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?

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