01From the Author

Three facts to begin this book with.

First. According to the World Health Organization, in 2022 approximately one billion people worldwide lived with some form of mental disorder. One billion—that’s one in every eight people on Earth. No somatic disease—whether cardiovascular, oncological, or infectious—reaches such epidemic proportions. And this billion isn’t decreasing. It’s growing.

Second. According to estimates by the same WHO experts, roughly seventy percent of people in need of qualified psychiatric and psychotherapeutic care do not receive it. In low- and middle-income countries, this gap rises to eighty-five percent. The global market, deprived of quality services, becomes flooded with everything but medicine.

Third. Into this vacuum rush practitioners of Hellinger’s family constellations,” “theta-healers,” regression therapists, authors of “unique methods,” psychics, hereditary healers, founders of “energy schools,” and “spiritual practices.” Each of them promises to cure in a few sessions what proper psychotherapy takes years to treat—and what psychiatry can manage but not always cure. Each boasts hundreds of thousands of social media followers and thousands of grateful clients, all paying into this river of promises.

This is a pandemic of madness. Unlike a viral pandemic, against which science can develop vaccines and antiviral medications, there is still no effective remedy for this pandemic. Moreover, a significant portion of society, including government institutions and legislative bodies, silently condones its spread.

This book delves into how we arrived at this point. And it explores who, in this story, is truly lost in the grip of madness.

In the early 2000s, in a ward of a Baku psychiatric hospital, I witnessed a scene I will never forget.

The patient was about to receive a sulfazin injection. It was routine—as ordinary as brushing one’s teeth in the morning. The medicine had been warmed in a water bath so that the sulfur solution would distribute more evenly under the skin. Deep injections were made—into both buttocks and beneath both shoulder blades—a so-called “sulfosin cross.” After the shot, the patient would inevitably endure a fever of up to 40 degrees Celsius, excruciating pain, and immobility for days. They called this “treatment.” They called it “pyrotherapy”—heating the body to “jolt” the central nervous system.

No clinical study has ever confirmed the effectiveness of sulfazine in treating schizophrenia. Moreover, by the year 2000, the scientific community worldwide had long dismissed this method as senseless and cruel. Yet in Baku, St. Petersburg, and other cities across the post-Soviet space, its use persisted—simply because it had always been done that way, because that’s how they’d been taught, and because it gave the staff the illusion that they were “doing something.

I was a young doctor. I stood and watched. I realized that what was about to happen wasn’t medicine. And I asked myself a question that hasn’t left me for over twenty years since: who in this scene is actually in a state of madness?

A patient suffering from hallucinations — harmless to anyone but themselves — now condemned to endure days of unbearable agony in the name of nonexistent therapy? Or the medical staff who’ve practiced this scientifically unfounded method for years while remaining convinced of its benefits?

Now I ask the same question—but in a much broader context.

Is the one who sits in a closed ward and hears voices—voices that harm no one but themselves—the true madman? Or is it the one who stands before an audience of a hundred thousand on social media, promising to “cleanse their karma” for forty-five thousand rubles, and gets dozens of takers every day, all while not a single government body sees any reason to intervene?

With this book, I aim to provide an answer to this question.

The central thesis of this book:

The history of mistakes in psychiatry is by no means an indictment of psychiatry as a science.

This is humanity’s mistake, disguised by science. Only by curing itself of true human madness can psychiatry become a truly essential discipline, one that safeguards the mental health of mankind.

Psychiatry as an evidence-based science, grounded in clinical research and verifiable methods, is only now—in the first quarter of the twenty-first century—beginning to take proper shape. Trepanation of skulls in the condemned, exorcisms for epilepsy patients, castration of women for “hysteria,” insulin comas, lobotomies, sulfazin injections, punitive psychiatry—all of this occurred when a true science of mental disorders did not yet exist. This was the history of trial and error, not intentional malice. Humanity sought answers without understanding. Humanity experimented without knowledge. Humanity acted with the best of intentions and the worst of intentions simultaneously—often unable to discern where one ended and the other began.

Modern pseudoscientific fields—family constellations, ThetaHealing, past-life regression therapy, Dianetics, shamanic practices disguised as psychology—use the mistakes of the past as their primary rhetorical shield. They say: “Look at what your ‘scientific psychiatry’ has done! It burned women, performed lobotomies, kept people in chains! But us? We just help.” And it is on this argument that they build their popularity.

But this is a logical substitution.

Lobotomy, sulfazine, and punitive psychiatry were not scientific errors. They were practices masquerading as science, founded on unproven hypotheses—just like modern family constellations and theta healing. The only difference is that the former were carried out by people with medical degrees, while the latter are performed by those without them. Yet the foundation remains the same: a hypothetical idea declared as truth without verification.

This is precisely why modern scientific psychiatry must accomplish two tasks simultaneously.

First and foremost, we must acknowledge the mistakes of the past as mistakes of humanity as a whole — neither silencing them, nor making excuses, nor allowing these errors to be wielded against the very concept of evidence-based medicine.

Secondly, to prevent unscientific practices—hiding behind vague terms like “healing” or “author’s unique method”—from continuing to harm people under the protection of social networks and the tacit approval of governments.

This book is not against psychiatry. It stands for scientific psychiatry. Against its past mistakes and against its fraudulent impostors of the present.

On Method and Structure

The book is structured as an investigation — divided into six parts.

Part One takes the reader into the pre-scientific era—where humanity first encountered madness and attempted to respond to it somehow. Stone Age trepanation, exorcism as a living practice, the “wandering womb,” and Battey’s operation on healthy ovaries. This section culminates in the very purpose of the book: defining madness and presenting the formula by which it reproduces from one era to the next. From here on, the reader will recognize this formula themselves—in every chapter, in every century.

The second part is the most harrowing. Here, the formula for madness dons a white coat. Kraepelin and Bleuler name the illness, but there is no cure—and into this void rush the methods: Wagner-Jauregg’s pyrotherapy, Sakel’s insulin comas, Moniz and Freeman’s lobotomy, Soviet punitive psychiatry, the dark and bright history of electroconvulsive therapy. Here, the formula boasts diplomas, university chairs, and one Nobel Prize—a decision the world would come to regret.

Part Three — on how science learned to distinguish itself from its own shadow. Freud, Jung, the phenomenological school, biological theories, Bateson, anti-psychiatry, the biopsychosocial model, the birth of professional ethics. This is the history of ideas—including mistaken ones. But here, for the first time, a watershed becomes visible: some erred within the rules of science—and science corrected them; others rejected the rules entirely.

Part Four focuses on today’s psychology marketplace. It opens with a chapter on why any of this “works”—the seven honest mechanisms of the psyche exploited by every peddler of miracles. Then come the peddlers themselves: Hellinger’s family constellations, ThetaHealing, past-life regression, Dianetics. And a chapter on what happens inside the profession itself when quality control fails—because every patient deceived by medicine becomes a client of its imposters.

Part Five takes the pandemic beyond the walls of the clinic. Shark cartilage “for cancer,” gut serotonin “for depression,” the “psychosomatic seven,” rituals and amulets—all part of the madness formula that permeates every sphere of life, including what I observe daily from my office in Baku. Then come social media as a vector for misinformation and legal asymmetry as the silent consent of governments.

Part Six — The Return. The story of a genuine recovery—without miracles, with setbacks, and with results. And finally: the answer to the question posed by this book’s title.

At the end of the book, you’ll find an appendix—a practical checklist titled “How to Spot a Real Specialist” and a list of red flags. If you need answers right now, before diving into the whole story—open it first: it was written precisely for this purpose.

Between the chapters, you’ll find interludes—monologues from patients and their loved ones. These have been reconstructed by me based on real stories from my practice; the names and details have been altered, but the essence and tone remain intact. In a book about mental anguish, it’s essential to hear not only the voices of doctors.

On Certain Warnings

I am a practicing psychiatrist and psychotherapist. Everything I write in this book is based on clinical experience and data from international scientific literature. When using examples from my own practice—whether during my internship at Clinical Hospital No. 2 in Baku, my clinical residency at the V.M. Bekhterev Institute in St. Petersburg, or my current work in Baku—I adhere to the anonymization standards of medical literature: names are changed, details adapted, and workplaces described in general terms. Yet the essence of every case presented here is real. These are things I witnessed with my own eyes.

This book mentions specific individuals—doctors, pseudo-healers, and authors of “methods”—whose names are publicly known and whose statements are documented in open sources. My critique is based solely on their public declarations. At no point do I cross the line into personal criticism; my focus is on the methods, teachings, and practices, not the individuals themselves. Should any of these people choose to revise their methods or publicly disavow them, I would be the first to acknowledge and welcome such a change.

The text employs terminology that is clinically precise and necessary in psychiatry, though it may sound harsh in everyday language: “schizophrenia,” “psychosis,” “mania,” “dementia.” These are medical terms, not value judgments. I use them as they appear in scientific literature—without condescension or contempt.

One last thing. If you’re reading this book and recognize yourself or someone close to you in any of the described clinical scenarios—please do just one thing: consult a qualified specialist. Not a systemic constellation therapist. Not a regression therapist. Not a theta healer. See a psychiatrist or clinical psychologist. If there are no qualified specialists in your town—they’ll be in the next town over, in the capital, or available online. This book is not a self-help guide. It is an attempt to explain why DIY treatment with pseudohealers ends badly.

With respect to everyone holding this book in their hands,

Kenan Ragimov, MD, Psychiatrist and Psychotherapist, Baku, 2026