Uniting Critical Voices: Where can we Collaborate?

Gary Sidley, PhD
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In a recent post on this site, Bonnie Burstow explored the meaning of the term ‘antipsychiatry’ and coherently argued that the word should be reserved as a descriptor for those seeking the eradication of psychiatry. By contrast, in this article I use ‘antipsychiatry’ as a catch-all term to refer to the wide range of people who are, to various degrees, critical of Western psychiatry. Although accepting the importance of language, and recognizing that the word ‘antipsychiatry’ is open to more than one interpretation, semantics is not my focus here. My purpose in writing this piece is a pragmatic one: exploring how best we might harness this array of dissent so as to realize radical change.

If we are to achieve the much-needed paradigm shift in the way we respond to human suffering, it is imperative that the various strands of the antipsychiatry movement unite. Given the powerful vested interests sustaining the dominant bio-medical model, a fragmented opposition will possess insufficient power to transform the current mental health system. Indeed, the adage ‘united we stand, divided we fall’ has never been more apt.

As a vocal critic of Western psychiatry I actively engage in a variety of social media and, like many others on this side of the debate, often find myself embroiled in arguments regarding the most appropriate ways to help people who are experiencing emotional distress and overwhelm. Predictably, many of these spats are with biological psychiatrists and others wedded to ‘broken brain’ explanations. But — perhaps more surprisingly — I’ve witnessed a growing number of passionately expressed differences between people who each identify with the antipsychiatry movement.

What are the sources of these conflicting ideas?

I suspect that tensions within the diverse range of voices striving for radical change in our approach to emotional distress originate from three major sources:

1. Abolitionists versus reformers?

One important line of division seems to be around whether the ultimate goal of our efforts should be total eradication of psychiatry or its radical reform.

Many argue that the inherent inadequacies of Western psychiatry are so deeply ingrained as to render the current system beyond repair. It is reasoned that the ‘illness like any’ approach to human suffering, justifying the gross overuse of psychotropic drugs and a perverse approach to risk, is now so energetically defended by vested interests — the pharmaceutical industry and a psychiatry profession desperate to retain its status as a bona fide medical speciality — that the prospect of meaningful change in our mental health services is remote.

The abolitionists often highlight the human-rights violations, and the mental health legislation that legitimises them, as justification enough for calling for an end to psychiatry. They claim that the collusion between the state and medicine, enabling doctors to incarcerate law-abiding people and impose ‘treatments’ without their consent, propels a psychiatrist into the role of enforcer of the government’s desire to control those who they deem to be troublesome. These discriminatory practices, it is argued, can only be halted by the total dismantling of the institution of psychiatry.

In contrast, the reformers draw attention to pockets of good practice in the existing mental health service, where innovators are striving to change the system from within. Promising initiatives, such as Open Dialogue, are held up as evidence that radical change can be realised within the existing psychiatric service. They propose that critical voices need to focus on incremental, evolutionary improvements rather than demanding a revolution and the overthrow of psychiatry.

2. Service-user versus professional perspectives

The relative weights given to the views of service users and mental health professionals is another major source of tension within the antipsychiatry movement.

At one end of the continuum are those people who have, understandably, been alienated by their direct experience of receiving ‘treatments’ from psychiatry, and often feel traumatised by their time spent in the services — who assert that anyone who has worked as a mental health professional (medical or otherwise) is automatically rendered incapable of being an ally in the struggle for psychiatric reform. Making a living from collusion with psychiatry’s human rights abuses, the argument goes, is unforgivable and strips the person of any credibility as an opponent of the current system.

On the other side of the spectrum are those critics of psychiatry who assert that the vast majority of mental health professionals entered into these careers expecting to learn skills that would help reduce human suffering, rather than for the opportunity to control, dominate and abuse. Furthermore, from a pragmatic point of view they argue that if radical change is going to be realised, agents of change need to be operating within the psychiatric system as well as outside it. And given that psychiatric professionals typically possess much more power than the people they are paid to serve, it would be foolish and self-defeating to disqualify this potentially influential ally.

3. Societal influences versus individual responsibility

Critical voices pushing for alternatives to biological psychiatry all recognise that societal ills (such as homelessness, poverty, discrimination and inequality) contribute in a significant way to the level of mental health problems within our communities. Nonetheless, there seems to be diverse views about the magnitude of societal change that is necessary to achieve a radical shift in the way we approach human suffering.

Many people within the antipsychiatry movement argue that a marked improvement in the emotional wellbeing of our citizens cannot be achieved within the political systems that currently dominate the Western world. They claim that globalisation, and the capitalist philosophy that underpins it, are engine rooms for the divisions and inequalities that fuel mental distress and that the total rejection of these political systems is an essential prerequisite for radical change to the way we prevent, and respond to, human suffering.

Activists who support this revolutionary stance typically emanate from the left of the political spectrum and champion socialist ideologies. Within this frame, mental health problems are viewed as inevitable consequences of a sick society with the individual sufferers having little or no power to improve their plights.

In contrast, others arguing for alternatives to biological psychiatry put greater emphasis on personal responsibility as a vehicle for recovery. Espousing the virtues of choice and free will, those on this side of the debate typically seek to minimise state involvement, via policies or laws, preferring to allow individuals to navigate their own routes to wellbeing, unfettered by government interference. In a more extreme form of this philosophy, it is assumed that each of us, irrespective of the environmental context, possess the inherent capability to steer our escape from emotional pain via a sequence of rational decisions — in effect, to think our way out of our problems.

Unifying goals

If we are to realise the strived-for transformation in the way our communities respond to distress and overwhelm, a collective and coordinated effort will be required. It is therefore encouraging that, despite the above-stated differences, there may be discrete issues that can unite the assorted voices opposed to the current bio-medical dominance, thereby allowing us to collaborate on campaigns for change.

I will suggest that the achievement of three significant goals could bind the collective energies of those critical of traditional psychiatry. Predictably, the initial thrust of each will involve the rejection or dilution of an element of existing practice that is deemed to be unethical, ineffective or damaging to people suffering emotional distress and overwhelm. But it is insufficient for us solely to be ‘antipsychiatry,’ rejecting and dismantling the most unsavoury aspects of the mental health system; we need to chart a new course towards our desired paradigm by stating the alternatives that we would like to see replace them.

Taking into account the above, the following overview will be presented in two parts:

1. The unifying goal: The elimination of a specific part of Western psychiatric practice the achievement of which should find favour with all those critical of the current bio-medical approach.

2. The desired alternatives: The sort of structures and responses, dedicated to the reduction of human suffering, we would like to see instead of the traditional practice.

Unifying goal 1: More frugal use of psychotropic drugs

It is difficult to find anyone among those critical of traditional psychiatry who does not recognise the over-prescribing of psychiatric drugs. Since the late 1990s there has been an explosion in the consumption of so-called antipsychotics and antidepressants across the Western world.

Reckless marketing campaigns by the pharmaceutical industry, targeting all-too receptive doctors, led to these drugs being prescribed for problems outside of their original remit and over longer periods of time. Dementia sufferers and children displaying behavioural problems have been increasingly administered antipsychotics, while one type of antidepressant drug (the selective serotonin re-uptake inhibitors, or SSRIs) has been routinely prescribed for a wide range of anxiety difficulties.

This irresponsible expansion of psychiatric drug use occurred despite widespread recognition of the debilitating side-effects and discontinuation problems for both antipsychotics and antidepressants.

If this gross overuse was not bad enough, recent research seriously questions the efficacy of these drugs. A review of the studies regarding the efficacy of SSRIs concluded that the size of any therapeutic improvements were of no clinical significance and “the potential small beneficial effects seem to be outweighed by harmful effects.” As for antipsychotics, long-term use appears counterproductive and may be a key reason why ‘schizophrenia’ recovery rates in the under-developed world exceed those in drug-focused Western countries.

Desired alternatives:

Small crisis houses in every town offering 24/7 respite care outside of a medical setting, and staffed by people displaying the core human qualities of genuineness, empathy, respect and compassion.

– Peer-support networks that offer routine access to one or more people whose previous experiences have included similar emotional crises.

– Information about psychotropic drugs that is freely available and that provides a balanced overview of their pros and cons. Such a resource would include reference to the mode of action (creating abnormal — albeit potentially preferable — brain states rather than restoring balance), the likely side-effects and the discontinuation difficulties following long-term use.

Soteria houses routinely accessible, offering non-drug alternatives for people suffering with overwhelming psychotic experiences.

Open Dialogue approach freely available to support both an individual struggling with psychotic experiences as well as the person’s immediate social network.

– Societal changes to counter adverse life experiences (such as intra-family abuse, discrimination, poverty and homelessness).

– Counselling and talking therapies routinely available, together with concise, non-partisan information about their rationale, content and limitations.

Unifying goal 2: The reform of mental health legislation

Mental health law across the Western world represents a form of legalised discrimination against people deemed to be suffering with a ‘mental disorder.’ Existing legislation allows innocent law-abiding citizens to be forcibly confined within a psychiatric hospital and compelled to ingest psychotropic drugs, routine practices that grossly infringe basic human rights.

In England and Wales, the government’s irrational preoccupation with the threat to public safety posed by those identified with psychiatric problems led, in 2007, to revisions to the existing Mental Health Act. Following these changes, under a (euphemistically termed) ‘Community Treatment Order,’ patients under section could be compelled to continue taking psychiatric drugs after their discharge or be forcibly returned to hospital. Despite a lack of evidence for any clinical benefits to service users, psychiatry’s deployment of Community Treatment Orders, and compulsion generally, has steadily increased over the last decade.

Typically, mental health legislation across the Western world is developed around two central constructs, each of dubious validity: the presence of a formal ‘mental disorder’ and an evaluation of the level of risk posed, to self and others, by the psychiatric patient. Forced treatment (‘sectioning’) requires no consideration as to whether the individual has the wherewithal to make his or her own decisions, thereby failing to recognise that people suffering high levels of emotional distress often retain the capacity to make informed and rational choices.

Their vulnerability to detention without trial, in the absence of any criminal offence, tars psychiatric patients with a similar status to suspected terrorists. Meanwhile, the state sponsors mental health professionals to implement this legalised discrimination, a task they (for the most part) dutifully fulfill without a murmur of dissent.

The demand for a radical reform of mental health legislation is, I believe, a campaign that would unite the array of critical voices striving for radical alternatives to the currently dominant bio-medical approach to human suffering. A key part of such a mission could be for mental health professionals on this side of the debate — and the formal bodies representing them — to consider a collective policy of non-cooperation (or perhaps something akin to conscientious objection) with implementing the requirements of the Mental Health Act.

Desired alternatives:

– Promotion of alternative legal frameworks that are developed around assessment of the individual’s ability to make their own decisions. Psychiatric treatment does not need to be the subject of special legislation; a unitary law governing non-consensual treatment of both physical and mental health problems is required.

Development of a Fusion law, as proposed by Szmukler and his colleagues, which would apply consistent ethical principles and would reduce legal discrimination against those suffering emotional difficulties.

Unifying goal 3: Abolition of the Diagnostic and Statistical Manual (DSM) classification system and an end to disease-mongering

For more than half a century the synergistic manoeuvres of psychiatry and the pharmaceutical industry have created a fantastical world of ubiquitous mental illness and chemical cures. Consequently, more and more aspects of human behaviour and emotion are construed as pathological and excessive drug-prescribing is legitimised. A total rejection of the DSM, along with the associated disease-mongering, constitutes a mission that could find favour with all of us critical of Western psychiatry.

Armed with the spurious assumption that the various forms of human suffering and overwhelm are analogous to physical diseases, a committee of the American Psychiatric Association occasionally gather around a table to decide which ‘mental disorders’ will be included in this hugely profitable DSM book. The most recent product (DSM-5) of this largely subjective exercise included 15 more illnesses than its predecessor and an expansion of the criteria indicative of a ‘mood disorder’ — anyone who remains low in mood two weeks after the death of a loved one is now considered to be mentally ill.

Despite these categorisations predicting neither the future course of a ‘mental disorder,’ nor the kinds of intervention that are likely to be helpful1, their misleading veneer of scientific respectability ensures that they continue to be influential across research, clinical and political arenas. Although defenders of the DSM system argue that they are an essential aid to communication within the psychiatric world, these classification systems perpetuate the dominance of bio-medical understandings of human distress and the corresponding overuse of drugs, as well as promoting stigma against those so labelled.

Desired alternatives:

Focus efforts on promoting wellbeing as opposed to the ‘treatment of mental illness.’

Routine use of non-medical language when describing human suffering and overwhelm.

– Greater emphasis on tacking the causes of distress such as trauma, inequality, discrimination, homelessness, poverty and victimisation.

Prioritise personal stories and individual formulations in determining the sort of help and support required.

– Strive to understand each individual’s construction of recovery and desired outcomes, while always recognising that each person’s journey will be unique.

– Accept distress as a normal human reaction to adverse life circumstances, rather than a sign of internal pathology.

In summary, this article has addressed the practical question of how those opposed to existing psychiatric practices can pull together to maximize the chance of success in the ongoing struggle for change. Irrespective of what terms we use to describe the movement, the central goal must be the realization of an alternative system for responding to suffering and anguish, radically different from the ‘drug and control’ approach that currently dominates. The success or otherwise of the antipsychiatry movement — or whatever we wish to call it — will ultimately be judged on the achievement of this fundamental objective.

With this in mind, the above represents my attempt to offer a broad manifesto to highlight the areas where those critical of Western psychiatry might join forces to achieve a radical shift in how our society responds to human distress. Is this a framework that all of us on this side of the argument could unite around?

Show 1 footnote

  1. Bentall, R.P. (2009). Doctoring the Mind: Why psychiatric treatments fail. Penguin Books.

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104 COMMENTS

  1. Given the choice between “a kinder, gentler” mental health system and no mental health system at all, I’m one of those who would opt for no mental health system at all.

    “Service-user versus professional perspectives”

    Some “services-users” are not “service-users” by choice. I see a broad divide between “consumer/users”, so-called “peers”, and psychiatric survivors or ex-patients. It tends to be drugs that “consumer/users” are “consuming/using”. Psychiatric survivors become psychiatric survivors by recognizing these damaging substances for the damaging substances that they are. Once force is removed from the equation, some “users” would cease “using”, pronto.

    “The reform of mental health legislation”

    Reform is the wrong word to use. Repeal is the right word. Mental health legislation is the thing that facilitates forced treatment of mental patients (i.e. different treatment from citizens [2nd, 3rd class citizen status]). Repeal mental health law, and you’ve eliminated the repression you see a need to reform.

    Decriminalize, demedicalize madness (unreasonableness, folly) and you get rid, at the same time, of this need for “alternatives” to abusive practices. The medicalization of human behavior is an abusive practice.

    My basic problem with “alternatives” is that they have a way of expanding the “mental illness” industry rather than of facilitating some kind of health producing contraction of that system. I’m all for Soteria type houses, and Open Dialogue has a huge success rate because it doesn’t use psych-drugs to excess like other programs. Drop-in centers, peer respite houses, etc., tend to be less of a need here, and one problem with them is that their establishment often breeds a collaborative, and as such, mutually beneficial and sustaining relationship, with the force and abusive maltreatment. Basically, the fund raising demands on “alternatives” end up becoming a corrupting influence, as you’ve got your own conflicts of interest at work here.

  2. Thanks Gary for emphasizing those areas where we can all collaborate. This doesn’t make areas of disagreement go away, or mean we won’t eventually have to have discussions about them, but its worth recalling that there are areas we can all pull together even if we don’t manage to agree on other things.

  3. Gary,

    I think your goals are rational and reasonable and worth discussing…but after 9 years of helping my wife heal, I understand the power of ‘triggers’. We all have them, not just abuse survivors. Sadly, triggers are one of the biggest hindrances to rational and reasonable discussions whether it’s what you have suggested or any other topic. And the stronger the emotion attached to those triggers, the harder it is for someone to hear another with whom she/he may disagree.

    When I look at the ugliness of what the U.S. has become on the right and left, I see triggers abounding from both sides. No one even pretends to listen. They have their ‘response’ ready to fire before the other side even says it’s first word.

    Until we can figure out how to move past people’s triggers, sadly, I think your reasonable arguments will never be heard by some.
    Sam

  4. We need to think a little more carefully about what the term “antipsychiatry” means. In her article, Bonnie explained the term beautifully and clearly. Of course true antipsychiatrists welcome even those who are critical of psychiatry to enter the fray. Those who are merely critical of psychiatry may be helpful even though they haven’t fully grasped the reality of the problem. But pragmatism follows clear thinking. Once the conversation turns from the abolition or the eradication of psychiatry to “how best we might harness this array of dissent so as to realize radical change,” we need to recognize that we are talking about two completely different things. If it is true – and I submit to you that it is – that psychiatry is inherently a system of torture, abuse, involuntary incarceration, drugging, electroshock, coercion and slavery, then the only reasonable position is that of abolition. It’s not simply a matter of “radical change.” Imagine if Lincoln, instead of issuing the emancipation proclamation, called for a reform proclamation or a paradigm shift based on a critical approach to southern slavery. That probably wouldn’t have gone over too well with Frederick Douglass, for example. We can learn much from Lincoln, however, in contrast to radical abolitionists like William Lloyd Garrison, because Lincoln understood that the deracination of slavery was a complex matter that would cost the Union dearly.

    “Many argue that the inherent inadequacies of Western psychiatry are so deeply ingrained as to render the current system beyond repair.”

    It’s not really a matter of deeply ingrained inadequacies. For example, with the advantage of historical hindsight, no one in their right mind argues that Naziism was inadequate, or that Hitler and the Gestapo should have taken a more critical stance toward Jews, Gypsies and other minority groups. No enlightened individual argues that Churchill and the Allied Forces should have attempted to repair the Third Reich. It may sound extreme to compare psychiatry to Naziism or slavery, but those who are familiar with the history of psychiatry understand the direct connections (think of Dr Imfried Eberl and drapetomania).

    The only “meaningful change” is abolition. Abolitionists do not lament the “gross overuse of psychotropic drugs.” Dr. Phil Hickey has demonstrated with great clarity why notions such as “overprescription” or “overdiagnosis” are misleading (see, e.g. https://www.madinamerica.com/2017/01/allen-frances-overdiagnosing-children/) One can no more “overuse” psychotropic drugs than one can “overuse” poison. Imagine if someone objected to a police officer’s overuse of shotgun blasts to the abdomen, thorax, and cranium of an innocent pedestrian. Would the solution be to moderate the shotgun blasts?

    There is a tension between abolitionists and reformers because abolitionists understand the history of psychiatry, whereas reformers generally do not. If we are to create unity in the antipsychiatry movement, we need to get clear on what “psychiatry” is. What is psychiatry? One simple thought experiment is to take a look at the word itself. What is the etymology of the word “psychiatry”? “Psyche” meaning “soul,” and “iatros,” meaning “medical treatment.” Does the word even make sense? “Medical treatment of the soul”? The medical treatment of the soul would require, first of all, that psychiatrists have special knowledge of the nature of the human soul, and secondly, that the medical treatment of a human soul is possible. Psychiatry is false on both counts. Psychiatrists don’t treat the human soul. They abuse, coerce, torture, label, drug, confine, enslave and shock their victims into submission. And psychiatry certainly has nothing to do with medicine, since there is nothing remotely scientific or medical about poisoning, shocking, and subjugating innocent people.

    Another helpful exercise is to research the work of some of the major founders of psychiatry and to determine whether or not they were legitimate scientists and doctors, or merely con-artists. It is difficult to ignore the fraudulence of Freud, the quackery of Kraeplin, the mendacity of Mesmer, the charlatanry of Charcot, and so forth. The array of modern phonies is also staggering: Frances, Spitzer, Lieberman… and thousands more.

    As Frank correctly observes, the term “service-user” is nonsensical. Since when is it a service to confine, poison, label, coerce, shock and abuse innocent people? Those who “use” the “services” of psychiatry usually have no idea what the “services” entail. We don’t speak of the “services” of Nazi guards or of slave owners, nor do we consider that their victims were “users.” It’s time to stop pretending that psychiatry renders any kind of useful service to the afflicted.

    “Unifying goal 1: More frugal use of psychotropic drugs”

    Again, with all due respect, this is nonsense. Should we be more frugal in our use of hammer blows to the skulls of children, adults, the elderly and the homeless? We need to understand that psychotropic drugs are not “medication.”

    “Unifying goal 2: The reform of mental health legislation”

    Frank’s statement on this topic is sufficient for now.

    “Unifying goal 3: Abolition of the Diagnostic and Statistical Manual (DSM) classification system and an end to disease-mongering”

    This is good. It would be like chopping of one of the heads of the hydra, but it is a big, ugly head. By all means, chop it off.

    Any discussion of “alternatives” to psychiatry takes for granted that we have achieved a consensus on what psychiatry is. We don’t discuss alternatives to Naziism or southern slavery. In other words, the natural alternative to psychiatry is the abolition of psychiatry, or in other words, the promotion of freedom and responsibility.

    • I agree with the gist of your argument but I still think that the practical points outlined in the article can be fought for by those who seek reform and those that seek abolition.

      It would all depend on who was leading a perticular campaign as to what the overall aim was but I would hope that both camps would cooperate on any campaign that led to less forced treatment, less drugging, less ECT and more humane compassion.

    • Beware the dark sayings of the Prophets regarding the existential reality, consensus reality is most certain of: They see yet do not see. They hear yet do not hear. And neither do they understand themselves?

      Yet ‘paradoxically’ they see and hear a certain truth, that the social world of community communication, is indeed, made of words. While Galileo did marvel at the infinite possibility of 20 characters (letters) laid upon a page. And within his latest book ‘What Kind of Creatures are We?’ Noam Chomsky points out that by far the most use of language-based communication, happens inside each subject’s cranium.

      While in trying to create an ‘integral’ approach to our common humanity, Ken Wilber points out ‘how’ we all honor the unspoken taboo on expressing our private ideation in public. Hence ‘unwittingly’ we all maintain the status-qua. Hallelujah! Cry the Christians in celebration of being here in heaven, while the wise Buddhists ask, “How you do that?”

      How do you do, Being You?

  5. It stood out to me that there was no mention of nutrition in this particular article. Because it is so basic to well-being, nutrition needs to be considered if general collaboration is to take place and if solutions to the mental health crisis are to be found.

    If Canada’s Minister of Health, Hon. Jane Philpott is committed to working towards quality change, she must correct her knowledge base regarding nutrition. In a recent CBC interview she stated that front-of-package symbols warning consumers about foods that are high in salt, sugar or saturated fat and that eating in moderation is what will save the day. She obviously knows nothing about nutrition, hasn’t heard the evidence that saturated fats are good for us and that the decades long restriction of them is strongly linked to the crisis in health that Canadians are facing, especially in children. She doesn’t appear to know the difference between healthy sea salts and the highly processed denatured salts common to processed foods. She makes no mention of the importance of choosing nutrient-dense traditional organic foods (non-GE foods) or that chemical residues of glyphosate (Roundup) are present in nearly all of our foods, especially processed foods of which over 80% contain GE’s. There is ample and profound evidence that nutrition impacts our mental health. Please see this edition of the Weston A. Price Foundation Wise Traditions Journal with fully referenced articles that attest to that the basic fact that we are what we eat – mentally and physically: https://www.westonaprice.org/journal/journal-spring-2013-nutrition-and-behavior/.

    Dr. Kelly Brogan’s successes in helping people recover from mental illness and the devastating effects of pharmaceuticals relies upon the traditional wisdom of clean, real, nutrient-dense foods. The importance of that cannot be overstated. I have witnessed what masquerades itself as nourishment that is served in hospital psychiatric wards, and it is the antithesis of what a healing diet would be.

    Please sign and share this petition to Jane Philpott and Health Canada: http://www.changethefoodguide.ca/. It was initiated by a Canadian physician and there are over 675 physicians and allied health professionals signing their agreement that Canada’s food guide needs to be corrected. The petition is open to anyone to sign, health professional or not, from any country. Please share widely. Currently (and for decades), the guide is based upon food industry recommendations rather than upon evidence-based nutritional policy.

    For further information, please see this article which I have written in support of this important petition: http://www.alternativeboomerlegacy.com/blog/lets-change-canadas-food-guide. Thanks, Linda Morken, Volunteer WAPF Chapter Leader, Victoria BC

  6. Gary,

    Thanks for the good practical article on uniting critical voices. If I may, I’d like to add one more suggestion. In the past I’ve been in hospitals, hotels/motels and restaurants that solicited my comments — in writing, and anonymously if I preferred — on the service they provided for me, and on the personnel who provided it. In fact, I’ve even been to a primary care doctor who did the same thing. I understand this is standard procedure in businesses and institutions that try to improve their reputation, and also their bottom line.

    Unfortunately, “mental health” “patients” are often the involuntary customers of the institutions and personnel tasked with serving them, so no one bothers to ask their opinion of what they receive. Seems to me we would immediately see a noticeable improvement in service if policies for collecting, analyzing and disseminating feedback were put in place. Why should these “patients” be treated as prisoners with no rights or opinions?

    What do you think?

    Best regards,
    Mary Newton

  7. i now consider myself antipsychiatry. my spiritual beliefs (I’m a Christian), my personal experiences, my reading, my observations…these factors combined lead me to think that psychiatry and psychology harm human beings all the time, and human kind would be be healthier, happier, safer, more genuinely free, and think more clearly if Mental Health, Inc. could be put out of business.

    Having said that, I personally welcome any critical, questioning, skeptical voices, any serious reflection, any serious analysis. The way I see it, Mental Health, Inc. cannot sustain very much analysis, criticism, or really…truth, of any sort…so unleashing a flood of questions and criticism from any and all angles might lead to a sort of death by 1,000 paper cuts. Something like that, anyway.

    I enjoyed the article, btw. Thanks for writing+posting this.

  8. The biggest obstacle I see in my daily observation of Mental Health, Inc is that the fourth wave feminists have bought into the biomedical model and are screaming it from the mountaintop in the name of “mental health parity” and “anti stigma”. I’m starting to understand why some people call feminists ‘feminazis’. No attempt to reason with this group is successful. On social media, attempts to explain the downsides of biomedical mental health results in blocking at best. I’ve also been doxxed, had accounts suspended by Facebook for simply disagreeing politely (if enough people report your comment, it results in automatic termination of your account), and had these (mostly women) post links to my accounts on their personal social media pages calling me ‘crazy’ and calling on their posse to also attack me. Honestly, if we were only dealing with doctors and researchers, it wouldn’t be as difficult to counter the biomedical narrative.

    I honestly don’t understand this either because in nearly every other arena, the feminists are the first to point out the effects of environment and inequality on human suffering. And yet, they don’t seem to understand that blaming the brain results in increased stigma. I wish everyone pushing the biomedical narrative would read the ‘Breaking Free From the Stigma Paradox’ that was recently published on this site, to get a taste of the effect of the biomedical model.

  9. I like the focus on finding points of agreement, Gary, and I found the points you mentioned excellent. I believe you are, however, missing one of the most, if not THE most important one. Financial corruption! I think we can get strong agreement that pharmaceutical companies purchasing influence in various ways, including sponsoring “educational” seminars promoting their products, ghostwriting articles, and engaging in DTC advertising and promotion to doctors which massively impacts prescribing habits and research priorities, is an evil that needs to be eliminated in the service of accomplishing any of the other goals you mention. Corporate malfeasance is also an area where many who occupy different ends of the left-right political spectrum can find solid agreement.

    Thanks for a timely article!

    — Steve

  10. Sorry, but before I even bother reading any comments let me say straight out: this usage of the term anti-psychiatry is a perversion of the term.

    Psychiatry cannot be reformed, as it is built upon nonsensical and fraudulent principles. Period. To ascribe the term “anti-psychiatry” to those who want merely want to rearrange the chess pieces on the board is offensive to those who truly desire to see psychiatry disappear.

    “Anti” means “AGAINST” — not “unhappy with” or “wanting a different version of.” Generally speaking, if a so-called “anti-psychiatry” demand can be met WITHOUT significantly undermining psychiatry’s power and influence it is not a truly anti-psychiatry position but a reformist one. And, again, something which is fraudulent at its core can not be “reformed.” There are no “reforms” which could justify psychiatry’s continuing with business as usual.

    Unfortunately the ambiguous semantics of the term “abolition” may be obscuring the important and irreconcilable differences between anti-psychiatry and “critical psychiatry.” Those who call themselves “abolitionists” differ from other people who consider themselves “anti-psychiatry” (when they differ at all) only in what approach and terminology they choose when explaining to the world why psychiatry should take its place in the dustbin of history. To call for anything less would be unacceptable, and certainly not “anti-psychiatry.”

  11. I am very happy that we are having this discussion. I agree with the dragon slayer and the kindred spirit for the most part, but I think it’s two things to talk about ideology on one hand and strategy on the other. In Reykjavík, Iceland there were once 4 communist organizations or parties which all hated each other. That proved, needless to say, to be counterproductive. When I read Philip Hickeys review of Robert Whitaker’s review of the new psychiatry apologetics I had this moment when I realized that at this point it doesn’t matter if it’s reform or anti-psychiatry if the cause is to the large extent the same at this point, which is in my opinion to:

    1. Raise awareness of what is and has been happening psychiatry
    2. Attack the DSM and the disease model on every level
    3. Affect change in legislature (it has to be stated clearly that it means protecting peoples rights to deny any treatment or intervention) (nobody should be a criminal unless they perform a crime, no field of medicine should work on preventing crime)
    4. File lawsuits against hospitals, states, psychiatrists and pharmaceutical companies
    5. (Most debatable) Support alternative forms of treatment, even if only to show that hardly any treatment is better than the current psychiatric treatment
    6. If there is any treatment at all, it must be understood by the state that a person cannot be your medical savior and your prison guard at the same time, that’s an absolute contradiction of roles.

    So this includes two of the three unifying goals, although the specifics are important because any vagueness in psychiatry legislature leads to vulgar displays of power even in the most minute and minor cases.

    So, frugal about psychotropic drugs? That’s the one I’ve never understood. But it comes from the open dialogue I assume. That in some cases drugs are OK. The DSM is bad, so is the disease model as a whole, but somehow a little bit of psychotropics drugs is sometimes necessary. Why?

    Anti-psychotics have murdered hundreds and thousands of people around the globe, and none of these people had any disease as far as we know. There is not a single idea of ethics in any religion or philosophy that can justify something like that? Risking peoples lives to save them from . . . what? I can assure you that being on anti-psychotics can be a much more dreadful experience than the psychosis itself. Psychosis isn’t that fucking dangerous. It’s not. It’s OK! and yet people are killed, soon to be millions.

    But for some reason, some people just “need it” and then they die, and who did it? Who murdered the person? because that is precisely what it is. Mass murder, holocaust, genetic cleansing (with no gene found)

    The middle way in this equation is = getting rid of all psychotropic drugs entirely but allowing a few people to still play doctor with some other types of toys while the rights to deny all forms of medical care are safely guarded.

    (and yes I would like alcohol and marijuana to be illegal as well but that’s a different discussion)

    well, that’s my opinion anyway.

    • ” but I think it’s two things to talk about ideology on one hand and strategy on the other. ”

      This is a fair point, Hildegard. I only want to add that talking about strategy without understanding the ideology that has led us to this point is somewhat short-sighted. In discussing strategy, there needs to be a place for debating the ideological perspectives that allow the disease model and pharma/medical to remain in control.

      Otherwise, I agree with your comment completely.

      • I guess what I´m also trying to put into words is that I largely agree on Gary’s idea of uniting goals, despite having fundamentally different view of some of the things are more or less similar. I wanted to point out that maybe if we turn it around it is not the ideology that is the basis of the problem but how people are being hurt on a day to day basis. If I tell people I saw someone beaten up in the mental hospital, by staff, they are shocked. If I yell at them with my Szasz-ean/Focault rant about the incurably fundamentally evil nature of psychiatry they run away. Also when I do that, maybe I’m starting to become more like a psychiatrist myself. It’s like Robert Whitaker, sometimes I find his criticisms rather “light” but that’s also why people listen to him, which is also why this website is great because it enables discussions like these ones to take place. Regardless of reform or anti-psychiatry debate, most people who write or read this site are in a marginal position with their opinions, in their area, I would assume and this way people can share tactics.

        • I find I have common ground with the reformists in the arena of psychology. I do not believe in burning the entire mental health system to the ground. I don’t think all the helpers are doing harm. I have a therapist I’ve seen intermittently since 2008. I like him. I trust him. When I’ve felt like I wasn’t getting what I needed, he referred me elsewhere, always offering that I could come back and that he wasn’t offended I was looking for another kind of help. So I believe in the power of having a good counselor. And unlike some of the complete abolitionists, I don’t see any issue with counseling being their paid vocation if they are truly good at relating with others and building respectful collaborative relationships for the benefit of the person seeking help and change. Where I clash with treatment providers, and where I am an abolitionist, is in the medicalization of human struggles in the face of adversity. If I were to try to work with reformists, it would have to be in the arena of ending the biomedical model of mental illness -abolishing psychiatry as a medical field – and returning to a structured compassionate caring supportive framework for helping those experiencing psychological distress.

          • Yes, I agree with you for the most part, but for me the other big topic if not the bigger one for me is the question of coercion. If you are coerced to see a councilor that’s very different. My experience with counseling/psychology is not entirely negative nor positive. Currently, if you show any psychotic symptoms they refer you to a psychiatrist to get pills. Alternative health people too sometimes, because nobody wants to touch it with a 10 foot pole, they’re scared of it. There is just this culture of “you have to seek help” that is very dangerous and kills people in the long run. I’m not against anything really except for lies and coercion/violence, which both are abuses of power those people should never have in the first place. If it was just a problem of capitalism+medicine it would be very simple, but it’s also a problem of government, law, police and every single power there is working against the freedom and well being of the mentally ill, probably out of sheer ignorance. But that’s the system today.

            Now, that doesn’t change the fact that I have met psychiatrists even, that were very nice, but they had wrong views and were indoctrinated into a cobweb of delusion, that wouldn’t have been harmful if they didn’t have this power and authority not in spite of but because of it.

            The way I see it, systems cannot become compassionate. People in any position can be. A good system prevents harm from happening. That’s how I see it. When I say law suits I don’t mean because these people are bad guys, but that way you can get a pressure from a different and higher authority because me as a nutcase against medical authority, I have none.

            Yeah, so pharmaphallacy/psuedomedicalisation and coercion are the two big subjects that I find vital to tackle with whatever means that work.

          • We are certainly in agreement against the use of force. My perspective on coercion seems similar to yours in that it goes beyond the use of legal force to include public attitudes toward the need for medical treatment whenever one admits to any degree of psychological distress whether it be garden variety anxiety and situational depression or the extremes of paranoid psychosis-induced violence.

            Beyond that, there has been a cultural shift away from “we’re all better off when we’re all better off” to “screw you, I’ve got mine, fend for yourself buddy”. People who reach out for support are not comforted, but rather asked if they’ve seen a doctor, or told to call their therapist. We’ve got more connection now than we’ve ever had before in terms of the internet. And yet we are so disconnected from our own responsibility to truly help one another. The idea of community has been eroded. Neighbors turn on neighbors, families are divided, and we have a generation of young adults who’ve grown up in the “if you see something, say something” culture of suspiciousness. We have more connection and treatment than we’ve ever had, and yet we’re, on the whole, isolated, lonely, and suffering. At least from where I sit and observe.

            And so we also need a cultural shift away from the idea that needy folks are burdens, and back toward the idea that we are each our brother’s keeper, in the very fundamental sense of shared burdens being lifted for the benefit of all. I think that talk about coercion without discussion of the underlying cultural attitudes that push people into psychiatry’s open arms is somewhat hollow and lacking.

          • And unlike some of the complete abolitionists, I don’t see any issue with counseling being their paid vocation if they are truly good at relating with others and building respectful collaborative relationships for the benefit of the person seeking help and change.

            I think you misunderstand what is meant by abolitionism. I would consider myself a “complete abolitionist” among other things, though I shy away from the term when it becomes a “litmus test” of one’s anti-psychiatry credentials. But there is nothing in your above statement I would disagree with; it’s only when counseling is portrayed as “medicine” that it becomes fraud. There are many forms of “therapy” which are not psychiatry per se; though the term itself is problematic, it can mean any number of things good or bad, mainly depending on the individual practitioner.

          • Oldhead, I believe we’re pretty simpatico on this issue. When I speak of some total abolitionists, I mean those who believe that all forms of therapy/counseling are always harmful and just as tainted as psychiatric “medicine”. And that genuine help should only come in the form of freely offered friendship support. I’m not going to call anyone out, but taking a look back at Bonnie Burstow’s recent post on anti psychiatry should make it clear. Totally agreed that “therapy” being couched in terms of medicine needs to go. I also think some of the people portraying themselves as “life coaches” are scam artists as well. I don’t think a good counselor necessarily comes from a trained program. Oddly enough, a priest I saw for a while for marital counseling years ago comes to mind.

          • KS — “Therapy” is a generic term, and a poor one at that. It can basically mean anything that doesn’t involve drugs or ect. It has basically no meaning so no real conclusions can be drawn until one gets much more specific. “Therapy” and “psychiatry” are generally differentiated from one another, unless the “therapy” includes drugs (in which case I would consider it psychiatry).

            Interestingly, while some of the early anti-psychiatry theorizing preceding the mental patients’ liberation movement came from the pages of The Radical Therapist, the movement became increasingly dismissive of the concept of “radical therapy” as it grew larger.

        • If I yell at them with my Szasz-ean/Focault rant about the incurably fundamentally evil nature of psychiatry they run away

          Don’t know if either Szasz or Foucault would characterize themselves exactly that way, but there’s no need to yell. 🙂

          I think “illogical” or “fraudulent” would be better descriptions, though the end result is certainly evil.

          • hehe,

            Yes, but when I, as somebody who has on occasions been institutionalized raise my voice and talk about what is fundamentally wrong with psychiatry people don’t listen, they just think “gee, that can’t be, that’s so extreme, he’s crazy”.

            I don’t think the problem is that society at large wants coercion to happen, on the contrary I think most people think that what happens is so extreme that they think it must be a lie.

            When I tell people that Zyprexa has killed more people than the bombings in Hiroshima they walk away. When somebody says, long-term research seems to show that most psychiatric drugs increase “relapse rate” they say, “what, can that be”? But listen. I don’t know why. If you spell the most difficult to accept parts of the truth out people just think it’s so overwhelming that it must be that I am crazy and a conspiracy theorist. And as a matter of fact, that’s what it says in my medical report. I was coerced into treatment on basis of the “fact” that I had conspiracy theories about pharmaceutical companies. Wherever I go I have no voice or credibility wherever I go, no matter how logical it is, no matter how well read I am, no matter the ethical values, by showing any sign of anger and or radically different believe to most ordinary people it undermines everything I say.

            So guess what I´m saying is, to be tactical you got to pick your battles at any given time, and take the path of least resistance at any given moment.

          • when I, as somebody who has on occasions been institutionalized raise my voice and talk about what is fundamentally wrong with psychiatry people don’t listen, they just think “gee, that can’t be, that’s so extreme, he’s crazy”

            Rule One: The power of truth is final. When they’re ready for the truth they just might remember they heard it from you first.

            When I tell people that Zyprexa has killed more people than the bombings in Hiroshima they walk away.

            See above response. Even if they don’t eventually come back for more info you will have planted a seed which may eventually blossom without your conscious awareness. Don’t insist on “agreement,” it’s overrated.

            Sure, it helps to be strategic about what battles to prioritize, but there’s no need to be timid either, especially with the truth on your side.

    • Not sure where the points came from but here’s my 2 cents:

      1. Certainly!

      2. Attack the DSM and the disease model on every level Yes, but keep in mind that ALL psychiatry is the “disease model”; otherwise it would not be psychiatry. So the only way to replace the “disease model” would be to eliminate psychiatry.

      3-4. These are more tactics which depend on what a specific situation may involve, rather than “principles” per se. Both are certainly legitimate in the right situation, though we should not limit ourselves to any one arena or tactic.

      5. No, sorry. There is no human need for which the fulfillment of such should be regarded as “treatment,” “alternative” or otherwise. To call the fulfillment of human needs as “alternatives to psychiatry” implies that psychiatry meets these needs in some way, and we’re looking for a “better” way. But all psychiatry is truly interested in is keeping people in line, despite a few individual exceptions.

      6. It goes without saying that no psychiatric procedure or incarceration should be involuntary. Although this is not an “anti-psychiatry” position on the surface, in effect the elimination of involuntary “treatment” would portend the end of psychiatry as a whole.

      • Any number of people can play at this game. I’m throwing my two cents into the ring as well.

        1. Ditto.

        2. All psychiatry isn’t “disease model”, there is also trauma theory, or what could be called the “trauma” model, or the injury model. Taking it even further, there is the problem of psychological/social “injury” given the slant professionals have given the matter. This goes well beyond medical, but not beyond medicalization because that’s what it is. Medical model incorporates both “disease model” and trauma theory however getting rid of either is not sufficient to de-fuse psychiatry altogether given psycho/social theories and interpretations.

        3. Legislation is the problem. We need to scrap mental health law as it is the law that allows people to be slandered, abducted, imprisoned, tortured, poisoned, brainwashed, and killed, all in the name of mental health “care” and treatment.

        4. Class action suits are like the casino gambling, and perhaps there are better ways to take on institutions, drug companies, etc. Drug companies have been able to weather some of the largest suits in history because they make so much money. (One would be better employed trying to figure out why that was, and doing something about it.) I wouldn’t encourage people to get into the activist game for mercenary reasons.

        5. Abolish forced treatment, and then any and every form of treatment offered will have to be entirely voluntary and not a matter of force and assault.

        6. The state needs to get out of the mental health treatment business entirely.

    • Also:

      at this point it doesn’t matter if it’s reform or anti-psychiatry if the cause is to the large extent the same

      It does matter in the long run, so it should in the short run too. If one realizes that psychiatry is first and foremost an extension of the prison system, not a branch of medicine, then certain immediate demands (such as the end of aggressive force, solitary confinement and torture/drugging) need to be pursued. But this is insufficient in itself. Since psychiatry is not conducted under the aegis of punishment but medicine, there is a simultaneous need to deconstruct the medical pretext as a precondition for formulating effective strategy. Psychiatry is based on logical absurdities and cannot be “reformed” any more than can waterboarding; to reform something it has to possess intrinsic value, however corrupted it may have become.

      • The key issue in my opinion is:

        Coercion

        and I think it unites both anti-psychiatry and reformists. If Thomas Szasz was right that should cut the Gordian knot because “without coercion, there is no psychiatry”.

        If that holds not to be true, then what remains after the end of coercion is reformed psychiatry.

        What I am thinking is – this is the priority no.1, because the fallacy of the biomedial model will be replaced by something similar or worse out of interest if which holds less sway if there isn’t the power of coercion.

        Even killing people with drugs and keeping them sick is less important, because if there isn’t any coercion, you can always choose and the rest of the problem is just about educating people about not using this “service”.

        We need people to understand that mental hospitals are north korea. We have U.N. , E.U. now and all kinds of things challenging psychiatry on the grounds of torture. The only question is, are we dealing with something that is bigger than psychiatry. Is psychiatry and pharmaceutical companies also serving other interests, for interest of governance. Subconscious even. Who else benefits?

        • I agree that the key issue is coercion, however, I don’t agree with the notion that it unites antipsychiatrists with reformists. Reformers don’t want to get rid of force. Antipsychiatrists do.

          The problem with the biomedical model is not the biomedical model, it’s coercion.

          “Even killing people with drugs and keeping them sick is less important, because if there isn’t any coercion, you can always choose and the rest of the problem is just about educating people about not using this “service”.”

          Thumbs up. I mean teaching lemmings not to be lemmings is kind of a self-defeating proposition, however, it is always possible, given reliable information, not to be a lemming oneself, figuratively speaking of course. Coercive treatment would, as it is constituted, deny one the right not to be a lemming. (Uh, and I must stress, that’s a human right by the way.)

          I tend to see in mental institutions Auschwitz and Dachau rather than North Korea that, and especially with the current head of state of the USA, is kind of like that Peter Sellers movie if you’ve ever seen it, The Mouse That Roared. (Cuba even more so than North Korea.)

          The status quo and big government certainly benefits from the efforts of psychiatry and big pharma to oppress and control people. Subconscious? What is that? Like advertising that relies on subliminal messaging, or understated propaganda? Yes, they’re out to maintain control of your head. It is not without an underlying reason that neuroleptic actually means ‘seize control’ of the nervous system. Zombification, given large doses of neuroleptic drugs, is a reality in some quarters.

          • I have direct experience with zombification and it’s no joke or exaggeration.

            I use North-Korea as symbol of vulgar use of power in current times. I have no way of judging if that is the case or not, but what people generally say north korea in general is like, the world of psychiatry certainly is like, and I know that for a fact. And yes, holocaust, concentration camps, but as much as it is true, a friend of mine once said, once any conversation mentions the holocaust it’s over, after that logic does not apply, and people are just angry comparing anyone they don’t like with Hitler. But it just so happened that the actual holocaust started out as “psychiatric treatment” done out of nothing but mercy just like today.

            Another important thing is that zombification is in effect = steralization. This is its own topic though.

            But when people are talking laws aren’t they usually talking laws against or not allowing coercion? What’s the priority? Are there really credible psychiatric reformists who support coercion? I ask out of ignorance, it’s not rhetorical.

            If that is the case then I do believe that all collaboration or bridging is largely counter-productive.

            Even if that was the case though, that wouldn’t mean that it’s a bad thing for neither. Collaboration can also mean criticizing the same things in different ways. I think this is also a matter of slaying a dragon by building one big dragon or slaying a dragon with many small ones that have only overlapping shared interests. In some ways it might be more effective. But having shared strategies is in all ways beneficial even if the ideologies are apparently not reconcilable. The overlaps are certainly many.

            I think the difference between the two is more about what people have seen and experienced. We all see that there is obviously a huge problem with psychiatry and the degree of dissident is in equal propotions to the degree of experience of violence.

            Having said that I believe that somebody who says he is a reformist is more likely to make headlines than somebody who says they are anti-psychiatry so in someways the might more easily achieve goals that would in our opinion fall under the anti-psychiatry category.

            Also, in my opinion, biomedical model in and of it self is not a problem. It’s just that this isn’t even a biomedical model, as there is no proof that there is such a thing. Recently chronic fatigue syndrome stopped being a mental illness because of compelling evidence that it had to do with the gut fauna or something similar. Once you have a biomedical explanation for a mental illness it ceases to be a MENTAL illness and becomes an illness. My experience of psychosis tells me that it is in large extent physical, even though its clearly started by lived experiences, but even if I know what’s going on, I couldn’t stop it with my thoughts. So in and of itself I have nothing against a biomedical model, really. That’s just not what psychiatry is.

            Well that’s just my thought.

          • Basically you’ve got two types of mental health reformers, ‘law and order’ reformers who want more coercive treatment, and ‘human rights, or ‘psychiatry critical’ reformers, who want less coercive treatment. Here it remains a matter of degree. I’m not going to tackle the matter of incremental change, and it’s relation to reform, because I don’t have the time, and I see a need for more radical change than that anyway.

            “Are there really credible psychiatric reformists who support coercion?”

            Most psychiatrists support coercion, and so do many victims of psychiatry BTW.

            I wouldn’t say all ‘collaboration or bridging’ is counter-productive. Some psychiatrists, and others, in fact, have come out in opposition to coercive treatment. I can definitely see uniting with them in order to take down coercive treatment practices.

            Anybody can make headlines if they have the proper bomb building equipment.

            The bio-medical model in and of itself is a problem. It supports coercive treatment, and it is prejudicial in nature. Blood brother, or perhaps offspring, to eugenics, it is the mental health version of white supremacy. Coercive treatment however makes it more, and much more, of a problem than it would be without coercive treatment. Bio-psychiatry has tried to reduce explanations of consciousness to a matter of the firing of neurons, and we know we’re dealing with more than that when we think. Consciousness comprehends a situation when a surge of activity along neural pathways doesn’t comprehend anything.

          • I don’t see any unity there. Reformists aren’t opposed to coercion, they are only for more or less of it, depending on their perspective. Abolitionists of coercion are opposed to coercion.

            Should one conceive of an end of coercion through incremental change, well, isn’t that like Lincoln and slavery before Fort Sumner and the Emancipation Proclamation? Abraham Lincoln before the war saw slavery as something that could go on in the south until sometime in the 1950s. The idea of incremental change bringing about an end to coercion is only a rationalization and excuse for present coercion, and should not be tolerated.

            To repeat, reformers are not for abolition as a rule. Ending coercion with finality is not a matter of reform, it is a matter of abolition. As for the abolition of psychiatry, I see that as something that is more problematic than the abolition of coercion. Generally speaking, any ‘abolish psychiatry’ slogan is empty rhetoric. When coercion is the real issue, blaming psychiatry alone becomes a detour and diversion from what really matters that is ultimately harmful to our movement and its aims.

          • Frank wrote:
            “Generally speaking, any ‘abolish psychiatry’ slogan is empty rhetoric.”

            Frank,

            I think you’re entirely right. I’m old as dirt, so I remember back in the civil rights era when the foot-dragging South insisted “change attitudes,” not “pass laws,” was the only way to end segregation. It turned out it was the other way around. Attitudes began to change only after segregation was outlawed. Anything less would have been a waste of time and effort.

            Old Thomas Szasz had it right from the beginning. The UN has already declared coercive treatment a form of torture. Now we need to work to change the laws, beginning with involuntary commitment.

            Mary Newton

          • First things first, get rid of coercion, then you might be better able to do something about psychiatry.

            You can’t call for a boycott of psychiatry. It’s parents of sometimes ‘adult’ children who utilize the field to get their errant kin locked up, when its not uptight neighbors, or brutish law enforcement who do so. Get rid of coercion, and if you call for a boycott, those participating in the boycott will be those actually affected by psychiatric practice.

            Psychiatry in the end is not the problem that coercive treatment is. I’m not objecting to people coming and going as they please, I’m objecting to them coming and going as captives of psychiatric detention orders.

          • Generally speaking, any ‘abolish psychiatry’ slogan is empty rhetoric.

            But it’s not merely a slogan. Abolition of psychiatry is the ultimate goal of the anti-psychiatry movement.

          • Here we go again. Usually, when somebody says ‘abolish psychiatry’ they mean something else besides ‘abolish psychiatry’. Get rid of it as a legitimate branch of medicine or whatever. You’ve got Bonnie Burstow saying that to do so would be to, in effect, ‘abolish psychiatry’. Perhaps in theory, in reality we’re not there. I don’t think getting rid of psychiatry as a medical practice would necessarily be the end of psychiatry, and, as I’ve said before, technically you could abolish psychiatry without abolishing forced treatment. I’m for ending forced treatment, and as for unforced treatment, we can worry about that when all treatment is unforced.

          • Well yeah, “here we go again” because your position doesn’t make any sense and you keep calling it anti-psychiatry when it is not. This confuses people who aren’t familiar with the topic, and does a disservice to all who have an actual anti-psychiatry agenda. Bonnie is 100% correct about abolition. Psychiatry is a branch of medicine by definition, so if it is abolished as a medical specialty, then it is abolished period.

          • I beg your pardon. I feel the same way about your position. I have no guarantee that if psychiatry were abolished as a medical specialty it wouldn’t persist in some other form, and if it were abolished as a branch of medicine, something equally oppressive might take its place. Psychiatry is also a religious sect by definition, if we are speaking in etymological terms, but not even psychiatrists take that part of their practice seriously. Good luck with your “abolition”. If you abolished psychiatry, you’d still have clown psychiatrists to worry about. I hear those ‘creepy clowns’ are everywhere.

          • I have no guarantee that if psychiatry were abolished as a medical specialty it wouldn’t persist in some other form, and if it were abolished as a branch of medicine, something equally coercive might take its place.

            So we shouldn’t try to abolish psychiatry because it might persist in some other form. And we shouldn’t try to abolish psychiatry because it could be replaced with something just as bad….

            These are the kinds of statements that don’t make sense to me. There are no guarantees in any human endeavor. There are no storybook endings where everything is perfect. What we have to contend with right now is psychiatry. We know it’s rotten, so let’s get rid of it.

          • Are you trying to imply that I am okay with forced “treatment”? Don’t see how you would reach that conclusion when i want to abolish the institution that oversees forced “treatment” and whose pseudo-medical theories provide the rationalization for it.

            I’m not touching the creepy clown comment! lol

          • No, I am saying that forced treatment is the real issue as far as I’m concerned. Talk abolishing psychiatry as much as you choose. If you don’t abolish forced treatment with your psychiatry where does that leave you? I think it more important to focus on the issue of force if we are going to get anywhere. When all treatment is unforced treatment we can talk about abolishing unforced treatment, however, that would be an odd thing to do, wouldn’t it? I don’t see any saviors in psychiatry although some people are looking for them. As for a world without psychiatry, sure, a person can dream, but force is the thing that it is crucial for us to work on abolishing, not psychiatry. Unforced psychiatric treatment is really NOT the issue.

          • To me, unforced psychiatry *is* an issue, because all psychiatry is coercive, and because the subtler forms of coercion often lead to the greater forms.

          • All psychiatry is not coercive. Unforced psychiatry is not coercive. Subtle forms of force are still force. Coercion is a synonym for force.

            I’ve known from the public mental health system how some of these subtler forms of coercion work, and how people try to compel people into unwanted treatment, but I don’t approve. Coercion is still coercion.

            You’ve got people compelled to attend “clubhouses” and day hospitals through economic coercion in some instances. Everybody sits around basically depressed, and shares their misery, when they certainly have better things they could be doing. I don’t think this is the way to operate anything, however some people keep attending…year after year after year…more for social reasons than anything else.

            Private practice has to be different. I would say that we’re basically talking about the public mental health system, and the problem there arose with the Kennedy administration creating a community mental health system through legislation. Basically, we’re all better off without this community mental health system.

            Not that long ago people were left to their own devices after discharge from the state hospital. No longer. Now you’ve got assertive community treatment teams, group homes, assisted living facilities, and very intrusive treatment, coming out of the pervasive paternalism under which the entire system operates.

            People have human rights, not so “mental patients”. Liberation is still some ways off from this constraining system of social control, and this liberation is the liberation I’m talking about.

          • The answer here is: Yes And No

            I’m continuing this ridiculously long thread at the bottom as I can see there are some key matters being “discussed.”

  12. Hi Gary – I really enjoyed your book ‘Tales from the Madhouse,’ and I took another look at it after reading this piece. Here are your own words from the blurb… “Current psychiatric practices are based on pseudo-scientific assumptions that are barely more valid than the claims of witchcraft and demonic possession which dominated society’s approach to madness in bygone times.” Agreed. My abolitionist viewpoint has been shaped in part by reading books like yours – how on earth is it possible to ‘reform’ a pseudoscience? It makes no sense.

    You say… “it is imperative that the various strands of the antipsychiatry movement unite,” but I don’t see this as a priority. Public awareness of psychiatry-as-pseudoscience is so pitiful that I am more concerned with raising the profile and credibility of antipsychiatry in the minds of the public by any means possible. If people have heard the word at all, they will almost certainly equate it with Scientology or Flat-earth anti-science conspiracy theorists. For me, turning this around is the crucial first step.

  13. Yes indeed , let’s have this this discussion . Read the following article from the Dragon Slayer’s recommended website, and let’s see if anyone that’s fully read it can tell us all with a straight face that psychiatry should not be absolutely abolished as quickly as humanly possible and placed into the dung heap area of the dustbin of history. (This article which IMHO out of lived experience since 1963 , actually understates the actual torture and terror which psychiatry embodies and should be defined by.)
    Why Psychiatry Is Evil by Wayne Ramsay
    http://www.wayneramsay.com
    Second to the last title in the contents list is the article ” Why Psychiatry Is Evil” by Wayne Ramsay
    Couldn’t hurt to read all his articles .

  14. So where were we? I guess I’ll start here:

    …it’s not merely a slogan. Abolition of psychiatry is the ultimate goal of the anti-psychiatry movement.

    Whether it’s an empty slogan or not depends on what the person using it is actually doing.

    Just to set some terms of debate, I’d say Uprising’s statement presupposes a lot. There is no unified anti-psychiatry movement at this point in time, so I’d consider it premature if nothing else to be making pronouncements on its behalf. Uprising, I know that for you “abolition” has been clearly defined, but if you ask people here (and especially elsewhere) what it means I think you’d get some widely varying definitions. The same goes for anti-psychiatry as a whole. It’s good to see people paying attention to this rather than pleading “but what about alternatives”; however there are a number of different approaches and schools of thought among those who identify as “anti-psychiatry” (and I’m not just talking about those who mistake it for “critical” psychiatry). We should be searching for a greatest common denominator.

    I’d say this debate has only just begun. We don’t need authoritative “spokespeople” so much as we need to help each other develop the skills of analysis and articulation needed to empower everyone as an “instant” spokesperson ready to spring into action as the situation demands.

    As to the actual issues of coercion etc. I’ll check back after I eat…

  15. So, coercion…I’m thinking out loud here…coercion is relative of course, as all government functions in the end via coercion. So calling something coercive isn’t always an argument for eliminating it, a more specific objection is needed. Obviously coercive psychiatry is oppressive; however all psychiatry is fraudulent by definition. So a question would be, should we ignore the fraud just because the issue of force is more immediate?

    Frank actually frames the situation well in his last statement (which is different from having a consistent analysis): Aside from the socially/economically coercive aspects of public psychiatry, and despite many instances to the contrary, it is possible to have a voluntary interaction with a psychiatrist, just as it is with a fortune teller. However if psychiatrists were kicked out of the medical fraternity, they would not be permitted to dispense drugs as medications. They could theoretically hang out a shingle saying “Psychiatrist,” but without the weapons of psychiatry (force and drugs) they would be just more variations on “therapist.” Which in itself could be construed as abolition depending on which definition you favor.

    As for what Frank calls “public” psychiatry, I agree it’s all coercive by definition and should be abolished by whatever definition of the term one may prefer. And whoever said it, I agree that right now the #1 objective of the movement and related coalitions should be the total abolition of involuntary and coercive psychiatry.

    • In a few states, psychologists have been given prescribing privileges. The excuse for this struggle by psychologists to attain prescribing privileges is that there are too few psychiatrists in the states where they reside. I say excuse because this is actually a part of a much broader power struggle between psychology and psychiatry for leverage. I expect psychologists are likely to have even more success in the future when it comes to gaining prescribing privileges. So the problem is not just one of a psychiatrist hanging out a shingle, as now psychologists are using what you call the weapons of psychiatry, a psychologist could do the same.

      Given the way the dictionary defines “health” and “illness” today, and due to the influence of psychiatry and psychology, psychiatry could not be said to be fraud. This is because “illness” and “health” when they are no longer organic, no longer in that sense objective, become abstractions. Semantically, we have to change this situation so that you can, in effective, once again call a spade a spade, or rather an illness an illness that is actually a physical illness, and not, as with the entire mental health field, an abstraction.

      Underneath it all I think the problem is that people know the system is not about medicine and that they know it is about social control. Even if you got psychiatry ousted from the medical community, we’d have a problem. What I’m saying here is that I do think the issue is about coercion, and not medical fraud so much. Some people go to psychiatrists of their own volition, however this cannot be said to be true for anybody who has been committed to a facility via a mental health hearing. Those people who go of their own volition do so because they see a need for doing so, and they are willing to pay for it. Those who go through the commitment process do so completely unwillingly.

      • Frank,
        I’ve been following this conversation. I’m with you, 100%, that ending coercion ought to be our #1 priority, and if people can’t collaborate on that, they either are ignorant of the most basic points of this issue or they simply won’t be a good partner for much of anything.

        Beyond that, I’d love to see the bio-medical model discredited, thoroughly, but I don’t know how much practical good it will do because with my wife’s d.i.d. it is the ONLY disorder that I’ve been told is trauma-based in the DSM (haven’t checked out that claim; just have heard that’s the case), and yet I really don’t see much practical difference that acknowledgment makes in how people with d.i.d. are treated over on WordPress. Most still have psychiatrists part of their ‘team’ and their psychologists don’t really seem to grasp the disorder any better than the disorders in the rest of the DSM that are supposedly ‘bio-medical.’

        I’m a pariah in most of the d.i.d. world because of how I approach her healing using attachment theory: h3ll it’s their own theory and they still hate me because they really don’t understand trauma-based issues any better even when they reject the bio-medical model for d.i.d and most have no desire to learn even though my wife’s recovery puts her in a completely different category of pretty much anything anyone has ever read about d.i.d.

      • Psychiatry is fraud by definition. Don’t see any way around it. Imbuing a mental state or any other abstraction with material characteristics is a no-go. Calling oneself a doctor who treats mental “diseases” is fraud. This is basic Szasz.

        • Problem. The standard definition found in any English dictionary defines “disease” in such broad terms so as to encompass your abstraction. Szasz, of course, didn’t define “disease” in such broad terms. When it comes to competing experts giving testimony in a courtroom situation, who do you think is going to have the ear of the judge? I’d say probably those having the standard dictionary definition because there are more of them. Otherwise, it’s a toss of the coin. Excuse me for playing devil’s advocate, but given a standard dictionary, what the definition therein doesn’t do, and probably because of the promotional and PR efforts of the “mental illness” industry, is equate psychiatric practice with fraud.

          • “Disease” – medical def from Merriam Webster:


            Medical Definition of disease

            : an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions, is typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors

            Granted there’s another definition relating to abstractions, but it is presented as metaphorical, not medical, in nature.

          • “An impairment of the normal state of the living animal”, etc. Excuse me, Szasz leaning on Virchow (a lesion in a bodily organ) is much more objective. These bio-psychiatrists, for one thing, are attributing “mental disorder”/”brain disease” “to inherent defects of the organism (as genetic anomalies)” despite the lack of any concrete evidence and given basically shoddy and thoroughly biased research methods. There is plenty of room here, with “normal state” as the “impaired” range, to let in psychiatry and its cronies. I would doubt, in fact, given psychiatry’s present cozy relationship with medicine, that such a nebulous definition wasn’t entirely intentional so as to entertain just such a collusive purpose.

    • Uprising, is your statement directed at me? Mine wasn’t directed at you.

      Unlike some in the anti-psychiatry crowd on this website, I don’t have many litmus tests for those with whom I would collaborate. It’s not ‘all or nothing’ with me which I think would be a far-wiser way to choose allies rather than Bush 2’s simplistic, ‘you are either with us or against us’. That kind of black and white thinking is juvenile and denies the complexities of people’s experiences and reality. So if you are for ending coercion, I’m all for joining you on that point even if we may not see eye to eye on anti-psychiatry vs. critical psychiatry.

      But even if someone wasn’t against ending coercion, I might, though it’s a big one, still be able to work with them if they were passionate about another aspect of the larger issue that I feel is important, like attachment theory, or refuting the bio-medical model, or validating the place/voice of the supporting family/SO’s in the healing journey, etc.
      Sam

      • Uprising, is your statement directed at me?

        It is directed at anyone to whom it may apply, but it was prompted by your comment.

        Unlike some in the anti-psychiatry crowd on this website, I don’t have many litmus tests for those with whom I would collaborate…

        Just stop it. The discussion we were having had nothing to do with any litmus tests for collaboration. I’m tired of seeing reformists here talking smack about people with an anti-psychiatry analysis.

    • Very true, Darby. I talk about abolishing force while others talk about ‘abolishing psychiatry’, but I think we’re pretty much trying to say something along similar lines. There is a big difference between modifying the amount of force being used, and using no force at all. Forced treatment, in any other circumstance, and without benefit of mental health law, is literally assault. The mental health system, through forced treatment, infringes on the freedoms of everybody. The issue is not just the harm being done to people through psychoactive drugs, the issue is that some people don’t have a choice as to whether they take these psychoactive drugs or not. It’s one thing to be harmed through one’s own gullibility, it’s quite another thing when one has no choice in the matter. We can spend a lot of time and energy informing people about the dangers of these drugs, but when people have no choice in the matter, what good is that information? Innocent, and knowledgeable, people are going to be harmed, and there is nothing they can do about it. This situation is unconscionable.

  16. I guess we are lucky to live under the rule of law , where we even have the right in a limited way depending on our finances to be heard verbally, or by the written word to oppose or criticize, and turn the other cheek , while authorized others can actually actively physically do abominable stuff to other people legally.
    In a world where at the same time undertakers legally embalm dead people for profit , injecting into them poison substances .
    Psychiatrists wearing the costume of health care , can legally semi- embalm / embalm live people, even children for profit , forcefully injecting poison substances and/or legally apply high voltage directly to the human brain of a live human being. Can legally lie to , label , and torture to their heart’s content . And are on the verge of expanding “their rights” to send teams to knock on people’s doors into right’s to enter people’s homes at will to enforce compliance .( maybe they won’t be financed to do it )
    All under the watchful eye and recommendations of clone IG Farben chemical ,pharmaceutical / biological /chemical , heavy metal, mix and match poison manufacturing cartels. All while they also attack the food supply , natural nutrients, and natural herbs. Very peculiar.