Fascinating book exploring a pivotal case of psychiatric malpractice and its consequences. It was a five star read for me for many of the points I raise below. I especially appreciate authors who when they come across an obscure reference follow it up and write to reveal something from the past that has importance in the present.

Raphael “Ray” Osheroff, a successful nephrologist, suffered from depression throughout this life. During a stressful moment when it appeared his second wife was going to divorce him and his two sons by his first marriage were going to spend some time with their mother in Luxembourg, he signed himself voluntarily into a Chestnut Lodge, a prestigious psychoanalytic hospital. Focusing on non- medication therapy, the Lodge worked on changing the person through abusive talk therapy and other techniques including holding him with schizophrenics and pedophiles. This only exacerbated his condition to where he was pacing constantly. Then the diagnosis was a narcissistic disorder - which at the time he was inpatient wasn’t a diagnosis in the extent DSM manual. His concerned parents were able to get him transferred to another institution, Silver Hill Hospital where he was out on medication in addition to talk therapy and was able to leave recovered only to find out that the lucrative practice he had left behind was taken over by one of his partners and he had to fight to regain his hospital privileges and to whom he could sell his practice. I will leave the summary to the above to say the book covers what happens and how his psychiatric case changed how psychiatry saw itself and waft good practice should consist of.

The book’s importance lies in its use of primary sources - primary documents, medical files, videos, legal archives and the like - to bright back to light a forgotten case. As the author notes several times in the telling other books written about the case didn’t use full source reviews often using interviews with individuals peripheral to the case. The author painstaking shows how doctors failed him and then misrepresented what they did - isn’t that how it goes: deny, don’t apologize, stonewall and stay silent. It was aggravating after reading about Osheroff’s treatment to read about what was said during the trial. I think also the perfidy and betrayal of his partner who he trusted to care for his practice was also grating.

As a former social worker I know how important it is to treat people with honesty, kindness and respect as you work with them and Osheroff certainly wasn’t treated well at Chestnut. The author I must note strives to give Osheroff a fair and even portrait of a complex but driven man overwhelmed by burdens he didn’t know how to prioritize. But as those psychiatrists with their infuriating diagnosis even I could see was wrong made my hackles rise. We should be thankful to Osheroff for bringing this case so the psychiatry specialty could make treatment changes.

My thanks to NetGalley and the University of California Press for granting me access to this ARC.

Some books entertain, some inform, and a rare few prompt deep reflection long after the final page is turned. For me, When Healing Harms was decidedly the latter.

As a current doctoral candidate in Psychology, I found this book profoundly intriguing. The exploration of psychiatry’s history, the ethical complexities of treatment, and the tension between prevailing clinical ideologies and individual patient needs immediately captured my attention. I knew I had to engage with this work—and I am grateful that I did.

In 1979, Dr. Raphael “Ray” Osheroff—a successful physician struggling with severe depression—admitted himself to Chestnut Lodge, a renowned psychiatric hospital. Instead of receiving medication, he underwent seven months of intensive talk therapy as his condition worsened significantly. After transferring to another hospital and beginning antidepressant treatment, Osheroff experienced substantial recovery, but the repercussions of his initial experience were profound. He subsequently sued Chestnut Lodge, initiating a landmark malpractice case that challenged established psychiatric practices and compelled the field to reconsider how serious mental illness should be addressed.

What impressed me most was Eric Caplan’s ability to transform what could have been a dense historical account into a deeply human narrative. This is not merely a book about a lawsuit or a shift in psychiatric practice—it is the story of an individual seeking help, and the consequences when institutional philosophy takes precedence over patient-centered care.

I particularly valued the exploration of conflict between therapeutic ideology and evidence-based care. The narrative raises questions that remain strikingly relevant: When does a treatment philosophy become rigid? What are the consequences when clinicians become so invested in a particular approach that they cease to question its efficacy? Most importantly, how do we discern when “do no harm” becomes a justification for insufficient intervention?

Caplan’s extensive research is also noteworthy. The book draws from thousands of pages of records, legal documents, correspondence, interviews, and over 120 hours of hearing footage, lending the narrative remarkable depth.

I also appreciated that Osheroff is portrayed as more than merely a patient at the center of a legal case. Caplan offers a nuanced portrait of the individual behind the lawsuit, rendering the consequences of his experience deeply personal and meaningful.

My primary criticism is that the wealth of detail occasionally disrupted the narrative’s momentum. Some sections—particularly those covering legal proceedings, expert testimony, and historical context—felt repetitive at times. While I recognize the importance of this information in establishing the case’s significance, I occasionally wished for a brisker narrative pace.

That said, readers with a particular interest in psychology, psychiatry, medical ethics, or the history of mental health treatment are likely to appreciate the depth and detail more than the average nonfiction reader.

When Healing Harms lingered in my thoughts long after I finished reading. It offers a fascinating examination of a pivotal moment in psychiatric history, but more importantly, serves as a reminder that medicine is not simply a matter of selecting a treatment—it is an ongoing process of questioning whether that treatment truly serves the individual before you.

For me, this was a particularly meaningful read as I continue my doctoral journey in psychology. It challenged me to think beyond theory, diagnosis, and treatment modalities, prompting deeper consideration of the ethical responsibilities inherent in mental health practice.

I am genuinely grateful to have read this book—and I fully intend to purchase a finished copy for my personal library. This is a work I anticipate revisiting, especially as my academic and professional journey continues.

Many thanks to NetGalley, Eric Caplan, and the publisher for providing me with an early release copy of When Healing Harms in exchange for my honest review. All opinions expressed are entirely my own.

When Healing Harms is well-researched, thorough, and utterly fascinating. Caplan went through mountains of primary sources in order to properly tell Ray Osheroff's story, and that work pays off in an account that is both clear and compelling. A must read for anyone interested in psychiatry or mental health more generally!

When Healing Harms unravels a long-buried story behind one of the most consequential—and most misunderstood—malpractice cases in modern psychiatry. Author Eric Caplan revisits the admission of a well-known doctor into one of the nation’s top psychiatric facilities, where he was confined to lockdown, neglected, and mistreated. When Healing Harms dives deep into a case from 1979, but considers how similar issues persist to this day. It’s deeply-reported using primary sources like medical documents, case files, and legal archives, yet remains highly accessible non-fiction that’s equal parts tragedy, thriller, and political expose. A true mental-health page turner.

Thank you to NetGalley and the publisher for the advance reader copy.