Upon the U.K. Launch of Psychiatry and the Business of Madness: A Reflection

Bonnie Burstow, PhD
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This is a study of psychiatry. It is a study of an area officially a branch of medicine and overwhelmingly seen as legitimate, benign, progressive, and effective. That psychiatry is typically so viewed is readily apparent and may seem a “no-brainer.” Doctors specialize in it. It is covered by our health insurance, overseen by ministries of health. A high percentage of the population uses it treatments. People encourage their loved ones to consult a psychiatrist when encountering “personal problems.” And the media routinely report its “discoveries” and “improvements,” much as they report “breakthroughs” in the treatment of cancer. But what if society had it wrong? What if this were not legitimate medicine? (Burstow, 2015, p. 1)

So begins the book Psychiatry and the Business of Madness. And so began my speech on June 12th.

Less than a week ago, in London, on June 12th at 7:00 p.m., what I see as a historic event took place—the U.K. launch and indeed the very first launch of the book Psychiatry and the Business of Madness: An Ethical and Epistemological Accounting.” Was this my book?  It was.  And why, you may be wondering, do I think of the launch as historic?  In short, because an uncompromisingly psychiatry abolitionist book had not come out in decades.

And yet here it was; and here were folk attending the launch, hailing from as far away as Cork Ireland. Against all odds—the event itself was in competition with a free showing of the film Asylum—between 31 and 40 determined souls had made their way to the well nigh impossible-to-find Palgrave headquarters—the location of the launch. And the evening was memorable, the speeches electrifying!

Dipping into the central tragedy in her life—the able m.c. Julie Wood set the tone for the evening by being deeply personal. She courageously revealed that the initial manuscripts used as an entry point into the investigation of psychiatry which forms the core of the book were documents associated with her psychiatrized son’s suicide.

London ECT activist and psychiatric survivor Cheryl Prax spoke next; she told the audience, “By page 5, I was crying with joy that such a book was written.”

The third speaker, psychologist Ian Parker, a consummate scholar, began by drawing attention to the subtitle and inviting people to see the careful tying together of epistemology, ethics, and accounting so integral to the book. He went on to highlight the significance of feminist and Marxist standpoint theory.

Finally, as the author and the last speaker, I suggested that two things united all of us in the room:

  1. The knowledge that something was profoundly wrong with psychiatry, and
  2. The commitment to do something about it.

I went on to outline the major findings of my research. Also, the core recommendation that the state sever its ties with psychiatry.

What followed was an animated and insightful question-and-answer period, with person after person coming up to the microphone to pose their question.  What do you think of the Soteria movement?” asked one.  Picking up on the discourse employed in the book, another asked, “wouldn’t you say that Open Dialogue is being colonized by psychiatry?” “Is the problem is that psychiatry can colonize anything?”

Then came the highlight of the evening—the survivor speak-out.  Survivors generously shared their stories, their analysis, their dreams, one survivor making it clear that the primary injury done her was the erosion of her self-confidence; another commenting that hearing the stories of other survivors is invariably a moment of learning. That the evening should have ended with survivors, I would add, is apt, for in the final analysis, whether we are antipsychiatry or critical psychiatry, whether we are professionals or survivors, the standpoint that we need to adopt is precisely the psychiatric survivor standpoint.

By this I do not mean that whatever any survivor thinks is ipso facto correct.  Only that this location itself offers a privileged glimpse into the regime of ruling known as psychiatry, just as the standpoint of workers yields a privileged glimpse into capitalism. To use an institutional ethnography term (see Burstow, 2014a), it highlights the disjuncture which happens when psychiatry enters people’s lives—and, indeed, running with that juncture and mapping institutionally how it is created and recreated is integral to what this book is about, part of why I see it as important.

The strength of Psychiatry and the Business of Madness is precisely that it begins with the standpoint of the survivor, that it shows how various problems or “disjunctures” that occur in people’s every day life can be traced to the day-to-day working of the institution—whether it be its use of “treatments,” its activation of diagnoses, the filling out of forms. Its strength, to put this another way, is its holism—the fact that in the process of exploring the disjuncture, it shines a light on every single facet of the institution. Its strength on a whole different but related level is its no-holds-barred antipsychiatry perspective, together with the solidity of the research and the arguments.  This is significant.  Insofar as Psychiatry and the Business of Madness makes this case and does this mapping, it takes us where we need to go, provides ammunition needed for meaningful social change.

The point here is that reformism will not serve us. As I have argued elsewhere (see Burstow, 2014b), and as the history of psychiatry clearly shows, reform agendas have always culminated with a return of biological psychiatry with a vengeance, and far from ridding us the problems posed by the institution, have guaranteed the continuation of those problems. What we need to do rather is to acknowledge that psychiatry was a colossal misstep, and in essence to begin again. For this to happen, we need determination. We need to know when we are being led astray. We need vision. We also we need texts capable of making a truly convincing case for abolition. What I am referring to here is not just demonstrating that psychiatry does “more harm than good”—significant though this is—but demonstrating that psychiatry has no validity and, what goes along with this, that it is not a legitimate branch of medicine.

That is precisely what Psychiatry and the Business of Madness sets out to do, and what, I would suggest, it achieves.  To quote in this regard from the first review of the book, Philip Hickey (2015) states, “This book is a major milestone in the antipsychiatry effort and it stands as a monumental challenge to psychiatry’s continued existence as a branch of medicine.” Don Weitz and Simon Adam, whose respective reviews will be coming out shortly, make similar points.

What are my hopes for this book?  To name a few, I hope that people threatened by family members with institutionalization—and we all know how psychiatry preys on families—give it to their family to read, and the family finds itself seriously entertaining second thoughts. That upon perusing Chapter Six, psychologists, nurses, and social workers take in the colonization of both their discipline and of themselves outlined here, reflect on their practice, get back in touch with why they entered a “helping profession” in the first place, and begin speaking up.

Having intricately traced not only the government backing and legitimation, but also the legal stranglehold that the state has created, I hope that government officials and our elected representatives are led to look more critically at what they are mandating, making possible—and in this regard, I am delighted that both member of the Ontario legislature Cheri DiNovo and renowned mental health lawyer Anita Szigeti will be speaking at the Toronto launch (September 18, 5:30, 12th Floor, 252 Bloor St. West).

First and foremost, however, my hope for this book is quite simply that it be read—more particularly that it be read widely and carefully.  The point is, I believe that the book genuinely has the capacity to be a game-changer, for it clarifies the territory, even I have found, for people who do not wish to see it.  “I just didn’t realize, I think maybe because I did not want to realize” said a friend to me, “but now that I see it, I can’t go back and not see it.” However, the book can do this heavy lifting only if it is widely read and discussed.

My invitation? Pick up a copy, read it, form your own judgment. And if your evaluation is similar to mine, call it to the attention of others. Perhaps give it to your mother for her birthday. Perhaps write a review for your local paper.  Maybe mention it to a coworker.

My invitation to people more generally?: Whether or not you ever pick up this book or indeed, any book of its ilk:  Dare to imagine a world where helping is not professionalized, where caring is not commodified.  Where decisions do not come from on high, but where in the spirit of community, we go about the business of life together (the subject of the last chapter).

To end these reflections by focusing back in on the launch itself, albeit I was present via Skype only, I felt very much a part of the gathering in that room that evening. How wonderful to actually see folk with whom I had heretofore but exchanged emails! And we all of us walked away knowing that together we had just pulled off an important piece of work. One small indicator of which is that the m.c. and her husband were up until the wee hours that night discussing psychiatry—exactly the kind of seriousness which one prays that a book launch will inspire.

* * * * *

(For this and related articles, see http://www.bizomadness.blogspot.ca)

References:

Burstow, B. (2014a) Liberal mental health reform: A fail-proof way to fail. Retrieved June 13, 2015.

Burstow, B. (2014b). Taking an entry point. On investigating the psychiatric-psychopharmaceutical complex. Retrieved June 13, 2015.

Burstow, B. (2015). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave.

Hickey, P. (2015). Review: Psychiatry and the business of madness. Retrieved June 13, 2015.

29 COMMENTS

  1. I haven’t been able to read the book yet, but I surely agree that our culture has to change before we can get rid of this parasitic growth called psychiatry. Our highest value seems to be the accumulation of things, and we don’t value people all that much. And I think too, as I continue in this movement all these years, that creating alternatives to psychiatry is more and more important in my mind.

    There will always be times in most people’s lives when they are troubled and unhappy, and are searching for help. As we have seen with things like Soteria Houses and Open Dialogue, help that works is often just emotional support that enables people to solve their own problems. But if that kind of help isn’t there, people are forced to turn to drugs and shock and the acceptance of the labels of mental illness, of the idea of oneself as subhuman.

    There is a lot of financial profit in that, a lot of money to be made. That value is something we have to fight, to swim against the tide and try to create a society where people, not profit, is the central value.

    I think this struggle over values is very central to the struggle against psychiatry.

    I am looking forward to reading Bonnie’s book, and I am happy to see the support our movement for human rights is giving it.

  2. I was so touched by meeting all the wonderful people at the book launch, all staunch supporters of Bonnie’s mission. And the book IS awesome, really worth a thorough read, all the sacred cows take a logic-based hit. You find yourself nodding and thinking “YES!” all the way through. But how to get through to the millions who have no clue that psychiatry could cost them dearly if they do not pay attention? We need to get to them before they learn the hard way. It is hard to combat the conventional wisdom, so much of which is wrong, that people get from the media and from other people.

  3. Bonnie

    “Dare to imagine a world where helping is not professionalized, where caring is not commodified.”

    A very inspiring statement as is the launching of your new book. I have a copy in my possession and will begin reading it as soon as I finish Whitaker’s “Psychiatry Under the Influence”; can’t wait!

    Congratulations! “Dare to Struggle; Dare to Win.”

    Richard

  4. hi.

    congratulations again! on your book activism post you asked me to tell you what i thought of your book i’d ordered , when it came – and i did, over on that post, about a week or two ago. you can check it out there.

    i want to confirm you will be speaking in ny on the 29th. i am not too far and hope to be there.

    ty again for all your effortsto get the truth out there- to the people who need to hear it now and to the people who don’t know yet how much this branch of “science” will be ruining their future lives….

    best

    erin

  5. sometimes, before falling asleep, I imagine myself writing a book about logical analysis of DSM and its concepts; in the morning, I give up – maybe I’m too young – then, in the night, I can visualize formulas and history of concepts proving its falsehood, etc…
    You made the first step – Congratulations!! I’m so happy you’ve given the start!

  6. Dear Bonnie, You write: And why, you may be wondering, do I think of the launch as historic? In short, because an uncompromisingly psychiatry abolitionist book had not come out in decades.

    Which reminds me of the wonderful meta-narrative novel & movie Cloud Atlas, in which a young American notery survives a poisonous voyage aboard a ship of fools aptly named Prophetess, to take a stance against Paternalism and its “natural-order” to become an abolitionist. I’m sure you will relate to his historical struggle as a single voice, in this paradoxical modernity where an inherited negative bias to normal perception insists its bad judgement of others in existential distress, is inherently correct.

    Only an hour ago, here in Sydney Australia, I watched the middle-class TV hosts nod head’s at professor Patrick McGorry and a young Phd, as they praised the ABC for raising funds in last years “mental as” week, announcing its repeat again this year. Sadly the nodding heads endorsed the negative bias of words like psychosis & schizophrenia “as-if” these terms define the reality of such experience. While those of us with lived experience, quiet rightly view these words as “poisonous.”

    Which leads me back to your valiant efforts to rid the world of misconception and modernity’s medicalized sense of mind. I do believe that the presence of the past is returning, as the reality of a technological search for biological causation continues to flounder and “metaphor” as a means of existential interpretation, is explored once again. (see Eleanor Longden’s presentation on this webzine) While Pat Bracken is calling for a return to psychiatry’s past links with philosophy, in a need for a more “heuristic” approach, in which he does mention one of those God’s of the “inner vine” (vegetative, peripheral or autonomic nervous system), Hermes.

    METAPHOR & myth, with myth now viewed by “modernity” as simply a non-truth, may be rising to the fore of our need once again, in the natural cycle of our emerging consciousness. Where the “business” of life, as you point out, needs re-conceiving: Dare to imagine a world where helping is not professionalized, where caring is not commodified. Where decisions do not come from on high, but where in the spirit of community, we go about the business of life together.

    Can we? Perceive the self-deluding game of survival in modernity’s material world? Where, well educated citizens imprison themselves in a system of their own making, because we are not raised with an embodied sense of self and we exalt language above nature. Wherein, a nightly presentation of The News takes on the surreal feel of Jim Henson talking head’s, Muppet show, like the media news I watched this morning.

    In an era when survival is more dependant on mental rather than physical skill, are we seeing the prophecy of “the meek shall inherit the earth?” Which is explored metaphorically in the character of Mr Meeks in Cloud Atlas, the “I know, I know” word regurgitating Parrot, one finds at an academic conference when trying to engage another in expansive discourse. While a media arts critique of Cloud Atlas discusses its exploration of Nietzsche’s “will to power in individuals and groups,” and HOW we enslave ourselves by veneration of the existential paradigm we perceive as being normal. Which in my humble opinion is the delusion that our identification with objects in the external world, affects within our psyche, that time has moved on and the past understanding of how to be human, is incompatible with modernity.

    Anyway, please forgive my gabbering n gibbering, as willy old Zachery suggests of our sign symbolism of actual lived experience, “as-if” words contain experience, while we nod our heads for fear of ignorance in appearance and falling out of the consensus nest mind. But your “abolitionist” hopes and desires reminded me of this life script scene in the movie Cloud Atlas:

    Patriarch: Listen to me Adam.
    Their is a natural order to this world and those who try to upend it do not fare well.
    You will be spat on. You will be beaten. Shot at, lynched or crucified.
    And for what Adam?
    No matter what you do, it will never amount to more than a single drop in a limitless ocean!

    Adam Everyman:

    Yet what is an ocean but a multitude of drops.

    I hope the book reaches a wide audience Bonnie, crossing many oceans in the future to come.

    The doctoral thesis on Cloud Atlas can read here:
    http://mro.massey.ac.nz/bitstream/handle/10179/1685/02_whole.pdf?sequence=1

  7. Reading Psychiatry and the Business of Madness now. It is a much needed volume, and hopefully it is one that will be put to good use in the future. I think it shows very well how people can become caught up in a system that is not in their interests, essentially punitive, despite medical pretensions, and from which they are allowed little defense whatsoever. In other words, you get a good depiction of the mental health railroad, and the kangaroo “justice” behind it.

    I’m glad the book launch in the UK was so successful. More importantly, I hope people read this book, and I hope they are able it to put it to good use. We need more people speaking out from a abolitionist, pro-freedom, pro-rights, perspective. Objectively, the book shows that much that takes place in psychiatry has everything to do with protocol and procedure, and nothing to do with medicine. This is something people need to scrutinize. Their happiness, their freedom, and their very lives could be in jeopardy if they don’t. Even if they are not affected so personally, somebody is, and Bonnie is great at utilizing the stories of survivors here to good effect.

    I haven’t reached the end of the book yet, but it is certainly a worthy endeavor, and I hope there will be more works, along the same lines–rights oriented, liberationists, abolitionist in perspective–from others to follow. Psychiatry has been given a free ride for way too long. If we make waves, well, somebody isn’t dead or dying, those waves were meant to be. Let’s hope they hit home.

  8. I ordered your book yesterday, and look forward to reading it, and likely referencing it in the book I’m working on, if you don’t mind. I’ve got a gas lighting story, and figure the U.S. hasn’t had a good one of those since 1940, so it’s time for one. And it’s a story of how my gas lighting was medically very similar to the gas lighting of likely millions of abused children. Hopefully, I’ll eventually find a publisher.

  9. Dear Bonnie,

    I’m looking forward to reading your book, and I certainly agree with many of your views and points. However, as long as there are people who society deems to be mentally ill, we will never get rid of psychiatry. There is also, believe it or not, such a thing as good psychiatry. The problem is that the psychiatric profession has gone totally off the rails, not that it ever had a great grasp on reality. There are many reasons for this, but one important aspect is that there are very few psychiatrists who don’t owe allegiance to some body outside of the patient. Most psychiatrists work within hospital systems and therefore end up functioning for the benefit of the system. Others work in research and owe their allegiance to funding organizations. Many others owe their allegiance to their pockets and need to promote and market themselves in order to make the incomes they desire. You and I are fortunate to live in Canada where we have decent health care, and as an independent psychiatrist, I don’t have to owe allegiance to anyone but my patients. I applaud your work to bring down the psychiatry industry, but we should never forget the needs of people in distress.

  10. Interestingly films often do a rather good job of telling the truth, that is, in fiction. “The Girl With The Dragon Tattoo” shows a psychiatrist that must touch the heart of many. In fact I am not sure I have even seen a film with what might be considered a good psychiatrist. I also think of Doris Lessing and her literary portrayals of psychiatry in England. And there are many tales of really heinous actions on the part of psychiatrists which are not fiction. Liars, thieves, mountebanks, I would say witch doctors but I suspect they are better men. No, on the whole the world would be a much better place without them and without many psychologists as well such as helped with “enhanced interrogation” some years back. Like politicians all we can mean by a good psychiatrist is an oxymoron.

  11. I was very happy to see this statement,

    ” The point here is that reformism will not serve us. As I have argued elsewhere (see Burstow, 2014b), and as the history of psychiatry clearly shows, reform agendas have always culminated with a return of biological psychiatry with a vengeance, and far from ridding us the problems posed by the institution, have guaranteed the continuation of those problems. ”

    Psychiatry is and has become a form of institutionalized Madness, one that disguises itself behind reasons, that are presented in terms of an arcane, priest like liturgy. To the public their words, are as indecipherable as a witches incantation to a Demon.

    I suspect that is a cognitive way of controlling their own symptoms, by controlling others. The question becomes can you control madness through reform? Not in this case, when so many people are denied the compassion, and attention that they needed as human beings, that would have nurtured them in the time of their suffering. Compassion that would have offered hope, instead of condemnation.

    Instead they were treated as experimental animals. Given, Malaria, Insulin Coma therapy, ECT, and now psychotropic meds, with the fervency of a religious dictum, that shut out anyone who questioned the Sanity of this.

    No, reform is not possible.