It is now nearly 50 years since the action–research sociologist Erving Goffman turned his insider-view daily notes into a devastating critique of the realities of mental hospital life. Back then, sociologists and psychotherapists were natural allies rallying to the flag of community psychiatry, united in opposition to the hegemonic medical model. Academically, social psychiatry was the sexy place to be, with as many as seven UK units funded by the Medical Research Council charting the social and psychological impact of mental hospital closure, the social origins of depression, the epidemiology of suicide, the impact of mental illness in primary care, and the relationship between class and mental health. Today all has changed. Neuropsychiatry rules; Asylums (1961) lies unread; the few remaining sociologists are in search of new targets for radical assault.

Psychotherapy is certainly much in need of sociological scrutiny. What is the class composition of psychotherapists and their clients? Can psychoanalysis realistically be provided for the masses away from the ivory towers of Hampstead? Does ethnicity influence choice of therapy or psychopharmacology? What, if anything, is the impact of psychotherapy as a social movement encompassing new ways of ethically and environmentally sound living? Is psychotherapy a valid profession? Does it instil creative opposition to prevailing mores or is it an instrument of subtle social control? What are we to make of the ‘model wars’ within psychotherapy – is the battle between psychoanalysis and cognitive–behavioral therapy a surrogate for Thatcherite assault on middle class complacency? Will registration of psychotherapists legitimise a valid social movement or represent the final bureaucratisation of radical protest? Is happiness a sensible goal for therapy or should we embrace Freud's aim of replacing neurotic misery with ordinary human suffering?

Morell's book, which has the feel of a worked-up set of first-year sociology lectures, touches on many of these issues but, sadly, goes into none of them in depth. He himself seems to have had unfortunate experiences of therapy and describes himself as ‘not just a trouble-maker [but] an angry trouble-maker’. Through this superficial analysis, interspersed with a few lists of therapy organisations and paragraph-length summaries of major sociology theorists, stalks the character of Heather, a supposed therapy seeker, and her ‘barefoot’ therapist Len, who first seduces and then is rejected by her. Morell seems to approve of Len in preference to trained therapists, whom he sees as peddling prostituted love under the guise of professionalism. It is all very confusing, to no one more so than the author himself.

When dealing with a problematic patient it is always a good principle to try to find something likeable about them. It was both surprising and a relief to learn from Morrall (p. 186) that ‘if I… were to succumb to madness it is the services of a psychiatrist that may be called upon. It is most definitely not a deconstructed sociologist or anti-psychiatrist’. This book is slightly mad. My professional advice (although of course as a psychotherapist I never give advice) is that the author retrain immediately as a neuroscientist. The jobs are there; the ground unshifting. The sociology of psychotherapy needs empirical data and subtle conceptualisation, not recycled right-on 60s clichés. The subject it seems is too tricky to be left to the sociologists, while psychiatry is beguiled by the romance of neuroscience. Oh, where are the Browns and Leffs of yesteryear?