The current practices of prescribing psychotropic drugs, according to Keen, are both inconsistent and irrational. Overprescription alone is epidemic, and is driven largely by popular demand and professional convenience. The fact that mental life is being affected with physical agents leads to theoretical complexities no simpler than the metaphysics of mind-body relationships. These deeper questions are being ignored, Keen asserts, in favor of pragmatic attitudes driven by convenience, cost, popular demands, insurance protocols, and theoretical preferences.

Keen first examines some of...

This history of ideas in American psychology divides 11 decades into three periods, marked out by specific themes central to psychologists over the years. Initially, the legacy of mind-body dualism challenged scientists to make coherent a single universe of mental and physical phenomena, but efforts were hampered by languages that embody mental, physical, and metaphysical commitments. This struggle began with James, whose work remains enormously relevant, is exacerbated by Titchener, whose mentalism provokes a reaction by Watson, whose physicalistic bias provoked a vastly expanded realm...

Most studies of depression focus on the psychiatric or medical interpretation of the experience. Sadness and guilt are human experiences, Keen argues, not disease symptoms. They involve the intricate layers of enacting a style for others, of coping with moral crises, and enduring disappointment. Depression tells us of life and death, good and evil, but not sickness and health.

Keen begins with human consciousness, in contrast to the non-reflective consciousness of animals. It becomes clear that the social meanings of being depressed complicate and may even obscure the...

Silently orienting us to the world are traditions embedded in our language. These traditions shape how we understand the necessities and possibilities of life and truth. Dualism, a metaphysical theory, is such a tradition, and, in Keen's view, the separate discourses of science and morality create double meanings in our experience. Psychopharmacology is a critical intersection of these two worlds, where physical compounds are used to change mental life. Increasingly, the language of neurochemistry formulates that treatment. To control ennui with chemicals is to direct our attention away...

Keen, a professor and practicing psychotherapist, addresses the essential distinction between the truly serious questions involved in human life and the superficial aspects so generally engaging people's concern-and often professional treatment-which he terms, triviality. He considers how contemporary practice of psychotherapy often fails to admit to the critical difference, fails to recognize it in practice, and subsequently treats patients for irrelevancies while neglecting core, essential issues.

Keen addressed his concern about the prevalent practices among psychological/medical...