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Book Review  |   April 2005
Hard Boiled Eggs and Other Psychiatric Tales: The Rebirth of the Psychotherapy of Severe Mental Illness
Author Affiliations
  • Rene J. McGovern, PhD
    Kirksville College of Osteopathic Medicine of A.T. Still University of Health Sciences Kirksville, Missouri
    Adjunct Assistant Professor of Psychiatry, Neurology, and Psychology Case Western Reserve University Cleveland, Ohio
    Associate Professor of Neurobehavioral Sciences
Article Information
Book Review   |   April 2005
Hard Boiled Eggs and Other Psychiatric Tales: The Rebirth of the Psychotherapy of Severe Mental Illness
The Journal of the American Osteopathic Association, April 2005, Vol. 105, 217. doi:10.7556/jaoa.2005.105.4.217
The Journal of the American Osteopathic Association, April 2005, Vol. 105, 217. doi:10.7556/jaoa.2005.105.4.217
Hard Boiled Eggs and Other Psychiatric Tales: The Rebirth of the Psychotherapy of Severe Mental Illness is the story of an osteopathic psychiatrist, Albert M. Honig, DO, and his commitment to mental health treatment as it can no longer be practiced in today's healthcare setting. 
In the book, a second edition, Dr Honig describes his years of practice at the clinic he founded in 1964, Foundations Behavioral Health (formerly Delaware Valley Mental Health Foundation) in Doylestown, Pa, to provide a sanctuary for patients with severe mental illness. This sanctuary was devoted to the long-term psychiatric care of people who had treatment failures in more traditional settings. The goal for clinicians at Foundations was no less than the repair of patients' minds, bodies, and spirits. 
Following the advice of his mentor, Theodore Reik, PhD, who told him, “In the great decisions of life, one must go by how one feels,” Dr Honig found that his compassion for his patients led him to envision and develop alternative—sometimes “radical”—treatment methods for them. 
In this book, Dr Honig shares the stories of four patients, each story representing his belief in the power of psychotherapy and the importance of the therapist's deep involvement in the process of healing. Yet, Dr Honig does not shy away from describing his struggle with the ethical issues present in administering psychiatric treatment using radical means. 
In the first story Dr Honig shares, Ann, a 16-year–old adolescent with anorexia nervosa, arrives at the clinic weighing 60 pounds. Dr Honig's unconventional treatment included force-feeding Ann hard-boiled eggs—the case-history detail for which this book is named. 
In the second chapter, “Deep Water,” Dr Honig retells how he used another radical therapy for Cheryl, a college student who had a suicide pact with her best friend. Although Cheryl's attempt at suicide was not successful, her friend's had been. 
The third chapter, “A Modern Joan,” refers to a young woman whose symptomology serves to maintain the secrecy of her father's incestuous relationship with her sister. 
Chapter 4, “A Wild State,” tells the story of a psychiatrist who succumbs to the psychotic delusions of his patients and ultimately becomes homeless. In fact, it is in this chapter that Dr Honig's great insight and skillfulness as a healer emerge most rapidly. 
These patient stories provide a rare opportunity to see the world from the eyes of a skilled and compassionate psychotherapist. Akin to the accounts of Irvin D. Yalom, MD, in his 1989 Love's Executioner and Other Tales of Psychotherapy, Dr Honig openly shares his psychologic processes. In his discussion of the case involving a fellow psychiatrist, Dr Honig admits to the “prostitution of intimacy” that a therapist may suffer when faced with the basic challenge of the doctor-healer to “assimilate, hold, and recreate within himself or herself what the patient feels without losing his or her own boundaries.” 
During his many years of clinical practice—including practice in family medicine, completing a residency in psychiatry, and working with the severely mentally ill in the back wards of state hospitals—Dr Honig began noticing the stubbornness with which patients, long psychotic, defended their beliefs. He describes their tendency to “protect their universe as if their life depended upon it,” despite their suffering. 
Dr Honig does not reject modern psychiatric tools that are available as a result of advances in biologic psychiatry, nor does he reject the legal regulations that protect patients from nonstandard treatment. Rather, his book documents the impact of his methods over 40 years of clinical practice, culminating with the advent of managed care and the dissolution of the role of the psychiatric clinic as he had envisioned it. 
In fact, the fifth and final chapter, “Boundaries and Borders,” fast forwards to a present-day description of psychiatric clinics as they are operated in the United States. He comments on the constraints in the present healthcare environment that restrict innovation in patient care. 
With insight and balance, Dr Honig credits his osteopathic training for his clinical success and humbly offers advice to fellow therapists. Although the book concludes with a description of the transformation of the psychiatric clinic to a model aligned with the realities of managed care, the book's last sentence offers the hope that reminders of past models for patient care, such as those documented in Hard Boiled Eggs and Other Psychiatric Tales, will “breathe new life into the long tradition of psychotherapy.” 
While reading Hard Boiled Eggs and Other Psychiatric Tales, I was reminded of why I became a psychotherapist. I was truly inspired by Dr Honig's wisdom and experience. This book made me yearn for the days of fee-for-service and private insurance payments for long-term psychiatric hospitalizations—but I also found myself wondering whether I had the grit of psychotherapists from an earlier era. Would I be able to relinquish the boundaries of current cognitive-behavioral therapy and practice instead according to principles that would allow me to set my own expectations for myself and for my patients? 
I recommend Hard Boiled Eggs and Other Psychiatric Tales for all healers who are at risk of forgetting why they entered their profession. 
 Albert M. Honig, DO. 2nd ed, 173 pp, $15.95. ISBN 0-9713876-0-5. Doylestown, Pa: North Street Publishers; 2002.