Joel Paris

In the 1970s, author Joel Paris was one of the first doctors in his hospital to prescribe lithium to a psychiatric patient. In the wake of the drug’s success, both in that case and countless others, why this book? As Dr. Paris’ historical examination of bipolar diagnosis and critique of the spectrum demonstrates, medicine has often been prone to fads that are assumed correct until proven wrong by science. This book opens discussion about the overdiagnosis of bipolar disorder and the negative impact of this development on clinical care. Dr. Paris explores why patients are being classified as bipolar on dubious grounds and are being prescribed drugs they do not need. He explains the differences between bipolar disorder and depression without mania, personality disorders characterized by unstable mood, and impulsive disorders. A separate chapter discusses the unique issues present in the field of child psychiatry. Fads remain popular as long as they answer elusive and complex questions. Unfortunately, the bipolar spectrum being used to explain a wide variety of psychopathological phenomena has caused classic bipolar disorder to become almost lost in the shuffle. Combining research findings and personal experiences, Dr. Paris documents the damage of overdiagnosis and explores alternative treatments patients could benefit from.

This book reviews what we know and what we don amp rsquo t know about PDs, and what this implies for clinical practice. Clients with personality disorders (PDs) present special challenges to clinicians. Nonetheless, successful treatment is possible, and a rapidly growing research base can inform diagnosis and intervention. A Concise Guide to Personality Disorders integrates a large body of research findings into a concise, highly practical approach to managing difficult clients. Rather than advocating a single method of treatment, Joel Paris promotes an integration of all evidence-based psychotherapies, as well as effective case management. The evidence base for pharmacotherapy is reviewed as well. Focusing particularly on borderline, antisocial, and narcissistic PDs, the author also reviews other PD categories. His extensive experience and clinical wisdom illuminate the discussion, demonstrating how to work productively and empathically with these clients.

The Intelligent Clinician's Guide to the DSM-5® is the second edition of the widely-read book first published in 2013. This second edition is thoroughly revised, and has several new chapters describing the response to the publication of the new manual, as well as suggestions on its use in clinical practice. The Intelligent Clinician's Guide to the DSM-5®, Second Edition reviews the history of diagnosis in psychiatry, emphasizing the limitations for classification of our current lack of knowledge of the causes of most mental disorders. It emphasizes that, in the absence of biomarkers, current categories can only be considered provisional. It takes a critical look at schema for spectra and dimensionaliztion of diagnosis, examines the borders between normality and psychopathology, and discusses the problem of clinical utility. The book has chapters on all the major diagnoses in psychiatry, in which the main problems of diagnosis are addressed, and in which all changes in DSM-5 are described.

Childhood has long been considered the major factor in determining adult life. It sets us on the path toward or away from happiness, shapes our personality, and is a major cause of mental disorders. Or is it?Myths ofChildhood strongly challenges these assumptions usually taken for granted in contemporary society and the mental health community. With a healthy dose of scepticism toward clinical impressions and using empirically-based research from areas including behavioral genetics and attachment, Dr. Paris builds a convincing case against the primacy of childhood in the development of adult personality and psychopathology. In its place, he offers an alternative model for development and shows how mental health professionals can apply this model to clinical pracitce.Myths of Childhood represents an important addition to the ongoing debate between mental health professionals regarding nature vs. nurture. For supporters of either side , this book is a valuable resource for further exploration of this controversy.

In the 1970s, author Joel Paris was one of the first doctors in his hospital to prescribe lithium to a psychiatric patient. In the wake of the drug’s success, both in that case and countless others, why this book? As Dr. Paris’ historical examination of bipolar diagnosis and critique of the spectrum demonstrates, medicine has often been prone to fads that are assumed correct until proven wrong by science. This book opens discussion about the overdiagnosis of bipolar disorder and the negative impact of this development on clinical care. Dr. Paris explores why patients are being classified as bipolar on dubious grounds and are being prescribed drugs they do not need. He explains the differences between bipolar disorder and depression without mania, personality disorders characterized by unstable mood, and impulsive disorders. A separate chapter discusses the unique issues present in the field of child psychiatry. Fads remain popular as long as they answer elusive and complex questions. Unfortunately, the bipolar spectrum being used to explain a wide variety of psychopathological phenomena has caused classic bipolar disorder to become almost lost in the shuffle. Combining research findings and personal experiences, Dr. Paris documents the damage of overdiagnosis and explores alternative treatments patients could benefit from.

"Dr. Paris has written an honest, balanced presentation of the ways in which psychiatric drugs are evaluated and prescribed. He highlights the complexity of the task, the limits of what is known and the mixed picture that research often produces. His conclusions are refreshing because they are built from an even-handed, pragmatic assessment of the empirical evidence. The result is a stimulating look at the world of treatments for emotional disorders that acknowledges the usefulness of both biological and psychosocial explanations where appropriate. His recommendations provide helpful roadmaps for patients, practitioners and researchers alike. The book is sure to serve as a welcome catalyst for the continuing debates about which treatments are likely to produce the best outcomes." —Roger P. Greenberg, Ph.D. Distinguished Professor and Head, Psychology Division Dept. of Psychiatry & Behavioral Science SUNY Upstate Medical University, NY, USA The message of this book is that psychiatrists have some very good drugs, but can expect bad results when they are over-used, prescribed outside of evidence-based indications, or given to the wrong patients. While acknowledging that many current agents are highly effective and have revolutionized the treatment of certain disorders, Joel Paris criticizes their use outside of an evidence base. Too many patients are either over-medicated or are misdiagnosed to justify aggressive treatment. Dr. Paris calls for more government funding of clinical trials to establish, without bias, the effectiveness of these agents. He has written this book for practitioners and trainees to show that scientific evidence supports a more cautious and conservative approach to drug therapy. After describing the history of psychopharmacology, including its early successes, Dr. Paris reviews the relationship between psychiatry and the pharmaceutical industry. This problem has received considerable popular attention in recent years and Dr. Paris documents initiatives to increase transparency and decrease the influence of pharmaceutical marketing on diagnosis and prescribing habits. Dr Paris then examines some major controversies. One is the fact that newer drugs have not been shown to be superior to older agents. Another is that while the number of prescriptions for antidepressants has increased dramatically, meta-analyses show that their value is more limited than previously believed. Still another is the widespread prescription of mood stabilizers and antipsychotic drugs for patients, including children and adolescents, who do not have bipolar illness. Polypharmacy is an especially contentious area: very few drug combinations have been tested in clinical trials, yet many patients end up on a cocktail of powerful drugs, each with its own side effects. Dr Paris briefly considers alternatives to pharmacology and again calls for more clinical trials of these approaches. He also discusses the current trend to medicalizing what many would describe as normal distress and states succinctly: Some things in life are worth being upset about.

Over the last few decades, academic psychiatry has undergone a revolution. After the Second World War, most department chairs were psychoanalysts who belonged to separate institutes, not subject to the checks and balances of academia, and who did not subscribe to the tenets of scientific medicine. The revolution against psychoanalytic dominance began when a group of psychiatrists developed an evidence-based model that brought psychiatry back into the medical mainstream.In The Fall of an Icon, Joel Paris narrates the history of this transition, placing it in the context of current trends in science and medicine. He illustrates the story using interviews with prominent academic psychiatrists in Canada and the United States, and describes his own experiences as a psychiatrist: how he was caught up in the excitement of the psychoanalytic model, how he became disillusioned with it, and how he came to a new and more scientific view of his discipline. This is an essential work for understanding the recent history of psychiatry.

Over the last few decades, academic psychiatry has undergone a revolution. After the Second World War, most department chairs were psychoanalysts who belonged to separate institutes, not subject to the checks and balances of academia, and who did not subscribe to the tenets of scientific medicine. The revolution against psychoanalytic dominance began when a group of psychiatrists developed an evidence-based model that brought psychiatry back into the medical mainstream.In The Fall of an Icon, Joel Paris narrates the history of this transition, placing it in the context of current trends in science and medicine. He illustrates the story using interviews with prominent academic psychiatrists in Canada and the United States, and describes his own experiences as a psychiatrist: how he was caught up in the excitement of the psychoanalytic model, how he became disillusioned with it, and how he came to a new and more scientific view of his discipline. This is an essential work for understanding the recent history of psychiatry.

Treating personality disorders can be extremely frustrating for clinicians. As a result, many doctors get caught in a cycle of diagnosing and rediagnosing in an attempt to find an approach that works. In Personality Disorders Over Time: Precursors, Course, and Outcome, Joel Paris, M.D., proposes a better approach-one based on management rather than cure-that he developed while following a group of patients with borderline personality disorder (BPD) for over 25 years. Paris believes that the key to effective treatment of personality disorders lies in understanding their progression over a lifetime. In Personality Disorders Over Time, he outlines a sound framework for treatment that features • A realistic long-term treatment approach that strives for gradual recovery with intermittent interventions• An examination of the progression of these disorders over time, including childhood precursors, course and outcome, and treatment• A general theory of personality disorders, including Axis I and Axis II cluster disorders• Suggestions for a broader, more accurate DSM classification reflecting the personality trait dimensions that underlie disorders Written in the first person, studded with clinical anecdotes, and filled with up-to-date literature references, Personality Disorders Over Time provides fascinating insights into these complicated disorders. It is an excellent resource for any clinician who wants to understand and provide more effective treatment to patients with personality disorders.

Childhood has long been considered the major factor in determining adult life. It sets us on the path toward or away from happiness, shapes our personality, and is a major cause of mental disorders. Or is it? Myths of Childhood strongly challenges these assumptions usually taken for granted in contemporary society and the mental health community. With a healthy dose of scepticism toward clinical impressions and using empirically-based research from areas including behavioral genetics and attachment, Dr. Paris builds a convincing case against the primacy of childhood in the development of adult personality and psychopathology. In its place, he offers an alternative model for development and shows how mental health professionals can apply this model to clinical pracitce. Myths of Childhood represents an important addition to the ongoing debate between mental health professionals regarding nature vs. nurture. For supporters of either side , this book is a valuable resource for further exploration of this controversy.

Personality disorders have only recently been recognised as categories of psychiatric illness, and still need to be better defined. This book interprets the personality disorders as products of the interaction between social influences and other aetiological factors as part of a broad biopsychosocial model, and explains how personality traits develop into personality disorders. Strongly oriented towards recent empirical findings, the author argues that although biological, psychological, and social factors are all necessary, none of them is by itself sufficient to produce a personality disorder. This basic model is also a model of treatment, in which biological, experiential, and social factors should all be addressed in therapy, and his treatment recommendations focus particularly on social adjustment through the adaptive use of personality traits.

The etiology of borderline personality disorder is essentially unknown. Although many well-known theoretical formulations remain the best possible hypotheses, much of what has been suggested thus far for the management of BPD has proved impractical in a majority of cases. Written by an expert in the field of BPD, Borderline Personality Disorder presents a practical approach to the management of patients with this disorder. Designed for readers who are skeptical of facile explanations, this book provides a broader view of the etiology of BPD than has been presented in previous studies. Readers will not only appreciate the review of the current research but also its theoretical integration into practice. Borderline Personality Disorderhas two goals: • to build a comprehensive theory of etiology which takes into account biological, psychological, and social factors.• to suggest treatment guidelines which are consistent with this theory, and which are based on the findings of clinical trials. Based on the most up-to-date clinical research available, Borderline Personality Disorder shows how these complex disorders are shaped by biological vulnerability, brought on by psychological experiences, and influenced by social conditions.