An article in Psychiatric Services that asserts “a renewed yet amorphous critique of psychiatry is emerging, even though the tarnished name of antipsychiatry is studiously avoided by all. This critique may intensify, given the likely media and public interest surrounding the upcoming release of DSM-5.”
Whitley, R., The Antipsychiatry Movement: Dead, Diminishing, or Developing? Psychiatric Services 2012; doi: 10.1176/appi.ps.201100484
From the article:
The term “antipsychiatry” originated in the 1960s to describe a broad-based movement that questioned the legitimacy of standard psychiatric theory and practice. The movement specifically challenged the validity of psychiatric categories, diagnostic practices, and common forms of treat- ment.
The antipsychiatry movement was motivated by anger at the perceived arbitrariness of psychiatric diagnostic practice as well as outrage at the apparent inhumanity of certain treatments, such as electroconvulsive therapy and long-term involuntary hospitalization. Specific parts of the critique propelled reform, including rapid deinstitutionalization and attempts to improve the codification and reliability of psychiatric categories and diagnostic practices embodied in DSM-III and standardized clinical interviews.
Nevertheless, mainstream psychiatry — the body of accredited personnel working in psychiatry and the common practices, treatments, theories, and categorizations they employ — rejected the underlying critique that psychiatry was little more than a pseudoscientific agent of social control. Mainstream psychiatry perpetuated its theories and practices in officially endorsed training programs, educational curriculums, diagnostic manuals, and professional journals sanctioned by the American Psychiatric Association and other organizations.
Together, the various disparate activities depicted in this Open Forum characterize a surge in critical thinking regarding mainstream psychiatry. Critics express widespread concern at certain aspects of mainstream psychiatry, commonly demanding significant reform in several domains. Most notably, this concern focuses on psychiatry’s expansionist — some would say medicalizing or imperializing — tendencies as well as its heavy reliance on pharmacological interventions and the many adverse side effects associated with them.
The reliance on medications is also criticized because of the shadowy re- lationship that is perceived to exist between psychiatry and the phar- maceutical industry. This meta-observation has been shared by others outside the discipline, notably the physician Marcia Angell, a former editor of the New England Journal of Medicine, in supportive reviews of books by Whitaker, Carlat, and Kirsch.
The upcoming release of DSM-5 will garner much media exposure and popular interest in psychiatry. This attention may act as a clarion call for the consolidation of the disparate islands of activity that are variously critical of mainstream psychiatry. Though the tarnished name of anti- psychiatry is studiously avoided by all, a renewed yet amorphous critique of psychiatry may be developing that is quite distinct from its supposed successor, the patient-based consumer movement. Although not a resurrection of antipsychiatry per se, the critiques described earlier, while not yet a movement, share many of the original concerns raised by the antipsychiatry movement. Perhaps Rissmiller and Rissmiller were premature in announcing antipsychiatry’s transmogrification. Only time will tell.