Last week I discussed the antipsychiatry movement in general, including some of their critiques of psychiatry – in this piece I will look at why antipsychiatry exists at all. After all, there doesn’t seem to be an anti-cardiology or anti-oncology group – what makes psychiatry so special?
Again, Henry A. Nasrallah, MD’s article: The antipsychiatry movement: Who and why nicely encapsulates this topic, but for those of you wondering about the history of antipsychiatry, here goes.
History of Antipsychiatry – the 1960s
As I mentioned in my last article, I think historical critiques of psychiatry are next to useless as they simply show our lack of understanding and knowledge at the time and bear little resemblance to the issues psychiatry and psychiatric patients are dealing with today. Nevertheless, if you want to know where antipsychiatry came from, you have to look back.
Antipsychiatry and David Cooper
The term “antipsychiatry” was coined in 1967 (although the movement had been around a long time by then) by psychiatrist David Cooper who seems to me is no one to hold up an entire movement. Among other things,
Cooper believed that madness and psychosis are the manifestation of a disparity between one’s own ‘true’ identity and our social identity (the identity others give us and we internalise). Cooper’s ultimate solution was through revolution.
And, my favorite, a quote from his writing in 1980,
Madness is permanent revolution in the life of a person…a deconstitution of oneself with the implicit promise of return to a more fully realized world.
Ah, so madness is good then. Tell that to everyone who’s been through a psychotic episode.
Antipsychiatry, Foucault and Szasz
At this time, Foucault, one of the seed-sowers of antipsychiatry seemed to like the idea of prescribing, “travel, rest, walking, retirement and generally engaging with nature” as a treatment.
Psychiatrist Thomas Szasz was a big part of the creation of antipsychiatry too although he decried the moniker and its adherents, instead, collaborating with the Church of Scientology to create the Citizen’s Commission on Human Rights in 1969. (I know that sounds like a good thing but all you have to do is wander around on their website for about 3 minutes to see why it’s not. They’re one of the most hate-spreading, propaganda-promoting groups I’ve ever seen.)
I suspect this is why many people right off all antipsychiatry groups as merely Scientologists (but they’re not).
According to Wikipedia:
It was later noted that the view that insanity was not in most or even in any instances a “medical” entity, but a moral issue, was also held by Christian Scientists and certain Protestant fundamentalists, as well as Szasz.
(And if someone were to tell me that my mental illness was because of my morals, well, it wouldn’t be pretty. My morals are fine, thanks.)
Also around this time:
- The idea that psychiatry is just an agent of social control began becoming popular.
- Psychiatry from the 1900s, 1930s and other eras was criticised (and rightfully so).
- Psychiatry was tied to the Nazis and the holocaust.
- One Flew over the Cuckoo’s Nest was also written and became a best-seller.
The History of Antipsychiatry – the 1970s
The “psychiatry survivors” began entering the antipsychiatry movement. These are people who claimed past abuses of psychiatry. (I rather despise the name, personally, because, of course, it makes it sound like psychiatry is something you “survive” rather than simply a medical specialty. It’s particularly insulting to me and those in psychiatry, I feel.) Of course, some of these people had, and have, genuine complaints about how psychiatry treated them, particularly before the proliferation of psychiatric medication when few options (pretty much all bad ones) were available.
Some would claim that antipsychiatry worked to successfully remove references to homosexuality as a mental illness, but I would suggest that the gay rights movement really lays claim to that particular gain.
Antipsychiatry Today
Today, antipsychiatry argues against the biomedical model of psychiatry (as it always has) and it decries the ties to the pharmaceutical industry (once much worse than it is today). They also fight the idea of psychiatric diagnoses altogether and the Diagnostic and Statistical Manual of Mental Disorders (the DSM) in particular.
Antipsychiatry is still marginalized within psychiatry and within the mental illness community at large. Although an exception to this seems to be online where antipsychiatry people and ideals are absolutely everywhere.
Thoughts on the Antipsychiatry History
There is no doubt that there are things to fight against in psychiatry. I do it. Other people do it. It’s pretty common. A good example is the DSM-V discussions which hotly debate all sorts of mental illness topics.
I just don’t agree with most of what antipsychiatry fights. Their raison d’être seems to be getting people off medication en masse, and that’s something I could never support. Antipsychiatry started at a time (pre-1960s) where conditions for the treatment of the mentally ill were deplorable and inhuman and wrong but they have continued into times when that’s just not the case. If anything people need more access to psychiatry, not less.
Antipsychiatry Benefits
While I’m hard-pressed to argue for antipsychiatry I will say that antipsychiatry provides checks and balances to a very powerful system. I feel these checks and balances could be better handled, but nevertheless, they are of benefit. While I don’t think psychiatrists should have to defend their profession in general (as with any other doctor) it may be helpful for them to cast a critical eye over what they do as what they do is very important and affects people greatly.
In short, naysayers (on this blog as well) force us to look at ourselves which can be seen as a benefit, but you really have to want to see it.
I’m a psychiatric survivor! But, I was also definitely misdiagnosed. My psychological problems were due to trauma, not a chemical imbalance. I think a lot of people’s psychological problems are a result of emotional trauma, which is why psych drugs don’t work for a lot of people and just cause more problems. But , I guess if you were born with a chemical imbalance and you can just pop a pill and that makes everything better, then of course you’d be pro psychiatry. I think the antipsychiatry movement started because there are a lot of misdiagnosed people who were harmed by the industry.
There are many in the field who are looking at chemical imbalance as a fallacy. Too many doctors in the field who really dont give a damn any more and we can feel it. Not much talking.. Take these pills and lets hope for the best and you have to fork over a check for money you cant afford. Insult upon insult. Heaven forbid you need to stay in a hospital of which some are good but so many are either closed or staffed with nurses, etc who themselves are on meds. The only ones left in my area cost 30,000 a month. This industry alone is a 300 billion dollar industry and its needs to be perpetuated. what realyy upsets many is that we go to these doctors who have no cure but mange this with trial and error pills in the form of cocktails that have so many bloody side effects that make us even more mad. W can fix a broken arm but not a broken brain. I see my psych doctor and he asks me how I am doing and I say horribly and his only answer to me is I wish I could help more but lets try this pill. How many times have we gone through that process.? TAS.. I agree with you with regard to trauma in many cases. I also have complex PTSD.Renowned traumatologist, John Briere, is said to have quipped that if Complex PTSD were ever given its due – that is, if the role of dysfunctional parenting in adult psychological disorders was ever fully recognized, the DSM (The Diagnostic and Statistical Manual of Mental Disorders used by all mental health professionals) would shrink to the size of a thin pamphlet. It currently resembles a large dictionary. In my experience, many clients with Complex PTSD have been misdiagnosed with various anxiety and depressive disorders, as well as bipolar, narcissistic, codependent and borderline disorders. Further confusion arises in the case of ADHD (Attention Deficit Hyperactive Disorder), as well as obsessive/compulsive disorder, which is sometimes more accurately described as an excessive, fixated flight response to trauma. This is also true of ADD (Attention Deficit Disorder) and some dissociative disorders which are similarly excessive, fixated freeze responses to trauma
For one that has never experienced the mh system it would be extreamly difficult to be enlightened to the experience. To try and explain horrific side effects to treatment is a very hard task when the so called proffesionals that administer the treatment choose not to understand themselves.When people say they are survivors nobody has the right to question that statement. It is a war. A war of the mind and spirit, its a legal andethical war. A war of human rights. Its a war of words and spirit. Many dont survive the treatment that you never hear about. The public never hear about what phsyc meds a murdering gunman was on. The truth is out there but do people really want to hear it. The people that are trying to tell you the truth are labelled as being mentally unstable. Its a common fact that if you want to discredit someone label them and stick a big stigma sticker on their forhead. There is far too much money to be lost if people actualy started listening to the truth. People come out brainwashed in thinking they are better but really they are just reprogrammed and drugged into beleiving that everything is ok and dont dig deeper or you see what is realy going on. Some are happy to be suppressed and carry on being happy for their abusers or they survive but is then alienated because they fight to hard for the reality of it all. All for antiphsyciatry and i wish people wouldnt give up so easy.
Hey Natasha. I actually have a paper from a few years which touches on some points from anti-psychiatry and I would looooooooooove getting some citations for it, so I’ll email it to you ;)
Basically I started out approaching from a medical anthropology rather than clinical viewpoint so touch on work like Erving Goffman’s “Asylums” and David Rosenhan’s “On Being Sane in Insane Places” but lately I’ve started citing more clinical work, including that of Patch Adams (a real person!) who is also against psych meds.
Working at the hospital I see the double standards on how “medical” patients get treated as opposed to “psych” patients–so if you want to talk about the medical model, I’m starting to catch on to the lingo such as “patient safety” and “evidence-based medicine” and “ethics” that is a more constructive way of trying to approach this than the “big bad pharma is out to get us” that you probably hear more of in your blog postings.
Anyway, I really like talking about the differences between all the different groups such as CCHR, NAMI, MindFreedom International, and even APA but maybe that’s a guest post I could do for you ?? Also with all the “psychiatrists are evil” posts, I wonder why noone never says “Psych nurses are evil” or “Mental health techs are evil” given that they spend WAY more time with patients than the psychiatrists and are the ones that actually enforce the medications and rules of the psych ward. Maybe that’s another guest post I could do??
Don’t bring up Michel Foucault. Your quotation of him is without any context at all. He’s actually a very difficult historian/philosopher to understand (he’s somewhat to blame for writing in an incredibly abstruse and obscure way). Also, linking him to Thomas Ssasz is unusual given the fact that Michel Foucault said in an interview that he had no relationship with the antipsychiatry movement including Ssasz who he names (I believe the interview was titled “Structuralism and Post-structuralism” which is a funny interview because he announces immediately that he doesn’t no what either term denotes).
Again, your lack of scholarly rigour and effortful argumentation is noticed by individuals with an education in any of the subjects you write about. Perhaps you should increase your effort beyond citing and paraphrasing Wikipeida.
Take care.
This message sounds more mean then it has to be. My point was that your not going to be very successful discussing Thomas Szasz, Michel Foucault, and David Copper (you might want to include Franco Basaglia and Ronald Laing) in 6 paragraphs. Instead, you might want to limit what you discuss. Maybe take one idea like the definition and conception of illness and why it’s changing more and more as we learn about neurobiology (even that’s difficult).
Or you could talk about your cats. That always works. : )
Take care.
I have no clue what you are talking about…congratulations on having an indepth understanding of philosophers, or at least on claiming to.
This is a blog for the public, people with bipolar, on everyday stuff. It is not a scholarly discussion and it would be ludicrous to try and meet those criteria.
Perhaps you should realise that too, and write appropriately for your audience. If I happen to bring up MY area of expertise here, I do it in such as way as everyone can follow. That would be smart.
Hey Sarah,
The article is about the “Antipsychiatry movement” and the author of the article cites/paraphrases their ideas. It’s far from being intellectual pedantic to argue that a person who writes about a group of authors and social activists should at least read what they have written. If the author of this article did so they would realize that not even Szasz calls himself an “antipsychiatrist” (he’s actually a member of the APA lol) and the arguments which are ascribed to them (really to the strawmen) are not authentic representations of their ideas.
I’m sorry I can’t be as smart as you would like (/cry) but there are some standards for writing about the history of social and intellectual movements. One of which involves a trip to the library and the other requires an acknowledgement that misrepresenting another persons ideas is simply obfuscation.
The reason people don’t use “Strawmen” in academia is then someone has to come around and say “no, no, that’s not right. Here’s what he/she actually wrote” which just wastes time and confuses people.
The author’s history of anti-psychiatry doesn’t mention:
(1) The ethical claims put forward by “anti-psychiatrists” that all persons have the right to refuse medical treatment (this is contentious)
(2) The claim that “mental illness” is incoherent because the mind is not an entity. It’s more of a phenomenon or event.
(3) Psychiatries system of classification is used to make pseudo-objective judgements about behaviour society doesn’t like (i.e. Conduct Disorder, Masochism, Narcissm, etcetera)
Take care Sarah.
You are correct that it is difficult to discuss the history of anything in limited space but I was trying to provide a little context for people, however much of an overview that may be. It is certainly a complicated subject as it is at least partially philosophical in nature which always brings up debate from many parties.
– Natasha Tracy
The criticisms of psychiatry (or at least the ones that are meaningful and coherent) are entirely philosophical, in the sense that, they address conceptual and ethical problems that cannot be solved by observations. Most people get confused because empirical and conceptual problems are conflated so when someone says like “intelligence has nothing to do with brain size!” you don’t know if they mean:
(1) Intelligence is essentially social and linguistic and has no application to the real world
(2) Intelligence is not a valid theoretical construct
(3) Measures of intelligence don’t really measure intelligence
(4) The research findings about brain size and intelligence are erroneous
The same follows for almost all the objects “anti-psychiatrists” make. When they say “mental illness does not exist” what exactly does that mean?
(1) The mind is an entity that cannot be sick (some kind of Descartian soul)
(2) The mind is not an entity and therefore cannot be sick.
(3) Mental disorders are made up, in the sense that, the APA merely sets forth the rules in which they occur and measures them.
(4) There is no neurological, biochemical or hereditary basis for mental disorders.
(5) Illness by definition can only be meaningfully ascribed to biological events that are observable and demonstrable.
So it requires alot of clarification before you can even begin to criticize what some of these groups are saying.
To be clear: if your going to try and cut through the nonsense of some of these groups your going to end up doing alot of philosophy of science, epistemology, logic/argument evaluation and philosophy of mind. It’s just how it goes. Neurobiology can’t solve everything (unless your Patricia Churchland : ) )
Take care.
It seems to me about the only tools psychiatrists have are pills and jails. If the psychiatrics traumatises a patient, well, that patient is being “uncooperative.”
I have always wondered why psychiatrists fail to listen to their patients when they describe mistreatment in the hospital.
The reason is, of course, that we are “just crazy people” and therefore out trauma is simply ignored.
Doctor you need to ask yourself what anti-psychiatry exists. It’s due to the abuse mental patients commonly experience.
I am a “survivor”. anti-psychiatry is a result of fraud and abuse of people.
I am a Zyprexa victim one of millions this is not my site but look http://www.zyprexa-victims.com/
Zyprexa does not correct a “chemical imbalance” thats fraud.
When I was suffering tardive psychosis when I quit zyprexa for “insomnia and stress” and went to the hospital I just got a new psychiatric label and coerced to take more psychiatric poison. I was treated worse than a criminal.
“…anti-psychiatry provides checks and balances to a very powerful system”
Yes it does, but it’s unfortunate that there aren’t enough checks and balances within psychiatry itself. And there certainly aren’t many checks and balances within anti-psychiatry, from what I’ve read. Society, by not supporting people with mental illness, GIVES inordinate power to the psychiatrist. How many of you have been told “Just go and get some help” with the subtext being “I can’t tolerate you any more”? This is different from “I think you should go and see a doctor/counsellor. Is there someone to go with you? Do you want me to come? Ok I’ll make the appointment and I’ll pick you up after work, say 4 o’clock?” With society’s constant support, the psychiatrist is a specialist doctor to provide treatment in consultation with the patient. Without it, the psychiatrist is the last line of defence for society to ‘protect’ them from the mentally ill. They have a licence to do anything they need to and they are expected to succeed, which is fairly easily as long as you keep the mentally ill out of sight of general society. Yes I know that in our system, adults under involuntary treatment orders are entitled to an advocate and generally receive one. But who is paying their salary? The state system. And what do the voters generally want? To keep mental illness out of sight and out of mind.
Thanks all for these postings, I’ve learned a lot.
Hi Sarah,
I’m not sure there aren’t enough checks and balances built into the system. It seems to me that there are actually more than in any branch of medicine considering the involvements of the courts.
And as far as within antipsychiatry – well, that’s a whole other kettle of fish.
“Society, by not supporting people with mental illness, GIVES inordinate power to the psychiatrist.”
This is a good point. You’re right, in many areas of society we do want to just “not see” people with a mental illness and we charge people in psychiatry with making that happen. Somehow. As if it were possible.
“With society’s constant support, the psychiatrist is a specialist doctor to provide treatment in consultation with the patient. Without it, the psychiatrist is the last line of defence for society to ‘protect’ them from the mentally ill.”
A good point and one which was recently made by a commenter of mine on Facebook. She was a speech therapist and she said it was similar in terms of delivering speech therapy to kids and needing environmental support.
I don’t believe that state-appointed advocates are interested in keeping people with a mental illness out of sight – from what I can tell, they try to do the best they can for their clients. But you are right that what’s best for the mentally ill and the general feeling of society do conflict.
– Natasha Tracy
“A good point..which was made by another commenter of mine recently”
Lol :) Glad you got it the first time! You know I’m so sick of repeating the obvious over and over again in so many different ways. Perhaps now someone has actually heard me I can move on with my life!
Sarah,
I may not remember names (seriously, big problem with me) but I remember ideas. And yes, we all want to be heard.
– Natasha
You listen to the person, which is the most important thing and a rare gift. People say that remembering someone’s name is a powerful thing. But honestly, I can’t stand it when people use my name when they don’t know me properly, as in salespeople. As you said, what we all want is to be heard and it’s good to know that someone is listening. I can’t tell you how pleased I was to see that you had remembered what I said and even quoted me!
(In Australia, a good-natured ribbing (i.e. teasing) is a mark of real respect. I think it comes from our convict background where we had no respect for the imposed authority and needed to make our own leaders. Hence why I am laughing at you for forgetting my name instead of saying “Oh Natasha you are so smart and have a great blog”, because that would be totally socially unacceptable.)
I’m pretty sure I deserved the ribbing on that one :)
– Natasha
Regarding state-sponsored advocates: I didn’t mean that the advocates are trying to keep the people with mental illness out of sight. You have clarified well what I was trying to say, that there is an inevitable conflict of interest in the role. There is that conflict of interest in any professional role supporting people with mental illness or any other sickness or disability, if the person with the illness is unable to advocate for themselves for some reason and there is no family member or friend who can speak for them. That is why there are advocates and community representatives involved on behalf of people with mental illness. But at the end of the day there is no replacement for a loved one.
Remember the movie ‘Love Actually’? The woman who was constantly there for her brother with a mental illness? Without her he would have had nothing at all. I suppose people looking at that might think “oh how sad, she has given up her whole life for him, she should just leave him and get on with her own life”. She suffered many losses. Most people would say that she suffered the losses because of his mental illness. I say she suffered them because of society’s attitude to mental illness. For example, how hard would it have been for her to get a little time off work to care for her brother or some kind of carer’s pension? How hard, really, would it have been for her friends to come with her to visit her brother then go and get coffee afterwards. Not an ideal girls’ night out but when things are shared around they become easier and this can lead to true friendship and not the kind of friendship that involves drinking contests and backstabbing bitchiness. And what about that sexy guy she wanted to sleep with? If he wanted a relationship with her what would be wrong with helping her with her brother? Then the couple would have heaps of time to roll around in the bed together. In this way everyone wins. It may seem unpleasant at first or scary but the long term health and life benefits of helping someone make it worthwhile, you’ll be surprised at what you might learn from the experience.
And yet again I find myself repeating myself about community support. But whatever way you look at it it makes sense. Only problem is, if we stop blaming people with mental illness who then can we blame for the problems in our lives? My preference for blaming is reality TV. :P
I can get on board the blame reality TV train. Except, um, I watch some of it… doh!
– Natasha
Typo:
“The short-term efficacy of antidepressants – measured in terms of symptom reduction ”
should read
The short-term efficacy of *antipsychotics* – measured in terms of symptom reduction
Hi Natasha,
Interesting blog post.
One point that comes to mind is that anti-psychiatry has been to a large degree an internal psychiatric discourse with prominent, even celebrated, public psychiatrists carving out a position against mainstream psychiatric practices. Examples would include Laing (although he would not accept the term), Cooper, Szasz, Basaglia and, in my own country, Ivor Browne. At a somewhat later date one could add people like Breggin and Mosher.
Aside from Szasz, who is something of a special case, most of these psychiatrists were, to a greater or lesser extent, left-wing and tended to see “mental illness” as having some kind of sociogenesis. Laing, famously, regarded the family itself as a largely pathological entity.
To a large extent, these individuals campaigned against the asylum as an appropriate institutional solution to the problem of madness and they were aided in this by the sociological critique of Goffman. I would say, generally, that Foucault, who has the most interesting and problematic critique, was not immediately relevant to most of this “movement”. His influence would have been more resolutely within academia and extended far beyond the asylum to encompass medicine more generally, the prison institution and the exercise of government.
It’s also relevant to consider the critique of the asylum was also of a moment when the prison as a rehabilitative institution was coming under concerted left-wing attack.
The alliance of Szsaz – the Ayn Rand of “anti-psychiatry” – with Scientology has resulted in one of the wierdest and, in some ways, unfortunate advocacy movements in existence. I say that in the knowledge that, though I hate to admit it, Scientology/CCHR has, at least historically, done some good in reforming deeply problematic psychiatric practices (e.g. Chelmsford, Australia). Szasz’s position, as I’m sure you know, rests upon a somewhat problematic mind-body dualism and an absolute and decidedly right-wing belief in libertarianism. His broader political views are not untypical of a certain section of Eastern European emigres and his attraction to an alliance with Scientology appears to have been motivated by his distaste for the left-wing politics of most prominent anti-psychiatrists.
Although they deny it, it is clear that the psychiatric survivor movement drew some inspiration and no little oxygen from what they sometimes refer to as the “campus intellectuals” of the anti-psychiatry movement proper. However, in terms of outside influences, they claim, I think justifiably, that the Civil Rights Movement was a more important and relevant inspiration. More recently there has been an obvious and fruitful exchange of concepts and tactics with the more powerful and evolved disability rights movement.
The real genesis of the psychiatric survivor movement, however, are personal experiences of trauma within the psychiatric system. That is why the movement coheres most clearly around personal narratives rather than a broader critique (I’m not suggesting it doesn’t have a critique). It is no surprise either that the leadership, or at least the American leadership, of the psychiatric survivor movement had their formative political experiences and contact with (usually) coercive psychiatric practices in the 1970s or earlier. Thus Ted Chabasinski experienced prolonged hospitalisation and (totally inappropriate & quite aggressive) electroshock treatment as a child (in the 1940s I think). David Oaks experienced seclusion and forced medication. Ditto for most of the rest of the old guard (Don Weitz, Judi Chamberlin, etc). Thus their experiences with psychiatry took place predominantly in the asylum era.
While it’s quite easy to attribute an inappropriate degree of malevolence and intent to do harm to medical practitioners within the asylum system of that era there is also no doubt as therapeutic licence increased, as concepts of informed patient consent were undeveloped, patients experienced gross abuses. Take a look at the excellent (and hard to get) documentary Hurry Tomorrow for a idea of where they might be coming from.
Generally, however, the psychiatric survivor movement would not describe itself as anti-psychiatry or even anti-medication. They are quite willing to ally with psychiatrists, such as Mosher, but on their own terms.
The issues in the present day are different. The asylum has largely gone and, rather than being restricted to a rather narrow band of what were considered to be the “seriously mentally ill”, psychiatric medications are being ever more widely prescribed.
The main critique now of the survivor movement is against bio-psychiatry and the medical model of mental illness. Arguably this critique simplifies the situation as there are, in fact, many different approaches with biologically orientated psychiatry. Nonetheless this critique, predominantly aimed against psychiatric medications but also at the validity of psychiatric diagnostic categories (or the notion of mental illness), does not, I think lack legitimacy.
Thus the evidence for the efficacy of anti-depressants is extremely poor with a clinically insignificant margin or improvement over placebo. Even for those experiencing severe depression the apparent increased efficacy of these drugs is due to the absence of a placebo effect in this group rather than any substantial positive drug effect.
The short-term efficacy of antidepressants – measured in terms of symptom reduction – is well established. However, there is no substantial evidence for their long-term efficacy and, indeed, the available evidence, although only partial, appears to indicate that outcomes may be substantially worse. This hypothesis has only gained in plausibility with the recent confirmation by Andreasen that antipsychotics result in dose dependent loses in brain volume over time.
So you have a situation where the treatments appear to offer minimal benefit and many potential harms and yet many adherents are advocating, and indeed carrying out, their extension into the wider population.
This must also be lain against reasonable, if hardly conclusive evidence, that for some classes of those who suffer psychosis a minimal or no-drug approach with appropriate psycho-social interventions produces comparable or superior results to current overwhelmingly psychopharmacological treatment modalities.
“Psychiatry’s traditional strengths have lain in an appreciation of the philosophy and psychology of treatment rather than in an ability to advance the public health through the mass delivery of treatment programs. Given how insecurely established treatment effects are for current interventions, and the capacity for developments in neuroscience to create markets rather than to advance understanding, it seems important to maintain traditional strengths. To have a clinical evidence base, consistent with a wider public health mission, psychiatry would need to track more rigorously the effects of the treatments it now administers before advocating for an even wider distribution of even more interventions with physical treatments than happens at present.”
http://www.ncbi.nlm.nih.gov/pubmed/19318768
Hi Fiachra,
Thanks for taking the time to share all that elaboration. I admit, with one article it’s awfully hard to provide a real history of anything.
“…most of these psychiatrists were, to a greater or lesser extent, left-wing and tended to see “mental illness” as having some kind of sociogenesis.”
Yes, which I find very interesting and, at least personally, completely off the mark but I can’t speak sociologically.
“The real genesis of the psychiatric survivor movement, however, are personal experiences of trauma within the psychiatric system.”
Yes, I agree. And that’s why it’s hard to address in any real way as I can’t say what was or was not a real experience for someone. I have to make judgements about the systems based on the majority and not the few which is what these people represent. And not knowing all the facts in any one of their cases, I just can’t comment on it. And, as I mentioned in my last article, I don’t find historical critiques of the system very useful.
I will say that you’re absolutely correct in that the abuses that people have suffered has led to a complete overhaul of the consent of informed consent and that it definitely a good thing.
“Generally, however, the psychiatric survivor movement would not describe itself as anti-psychiatry or even anti-medication. They are quite willing to ally with psychiatrists, such as Mosher, but on their own terms.”
That’s not what I’ve seen, but that’s just me.
I would have to disagree with some of what you say about medicine efficacy. I did write two articles on the long-term outcomes of those who took antidepressants. It looks at the outcomes over a decade and those that took antidepressants did better than those who didn’t. It’s the only study of it’s kind I’m aware of: https://natashatracy.com/mental-illness/depression/depressed-people-antidepressants-long-term/
“…many adherents are advocating, and indeed carrying out, their extension into the wider population.”
See, I disagree that this is psychiatry. I think this is mostly GPs and psychiatry gets unfairly painted with their brush.
And yes, for 20% of people who experience psychosis, they will not relapse within one year. We do know that but not how to identify that 20%.
– Natasha Tracy
I have a lovely psychiatrist and take my Lithium with good cheer so I could hardly be called anti-psychiatrist. You are right to locate anti-psychiatry in a particular historical context (and surely there is space for a mention of RD Laing). Part of what Foucault did was to shine a light on the sociologoy of Madness as a phenomenon and to make possible the idea that insanity rendered you inhuman because you were treated that way in a circular logic which I’m glad we’ve escaped – perhaps because of that light.
The problem is in the binary oppositional language of the psychiatry/anti-psychiatry debate and getting bogged down in the ‘anti’ as if it was black (or white). It is entirely possible to think differently. So, I am glad that there are regulators who are charged with ensuring health & safety in restaurants, that our teachers are adequate, that our lawyers don’t simply rip us off (thought they sometimes do).
Who is there speaking up for the subjects of psychiatry? As one of your correspondents notes Robert Whitaker is doing a real service to us all by exposing the pharmaceutical industry and the diagnostic bias. My point is that you don’t have to be anti-psychiatry to believe that the history of psychiatry is littered with flaws and failures which we need to be protected from then, now and in the future. Complacency is no antidote to profit. This is a function and we need as much critical analysis as we can get – whatever term it goes by.
BTW my psychiatrist tells me that Lithium is still THE BEST drug for bipolar but that you Americans don’t get it any more because its off patent so there isn’t enough money to be made – that is why the existing system sucks and we need people to work with psychiatry to provide the best solutions we can get, not those which deliver the biggest profits
All the best
Hi Richard,
Sorry if I missed your favourite antipsychiatrist but the article was already running way over. (He’s mentioned in this article though, FYI: http://www.currentpsychiatry.com/article_pages.asp?aid=10076 )
I do agree, and others have mentioned, the problem with binary language – black and white. (Of course, I didn’t choose the language.) But I consider the opposite of antipsychiatry not to be pro-psychiatry – which I don’t think really exists – but simply psychiatry. Antipsychiatrists were the ones who chose to be against something, it doesn’t mean the rest of us are de facto “for” it, simply that we are not against it.
I’m not a fan of Whitaker, but that’s me.
Well, I don’t know about Americans, but I’ve had lithium prescribed to me several times (including in the US). I agree, it still has some of the most powerful effects for bipolar disorder but as it has many side effects, it really isn’t for everyone.
– Natasha Tracy
Dear Mr. Saville-Smith
“BTW my psychiatrist tells me that Lithium is still THE BEST drug for bipolar but that you Americans don’t get it any more because its off patent so there isn’t enough money to be made – that is why the existing system sucks and we need people to work with psychiatry to provide the best solutions we can get, not those which deliver the biggest profits” — Richard Saville-Smith
To the contrary, Lithium is readily available in the U.S.
I’d also like to report that from my many years as a support person and health care advocate for my spouse and others that “THE BEST” medication(s) and/or therapy(ies) is the one which works for the individual. In my spouse’s case history Lithium along with a long list of the pharmacopeia were refractory.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com
My view: Me, I’m pro-psychiatry and anti- the bad bits, as I am anti any bad bits in any medical endevour. But there is no area of medicine that is without weakness because knowledge is incomplete in most, if not all, areas. I suppose the fundamental weakness of psychiatry at this time is that the treatment of mental illness is still, as my GP puts it, as much an art as a science because one cannot tell without a trial period if a particular course of medication, or dosage of it, will have the desired effect on a patient: Some experimentation is often required before swinging moods may be tamed. But this area of criticism does not seem to be levied else where even though your average MD/GP (mine included!) is not careful to match the best antibiotic against a bacterial infection that you may contract: S/he dips into their “tool box” of different antibiotics, prescribes one and ‘hopes’ that will work. If it doesn’t they prescribe another. It is no different with psychiatrists: They too have a “tool box” of drugs they know from their own practice, from that of peers and from trials, often work with certain conditions, and they also know they really do work better than placebos whatever the doubters, with their dodgy research samples, claim to the contrary. But that will get better as our understanding of mental illness improves. Current research into Bipolar Disorder is turning up fascinating finds about the genetic factors, which are much more complicated than it first appeared, and then the environmental impacts, and co-morbidity factors have yet to be fully understood in the roles they play as triggers to Bipolar Disorder. One line of inquiry at the moment is in trying to match the genetic factors against the different symptoms of Bipolar Disorder, although we ought not to presume this will lead us directly to a magic bullet; but such knowledge is bound to help narrow down the best treatments eventually and to suit the patients. However, I do have a very personal beef with anti-psychiatry … I am a Bipolar with a wife who doesn’t even believe Bipolar Disorder exists, let alone that it needs treating – try living with that for 5 years!
Hi Graham,
You make an excellent point. While more guess-and-checking is needed with, say, antidepressants, normally, the same strategy is used throughout medicine. If you don’t respond to radiation, they do chemo, because no one knows to what an individual will respond. That really underscores the importance of having a quality doctor.
Thanks for the comment,
– Natasha Tracy
weak, apologist article — have you read “anatomy of an epidemic” by robert whitaker? it contradicts much of what you write here and he is being given kudos by more and more and more psychiatrists themselves!
I’m sorry, but your “history” bears only a passing resemblance to reality. You really have no idea what you’re talking about, what we believe and why, and what the history of our movement is.
Then enlighten us.
Dear Ms. Goldman,
I do agree with Graham, so please enlighten me as well.
Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com