"A provocative and revealing perspective.” - Booklist
Shows how mental distress is often caused by relationship imbalance, not chemical imbalance.
Diagnosis Human offers a compelling alternative to the biomedical model of mental health as it’s been promoted over the last 30 years--a model which says that mental distress is a problem of chemical imbalance, or brain chemistry. Promoted by the highly profitable Psychiatry/Pharmaceutical industrial complex, and followed by much of the broader psychotherapy community, biological psychiatry focuses on quantifying the “illness” by an almost exclusive focus on symptoms. In this model, symptoms are never good. They are always seen as a sign that something is wrong with that person, a sign of pathology that must be changed. People now have a name for what they “have” and receive a prescription for it.
What may appear as intractable individual problems, however, often aren’t individual problems at all. This book reveals how many of these distressing emotional states are created by nearly invisible, intimate patterns in our relationships. Diagnosis: Human invites readers into the therapist’s office to be part of family therapy sessions, where they can experience practically first-hand what these intimate relationship patterns look and feel like. The authors present cases of adults dealing with depression, couples who come to therapy reeling from the betrayal of an affair, families with kids diagnosed with ADHD, teenagers with anxiety or young children with temper tantrums. Each therapy session includes the voice of the therapist, inviting readers to sit in as observers to watch and listen as the case unfolds, sometimes in dramatic fashion.
Amy Begel is a family therapist who received her family therapy training over 30 years ago with one of the creators of family therapy, Dr. Salvador Minuchin. Since then, she has maintained a busy private practice in New York City. Until 2011 Amy was Senior Faculty at The Minuchin Center for the Family where she conducted family therapy training nationally and internationally. In addition to her clinical practice in family therapy, Amy is on the teaching faculty of both the Department of Family Practice, Mount Sinai School of Medicine, and Department of Internal Medicine and Cardiology at Maimonides Medical Center where she trains resident physicians in looking at relationship dynamics in the context of medical care. Amy has authored numerous professional articles and posts, including the Psychotherapy Networker, the popular medical blog KevinMD, and HuffPost. She writes the blog Most Human. She lives in Teaneck, New Jersey.
David Keith is Professor Emeritus of Psychiatry at SUNY Upstate Medical University, Syracuse, New York. He has been in practice for 45 years. He was on the Psychiatry faculty at Wisconsin for eight years, then entered private practice for five years with the Family Therapy Institute in St. Paul, Minnesota. It was at the University Wisconsin that Dave met Carl Whitaker, MD, considered to be one of the important forefathers of the Family Therapy movement. He became a co-therapist, co-author and therapeutic collaborator with Dr. Whitaker, working with him for over 20 years. Dave is board certified in Child and Adolescent Psychiatry. Dave has published 22 book chapters and 31 papers. He coauthored Defiance in the Family: Finding Hope in Therapy (2001), and he co-edited Family Therapy as an Alternative to Medication: An Appraisal of Pharmland (2003). He is the author of Continuing the Experiential Approach of Carl Whitaker: Process, Practice & Magic (2015). He lives in Manlius, New York.
Individuals struggling with mental illness have long been dosed with drugs and sent to therapy. Their conditions were considered their own, the result of a chemical imbalance, and they alone were given treatment. Begel and Keith have turned those practices on end by focusing on the people in the patient's life. It’s the doctors’ premise that often more than one person involved is depressed or anxious, that imbalances can be found in relationships, not only internally. Using examples from their practices, the doctors present a series of cases to support their theory. Each chapter follows three groups of clients sharing similar challenges, including marital affairs, sexless marriages, kids with ADHD, and teens who threaten self-harm. Readers are allowed to sit in on the sessions as interactions between family members and the therapist are detailed and interpreted. While there are some successes, not all encounters end happily or by resolving the issues involved. The authors admit to taking gambles to spark emotions in their patients, an approach with mixed results, but they contend that, nonetheless, healing begins. A provocative and revealing perspective.
To a society increasingly relying on prescription drugs that promise to improve one person's behavior without inconveniencing others, Begel and Keith offer a more humane alternative: let us look less at what happens inside our brains, and more at what happens between us. And let the way we dance together change our inner wiring, rather than the other way around. An enlightening read for couples and parents, as well as for clinicians.
Diagnosis Human is a critical book for our time. While we, as doctors, have been focusing on the individuals’ mental health we have forgotten that individuals exist in relationships with family and friends and that oftentimes, the problems that individuals’ face can be addressed by bringing the family together with experts in family therapy. The stories in this book are truly fascinating, and once you start to read them, you will quickly see the important role that highly skilled family therapists can play in improving the life of a family and every individual within it. Begel and Keith take us inside their offices and show us that what we see as an individual’s "symptoms" is actually the result of subtle family dynamics. As a family physician with many years of experience. I am grateful that we have this precious chance to gain important insight’s from these authors' experiences. Every family will see themselves somewhere in these stories as the authors bring peace and healing where there was turmoil and dysfunction. As a family physician for over 40 years, I highly recommend this book to professionals and struggling families alike.
As a marriage and family therapist for over thirty years, and a parent for over forty years, I applaud the authors for finally saying what so many systemic therapists know…that problems are relational. This book is a breath of fresh air, providing those who read it with new ways of envisioning problems, by healing relationships, which then heal behaviors. Parents who read this book will be reassured that things are not hopeless, when diagnoses are given out too freely to their children. That hope may result in better interactions at home, as hope emerges and worry decreases. Children will benefit when their parents focus on the family’s relationships and watch those they love restore peace at home. This book offers a glance at what magic can occur when we look beyond a person’s issue, into the interactions of the family system for solutions.
Diagnosis Human by Amy Begel and David Keith offers an intelligent window into the workings of psychotherapy. Understanding the mechanisms that empower psychotherapy enables consumers to more easily benefit from treatment.
Diagnosis Human presents reparative relationships as a refreshing alternative to a medical model. Symptoms are multifaceted and can be the result of underlying ruptures in family relationships. Symptoms are not merely biochemical abnormalities requiring medication.
This book is healing! With vivid storytelling, this book is an illuminating dive into family therapy and can help us all unlearn the rigid patterns that prevent us from connecting with our partners and families.
Amy Begel and Dave Keith's book, Diagnosis Human, on family and couple therapy is a gem. They combine their extensive clinical experience with Amy's talents as a jazz musician to create a lively, insightful insight into the music that families co-construct. This book is suitable for both lay readers wanting to understand their own family dynamic as well as for therapists wanting to deepen their systemic skills in working with couple and family systems. They have included questions at the end of chapters to help facilitate group discussion, a helpful tool for clinical learning. A much needed contribution both to the field of family therapy and for anyone with challenges in their own family.
As a child psychiatrist for almost 40 years I find this book a wonderful guide to understanding and helping children in a therapeutic context. We live in an expanding world of psychopathology, an ever-expanding DSM diagnostic classification system with more and more individual diagnoses in each revision. Additionally more and more children diagnosed psychiatrically are given medication as sole treatment for problem mental health issues. Then along comes Amy and Keith, addressing the power of the family on how children and parents feel and understand each other and act. In the old question of nature vs nurture the authors bring us back to families and nurture in a very fundamental way. They understand and appreciate the “problem child” developing in the context of the wholefamily asan active nurturing nexus. The methodology is joining, hearing, respecting, understanding and empowering the individuals of that nexus to make changes. The authors model an understanding and an approach to treatment utilizing the most powerful ongoing impact on individuals: the family. They show how to understand and address the family impact on a child’s development. The family approach and engagement facilitates therapeutic work that can lead to changes in roles and relationships to benefit all. This book is useful for parents, children and professionals to better understand and help the core vehicle of child development.
In Diagnosis Human, Begel and Keith provide us with compelling stories that illustrate the role of relationships in promoting or impeding our health, broadly speaking. Scientific evidence now supports the connection between our health and the quality of our significant relationships; this book provides us with qualitative evidence.
These narratives are page-turners, as we are invited in to observe the complex and powerful world of family therapy. Altogether, the book is a powerful argument against an exclusively biomedical explanation, and for a comprehensive biopsychosocial explanation for physical and mental health.