For decades, Ivor Browne has been one of the best-known psychiatrists in the country.
Lauded by his admirers like a mystical guru, he has been credited with breaking down the walls of our mental hospitals, and freeing many patients from incarceration.
As a sprightly octogenarian who meditates twice a day and lives in a house named Gandalf – in honour of a character in JRR Tolkien’s The Lord of the Rings – he is no ordinary doctor.
The writer Colm Tóibín, who has attended his therapy sessions, once said of him: “There’s an aura off him that is almost holy.”
The psychiatrist prompted Tóibín to unleash “unexperienced” pain over his father’s death when he was a boy of 12. Tóibín once wrote of how he once lay on a mattress and screamed with grief, having suppressed it for years.
As a psychiatrist, Browne is said to have “dried out” Ronnie Drew of the Dubliners, and there is no shortage of well-known figures who are prepared to endorse him.
Few doubt that he helped to shake up the world of Irish psychiatry over the decades, and shed light on a hidden world of mental anguish. But his views opposing the use of antidepressants are also highly controversial, and are heavily contested by many other psychiatrists working in Ireland today, including those who advocate talking therapies.
The psychiatrist is again in the spotlight as the subject of a documentary, now showing at Dublin’s Irish Film Institute. It not only tells the story of Browne’s life but also lifts the lid on our attitude to mental health and depression. Browne tells how when he started as a medical student, doctors were giving residents of mental hospitals lobotomies.
He recalls how he helped in operations, where holes were drilled in patients’ heads. A knife was inserted to sever the frontal lobes of the brain.
Browne sought to close the often inhumane institutions that house those with mental illness and wanted to integrate the patients into the community.
He acknowledged that this was only a partial success, and believes that many people out in the community are now institutionalised by heavy drugs.
The semi-retired former professor of psychiatry at UCD this week reaffirmed his view that there is a vast overuse of antidepressants in Ireland.
The debate over antidepressants is of concern to tens of thousands of people. The mental health support organisation Aware estimates 450,000 people are affected by depression in Ireland, the equivalent of one in 10, at any one time.
It is hard to quantify the number of prescriptions for antidepressant pills in Ireland every year, but Browne says if he was writing prescriptions nowadays he wouldn’t dream of giving an antidepressant drug to any of his patients. He claims they are “highly habit-forming and difficult to get off”.
“I think they are ineffective. They can give temporary relief but they don’t achieve any far-reaching results,” he tells Review.
It is a long-held view that inevitably makes Browne the target of criticism and out of kilter with the psychiatric establishment, particularly in cases where patients may be suicidal.
Browne, himself the former chief psychiatrist at the Eastern Health Board, emphasises that he is not totally against the use of drugs when treating patients. He says he would prescribe antipsychotic medication in cases of acute psychosis.
That is where a patient loses grip on reality, and may suffer severe hallucinations or delusions. As Browne puts it: “It’s what in ordinary parlance we would call ‘mad’. Otherwise I would not prescribe medication because I think it’s better to work with people’s difficulties, to help them discover the source of their problems,” he says.
“In my experience, medication makes it more difficult to deal with the underlying reasons for depression.”
So if the drugs don’t work, in his view, what would he recommend as the best treatment for depression?
“I would say, in broad terms, effective psychotherapy. If you can work on the person’s life story, and more specifically deal with any traumas people have suffered from the womb through birth, or in later development, you will make more progress.”
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