Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs

by Jonathan Metzl

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Author: Jonathan Metzl

Publisher: Duke University Press Books

Paperback:
ISBN 10: 0822335247
ISBN 13: 978-0822335245

Hardcover:
ISBN 10: 082233061X
ISBN 13: 978-0822330615

Pills replaced the couch; neuroscience took the place of talk therapy; and as psychoanalysis faded from the scene, so did the castrating mothers and hysteric spinsters of Freudian theory. Or so the story goes. In Prozac on the Couch, psychiatrist Jonathan Michel Metzl boldly challenges recent psychiatric history, showing that there’s a lot of Dr. Freud encapsulated in late-twentieth-century psychotropic medications. Providing a cultural history of treatments for depression, anxiety, and other mental illnesses through a look at the professional and popular reception of three “wonder drugs”—Miltown, Valium, and Prozac—Metzl explains the surprising ways Freudian gender categories and popular gender roles have shaped understandings of these drugs.

Prozac on the Couch traces the notion of “pills for everyday worries” from the 1950s to the early twenty-first century, through psychiatric and medical journals, popular magazine articles, pharmaceutical advertisements, and popular autobiographical "Prozac narratives.” Metzl shows how clinical and popular talk about these medications often reproduces all the cultural and social baggage associated with psychoanalytic paradigms—whether in a 1956 Cosmopolitan article about research into tranquilizers to “cure” frigid women; a 1970s American Journal of Psychiatry ad introducing Jan, a lesbian who “needs” Valium to find a man; or Peter Kramer’s description of how his patient “Mrs. Prozac” meets her husband after beginning treatment.

Prozac on the Couch locates the origins of psychiatry’s “biological revolution” not in the Valiumania of the 1970s but in American popular culture of the 1950s. It was in the 1950s, Metzl points out, that traditional psychoanalysis had the most sway over the American imagination. As the number of Miltown prescriptions soared (reaching 35 million, or nearly one per second, in 1957), advertisements featuring uncertain brides and unfaithful wives miraculously cured by the “new” psychiatric medicines filled popular magazines. Metzl writes without nostalgia for the bygone days of Freudian psychoanalysis and without contempt for psychotropic drugs, which he himself regularly prescribes to his patients. What he urges is an increased self-awareness within the psychiatric community of the ways that Freudian ideas about gender are entangled in Prozac and each new generation of wonder drugs. He encourages, too, an understanding of how ideas about psychotropic medications have suffused popular culture and profoundly altered the relationship between doctors and patients.

Review

”Prozac on the Couch combines a bold thesis regarding the persistence of Freudian categories of sexual difference amid the paradigm shift in psychiatry, documentation spanning professional and popular discourses, and lively, clear prose.”

-- Mari Jo Buhle author of, Feminism and Its Discontents: A Century of Struggle with Psychoanalysis

"[A] plea for a truce between those who deal with the mind and those who study the brain. . . . [An] engrossing history of psychiatry over the past 50 years. . . ."

, The Economist

"Prozac on the Couch is a creative, intelligent, and provocative challenge to the notion that biologic psychiatry has replaced psychoanalysis as the dominant therapeutic model in psychiatry. . . . [A]n intriguing and challenging work standing at the intersection of medicine, history, culture, and 'gender studies.' . . . [F]or those who are looking for fresh perspectives, and who are willing to have their assumptions questioned, this book will be a real education and a pleasure to read."

-- Delese Wear, New England Journal of Medicine

"Jonathan Metzl's provocative book . . . takes on biological psychiatry's master narrative . . . and persuasively, with wit and elegance, deals it a devastating blow. . . . Sparkling insights abound in Prozac on the Couch. . . . [A] delightful, challenging book that will be of great interest to historians of psychiatry and, more generally, to anyone interested in the intriguing gender politics of psychopharmacology."

-- Elizabeth Lunbeck, Isis

Review

“Jonathan Michel Metzl's book is an original and insightful exploration of the lively cultural meanings he locates in the spaces between the person, the psychotropic drug, the physician, and the neuroscientist.”

-- Emily Martin, author of, The Woman in the Body: A Cultural Analysis of Reproduction

From the Back Cover

""Prozac on the Couch" combines a bold thesis regarding the persistence of Freudian categories of sexual difference amid the paradigm shift in psychiatry, documentation spanning professional and popular discourses, and lively, clear prose."--Mari Jo Buhle, author of "Feminism and Its Discontents: A Century of Struggle with Psychoanalysis"

About the Author

Jonathan Michel Metzl is Assistant Professor of Psychiatry and Women's Studies and Director of the Program in Culture, Health, and Medicine at the University of Michigan. In this capacity he works as a senior attending physician in the adult psychiatric clinics and teaches courses at the undergraduate and graduate levels. He has written for the American Journal of Psychiatry, the American Journal of Psychotherapy, Academic Medicine, Gender and History, and SIGNS: The Journal of Women, Culture, and Society. This is his first book.

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Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs