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We live in an age when psychiatrists respond to treatment 'failure' by ever more elaborate tweaking of the drugs we prescribe our patients. We end up with elegant drug regimens, but increasingly find that our patients are getting worse, not better. This wonderful book, replete with clinical case examples, reminds us to take a deeper look into the minds of our patients. Sometimes a 'treatment failure' reflects our own failure to listen to how patients are interpreting the medications, or how they are viewing us as human beings. This book is long overdue and will enhance the reader's clinical practice.--Daniel Carlat, MD, publisher, The Carlat Psychiatry Report and author, Unhinged: The Trouble with Psychiatry

[S]uperb volume . . . .[P]sychoanalytically informed approach at Riggs aims to restore the patient's sense of agency...Each author impressively and persuasively demonstrates how difficult, how emotionally and intellectually demanding a process this is, and how effectively Riggs is able to do it...enormously gifted group of like-minded staff members who have worked together for a long time and have painstakingly hammered out a coherent view of the treatment process through painful trial and error. . . .[A] veritable tour de force, a brilliant exposition of the concept and a persuasive demonstration of its need for wider applicability in a hospital setting. . . . [O]ught to be required reading for all psychiatrists and insurance carriers. It is one of the most thoughtful treatments of the psychological complexities of psychopharmacoloy I have ever read, at once both exhaustive and concise. . . . [S]ufficient variability in the authors' vantage points that the book never becomes tiresome. . . each chapter abounds with rich, insightful clinical cases. . . . [O]ffers clinical writing at its best; psychoanalysts who aspire to write clinically should study these cases and learn from their simple, vivid, and jargon-free language.

In this managed care era of psychiatric treatment driven by economics, Austen Riggs stands alone in its individualized, psychodynamically-informed but multimodal approach to hospital care for treatment of individuals who have failed multiple efforts. Treatment Resistance and Patient Authority is an outstanding contribution and a must-read for all of us, regardless of the treatment setting, engaged in trying to understand and care for these severely ill individuals. --Steven S. Sharfstein, MD, President and Chief Executive Officer, Sheppard Pratt, Past President, American Psychiatric Association, Clinical Professor and Vice Chair, Dept. of Psychiatry, U Maryland

Author Information

Eric M. Plakun is the Medical Director/CEO of Austen Riggs Center in Stockbridge, Massachusetts, an award-winning clinician, researcher, author, and leader in organized psychiatry, and an advocate for the value of psychotherapy and psychosocial treatments.

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