Ten books

I grew up in Galway, in the west of Ireland, in a house that was filled with books. Since then, I have remained a committed reader, although my reading habits have changed steadily over time: less fiction, more fact; fewer novels, more travelogues. Specific books have shaped my professional interests, drawing me towards social justice, Eastern psychology and the history of psychiatry. Along the way, books led me to diverse places (Japan, Russia, India), diverse academic interests (epidemiology, governance, law, history, Buddhist studies) and diverse projects, ranging from a history of psychiatry in Ireland,¹ to a 1-year meditation diary,² to a book about coping with COVID-19.³

Initially, I doubted it would be possible to select ten books to reflect all of this, but I had no doubt about where to start: Japan.

The Lady and the Monk: Four Seasons in Kyoto by Pico Iyer

I read The Lady and the Monk: Four Seasons in Kyoto when it was first published in 1991.⁴ I instantly fell in love with both the book and Iyer's picaresque vision of Japan. Iyer went to Kyoto to live in a monastery and learn about Zen Buddhism. The book recounts his thoughts and experiences there and provides one of the most insightful and sensitive portrayals of Japan that I have ever read. Iyer's plans for a monastic stay were set askew when he met ‘Sachiko’, the educated wife of a Japanese ‘salaryman’. While their gentle, conflicted romance is sensitively portrayed, what draws me back to this book every few years is Iyer's thoughtful, literary exploration of Japan itself and his particular focus on Buddhism. To my joy, I had the opportunity to spend 2 weeks in Japan in 1993, when I realised that Iyer's impossibly poetic portrayal of the country was utterly and gloriously true.

Pure Heart, Enlightened Mind: The Zen Journal and Letters of an Irish Woman in Japan by Maura ‘Soshin’ O'Halloran

Several years after visiting Japan, I was browsing in the wonderful Hodges Figgis bookshop in Dublin when I came across Pure Heart, Enlightened Mind: The Zen Journal and Letters of an Irish Woman in Japan by Maura ‘Soshin’ O'Halloran.⁵ I read the book over a single weekend, and then sat down and read it again. Maura was educated in Dublin and trained as a Zen monk in Japan. After 3 years, she was given the Buddhist name of Soshin-san, which means ‘pure heart, enlightened mind’. Two months later, Maura died in a traffic accident in Thailand. Pure Heart, Enlightened Mind contains a meditation diary that Maura kept during her time in Japan, along with some other documents. The unvarnished immediacy of Maura's spiritual and psychological journey is stunning. A great deal is written about Buddhism and meditation, but there is a directness to Maura's account that is very rare, very compelling and very Zen.

Advice Not Given: A Guide to Getting Over Yourself by Mark Epstein

Mark Epstein is an American psychiatrist and clinical assistant professor of psychology at New York University. Epstein writes extensively about Buddhism and psychiatry, so it is difficult to select just one of his books for this list. I was sorely tempted to include Psychotherapy Without the Self: A Buddhist Perspective,⁶ but in the end decided to just smuggle in that quick mention, and focus instead on Advice Not Given: A Guide to Getting Over Yourself.⁷ Throughout his work, Epstein marries the clear, proven benefits of psychiatric treatments with powerful aspects of Buddhist thought and practice. He writes with wisdom and he won me over yet again with Advice Not Given where, among many other insights, he points out that being right is not the point in the profession of psychiatry; being useful is. Epstein's work is very useful indeed.

Psychiatry in Dissent: Controversial Issues in Thought and Practice by Anthony Clare

What can I say about Psychiatry in Dissent that has not already been said?⁸ Nothing, probably. But this is my list of ten books and I can select whatever I wish. So, I choose this.

When I first read Clare's magnum opus, I was deeply impressed by his eloquence, his flowing logic and his humane defence of conventional psychiatry. His account fitted precisely with what I saw as a trainee, over 20 years after Clare's book first appeared: psychiatry was certainly imperfect (which field of medicine is not?) but was suffused with deep humanity and profound consideration for those who suffer. Subsequent readings confirmed my impression that Psychiatry in Dissent is a masterpiece of thinking, writing and communication. The book is, in many ways, a perfect distillation of the character of its author: fluent, thoughtful, witty and provocative. It provided a robust riposte to psychiatry's many critics and restored the credibility of psychiatry in the eyes of the public and, perhaps most of all, in the eyes of psychiatrists themselves.

Our Necessary Shadow: The Nature and Meaning of Psychiatry by Tom Burns

Explaining psychiatry to the public – and to ourselves – is a crucial task that rarely receives the attention it merits. While David Stafford-Clark's 1952 book Psychiatry To-day ⁹ was comprehensively eclipsed by Clare's Psychiatry in Dissent in 1976, it was not until 2013 that another substantive volume explored and explained psychiatry for public and professional audiences, in Tom Burns's Our Necessary Shadow: The Nature and Meaning of Psychiatry. ¹⁰ I recommend Burns's book to patients, families, students and trainees. Like Clare, Burns addresses the big questions in psychiatry but always stays rooted in clinical realities. Our Necessary Shadow is one of those rare volumes that truly is an ‘essential read’.

A History of Psychiatry: From the Era of the Asylum to the Age of Prozac by Edward Shorter

Of all the books published about the history of psychiatry, one has always stood out for me. As the years go by, I return ever more often to A History of Psychiatry: From the Era of the Asylum to the Age of Prozac by Edward Shorter.¹¹ Somehow, Shorter combines extraordinary erudition with an enviable writing style that brings out the triumphs and tragedies of psychiatry with elegance, wit and compassion. The story of the history of psychiatry is both salutary and inspirational, and there is no better introduction than this.

Pathologies of Power: Health, Human Rights, and the New War on the Poor by Paul Farmer

I happened on this book by chance and it radically changed my view of medicine and psychiatry. In Pathologies of Power: Health, Human Rights, and the New War on the Poor, Paul Farmer writes about ‘structural violence’, which comprises forces such as poverty, racism, socioeconomic inequality and discrimination, which necessarily have an influence on people's health.¹² While the concept of ‘structural violence’ had been usefully applied to specific medical and public health issues, it seemed to me a useful way to look at mental illness too. For example, although schizophrenia itself is associated with disabling symptoms, various overarching social and economic factors amplify this disability to the point that many people with schizophrenia are systematically excluded from full participation in civic and social life and are constrained to live lives that are significantly shaped by stigma, isolation, imprisonment, homelessness and denial of rights.¹³ Farmer helped me to see this clearly and made me angry or, rather, activated about it. For this, I thank him.

Civilization and its Discontents by Sigmund Freud

For reasons too complex to explain, I have undertaken to read all 24 volumes of the Standard Edition of the Complete Psychological Works of Sigmund Freud, at the rate of one volume per year, over the course of 24 years. Each year, I write an essay about the volume I read in the Irish Medical Times. I am currently at year 10,¹⁴ but I skipped ahead to year 21 to read Civilization and its Discontents.¹⁵ First published in German in 1930, Civilization and its Discontents is very concise (for Freud) and very insightful (for anyone). Freud argues that civilization is built on the renunciation of instinct and that is why scientific, artistic and ideological activities play such an important part in civilized life. I am never quite convinced by Freud, but I enjoy his writing style, his curiosity and his implicit belief that the inner lives of humans are understandable. I am not so sure.

Around India in 80 Trains by Monisha Rajesh

Over the past 5 years, I have fallen in love with India. On my first visit, to Bangalore in 2016, I read Around India in 80 Trains by Monisha Rajesh.¹⁶ I was immediately captivated by both the city and the book. Rajesh writes with an infectious spirit of adventure. I didn't actually travel on Indian trains until another trip some years later, but Rajesh's book filled me with a desire to explore every corner of this astonishing country. This will take a lifetime: India is infinite, which is just one of the many reasons why I love it.

Narcissus and Goldmund by Herman Hesse

Narcissus and Goldmund by Herman Hesse is the sole work of fiction on my list.¹⁷ While I have no hesitation including it, I am at a loss to explain why this novel about two medieval men matters so much to me. It is very well written, but it is not brilliant. And yet, here it is. Previous lists of Ten Books have always presented logical reasons for each choice, but I think I need to break with tradition here. I have no idea why I like this book so much, but I do.

Selecting ten books was easier than I anticipated. I cannot pretend that there is much logic or thematic consistency in my list, but it is an honest reflection of much meandering over many years. Ultimately, this is what books provide: excursions down side roads, unexpected themes, expanded horizons.