Dr. Duncan Double: On Being a Critical Psychiatrist


This week on MIA Radio we interview Dr. Duncan Double. Duncan is a Consultant Psychiatrist at the Norfolk and Suffolk NHS Foundation Trust. He is a founder of the Critical Psychiatry Network and also runs a critical psychiatry blog. He edited the book Critical psychiatry: The limits of madness published in 2006 and has written a number of journal articles and book chapters.

We talk about Duncan’s experiences as a critical psychiatrist working within a bio-medically oriented profession.

In this interview we discuss:

  • How reading Freud as a teenager led Duncan to his interest in psychiatry.
  • That, early in his training, he found it difficult to take to the overly physicalist aspects of what he was expected to learn.
  • How he became interested in the work of RD Laing and Thomas Szsaz.
  • How he left his studies for a time, working with drug users in London, studying for a psychology degree and working in banking.
  • The formation of the Critical Psychiatry Network in January 1999.
  • How critical psychiatrists take a different perspective from mainstream psychiatrists who tend to believe that mental illness is a brain disease.
  • That critical psychiatrists are not so interested in arriving at a single word diagnosis, instead the focus is on understanding the person and why they have presented with the problems they have in the context of their life situation.
  • That critical psychiatrists aim to minimise the use of coercion and have been against the introduction of community treatment orders.
  • That the emphasis in treatment is on helping people improve their social situation and to be as independent as they want to be.
  • How Duncan felt about a period of suspension which arose partly because of his different practices, being less concerned about formal diagnosis and using less medication than other psychiatrists.
  • That critical psychiatry is still looking for more acceptance from the mainstream.
  • That Duncan welcomes the more recent emphasis on recovery in mental health services.
  • That Duncan does use medication but is very aware that the evidence for psychiatric treatment is biased for methodological reasons, for example, the difficulties having properly blinded placebo-controlled trials.
  • That good science is often being sceptical about the evidence.
  • That people can form attachments to their medication, so it is not surprising that people may become dependent on it and therefore may have discontinuation problems.
  • Duncan’s critical psychiatry blog which he would like to invite readers to visit and that he would like to develop an Institute of Critical Psychiatry.

Relevant Links:

Critical Psychiatry Blog

Critical Psychiatry Website

The Critical Psychiatry Network

Critical Psychiatry: The limits of madness (2006)

My tutor said to me, this talk is dangerous

What is Critical Psychiatry?

To get in touch with us email: [email protected]

© Mad in America 2018


  1. thanks james….I see a problem here…I think dr double
    views critical psychiatry as accepting only psychology
    and sociology causes and not including biology…
    I think this is a mistake….we don’t know enough yet
    to eliminate biology…critical psychiatry should include
    bio/psy/soc model of causation and treatment…

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    • I get the impression that you think an antipsychiatry position is not compatible with the possibility of biological causation. This is not accurate, in my view. I think an antipsychiatry view would say that biological causation exists, but should fall into the categories of neurology, immunology, nutrition, sleep apnea, or whatever real medical category applies. The problem is not that these phenomena called “mental illnesses” don’t exist, but that they are grouped together AS IF they all had the same cause. You acknowledge that they don’t, so what’s the point of calling someone “bipolar” if it doesn’t tell you what’s wrong or what to do about it?

      If someone has hallucinations due to a brain injury, they should see a doctor who knows about brain injury. Not a psychiatrist, because they don’t know anything about brain injuries. They just know about drugs and labels, and that doesn’t help people get better.

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      • thanks for your ideas steve….my main problem with anti-psychiatry…
        it is too extreme…it is mostly talk and no effective walk…it will cause more problems than it is helping…my psychiatrist wants to change the system but
        he will not join a radical group because people will just get hurt even more..
        my psychiatrist believes people have to change the way they are treating each other….people are being very violent and blaming….we need to go after
        the perpetrators not the whole system….

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  2. ok… anti-psychiatry would like psychiatry to no longer exist..
    critical psychiatry isn’t there yet…what is it all about..

    i have a mood problem…i have had 3 breakdowns..
    i still have a depression problem…i am very unhappy…
    i see a psychiatrist every 3 months…i shouldn’t do that..
    i take an anti-depressant….i should stop that now..
    i have been helped by a psychologist…that was wrong..
    i was dependent on valium for many years..that was wrong..
    i should never ever take another valium…
    i still don’t know the cause of my depression problem…
    i am told here that the cause model is psy/soc…
    i am told here that i shouldn’t pay any attention to the bio..

    am i thinking right…

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    • You want a direct answer?
      3 breakdowns, why did you have breakdowns? too much stress in the rat race? you MUST make money.
      depression yes many people have depression and need to find a treatment.
      see psychiatrist , should/shouldn’t do? I don’t see that anywhere
      take drug, whatever is working for you , you do it
      psychologist help , who said it was wrong?
      Valium use on a continual basis is bad for the physical brain , like any drug used on a continual basis.
      Cocaine alcohol Valium are drugs, you can take them if you wish.
      cause of depression, are you kidding me? depression has been around since the dawn of time.

      Giving to the poor, or poorer than you, used to make people feel good, otherwise known as charity. Giving people what they want https://en.wikipedia.org/wiki/Charity_(practice)

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  3. I don’t like a practice that is based on theories and assumptions. It makes no rational sense.
    It is still a practice that is practicing but on humans. The practicing is called experimentation.
    Even the idea of “mental illness” is simply differentiating between those who thrive according to what is thought of as the mainstream of society and those who do not. The theories are about why that may be. BUT, through these wonderings and theories have evolved labels and much hurt has come about.

    Why would any one be against psychiatry? If there was validity, people would not suffer stigma, resentment, hatred, worse medical care, lack of basic rights.

    No one within their right mind can defend a system that causes harm across the board.

    In anti-psychiatry NO ONE denies that suffering exists. Now I would like to know the necessity of hurting those who hurt, even more.

    That remains the biggest question. Making money of the backs of the suffering is as old as the hills. To proclaim to do good while doing it, is also as old as the hills.

    The practice of a disillusioned power to use those who are vulnerable is not new at all. It is simply
    a lack of awareness by those able to carry out the pain.
    I might suggest that power is the disorder.

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