A mental health professional writing about her or his “most bizarre” cases is a double-edge sword. On one hand, there is the desire to educate the reader about complex psychiatric conditions, their etiology, and what can be done to resolve them. At the same time, the writer must not overstep the bounds of professional ethics and decorum by depicting patients in a manner that could be construed as reductionistic or salacious. Despite its provocative title, The Naked Lady Who Stood on Her Head is psychiatrist Gary Small’s lucid account of case histories he hopes, “will both entertain and help those who fear psychiatry to overcome their fears and get help if they need it.” His wife, Gigi Vorgan, is a co-author.

The chapters in the book are arranged chronologically, starting with patients Dr. Small confronted during his formative years of training and concluding with him as an established practitioner who has “seen it all.” He introduces the reader to the details of each case, describes his therapeutic approach, offers a précis about the presenting psychopathology, and reveals what happened in the short and long term. The chapters abound with dialogue between Small and his patients, admittedly condensed and constructed somewhat artificially, but illustrative of what usually goes on in the therapy room. He also interjects elements of his personal life with family, friends, and colleagues, mostly brief interludes that show him to be an optimistic, introspective, and confident physician.

The patients Small describes run the course of depression and adjustment disorders but as well, some unusual maladies such as hysterical blindness, apotemnophilia (amputation as a sexual preference), and a man who thinks his penis is shrinking! There is humor in these descriptions, often self-deprecating, but never at the expense of the people seeking treatment. Dr. Small’s methodology is primarily “talk therapy” combined with pharmacology that targets symptom reduction. Be advised that there is nothing “bizarre” about his approach to psychotherapy—rather, a reasoned application of conventional methods implemented conservatively.

Medical authors such as Oliver Sacks have made a living writing case histories and so too, Gary Small adopts this genre in The Naked Lady Who Stood on Her Head. General readers may enjoy the book, its relaxed prose, and the glimpse it takes at people trying to solve their problems. I suspect that professionals would see the book as a lighthearted exploration of familiar terrain. Whatever the audience, this is a breezy read that stays true to it purpose, informs, and lets us in on the author’s personal and professional journey.

© 2010 James K. Luiselli

James K. Luiselli, Ed.D., ABPP, BCBA-D is a psychologist affiliated with May Institute and a private-practice clinician. Among his publications are 6 books and over 200 journal articles. He reviews books for The New England Psychologist.