associated disruptions as they may present in a clinical setting, including delirium, or disorders of appetite, or hallucinations. He then progresses to the "integral mind", describing functions of mental life such as attention, memory, habit, and motive, and also describes their disruptions including distraction, amnesia, addiction, or anhedonia. In the "synthetic mind", he advances his model to describe secondary functions of mental life such as bias, personality, and belief, and here too describes associated dysfunction. Lastly, he describes the "psychiatric mind" by describing different realms of mental illness, including psychosis, affective illness, neurosis, and anguish.
Dr. MacKinnon's model of the mind and mental illness struck me as boldly creative, exciting, and refreshing. I found the book especially engaging since it seems to be borne of rich clinical experience; the book and its appendix sections contain brief clinical vignettes and clinical case examples throughout.
Happy Reading!

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Posted in: mental illness, psychiatry