Reading Tyrer's Models for Mental Disorder felt like a secret dietary pleasure—it was an easy (and sometimes fun) read. But even better, it is detailed and accurate and wide-ranging in its survey of these fundamental concepts in our field.
Now in its fifth edition, this book represents an overarching guide to the fundamental bases of psychiatry. Specifically, it provides a summarization of the medical model, the psychodynamic model, the cognitive-behavioral model, and the social model. What Tyrer does masterfully is to provide a detailed and rounded description of these four models. He provides vignettes of clinician-patient interactions within the model. The absence of consideration of interventions within the models probably protects the effectiveness of the text. Its funny cartoons are a leitmotif for an otherwise accurate and straightforward book.
Tyrer has served as the editor of the esteemed British Journal of Psychiatry, and so he is obviously keenly aware of the range of thinking that is psychiatry. Especially (or, at least), British academic psychiatry. But, to me, the author provides an appropriate set of perspectives as he is respectful and accurately provides the strengths and limitations of these models. For example, of psychodynamic approaches, he writes, “There is a great deal of truth in psychodynamic notions, but it is not the whole truth…” In fact, Tyrer recognizes the trans-model value of free association when he writes that it is likely that “some neurophysiological and neurochemical representation in the brain tracts and synaptic connections” and yet at the same time that psychodynamism represents a “humane” mode of medicine that demands the highest degree of trust, rapport, and the capacity to listen.
Models for Mental Disorder was useful (and enjoyable) to me as I learned or relearned various components of these models. The text will not change my practice of medicine. Instead, this text is most appropriate for late-stage medical students and early residents. One needs to understand psychiatric treatment and how it is done to appreciate this book; with that background, it will have tremendous value. The British perspective of the book is not pervasive and does not get in the way of understanding it. American readers will gain greatly from Tyrer's explanation of the “social model” given its minimal presence in American psychiatric thinking.
Other features that assist the reader include a glossary, apt cartoons, and up-to-date references. With these features, Models for Mental Disorder is a valuable text that will help future psychiatrists to be able to provide, as Tyrer proposes, a functional integrated model for our future practice of psychiatry.
Avram H. Mack, MD
The Children's Hospital of Philadelphia
The author declares no conflict of interest.