Abstract
John Cawte Melbourne: Melbourne University Press, 1998 ISBN 0 522 84804 4 pp. 177 A$24.95
Emeritus Professor John Cawte revisits his early days in psychiatry in this attractive, slim volume. In returning to these days, just prior to the advent of effective psychopharmacological agents, he bears a message: that ‘asylum’ and a touch of humanity often proved effective for people with severe mental illness. Moreover, his book captures the rich detail of psychiatry in an era when florid insanity was not controlled by efficacious drug treatments. Fortunate to have the opportunity to revisit files from the 1950s in South Australia, Cawte has produced a richly evocative picture of the presentations and problems faced by psychiatrists, before neuroleptics and antidepressants became available. His vignettes communicate the distress not only of the patient, but also of the young clinician. Cawte's humanity resounds through descriptions of patients for whom the only options were asylum, straitjackets, padded cells and pre-anaesthetic electroconvulsive therapy. To contemporary psychiatrists, such a restricted armamentarium of treatments is unthinkable. Yet Cawte challenges contemporary standards, asserting that rapport, and sanctuary from the complexities of modern life, are indeed major steps towards healing. In the late twentieth century, when performance indicators and brief admissions are the norm, it is compelling to hail back to the not-so-distant past. He reiterates that despite the lack of effective treatments, psychiatrists and nurses were often able to effect cures of severely disturbed patients. This book is a delightful but unfortunately brief read. It is in clear, lay prose, of conversational style. The author's digressions, musings and explanations lend it the character of autobiography rather than that of a work of history. Those well-versed in psychiatry may well find it too simple; and those for whom the field is novel may well wish that the book were longer, and revealed more of the author's thoughts. Nevertheless, Cawte's book is a thoughtful - if short - reminder that psychiatry is but young, and that all the treatments in the world may not overcome a lack of caring and the opportunity for respite. His scholarship is appreciated, and I would recommend this book to all in the mental health fields who occasionally feel frustrated at constraints upon their opportunities to respond to human distress.
