Abstract
Professor Guy Goodwin is Senior Research Fellow at the University of Oxford, United Kingdom, and was previously WA Handley Professor of Psychiatry and Head of Department. He has served as president of the British Association of Psychopharmacology (BAP) and the European College of Neuropsychopharmacology (ECNP) and is a National Institute for Health Research (NIHR) Senior Investigator. His main research interest is the neurobiology of mood disorders, with a focus on developing new treatments.
Brunching with Guy in Sydney Harbour, on a glorious sunny day, while listening to him talk dotingly about his daughter’s Oscar nomination, there is little evidence of his Mancunian past – until that is, he turns his attention to the ‘pitiful state of psychiatry’. Despite having three words all with positive valence constructing his own name (‘win’, ‘good’ and ‘guy’) – he is capable of remarkable lugubriousness coupled with exquisite persiflage; explaining to some extent perhaps why he has successfully advanced the field of mood disorders whilst remaining a seemingly self-deprecating cheerleader.
What makes you you? I come from Manchester. It is a strange provincial place with a remarkable industrial history. This may explain a population who daily displayed profound pessimism about most things, while appearing to enjoy themselves whenever they could. I went to a completely meritocratic school, Manchester Grammar School: if you passed the exam, you were in – no interview – and from there almost all pupils went to a top university. It was incredibly competitive and I only half liked it, but inevitably it shaped my attitudes and ambition. University was easy by comparison, but Oxford gave me a social confidence I lacked, mainly because you actually met and were taught one-to-one by brilliant people. So my formative years made my humour bleak, my preferences egalitarian and my experience elitist.
My favourite idea in psychiatry is … that neuroscience can give us answers that matter. Because the scientific method gives us the closest we will ever get to the truth of anything.
One important but soluble question in psychiatry is … Can any form of early intervention really prevent progression to poor outcome in severe mental illness?
What is the future of psychiatry? In the long run, I think science will give us a real understanding of aetiology (it has actually advanced dramatically during my working life), and I hope better treatment is founded on neuroscience. I would also anticipate a little supplementation from the kind of serendipity that gave us lithium, although regulation so restricts the freedom to discover that I doubt it can now happen very often.
In the short run, I am pessimistic about psychiatry in the United Kingdom I am sorry to say. De-medicalization has been a policy driven top-down now for two decades, and it has had the inevitable effect of driving away talented doctors from our specialty. It’s a pity because research opportunities are great, and basic neuroscientists increasingly see psychiatry as posing big questions they want to solve. Re-medicalization will only occur through really new ways of inventing and delivering services, not by turning back the clock.
We must hope that the perennial tedious anti-psychiatry that denies physical causes of anything dies with its current proponents.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.