Anti-psychiatry
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Beginning in the 1960s, a movement called anti-psychiatry claimed that psychiatric patients do not necessarily have a 'mental illness', but in fact are individuals who do not ascribe to the same conventional belief system, or consensus reality, shared by most people in their particular culture. Adherents of this movement sometimes refer to "the myth of mental illness", after Dr. Thomas Szasz's controversial book, The Myth of Mental Illness.
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Origins of anti-psychiatry
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The term 'anti-psychiatry' was first used by David Cooper in 1967, though opposition to either psychiatry in general, or its practices, predates this coinage; surrealism's opposition to psychiatry predates it by decades. R. D. Laing, a psychiatrist, has been very influential; another psychiatrist, Thomas Szasz, is equally important, but he rejects the label 'anti-psychiatry' based on several disagreements with Laing's approach. Other critics of psychiatry often associated with the anti-psychiatry movement include Dr. Peter Breggin, Dr. Elliott Valenstein, Bruce Levine, Douglas C. Smith and Jeffrey Moussaieff Masson, a psychoanalyst who uncovered evidence Sigmund Freud had suppressed observations of child sexual abuse. Many anti-psychiatrists put terms such as 'mental patient' in quotation marks to show their rejection of, or ambivalence toward, the terminology of conventional psychiatry. Also, some new age religions, such as Scientology, believe psychiatry is harmful to spirituality. Psychiatrists have said that Scientology only opposes psychiatry because new age methods for treating mental illness, such as Dianetics, are ineffective.
Libertarianism has opposed psychiatry or abuses of psychiatry on constitutional or other legal grounds. Among other popular movements against psychiatry are: the Psychiatric survivors movement (including such groups as MindFreedom and International Center for the Study of Psychiatry and Psychology); persons charged with abuse based on repressed memories; political prisoners of totalitarian regimes; believers in a range of anti-realist ideas including the theory of reality enforcement; and certain documenters of the Nazi holocaust. The United States Libertarian Party can also be associated with anti-psychiatry as it has opposed involuntary commitment in its platform.[1] (http://www.lp.org/issues/platform/platform_all.html) Anti-realists have argued that the definition of a "lack of capacity to recognize reality," both clinically and legally, constitutes or could constitute a direct attack on their ideas. Holocaust documenters point out that medicalization of social problems and systematic euthanasia of people in German mental institutions in the 1930s provided the institutional, procedural, and doctrinal origins of racial mass murder of the 1940s. The Nuremberg Trials convicted a number of physicians, mostly psychiatrists, who held key positions in both eras of Nazi murder, providing further overlap between psychiatry and oppression, according to Szasz and others. A sermon against the earlier practice by Bishop August Clemens Graf von Galen of Münster delivered on August 3, 1941, is credited with inspiring a group of young medical students to publish anti-Hitler pamphlets in 1942 and 1943, in the name of White Rose.
Cooper, who coined the word, was a Marxist, many Marxists oppose contemporary psychiatry, but the anti-psychiatry movement is by no means homogenous ideologically, and Szasz approached psychiatry's problems from a libertarian perspective, by arguing any form of socialism would lead to more medicalization and the strengthening of psychiatry.
Most, if not all, antipsychiatrists oppose inhumane treatment of mental patients (or even their status as 'mental patients' in the first place), either through the damaging effects of long-term institutionalization or the use of specific interventions given without informed consent. Electroconvulsive therapy, or ECT, has been used to sedate and punish difficult psychiatric patients, rather than for therapeutic purposes, and even some psychiatrists oppose ECT based on studies of its safety and effectiveness. Others, such as Szasz and Breggin, contend even accepted therapeutic practices remain instruments of social control. Punitive use of 'treatment', including ECT, isolation, and restraint has diminished, but is still widely documented.
There has been a resurgence of ECT research and treatment in the past decade, for treatment of a wide range of mental illnesses including severe depression, but many things about ECT are still poorly understood, including exactly how ECT works, and opponents of the practice allege that ECT causes brain damage and has killed several patients on whom it was used, some without their consent.
Observation of the abuses of psychiatry in the Soviet Union also led to questioning of the validity of the practice of psychiatry in the West. In particular, the diagnosis of political dissidents in the Russian Soviet Federated Socialist Republic with sluggishly progressing schizophrenia, led some to question the existence of schizophrenia. To a lesser extent, psychiatry is used as a coercive arm of various groups in the United States against dissidents and whistleblowers today [2] (http://www.veteransforcommonsense.org/?Page=Article&ID=2925).
Some, such as Szasz and Breggin, argue the body of information making up the discipline consists mostly of vague and non-falsifiable hypotheses, or, worse, hypotheses not testable without resorting to unconscionable and inhumane experiments on human beings. The indeterminacy of psychiatric diagnoses make it useful as a mechanism of social control, according to these authors.
During the 1970s, the anti-psychiatry movement acquired sufficient respectability to advocate and effect restraint from many of the worst psychiatric abuses. Jurists such as David Bazelon brought legal force and stature to anti-psychiatry sentiments. Still, in the modern therapeutic culture, often reliant upon pharmaceuticals as an important part of psychotherapy, those who question the ethics and efficacy of psychiatric practice in general remain outside the mainstream.
Arguments against anti-psychiatry
The reputed discovery of evidence suggestive of biological and genetic bases, for a limited number of the wide range of conventionally accepted mental illnesses (see DSM IV), may be eroding support for the claim, widespread within the anti-psychiatric movement, that mental illness is more a social label than a biological disorder.
Anthropological studies have been interpreted as suggesting roughly equivalent percentages of people in a variety of cultures, some very different to modern Western culture, develop a disease recognized by that culture as such, with symptoms similar to schizophrenia; subsequent medical examination of such afflicted individuals has shown certain physical abnormalities consistent with those evidenced in schizophrenics.
However, the lower rates of diagnosis for the forms of schizophrenia accepted in Western Europe than in the United States have led some to question the criteria for diagnosis, and even speculate that in some cases schizophrenia is deliberately misdiagnosed in the United States as a means of political or philosophical repression or as the result of increasing pharmaceutical industry marketing influence upon mental health professionals. DSM-IV-TR also notes that there is "a far higher incidence [of schizophrenia] for second generation African Caribbeans living in the United Kingdom."
The form of treatment also may vary according to criteria that some find suspect; young African American males in the United States are disproportionately prescribed high doses of 'anti-psychotic' medication, and African Americans are disproportionately subjected to involuntary commitment.
Many people diagnosed with a mental illness or illnesses - and many of those who have family members or close friends who have been diagnosed with mental illness - find the views of the anti-psychiatry movement contrary to their own experience with mental illness. They believe the very real and terrible suffering produced by mental illnesses have been effectively relieved by psychiatry and social treatment programs. One of their strongest advocates is Dr. E. Fuller Torrey. Torrey maintains psychiatry diagnoses 'normal' people. He also believes in the forcible medication and confinement of those he believes have genuine neurological problems.
As Thomas Szasz points out, one of implications of the argument that mental illness does not exist is the insanity defense would thus be abolished. He insists someone who has killed someone under the influence of psychosis should be fully criminally responsible for his actions. This position is regarded as inhumane by many people. However, despite perceptions caused by sensationalist news stories, most people with psychiatric labels suffer violence by others more than they commit violence.
Institutionalization and coercive treatment
Some who are active in anti-psychiatry have not challenged the illness of psychiatric patients, but have instead merely challenged the practice of involuntary commitment from a legal or civil liberties perspective. Many people argue that, even if it is sometimes necessary to detain a few people with extreme mental illnesses behind bars, society is far too eager to utilize psychotropic medication treatments, often coercively (see Sally Satel, or lock up people with minor mental illnesses (see New Freedom Commission on Mental Health). The growing practice in the U.K., and elsewhere, of 'care in the community' was instituted partly in response to such concerns. On June 22, 1999, the United States Supreme Court ruled in Olmstead v. L.C., against unnecessary confinement of people with disabilities, including the mentally ill, in institutions. However, in the United States, 42 States have now passed legislation allowing court-ordered involuntary treatment of outpatients with psychiatric drugs (see outpatient commitment).
A number of individuals and advocacy groups have criticized certain State statutes in the US providing for involuntary commitment, as unconstitutional violations of the First, Fourth or Fifth Amendments (however, there have been court rulings that the Fifth Amendment is not applicable to these cases). They argue that, in those cases in which the statements or writings of the individual examined by a psychiatrist - who will possibly be certified as being in need of treatment - forms the basis for the diagnosis, then the deprivation of liberty which will result (if the individual is so found) will actually be a result of his speech or writing, and testimony taken while in custody, would therefore be in violation of the United States Constitution.
State of modern-day psychiatry
A major area of concern to critics of modern psychiatry is that of over-diagnosis, facilitated by the escalating use of medical algorithms and evidence-based medicine (see Texas Medication Algorithm Project). Again, while some advocates argue that, while serious mental illness does exist, currently far too many people are diagnosed as mentally ill - and sometimes detained involuntarily in mental hospitals - when they are (or their speech or behaviour is) merely different (or said to be different) from the prevailing attitudes of their society. There have been allegations teenagers are particularly susceptible to improper involuntary commitment, and bounty hunters have even been used to take them to private psychiatric hospitals against their will (see Joe Sharkey). The treatment of patients in private psychiatric hospitals, chiefly teenagers, has been the subject of investigations by State attorneys general in the US.
In 1998 Szasz and others staged the Foucault Tribunal on the State of Psychiatry in Berlin (named for the philosopher Michel Foucault, who conceptualized madness in the History of Madness in the Classical Age (1961), and other works, as a social construction enforcing a definition of normality eminently useful to the functioning of power over bodies). This tribunal reached what could be said to be a preordained verdict -- that, among other things, "We demand the abolition of the mental patients laws as a first step toward making psychiatry accountable to society."
Many of the premises of anti-psychiatry have been adopted by psychologists working to treat mental disorders without medication, including sexual addiction counselor, Joe Zychik and David Keirsey, a clinical therapist and author of several books on temperament traits.
One organization often confused with the anti-psychiatry movement is the Citizens Commission on Human Rights (CCHR), founded in 1969 by the Church of Scientology and Dr. Thomas Szasz, who has since disavowed any further association with CCHR and Scientology. Scientology has used its considerable financial resources, funneled through CCHR, to wage media campaigns against various psychiatrists, psychiatric organizations, and pharmaceutical companies (especially Eli Lilly). Dr. Breggin and other prominent figures and organizations in the anti-psychiatry movement have emphatically denounced efforts to associate them with Scientology, from which they are completely independent and, often as not, vehemently opposed. The prominence of Dr. Szasz - a co-founder of the CCHR - within the anti-psychiatry movement adds to this confusion.
One controversial offshoot of the anti-Psychiatry movement is the Pro-ana movement, whose members argue anorexia nervosa is an alternative lifestyle rather than a disorder.
See also
- Bruce Levine
- Chemical imbalance theory
- Douglas C. Smith
- Elliott Valenstein
- ICSPP
- Joe Sharkey
- Peter Breggin
- Political psychiatry
- Psychiatric abuses
External links
Psychiatry media reports and opinion
- BBC.co.uk (http://www.bbc.co.uk/bbcfour/documentaries/features/century_of_the_self.shtml) 'The Century of the Self', BBC documentary (explores Freud family role in fostering the "rise of the self", from Sigmund Freud, to Anna Freud, to Edward Bernays and to Matthew Freud)
- AntiPsychiatry.org (http://www.antipsychiatry.org/schizoph.htm) 'Schizophrenia: a nonexistent disease', Lawrence Stevens, JD
- Mother Jones (http://www.motherjones.com/news/feature/2005/05/medicating_aliah.html) Medicating Aliah, 'When state mental health officials fall under the influence of Big Pharma, the burden falls on captive patients. Like this 13-year-old girl.'
- Oikos.org (http://www.oikos.org/antipsicen.htm) - The Dark Side of Psychiatry
- ZMagSite.org (http://zmagsite.org/May2004/levine0504.html) - 'Eli Lilly, Zyprexa, and the Bush Family: The diseasing of our malaise', Bruce Levine (May, 2004)
- Tripod.com (http://samvak.tripod.com/mentalillness.html) - 'The Myth of Mental Illness', Dr. Sam Vaknin
- UEA.ac.uk (http://www.uea.ac.uk/~wp276/define.htm) - 'What was Anti-Psychiatry?' (article critical of psychiatry)
- UKY.edu (http://www.uky.edu/~cperring/PPB2.HTM#Antipsychiatry) - Philosophy of Psychiatry Bibliography
Sites dedicated to prominent figures
- Breggin.com (http://www.breggin.com/) - Homepage of Peter Breggin
- LaingSociety.org (http://laingsociety.org) - The Society for Laingian Studies
- PsychLaws.org (http://www.psychlaws.org/PressRoom/Bio1.htm) - E. Fuller Torrey, MD (biographical summary)
- Szasz.com (http://www.szasz.com) - The Thomas S. Szasz, MD, Cybercenter for Liberty and Responsivility
Organizations critical of psychiatry
- AdBusters.org (http://adbusters.org) - Prozac Spotlight
- AHRP.org (http://www.ahrp.org/) - Alliance for Human Research Protection
- AntiPsychiatry.org (http://www.antipsychiatry.org) - The Antipsychiatry Coalition
- CCHR.org (http://www.cchr.org) - Citizens Commission on Human Rights
- GIDReform.org (http://www.gidreform.org/) - Gender Identity Disorder Reform Advocates (opposes psychiatric classifications of transgendered people)
- IAAPA.ch (http://www.iaapa.ch/) - International Association Against Psychiatric Assault
- ICSPP.org (http://www.icspp.org/) - International Center for the Study of Psychiatry and Psychology
- MindFreedom.org (http://www.mindfreedom.org) - Support Coalition International (a coalition of groups supporting "United Action for Human Rights in Mental Health")
- PsychRights.org (http://psychrights.org/index.htm) - Law Project for Psychiatric Rights
Psychiatric advocacy organization
- NAMI.org (http://www.nami.org) - National Alliance for the Mentally Illde:Antipsychiatrie