Antipsychiatry and Forced Mental Health Treatment?

I recently read, for the first time, the long out of print Psychiatry and Antipsychiatry authored by David G. Cooper. The question I had, in dipping into this slender volume, it’s only 148 pages long, was could there be any credence to Thomas Szasz’s accusations that some of the leading proponents of so called antipsychiatry were actually, if not favoring forced mental health treatment, soft on forced treatment?

The book bears a copyright for the year 1967, the same year co-hort R. D. Laing came out with The Politics of Experience. Between the two books, Laing’s is the stronger work, and to bear this point out, it is still in print. I had read Laing’s book years and years ago, and I had little desire to return there. However I was curious about this other book which had introduced the world to a strange new word, antipsychiatry.

I had gotten the idea from what I was reading that this idea of antipsychiatry was still relatively rudimentary, and I was surprised to get out of the book, rather than simply a diatribe against psychiatry, more psychiatry. David Cooper simply contrasts what we call biological psychiatry with his own psycho-dynamic brand of psychiatry, dubbed antipsychiatry. The arguments used, if more fully developed, are still around today.

What goes to the point of the question I was posing is the fact that David Cooper’s experiment, Villa 21, took place on an inpatient ward in Shenley psychiatric Hospital. This means that the people, males in the case of Villa 21, were not allowed to come and go as they pleased. They were literally prisoners. Cooper in fact dismissively refers in his book to a 1959 law under which they were held. You can only do so much on a locked ward at an inpatient facility, even if you are a psychiatrist wishing to implement changes.

The term Cooper used for what conventional psychiatry did was “quasi-medical”. This is a big difference between his view and my own. Psychiatry is simply not medicine, as far as I am concerned, despite the educational training of its practitioners and the pretence.  I’ve got another term for what this sort of conventional psychiatry is all about, and that term is quasi-legal. You’ve got a law for locking up innocent people, who have broken no law, on medical pretences. Generally the law exists to protect people from just such a consequence, making mental health law very murky territory indeed.

Much of his critique is subtle. The state is left off the hook, mostly, while he goes after one small unit for the implementation of the state’s will, the family. He begins his book by making violence a central issue, but this violence boils down to an invalidation on the part of parents and siblings of a family member. The state, the school, and the communities role in this depersonalization and invalidation is downplayed. He, as a therapist, is working to resolve issues that come up within this relatively circumscribed context.

I have always thought that R. D. Laing’s experiment at Kingsley Hall would have been much preferable to what I experienced. Such is the kind of an option that I wish I had had when I was imprisoned and forcibly drugged in a psychiatric hospital that I didn’t have. R. D. Laing had earlier worked in a psychiatric ward run by the military to loosen restrictions there. The problem with developing alternatives to conventional psychiatry, a problem that Dr. Szasz, restricting himself to private practice, didn’t have, is that doing so is going to mean a relationship to conventional psychiatry, and perhaps, as such, compromising with principle.

When this compromise is allowed to swerve into hypocrisy, we’ve got a problem. There has been some suggestion that the stance of R. D. Laing in the 80’s was not quite so adamant as the stance of the Laing of the 60s and 70s had been. As Thomas Szasz put it in his Reply to [Tristram] Englehardt in Szasz Under Fire, Edited by Jeffrey A. Schaler:

Even the “antipsychiatrist” Ronald Laing recoiled from denying the reality of mental illness, rejected my opposition to psychiatric coercions, and reasserted his loyalty to psychiatry as medicine.

Of course, it should be said to his credit that this same Ronald Laing may have had reasons for being deceptive as he was fighting a losing battle to save his license to practice towards the end of his life.

I think the case against is probably overstated in Antipsychiatry: Quackery Squared, a book authored by Szasz, that I have no desire to read. All the same, I’d like to see more psychiatrists take a position, as Dr. Szasz did, unreservedly in support of the abolition of forced mental health treatment. Many of the psychiatrists associated with what was termed the antipsychiatry movement didn’t take such a strong and unwavering stand, and for that I would fault them. If their credibility has suffered as a result, it should come as a surprise to no one.

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2 Responses

  1. The love of theory is the root of all evil. And where is there more theory than in the field of psychiatry? The bastards will slander their own own patients to support their pet theories, so stupid and dishonest they are.

    • Well, theory isn’t fact. I imagine much of the root of much harm is the taking of theory for fact. I don’t think theory is the problem so much as the bias in favor of one theory over all others, especially since it is a theory unsupported by evidence. Then this theory is guiding research into the total dupe zone. Slander of their patients is build into the system, and the theory. Typically, when it comes to attributing aberrant misbehavior to a birth defect, healthy skepticism doesn’t describe your psychiatrist.

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