Abstract
This collection of eight essays (with commentaries) by Nobel Prize-winning psychiatrist Eric Kandel offers a feast of heady and controversial stuff to anyone interested in the mind–brain relationship and in ‘whither psychiatry’ in the 21st century. Kandel's discoveries of the effects of learning and memory on synaptic transmission and plasticity are of enormous importance to psychiatry. They bring a new perspective to the nature–nurture debate about mental illness and open new doors to wide-ranging clinical and research applications.
The essays (spanning nearly three decades) give a detailed account of Kandel's work and the promise of neuroscience for psychiatry. They showcase advances towards a ‘hard-nosed’ understanding of mental processes and exhort psychoanalysis and psychiatry to embrace involvement in this area of research. Kandel believes that psychiatry has not capitalized enough on the golden age of neurobiology and that its failure to do so has left it in an educational trough.
He notes that whereas the scientific community at large has become interested in the biology of mental processes, the interest of medical students in psychiatry is declining. From Kandel's perspective, a strong foundation in neuroscience would bring excitement back to psychiatry, make it more attractive to medical graduates and also bring it more fully in line with other medical specialties. Kandel is nevertheless aware that a biological analysis of psycho-social processes ‘might not prove to be the optimal level or even an informative level of analysis’. He is also realistic about the achievements of biological psychiatry to date and recognizes that there are differences of opinion about the importance of biological understanding in psychiatry. “But in 2004, most would agree that we still have a long way to go in reconciling the relationship between biology and psychiatry and many would debate whether to even go there.”
This book is a must read for every psychiatrist who is not familiar with Kandel's work or views on ‘whither psychiatry’. Arguably psychiatry's involvement in the progress of neuroscience has been less than desirable and it may well be timely and prudent, as suggested repeatedly by Kandel, to ‘lift its game’.
Hans Stampfer
Nedlands, Australia