Antipsychiatry, (Ex)consumers, Peers, and ‘This Movement’: Assembling the Histories of Reform and Resistance, Part 1

Derek Pyle
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What unites antipsychiatry, psychiatric survivors, peers, consumers,
(ex)patient/service user, voice hearers, and the recovery movement?

Within the communities that surround Mad in America one is likely to hear reference to ‘the movement.’ The basic meaning of this phrase seems clear enough. The movement broadly refers to the groups of people actively rethinking the mental health system, and the treatment of persons labeled as mentally ill, in the United States and abroad. Upon further inspection, however, we realize that there is no centralized ethos uniting these groups. There may be consensus that the current mental health models are troublesome, but within each subset of ‘the movement’ there are many different perspectives about such troubles’ causes and solutions.

In recent years many articles and books have been published, and many conferences held, outlining various problems facing the mental health system in this country. Each person speaking out seems to have their own solution to these problems. There does not appear, however, to be any work that outlines, compares, and synthesizes the broad array of what we call ‘the movement,’ as a whole, with all its the varying proposed solutions, perspectives, and reform initiatives.

In this forthcoming blog series, my aim is to outline the history of this diverse movement. This is, in part, a project collecting bits and pieces to make a map that is less scattered. I intend to interview those members of the movement who have emerged as leaders, but my hope is that this will be a much more collaborative effort. As a digital community, Mad in America already connects many of the people who actually compromise this movement. By way of comments, emails — and who knows what else — I hope readers will also become contributors, offering necessary pieces in patching together these histories.

But in such a survey, what histories are to be included? I will focus on the history of the United States. This will allow me to research primarily within my native language, and within the geographic, cultural, and political regions with which I am most familiar. At a glance I am concerned with the history of those who would work to change the mental health system. The mental health system includes institutional, residential, community-based as well private individualized care, as affected by the disparate domains of psychiatry, pharmacology, psychology, social work, social services, and the penal system. Part of the movement may also be concerned with addressing individual, familial and societal aspects of ‘mental illness’—advocating for pluralistic acceptance of mental differences; combating stigma and stereotypes; addressing societal causes of distress and marginalization—and certainly such work also deserves attention.

Who is to be considered in this history, and for what work? The concept of peers, survivors, and consumers may lead us to focus solely on those who have once sought help from, or perhaps were unwillingly subjected to, the system. Yet a history of this movement focusing solely on ‘peers’ leaves out the important albeit controversial legacies of people like Thomas Szasz and Dorothea Dix. Whether psychiatric survivor groups would willing associate themselves with Dix is another question.

In a history of resistance and reform, I propose focusing on these two categories of people. Those whom, having been recipients and subjects of the mental health treatment, become involved in the treatment of mental illness. This would include not only those individuals who are primarily concerned with critique of the system, but everyone who advocated from the perspective of personal experience. By this standard, the “peer” model of Alcoholics Anonymous would be worthy of historical inclusion, as would consumer advocate groups that do not explicitly question the status quo of mental health treatment. While inclusion of such “non-radical” groups might seem egregious to some, I do not want this history to become fodder for ideological battles amidst various groups.

The second group to be included in this history is those who are inspired to change or dismantle the mental health system due to significant criticisms. It is natural that the fields of psychology, psychiatry, and social services change over time, for many different reasons. These changes often involve intense debate and criticism, but to include all such forerunners of change would render the theme of ‘resistance and reform’ meaningless. Psychotherapy in the United States, for example, has significant roots in hypnotism and although inspired by individual who sought to provide better treatment for mental illness, the innovations that brought about psychotherapy in lieu of hypnotism will not be considered here. Nonetheless, in these early posts involving history prior to the 1900s, I focus in detail on the origins of our mental health system. This seems necessary to understanding subsequent resistance and reform but as opposed to the numerous works focusing on the history of ‘the system,’ my overall emphasis is on resistance and reform.

The labels of mental illness and mental disorder are currently receiving widespread scrutiny. In the U.S., critical discussions of insanity, mental illness and disorder, trauma, and lived experience take place, or divest from, specific frameworks of psychiatric and psychological theory, but throughout human history, there have been many ways of conceptualizing and relating to distress. The history of human distress treatments that have never been subsumed under the guise of mental illness will not be considered here, as they do not pertain to the topic at hand: Catholicism, for example, presents an entirely different way of understanding human distress and its treatment (distress is caused of original and moral sin; relief is provided by pious life and priestly absolution). I do not wish to assume that Catholicism was just a primitive way of thinking about psychology; such disparate frameworks may not be comparable at all, and I wish to avoid presentist history. Scientology’s religious framework for treating human distress, on the other hand, is inextricably defined through its relationship to psychiatry (defined as “not psychiatry”). As such, it is a specific attempt to move away from pathologizing, and as such is to be included in the present history.

I begin now by outlining the specific groups and histories that seem, at present, most notable. Whatever I leave out, I hope, you will inform me. Once an outline is established of those individuals and groups that have been most influential, my future blog posts will explore these specific histories in more depth. I begin by reviewing this country’s early history, drawing extensively on Gerald Grob’s Mental Institutions in America and Mental Illness and American Society, texts recommended to me by George Makari.

A note: my language and word choice reflects a combination of past as well as present worldviews; when I employ a phrase like the ‘indigent insane,’ for example, this is not reflective of my personal lexicon but rather I intend to illustrate how language worked in the past. My reference to the treatment of mental illness is a pun: while referring to the ways in which we have conceived of helping those labeled as mentally ill (treatment), I refer also the way we as a society have dealt with such persons (to treat a person, well or poorly).

I do not know whether far-reaching and systematized forms of treatment for those deemed mentally ill existed before colonization of the land now called the United States. Likely the first immigrants to this land came across the Bering Strait, along the land and ice bridge that once connected Eurasia and present-day Alaska; the Paleoamericans arrived during the Late Pleistocene era, and migrated south from there some 18,000 years ago. In the subsequent millennia, the various regions now called the “United States” were populated by many different peoples. Thus if we were to truly assess the history of this geographical region, we would begin with the histories of the Clovis culture, the Folsom complex, Na-Dené-speaking peoples, Athabascan-speaking peoples, Poverty Point culture, peoples of the Woodland period, Hohokam culture, and the Mississippian culture. Whether any of these peoples considered ‘mental illness’ or its ‘treatment’ in ways that are comparable to our present day conceptions, I do not know. A truly thoroughgoing history of ‘madness in America,’ however, would have to start by asking these questions. Although our mental health system was created predominately within urban areas on the eastern half of the country, a complete history would also need to examine what regionally-bound conceptions and treatments may have been in place contemporaneously, amongst indigenous populations, in the Spanish missions, in the rural South, and along the so-called American frontier.

In colonial America mental illness was not considered a widespread problem. People unable to provide for themselves due to poverty, illness, old age, orphanage or insanity were taken care of either by family members or the community. Caring for the insane generally did not involve any kind of psychological treatment; the chief problem was that as a whole dependents persons were not able to work, and there could not provide for themselves. Community support was a matter of social custom, but also a dictate of poor laws. These laws were carried over from England. Widespread poverty was by no means a novel phenomenon in England, but as rural populations changed into centralized townships during the 14th century development of commerce and money currency, new kinds of poverty emerged amidst urbanity, and poor laws developed to dictate how townships should respond. Urbanity was not yet a problem, however, in 17th century colonial America. Populations were still small, and the numbers of dependents were accordingly few. As townships grew in the 18th century, colonies adopted almshouses. In the absence of widespread regulation, living conditions and care within poorhouses varied widely. As in England, almshouses indiscriminately housed orphans, the sick, the elderly, and the insane; growing concern about this would give rise to the creation of hospitals specifically designed for the insane, especially in the mid-198h century.

As general population grew along with the numbers of insane persons, townships became increasingly concerned with the derelict influence of insane persons and actual as well as perceived threats of danger. Determining who should be confined was generally viewed from the perspective of safeguarding the community, not the individual. Some “madhouses” confined furiously insane persons within their rooms, and by the end of the 18th century townships also began imprisoning their insane persons.

There were also efforts to differentiate between idiots and distracted persons, as opposed to lunatics and the furiously mad. Early America was also a place of widespread religious beliefs, and sometimes distressed individuals were seen as suffering from spiritual afflictions (like demonic possession). People could be persecuted because of their perceived or actual religious beliefs and powers, as in the case of witchtrials. Whether there were any early social reformers who sought to view religious afflictions not as a matter of spirit, but relating to insane mind, I do not know. Certainly these people, if they even existed, would be of historical importance.

In the 1750s, hospitals began to open in the States’ growing urban areas. Seen as necessary to address the new concentrations of urban dependents, early hospitals were funded by private philanthropists but with the intention of treating everyone—paying as well as nonpaying patients. While some hospitals focused at least in part on caring for insane persons, all early hospitals were small, admitting perhaps a hundred patients per year—twenty of which might be insane. Such a small scale was consistent with the small size of contemporary urban populations; in 1800, a city with more than 10,000 residents was very rare.

For the first hundred years individual hospitals were not unified by any overarching ethos, regulation, or theories of treatment. They existed primarily in isolation, and did not affect widespread social change regarding treatment or public opinion of insanity. Early hospitals attempted to provide treatment for insanity, as opposed to almshouses which typically provided custodial services, and confinement. Bleeding, diet, the use of purgative drugs like mercury, hydrotherapy, physical restraint and sensory deprivation were all employed as forms treatment.

How are we to view such “treatments” in the present? For the moment my thought is brief: while it is certainly possible that some hospital staff sadistically enjoyed administering such treatments, one must also remember that such practices were the common medical treatments of the day, administered in cases of physical and mental illness alike.

By 1800 there were 16 ratified States in the Union and the constitutional republic’s centralized government was only eleven years old. Although differentiation was beginning, insane persons were still largely regarded within the generalized conglomerate of dependent persons. Communities were, however, beginning to discriminate between idiots and distracted persons as compared to lunatics and the furiously mad, and as separate from other kinds of dependents. Although the former group was unable to work and therefore needed support, they were not perceived as a threat to the larger community. If such persons had family, they would be cared for by their family; if not, they would seek support from an almshouse. The latter group was considered dangerous and confined accordingly in almshouses and jails, and later hospitals. When towns had a hospital, insane persons might seek treatment there. As income allowed, some people would pay for their family member’s hospital stay; paying patients helped fund the hospitals, which in turn provided care for non-paying patients. Hospitals believed in the prospect recovery, and provided contemporary medical treatment—many persons were deemed “recovered” and released, although others were not. Unlike in Europe, history does not seem to report many widespread critics of the United States mental health system prior to the 19th century, because systematization did not yet exist. There would be many critiques, however, in the decades to come.

37 COMMENTS

  1. “Yet a history of this movement focusing solely on ‘peers’ leaves out the important albeit controversial legacies of people like Thomas Szasz and Dorothea Dix. ”

    There is a lot of controversy – People who acknowledge mental illness is real & who want proper care & treatment of the mentally ill, especially for those more severely effected. i have chatted to many people who decry the closing of the Asylums & past 50 years or so of the direction things have been headed in. Many people i think considered the Asylums a generally good thing & de-institutionalisation as generally bad, mental patients & the general public alike.

    You have those that acknowledge that mental illness/distress is real, & who want genuine social reform & change to far better systems of treatments & care – usually centred around far more holistic & comprehensive psychological & social support approaches.

    Then you have the Szasz’esque camp & the illness deniers – the extreme libertarians.

    Are these position in any way mutually compatible? i’m not sure that they are nor can be? There is a lot of anger, frustration & blame it seems from all sides.

    You point out the complex history of mental health treatment – ‘anti-psychiatry’ is also a very complex subject/area.

    “Communities were, however, beginning to discriminate between idiots and distracted persons as compared to lunatics and the furiously mad, and as separate from other kinds of dependents. Although the former group was unable to work and therefore needed support, they were not perceived as a threat to the larger community. If such persons had family, they would be cared for by their family; if not, they would seek support from an almshouse.

    The latter group was considered dangerous and confined accordingly in almshouses and jails, and later hospitals. When towns had a hospital, insane persons might seek treatment there.”

    Seems to have returned to all that? Instead of hospitals it’s prisons that currently house the severely mentally ill.

    For all it can be criticised for, the severely mentally ill were likely far better off under the old Asylum system than how things are currently, in the US & UK.

    How to actualise a genuinely effective, fair, & humane treatment of the mentally ill? i have yet to hear anyone say how? Let alone how to implement such a solution?

    i have asked how people expect to change the current system? Still No genuine answer.

    • “You have those that acknowledge that mental illness/distress is real, & who want genuine social reform & change to far better systems of treatments & care – usually centred around far more holistic & comprehensive psychological & social support approaches.

      Then you have the Szasz’esque camp & the illness deniers – the extreme libertarians.”

      This is a blatantly false dichotomy. The myth of mental illness is so strong now that those who dare to expose the myth for what it is are labeled as “illness deniers” and “extreme libertarians.”

      Why don’t we just start with the simple question: “What is mental illness?” As soon as someone can answer that question, then we can start to think about writing a book on the topic. Until then, we are just building a house of cards on a foundation of sand inspired by a mythological idea.

      • “This is a blatantly false dichotomy. The myth of mental illness is so strong now that those who dare to expose the myth for what it is are labeled as “illness deniers” and “extreme libertarians.””

        From 30 years of experience & careful research; i think it’s quite accurate. You deny mental illness exists – what is it then?

        “Why don’t we just start with the simple question: “What is mental illness?” As soon as someone can answer that question, then we can start to think about writing a book on the topic. Until then, we are just building a house of cards on a foundation of sand inspired by a mythological idea.”

        i suppose what causes psychological/emotional distress & loss of functioning? Of course it’s very hard to define what it is – it’s dealing with the psyche, primarily. i have my own ideas in my own case – along integral lines – But it would take a book to try & explain it all, one i want to write – But many would still disagree.

        i really don’t think Szasz was any kind of an authority on these matters (yes i have read/studied him), i disagree with him (as many do), & as i’ve said before – he has been largely very well refuted (imo). Jung & Laing i can truck with more – they incidentally didn’t deny the existence/reality of mental illness.

        • There is a difference between denying that the current conception of “mental illnesses” as discrete categories defined by the APA in the DSM and having assumed biological underpinnings that are similar for all sufferers and denying that the phenomenon of “mental illness” exists. Szaz never denied that people suffered depression or hallucinations or such things, he merely pointed out that you can’t assume that someone has a physiological illness based only on psychological symptoms. It’s a position I can readily agree with, and yet I have worked as a “mental health professional” for many years and believe that quality psychotherapy is a godsend to those who are able to process their experiences in that fashion.

          Most “mental illness” is the result of people’s reaction to stress and trauma in their lives, current and historical, and “mental illness” is itself clearly socially defined and mediated by assumptions of what is “normal” (see the DSM categories for proof of this). It makes little to no sense to me to take what is so clearly a social phenomenon and deny or minimize the social contributions to it, as psychiatry has done. Again, these things do occur, but I don’t view them as essentially medical problems, even though medical issues can contribute to them. I think that is what most “antipsychiatry” activists believe as well. So the dichotomy is not accurate to me, and I think I have answered your question of “what is it, then?”

          — Steve

          • I’ll jump into this fray and first thank you all for continuing to engage on this topic. The more civil discussion and attempts at understanding other points of view, the better.

            A couple comments:
            1) mental health issues, to me, is something that a person decides or decides not to identify with (person centered)
            2) one is not defined by any system of care. A system of care provides options to any person that may care for the options
            3) the DSM, is, well, malarchy – my cat writes better more coherent abstracts

            I wish us luck in the years to come from working with the radical left to the ultra-conservative right. We have as many shades of gray in our MH politics as we do in our general politics – if not more.

            If research and / or a paper is going to be done here – I encourage you, respectfully, to see where we can find common ground between the groups just mentioned. Even on items such as ECT, in the USA, we are very much divided – – the most common ground I have found is banning Involuntary ECT and letting Voluntary ECT stand. A somewhat Constitutional / Bill of Rights approach. If one believes in that sort of thing along with Democracy.

            Cheers.

          • But a bit more then just the physio-/psycho- treatment implications follow, Steve. All of the question of cognizance and self-determination stems from the basic fact of how behavioral and linguistic criteria matter to the judgment of who is some “truly” mentally ill person. You might really like seeing how this program is defended, finally, and less equivocally than Szasz himself pursued it:

            http://www.hannapickard.com/responsibility-without-blame.html

        • “You deny mental illness exists – what is it then?”

          You claim that mental illness exists. What is it? You see, it is hard to define a myth.

          Mental illness exists in a way comparable to the existence of Bigfoot, the Abominable Snowman, or the Loch ness monster. The myths are so powerful that people believe them without examining the substance. You may claim to have seen Bigfoot, the Abominable Snowman, or the Loch ness monster, but please don’t insist that others have to believe you.

          Some will say that they have observed “mental illness”… but what they are observing are behaviors that they find objectionable (often behaviors resulting from the dangerous drugs). There is no medical, scientific entity that can be diagnosed as “mental illness.” As soon as there is any biological problem identified it is no longer “mental,” but an actual illness.

          Do you know how the DSM was created? It’s a work of fiction, and that’s where most every diagnosis comes from. Read Gary Greenberg’s “The Book of Woe.”

          People are free to believe in myths if they wish, but ideas have consequences. The myth of mental illness is the tool of psychiatry, and the “chemical imbalance” is a great marketing weapon in the arsenal of the psychopharmaceutical industrial complex. These lies are bandied about in the name of “medicine,” but not everyone is fooled.

          Of course people suffer with a variety of afflictions, emotional and otherwise. But these symptoms are no more “mental illness” than psychotropic drugs are “medication.” Freud was a fraud. Laing was a pathological liar.

          You can’t really disagree with Szasz until you understand what he was actually saying.

          • Our society is practically all myth. If you believe what you read/hear in the media at all, you are buying into myths. If you vote, you are buying into myths. If you care about what others think, then you are buying into myths. Truth is found in our own lives, not in lives observed. When we believe truth is found in others outside of ourselves, we are buying into myth.

            I think it’s a matter of feeling better and finding clarity about our own lives and selves. What else matters?

    • Cpuusage, I really appreciate your voice here. I agree with a lot of what you say, that there is a lot of denial around issues of ‘mental illness.’ I, myself, use quotations marks around the term when writing about it, simply to acknowledge the ambiguity of it all and respect for the collective.

      Still, personally, I believe it is a tangible concept, and I believe it is more common than not. And yes, there are some that have fallen into the ‘severe’ category, and there is so much controversy around why this would occur with some. I had put myself in that category at one point in my life because the effects of whatever was happening in me were, indeed, severe in the impairment it caused me. There were a few reasons that it got this bad, which I eventually was able to identify and took control of in order to reverse these trends in my own life.

      Now, I put myself in the category of ‘healed,’ and this has caused me more backlash than anything, in the political world of mental health activism. I say I was ill and now I’m well, that’s my truth. Others have shared their opinions of my truth, which of course, is a reflection of them, not me. Although it is irritating when someone tells me about myself in opposition to what I say about myself. That’s what most psychiatric survivors complain about in the first place! I think that’s a bad and very dangerous trend in this ‘mental health’ arena, which has led to an unnecessarily hard life, at best, for so many. When it comes to me, it’s my voice that matters. I’m not looking for approval from others, but alignment with my own truth. That’s how I have ease and clarity in my life now.

      The issue of what is or isn’t ‘mental illness’ is terribly confusing to society, at large, because there are so many personal issues and deeply felt emotions that touch us at our core when attempting to dialogue, or even think about, these issues. Plus, and this is so true in this area, everyone has an opinion about it. That’s probably just, as long as we apply that opinion to ourselves, not to others. That would be false, inherently.

      Clarity would bring a lot of reform, but there are blocks to achieving clarity, here. First of all, denial of real phenomenon does not breed clarity, only further confusion, denial, and avoidance of what is truly relevant. Some of us claim that ‘mental illness’ is something that is real (even though it may be caused by a crazy society) and that it can actually heal. That would be the best outcome, I believe, and many of us are working to get this all out there.

      But again, there is resistance, because it threatens the economics, as well as the carefully guarded social hierarchy created from all these illusions. If we cure and heal what had been considered chronic, then there goes the chronic business and weekly/monthly payments to all those people, right out the window. And again, there are those that say you can’t ‘cure’ something that never existed. Ok, so where does that leave us? I’m not sure that’s a productive approach, that’s more about personal ego than healing and truth.

      Of course, there will always be healing to do and we all need support from time to time in our lives, but when one group of people is chronically dependent on another group for life, then imbalance, oppression, and abuse are guaranteed. I don’t believe this needs to be the case, but it will take a lot of work and introspection to break these bad habits of dependence, because there are deeply ingrained beliefs about this that have spilled into our sense of identity. Frankly, I believe that is all cultural programming. I think we can shift our self-perception, and that is not only healing, it is empowering.

      To me, true reform would be forgetting altogether about what we call it, and focusing 100% on alleviating suffering. When this is opposed and these intentions are undermined, which occurs readily in the status quo—keeping it good and static–that is where the problem comes in. With all these smoke and mirrors amid emerging new perspectives, it can be hard to tell who’s who.

      From all you have expressed on here, you seem to have bottomless courage. I see the evidence of your healing journey, you stand firm in your truth and I see you are so conscious with your process, truly awake, which I so humbly respect. I really appreciate the perspective you bring, from your obviously thorough lived experience. Thank you.

      • Thank you Alex for the kind & intelligent reply.

        “Some of us claim that ‘mental illness’ is something that is real (even though it may be caused by a crazy society) and that it can actually heal. That would be the best outcome, I believe, and many of us are working to get this all out there.”

        i’d agree with this to a large extent – i think there are far better ways of healing, helping & supporting people, & far better ways humanity could be living on the planet – i’m an idealist in that sense, Not a utopian – But i think there are so many ways that everything can be improved.

        i think some people are ill in various ways to different degrees, for various reasons – that it’s individual & complex. i don’t see how it really helps some people to deny illness? i do take the integral/holistic view – bio/psycho/social/spiritual. i think things can cross a range of those areas.

        It isn’t easy – i’m dependent on medication & benefits – i’m Not well enough to work, & doubt i ever will be – i have made a lot of progress, but it’s a massive achievement for me to ‘just’ continue to maintain sobriety & independent living – i am in need of a certain amount of support from the state – my overall functioning, motivation & capacity to cope has been very effected a lot by what i have been through.

        i don’t know what other approaches would have been like? It’s hypothetical – as things stand i need the medication for what stability i have – stopping it i go into a severe catatonic psychosis/illness – have stopped the current medication 3 times with disastrous results – the last time with a 2 year tapered reduction & doing everything ‘by the book’.

        “i think there’s an element of alternative/anti psychiatry thinking that likes to think you are lacking in moral fibre if you can’t think your way out of distress/mental illness.”

        Thanks again Alex for the kind words & reply.

        • “i think there’s an element of alternative/anti psychiatry thinking that likes to think you are lacking in moral fibre if you can’t think your way out of distress/mental illness.”

          This made my heart break a little to read, and I do relate to this, so I felt compelled to respond to this one sentiment. Yes, I know there is a lot of judgment out there and it is painful when we internalize it. I discourage people from taking it on and to stay focused on self-validating, not self-shaming. Where we are in our evolutionary path has nothing to do with our character. If we are even aware that we are some kind of path or journey, then we are awake enough, and will awaken more as we go, from life experience. That’s an advantage, to have that awareness, which I can see that you do.

          Personally, I do feel that there is a way to focus and internally dialogue our way out of distress, even severe distress, but it takes a lot of practice and repetition to break old thought patterns and shift beliefs. I’d call it ‘higher self dialogue,’ something like that.

          It also takes encouragement from others. When we are judged for where we are and how we choose to grow, especially when we know our own story over what others think they know about us, that can be quite disheartening and discouraging. I just say don’t listen to them, and know you are healing, growing, and evolving your way. We all address our issues in order of our path and personal priorities, that’s our individuality. We are diverse.

          • Cpuusage,

            I appreciate your civil tone and clarity in this discussion.

            I really don’t agree that there are significant numbers of people suggesting that you are lacking in moral fiber if you can’t think your way out of a mental illness. I think that particular line is used to distract from the legitimate arguments of psychiatry’s critics, because it throws down the unstated assumption that either you buy into psychiatry’s view of “mental illness” or you are automatically stigmatizing victims and blaming them for not “bucking up.” Those are not the only two viewpoints. It is possible to take the position that life is challenging and that it’s perfectly normal and acceptable, not a moral failing in any sense, to struggle emotionally and mentally with the challenges we face, especially in our crazy modern world. It is my contention, in fact, that the psychiatric labeling process does more to stigmatize sufferers than even the “buck up” message does. There is research showing that people view sufferers more negatively when given a biological explanation for their suffering. I think it is much healthier to identify the source of conflicts between what the person wants or needs to survive and what the world has provided them to date, and to help them start to figure out some new and more effective ways to get their needs met. There is absolutely no criticism in this approach – I generally frame it as what the person has been taught or learned to date has not prepared them for what the world is expecting them to do, and therefore some new learning is in order. I don’t recall anyone ever telling me that they felt I was judging them for not having it all figured out, because I spend a ton of energy normalizing their struggles as part of the challenges of life. To the contrary, most people report feeling very safe with me because they know I do NOT judge them for not “adjusting properly” to the world as it is.

            Psychiatry is actually very much built on the assumption that people should automatically adjust to whatever expectation the world puts on them. For instance, it takes kids who don’t fit in to the standard educational classroom and tells them they have a mental illness and need to take drugs, when research shows that putting them in an open classroom environment, or even waiting a year before starting them in school, can reduce or eliminate the “symptoms” of their “disease.” Talk about stigmatizing! I do NOT expect the child to “buck up” and make it in the standard classroom. I expect the teacher to modify his/her approach or the school to be restructured to meet this child’s actual needs.

            I hope that makes my point clear – being opposed to psychiatry as currently practiced does not equate to “blaming the victim.” I believe most antipsychiatry activists find that it is the larger society that is being let off the hook for first creating unnecessary distress and then putting all the blame on whatever person doesn’t fit into the status quo paradigm.

            —- Steve

    • CpuUsage,

      Have you ever thought about writing a personal op Ed for this site. I’ve came across many of your comments of different threads, and you seem to have a bit of an oppositional view when its comes to this site. I actually enjoy your comments and think you make a lot of sense.. So maybe Robert Whitaker would let you write something, I think it would spark some needed dialogue as it relates to anti-psychiatry vs pro-psychiatry .

      Eitherway,, just my two cents

      Best wishes

      • Thanks – i’m quite willing to write something if Robert agrees – how do i go about it?

        i think we need a far more comprehensive/integrated view – there is a lot of venomous disagreement & polemics within all these areas, & a lot of it is silly – & as much as i admire critical perspectives of psychiatry & alternatives to the current mass drugging – it’s Not some simple solution/subject.

        Am still waiting for an answer as to how “we” change the current system?

        • I agree and I think you have a vital perspective to offer. I’m very interested to hear your story and your perspective about where we might go from here. We’re all still waiting for that answer re how to influence change in the system, if it can be changed at all.

          To me, the question at this time would be: do we have enough faith in ‘alternatives’ and our own personal power to let go of the system altogether and just let it fail and disappear? After all, nothing is permanent, no system lasts forever, and this one right now is on very shaky ground, it may just be something we have to accept. I hope no one is actually trying to save it, I’d have to wonder why, with all we know about it.

          Would something better and more clear and sound emerge in its place, based on some kind of universal principle(s) on which everyone can agree? Who knows? Although plenty exists in the world that is not this.

          I hear you, though, that you need your medication and other support, and I totally respect that of course, no question there for me. I also know that everything evolves and things change as we go along. Although I don’t see anything at all wrong with taking care of yourself, as you are doing. For me, it is your perspective which matters, I feel it is important. What you have to say would more than likely get us that much closer to clarity.

          https://www.madinamerica.com/submitting-personal-stories/

        • It’s like asking how do we change slavery. A lot of people wanted to reform slavery. Why? Because they benefited from it financially and otherwise, even though they understood it was evil and wrong. Slavery was abolished, and I hope most of us will agree that that was a good thing.

          Psychiatry enslaves innocent people, including children and the elderly. It binds them down under a chemical yoke, and the burdens of psychiatric labels. It is a system of oppression. It does not need to be changed. Like slavery, it needs to be abolished.

          • Then perhaps that is our universal theme: freedom.

            Although not all can see the light of freedom. A lot of survival fear surfaces when we are asked to take responsibility for ourselves, and shed dependence on others. Some people are raised to believe they are dependent and will always be.

            Perhaps if people were to be re-educated about their own personal power, given that trauma and dysfunctional environments undermine that relationship with our power, then they would have incentive to not even begin an association with psychiatry in the first place; or if they are already embroiled with it they would be motivated to defect this dubious institution in order to find a better and more sound truth and healing path, which includes their sense of freedom.

            People have to want to be free if they are going to achieve freedom. Otherwise, they are slaves to their own negative self-beliefs. For anything to change, perspectives must change, first. Change outside of us follows internal change.

          • Yes, exactly. Although we are all ignorant until we learn from experience, that’s how we acquire wisdom. I’m always available to offer alternatives or to guide people to them, that’s my work. However, people have to be willing to take in new information, and stretch themselves a bit to consider a perspective which they have yet to experience. I have found this to be very challenging for some people, although not so much for others. Really depends on one’s attitude and openness. Ego/fear can create tons of resistance to learning.

            Takes courage and trust to allow one’s self to be educated, rather than indoctrinated. There’s a big difference, but people often fail to perceive this, due to desperation, and also to false beliefs we’ve taken on.

            True education is where we learn to think for ourselves. When we are desperate, or if we believe that we are, somehow, limited in our ability to self-care and self-guide, then we are more likely to be gullible and easily manipulated into taking on someone else’s reality as ours, which is guaranteed suffering, square peg never fitting into a round hole.

            That’s how I discern between these, in any case.

          • So I guess what I’m saying here is that if ignorance is bondage, then experience is freedom, since we learn from experience. When we allow ourselves to experience every aspect of ourselves and our lives–and there are sooooo many aspects to who we are, we have barely scratched the surface of this exploration–without shame, judgment, or trying to figure out who is at fault for what, and instead, just focus on finding balance and grounding in the present so that we can feel safe to create what we desire, then we are totally and completely free. Wouldn’t that be the opposite of ‘ignorance?’ That level of freedom is a big leap from the bondage to which you refer, so one step at a time, of course…

  2. I applaud your efforts. I think that a discussion of the history of mental illness is complicated because the definition (inclusion criteria) have been broadened to include the entire human race. In the DSM II, depression referred to the dysphoria of those with psychosis who would now be referred to as Bipolar I. With the publication of the DSM III, those with psychotic depression and neurosis were placed into the mood disorders section. Ghaemi’s account, discussed in my book Neuroscience for psychologists and other mental health professionals, clarifies how those with psychosis were merged with common variety dysphoria. Thus, the DSM III became the book which classifies everyone.

    Ironically, in the days of the DSM II, the disorder of Inadequate Personality was represented in the state hospital. It was also discussed in courses on Abnormal Psychology. The disorder is no longer in the DSM. Those with an Inadequate Personality just did not seem to have the drive to take care of themselves. They were perfectly content to be directed by others. I’ve met such individuals. One of my state-hospital patients in the 1960s was labeled “Inadequate Personality Disorder”. Ray was always whistling and happy. He never heard voices. I don’t recall ever seeing him angry. With deinstitutionalization, Ray was kicked out of the hospital. Ray then broke into a building and left a note for the police so that they could pick him up and return him to an institutional setting. Neuroscientists have identified the Ventral Tegmental Area of the brain, an area of high dopamine concentration, as key for motivated behavior. My guess is that Ray suffered from not enough activity in this brain area. He just did not seem to want to do or be anything. He had achieved contentment. I think this is a real big problem for some people, although it the category did get bounced. Perhaps it’s because there is no pharmaceutical to treat it.

  3. “What unites antipsychiatry, psychiatric survivors, peers, consumers, (ex)patient/service user, voice hearers, and the recovery movement?”

    Look. It’s really not that complicated. It’s the age old battle between good and evil, truth and error, right and wrong, liberty and slavery, justice and injustice.

    The history of psychiatry is one of coercion, abuse, manipulation, drugging, torture and murder. If you are opposed to these evils, then you are opposed to psychiatry.

    If you focus only on the history of the United States, you will not understand the roots of psychiatry.

    Much of the history has already been written. The problem is that psychiatrists write a fictitious apologetic history of psychiatry in order to preserve and promote their own profession. The real history is found in books by Robert Whitaker, Thomas Szasz, and to some extent, Michel Foucault.

    The “movement” would be united if people of average intellect, morality and common sense just read the right books, instead of absorbing all of the propaganda and misinformation that is funded by pharmaceutical companies.

    The abolition of slavery was the right thing to do, but it took courage on the part of many people to stand up to the status quo. The same is true of psychiatry. Once all of the lies, justifications, and deceptions are removed, it is easy to see that psychiatry is, and always has been, an evil institution bent on oppressing innocent people.

      • Yep. It’s actually worse than that.

        The problem with psychiatry is that it pretends to be so good, so compassionate, so caring. It is a facade. It just takes a little discernment, a little study to see behind the fake veneer of the mental health industry. It takes a little effort to see through the mental health masquerade. But once you do, once you uncover the lies, the deception, the torture, the murder, and the propaganda, it is plain to see that psychiatry is an evil proportionate to slavery.

        Psychiatry claims to be the “medical treatment” of the soul. From the Greek psyche, and iatros. Think about that for a minute. Can the human soul be treated medically? Can science (or pseudo-science, in the case of psychiatry) or medicine (or pseudo-medicine, in the case of psychiatry) even define, let alone heal, the human soul?

        Of course there are good people who get caught up in the system. The same was true of slavery. The same was true of Naziism and the Holocaust, or of communism. A lot of people, including good people, were duped.

        Of course it can be helpful to talk to people about our problems. But for anyone who sincerely studies the history of psychiatry (the real history, not psychiatric apologetics), will not be able to deny that it is riddled with abusive practices, coercive “treatments,” and horrific methods of drugging and subjugating innocent people. Read Whitaker’s “Mad in America,” or “Anatomy of an Epidemic.” Read Szasz’ “Psychiatry: The Science of Lies.” Read Peter Breggin’s “Toxic Psychiatry” or “Medication Madness.” Whitaker even has a new book coming out. Read that.

        One can also study the other side, the psychiatric apologetics, the histories written to defend psychiatry and cover up the evil deeds. The arc of the moral universe is long, but it bends toward justice.

        Please don’t write anything until you’ve actually read the books that have already been written.

    • “The ‘movement’ would be united if people of average intellect, morality and common sense just read the right books, instead of absorbing all of the propaganda and misinformation that is funded by pharmaceutical companies.” The “right books?” Who decides? Dividing the world into a pro-pharma and anti-pharma camps is not accurate. There are brilliant and honorable people not funded or tied to pharma who are doing serious work that advances our knowledge of mental illness who, to my knowledge, have never been featured on MIA. I do not agree with your larger point as to what it will take for the movement to prevail. It will take more than books that indict the drug paradigm. It will take a meaningful alternative to drugs. It is not enough to curse darkness; we must light candles of drug-free recovery.

      • The candle has been lit my friend, and the light is shining on the filthy truth of psychiatric history. Who decides? Truth decides. Truth is not subject to opinions or whims, or even brilliance. The world is already divided, and true unity can only coalesce around truth. Brilliant and honorable people do not perpetuate myths that harm millions of innocent people. How can knowledge of mental illness be advanced when no one since Szasz has even been able to define what mental illness is in the first place? It’s like advancing knowledge of the tooth fairy or the Easter Bunny. It’s advancing the myth of mental illness.

        Of course it will take more than books to indict the drug paradigm, but books are a part of it. Drug-free recovery is great, but just imagine how much easier that would be if there weren’t any drugs in the first place. The reason there needs to be an alternative is that psychiatry has introduced a severe problem into the world.

        The funny thing about lighting candles is that when you do it, it exposes all sorts of critters. Shining the light into the darkness reveals a lot of filth that people ignore or refuse to look at. Many are lighting a candle, but soon the sun will shine as clear as day and psychiatry will have no where to hide.

        • The funny thing about lighting candles is that when you do it, it exposes all sorts of critters. Shining the light into the darkness reveals a lot of filth that people ignore or refuse to look at. Many are lighting a candle, but soon the sun will shine as clear as day and psychiatry will have no where to hide.”

          Love this. Light reveals truth, so it elicits fear from many that count on truth remaining hidden in the dark. I think the dividing line now is between those lighting the candles, and those trying to blow them out. No doubt there are saboteurs of the light, based on enormous fear. Personally, I think they need to get over it, for their own sake, because sabotaging light is never really a good idea, and most definitely comes back to haunt.

          I agree, the light will win out because it is more powerful than sabotage at this point. I believe enough people around the world have awakened to this fact, and more will continue to, allowing the light to flood humanity. And it will be a shock to many what is revealed. This is the great change of these times, I truly believe.

  4. I have a problem with this idea that violation by the state and psychiatry should lead to incorporation of the violated as violators. Where the c/s/x movement, or whatever, joins with the mental health movement, I have to throw up my hands and say, “Not me! Not now, not ever. No way, Jose!” I don’t need to be continually washing my hands to keep them clean. The mad may, after taking over the asylum, be taking over academia, but all the same, I have to draw a line.

    Pathologize “distress” and, of course, you are going to have no problem characterizing 1/4 or more of the population as “mentally sick”. That doing so would, in essence, expand the mental health treatment, actually “mental illness”, system is another thing altogether. This system is a drugging and brain washing system. I don’t need drugging nor brainwashing. Perhaps, you do?

    I’ve read the petition for the establishment of the Philadelphia hospital, around 1750 or thereabouts, the petition which initiates institutional coercive psychiatry in the USA, and it essentially points to the British example (i.e. St Mary’s of Bethlem or Bedlam) as the primary example and model for practice. Keep in mind that this inspirational influence predates by a good shot the “reforms” that came about with moral management a few years later, and maybe, just maybe, you will begin to get my drift.

    This seems necessary to understanding subsequent resistance and reform but as opposed to the numerous works focusing on the history of ‘the system,’ my overall emphasis is on resistance and reform.

    Radical means “of, or relating to, or proceeding from the root” or basis. Abolition is radical. Reform is just more of the same, with either more or less oppression, that is, deprivation of liberty and force involved, depending on popular sentiment and trends. Get rid of coercive treatment, that loophole in the US constitution, and you will have really done something worth doing.

    I’m not crazy about this idea of everybody working in the mental health treatment, actually “mental illness”, system. I would like to see people choosing other vocations. The great hospital of the future doesn’t interest me so much. Well in advance of admission, I’m hungry for my discharge papers already. The question I have is how are we going to cure all these victims of mental health professional disorder, you know, Peer Support Specialist Syndrome sufferers and the like? If they are actually incorrigible, incurable, unrecoverable, or what have you, as would be indicated, isn’t that a sad state of affairs for the rest of us to have to endure.

    I’m happy however that you were able to use the word antipsychiatry so effectively in your blog heading, and I’m curious as to where you are going to take this matter in Part 2.

  6. Where the c/s/x movement, or whatever, joins with the mental health movement, I have to throw up my hands and say, “Not me! Not now, not ever. No way, Jose!

    Go for it Frank! The notion of a c/s/x “movement” still makes me barf, as once you include those who consider themselves “consumers” it’s no longer a movement, just organized surrender. The only true movement as pertains to “mental health” is the anti-psychiatry movement, which doesn’t really exist as much more than an idea right now, though it is showing signs of slowly being resurrected.

    • The mental health treatment industry is nothing without customers. There are a heck of a lot of people said to be mentally disturbed because they buy mental health treatment. Encouraging more and more and more purchasing of mental health treatment increases the “mental illness” rate. Discouraging expansion of the mental health treatment industry will get people accused of “stigmatizing” other human beings. Were people to boycott the mental health treatment industry tomorrow, the mental health rate would correspondingly rise significantly. Hiring more and more workers in the disability field is not the way to a healthier populace. If you pay people to play “sick” you will see many Oscar worthy performances. What do we get out of this effort? An expanding mental health treatment industry, and, with it, a global “mental illness” pandemic. What can I say? However absurd, you get what you pay for.

  7. The “movement” has already begun, and it is to abolish psychiatry, to eradicate it from off the face of the earth. The time has come to slay the dragon of psychiatry.

    This can be done in a peaceful way, in the model of Martin Luther King, jr., a model that I much prefer. It would be wise for psychiatry to yield to truth and liberty in a peaceful fashion. I truly hope that is how psychiatry will be conquered, and the captives set free.

    Otherwise, there will certainly be those who prefer a more Malcolm X – like approach. If the Gandhis and Kings are rejected, it can only spell trouble for society when justice comes calling.

  8. Dragonslayer (hope you don’t mind my condensing your name), thanks for all your commentary; it sure makes my job here easier, that’s for sure.

    A couple things:

    The movement exists in spirit, and has for a long time. However in terms of effective, widespread, organized, strategic action it’s still in utero this time around so far; that’s what I was referring to. Hopefully enough anti-psych folk will avail themselves of the anti-psych organizing discussions in the forum section asap that we can start approaching some kind of critical mass in our conversations, so that at some point it will become clear to the public that we have articulate, collective positions on basic issues which are in their interest to explore.

    Second, I urge you to reconsider your implication that Malcolm X was “violent”; he was not. He encouraged Black people to love and respect themselves and stand up for their rights, which scared the crap out of the white establishment. It’s something we should emulate. Personally I think things like hunger strikes in situations where there’s an alternative are excercises in masochism and self-negation.