Is “mental illness” underfunded?

One way to deal with a problem is not to pay for it . In fact, it could be a solution to all sorts of problems. Problems that are subsidized tend to thrive.

The man who probably did the most to end forced psychiatric treatment in the USA in recent history was a Republican politician by the name of Ronald Reagan. I think you’ve probably all heard of him. He helped deinstitutionalize institutions, first in California, and second in the rest of the nation, by defunding them.

 A little refresher 101 might come in handy at this point. We have had a mental health movement for some time in this country. This movement is actually a “mental illness” movement. (Review the first paragraph.)

First you have moral management with the introduction of asylums, then here comes Dorothea Dix contributing her part to the asylum building boom that immediately followed. At the beginning of the 20th century, there’s Clifford Beers doing his part for mental hygiene, supporting treatment, bashing illness, if entirely theoretical illness at that.

 The mental health movement wants the government to pay for mental health treatment. The mental health movement hit pay dirt with the Kennedy administration. The Kennedy administration came up with the community mental health system idea, and passed an act to get it started.

Depopulate state mental hospitals, and what do you do with all the inhabitants then? No Clue? Well, one thing you could do is create little mini-hospitals in communities throughout the country. Another thing you could do is treat the prodigal son or daughter returning from one of these institutions like everybody else. The Kennedy admin legislation decided on the first option.

I read once that a person is “mentally ill” until the insurance runs out, and I think this statement is relatively true. If necessity is the mother of invention, as the saying goes, when one is subsidized by the tax payer, working ceases to become a necessity.

 Today there is a movement directed towards hiring patients in the mental health system as para-professional mental health workers. I have a few issues with this approach. Namely, what is the difference between a disabled person and a non-disabled person in the mental health field? Stumped. Well, I will tell you then. Employment.

Employing people in mental health is not getting them jobs in other fields, nor is it getting them very far from the problem, that problem being the mental health system. If a person enters the system against his or her will and wishes, does working for that system really represent a significant improvement?

Unfortunately, mental health insurance parity is on the horizon for which I suggest holding your nose. What was I saying about necessity? I know, There are those people with jobs in mental health care. Maybe some of them might be able to do a little bit of good.  All I can say to  them is, “When are you going to get a real job?”

R. D. Laing and the Politics of Liberation

I am not a Laingian psychotherapist. The spirit of the Pasha of Kingsley Hall can guide other disciples on a lifetime regimen of therapy to its wispy heart’s content, not me. I don’t see losing one’s way as a lifetime endeavor I would wish to pursue. I’m not an apologist for R.D. Laing excesses. Leave that to those of his associates who have survived him and their associates.

I have no aversion to being called Szaszian. Thomas S. Szasz was, from beginning to end, against psychiatric oppression. Dr. Szasz, in fact, supported the abolition of coercive psychiatric practices. R.D. Laing’s position on the same subject was much more circumspect, except where specifically stated, and then rarely. I think it important for doctors to take sides as advocates on this matter, and Dr. Laing, when he wasn’t practicing non-coercive psychiatry, seems to have, wrongly in my view, taken the other side.

I don’t want to bash Dr. Laing entirely. Credit must be given where credit is due. He did much good. He humanized the face of madness, he discerned that there was often a hidden reason to it, and he put it in a social–mainly familial–context. He also inspired the initial Philadelphia Association experiments that have in turn spawned whole generations of successors, most impressively the Soteria Project, still with us today.

When the BBC would discredit R.D. Laing, that is one thing, when Thomas S. Szasz would do so, that’s another. The BBC just wants to finish the reactionary establishment job of making this Maverick psychiatrist mud that his heart attack on a tennis court along the French Riviera started. Thomas Szasz, on the other hand, wanted to show that this Maverick psychiatrist was actually not so much a Maverick psychiatrist after all, and certainly not the Maverick psychiatrist he was taken for.

Perhaps, as has been indicated, R.D. Laing’s position hardened over the years. Dissident psychologist Seth Farber in his recently published book, The Spiritual Gift of Madness, makes a great deal out of Laing’s The Politics of Experience. Laing himself, near the end of his life, in a series of interviews with Bob Mullan, published as Mad To Be Normal, refers to this same book, The Politics of Experience, as a mistake. R.D. Laing, also in Mad To Be Normal, speaks about how disturbed the people he dealt with were, something he might not have done way back when The Politics of Experience was published quite so explicitly.

The thing I’m trying to stress here is that you don’t equalize the field merely by donning informal attire. At Kingsley Hall, behind the illusion that there was no illusion, all residents weren’t on an equal footing. They played at being on an equal plane, but without the assent of the psychiatrist residents, there was no equality. When R.D. Laing in his memoir, Wisdom, Madness, and Folly, rationalized forced institutional psychiatry as necessary, he turned poser and hypocrite. There is something hypocritical, after all, in reattaching the chains Sunday that you had removed on Monday.

Historically there are parallels. Take the much lauded casting off of chains at the beginning of the movement for moral management in mental health treatment. Restraints may have been removed in some cases, but these restraints were being removed from people who were quite literally prisoners. If any problems ensued, they could be quelled simply by throwing the prisoner into solitary confinement. The moral management movement created an asylum building boom, and thus raised the rate of people being held captive by the state for alleged “mental illness” substantially.

Given that R.D. Laing, by his own admission, considered psychiatric hospitals necessary, I wouldn’t rank him up there with the great liberators, and if he was not a liberator, he was a collaborator with the psychiatric plantation system. Perhaps there were two faces to him as far as R.D. Laing was concerned; if so, I guess you can choose the face that most pleases you. I much prefer honesty and integrity myself. It is, quite frankly, less deceitful.

Missing ‘The Psyche’ In Psychiatry

I came across in this Information About Psychiatry blog a post, Origins of the words Psychology and Psychiatry, on the word origin of the specialty beginning with a sentence on psychology.

The word psychology first appeared in the English language in the 17th century and derives from psyche (soul) and ology (study of).

Closing with a paragraph on psychiatry.

Later, in 1808 the word “psychiatry” was coined by Johann Christian Reil. This word means “doctoring the soul”, coming from psyche (soul) and iatros (doctor). This new word allowed psychiatrists to take matters of the soul away from religion and into their own, incapable hands.

It was quite fascinating to think that the second half of the word psychiatry seemed to have the same root as the first half of one of my favorite words, iatrogenic, or doctor caused. Used in a sentence: Psychiatry is the source of much iatrogenic illness found in the world today.

The base of iatrogenic, according to Mosby’s Medical Dictionary.

Etymology: Gk, iatros, physician, genein, to produce.

Soul, in this instance, often translates interpretively into mind, and the word mind in its origins is related to memory.

I know of people who see conventional twenty-first century psychiatric practice as ‘soul killing’ or fostering ‘soul death’. This has to be ironic as the psychiatrist was initially viewed as a person who would be a healer of souls.

Much of this direction away from the original slant of psychiatrist has come with the ascendancy of biological psychiatry. Biological psychiatry sees human problems primarily in terms of brain dysfunction, and it does not tend to look to psyche or consciousness for the source of, or the solution to, those problems.

Re-translating psychobabble into bio-babble certainly hasn’t increased the success rate for the field. In fact, the biological approach to problems in living seems resigned to a belief that subtle birth defects are the source of psychiatric disorders.

One has to point out, time and time again, that there is very little concrete proof for a biological basis to psychiatric problems. There has been, on the other hand, much heavy-handed theorizing and thoroughly biased verbiage expended to bolster such a faith.

Specialty Specialist Word Usage Timeline

psychology 1653

mad doctor 1703

psychologist 1727

psychiatry 1846

alienist 1864

psychiatrist 1890

shrink 1966

The DSM-5 is only a dead sea scroll and not the fully approved Allen Frances version

I hear a constant buzzing. No, wait. It’s only Allen Frances.

The chief editor of the DSM-IV is posing as the chief critic of the DSM-5, if that makes any sense. The problem is that the criticisms this retired psychiatry professor applies to the DSM-5 apply to the DSM-IV as much as they do to anything, and I’m still waiting for a major display of remorse over that document.

If we look at his latest in a catalogue of complaints against the upcoming DSM revision, DSM-5 Is A Guide, Not A Bible—Simply Ignore Its 10 Worst Changes, some of his criticisms are right on target.

His numero uno is a real humdinger, Disruptive Mood Dysregulation Disorder (DMDD) or temper tantrum disorder. This is the DSM revision teams way to try to deal with an artificially created epidemic that isn’t even in the DSM. A Harvard psychiatrist developed this notion that a number of these kids diagnosed ADHD were actually bipolar, and thus began the pediatric bipolar disorder boom. The DSM revision team has simply created a third diagnosis with which to compound the prior two diagnoses. When ADHD and bipolar disorder are at epidemic proportions, this is certainly paving the way for a third wave. Just wait, perhaps in 10 or 20 years they will come up with an adult DMDD diagnosis.

His second and ninth complaints we can skip over. Sadness, grief, and anxiety aren’t illnesses, or diseases, or disorders, or whatever you want to call them. They are emotions known to all of us. The distinction between clinical and “normal” is a distinction between the everyday and the psychiatrized. If you want one, go about your business, it will come. If you want the other, see a shrink. He or she has their “help” to contribute.

Number 3 is Neurocognitive Disorder or old folks disease. Oh, yeah. Age happens to everybody. I kind of think it redundant as when the brain breaks you have dementia or Alzheimer’s. If we had a ready trash can we could scrap number 3, too, but, of course, psychiatrists must to make a…I dunno…Is it a living, or is it a killing? Anyway, it’s bread, bacon, and a big house in an upscale neighborhood.

Number 4 is adult ADHD. I think I covered the subject sufficiently with number 1. There was a time when there was absolutely no ADHD. A few unruly children popped up, and the editors of the DSM-III put it in the DSM. ADHD babies grow up. 30 years on and, it’s epidemic among children, while the revisers of the upcoming edition are making it an adult “disease”. Pill popping babies grow up to be pill popping adults. Although the drug companies know this, they aren’t letting on. Why nip a good thing in the bud.

Number 5 over eating isn’t a disorder any more than over drinking is a disorder. Alcohol poisoning, with attendant headaches, on the other hand, bellyaches, diarrhea, and vomit, are major concerns. If you’re going to over indulge, learn to under indulge, er, or moderate your appetites. If you need a shrink to do so, well, you’re probably pretty gullible when it comes to a number of these other disorders. Excess in anything could be “co-occurring”, lay talk for “co-morbid”, with any human trait, negatively labeled a disorder, under the sun, moon, and stars. Psychiatrists tend to think “mental disorders” lead to “substance abuse” and vice versa. What a racket!

His complaint number 6 is a little weird coming from a psychiatrist. This has to do with the switch from Autism and autism related disorders to a general Autism Spectrum Disorder.

School services should be tied more to educational need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.

Alright. Should you be talking to the nation’s shrinks or the nation’s educators on this score, and then how does this effect other controversial juvenile diagnoses (say, ADHD, conduct disorder, etc.)? If your talking about the collusion between this nation’s educators, law enforcement officers, government officials, mental health workers and psychiatrists that is an even bigger issue than we’ve got time to cover right here and now.

Number 7 is certainly a valid complaint, and number 8 follows close behind. If recreational illicit substance use is abuse, habit and indulgence equals abuse, too. Although hypersexuality was not included in the upcoming revision, internet addiction is going to be there, and internet addiction is a behavioral addiction. Behavioral addiction opens up the flood gates for any fad or trend to be classified an addiction. If internet addiction makes this edition, you can bet other behavioral addictions are coming, and sexual addiction, however you spell it, is way up there at the top among the candidates for inclusions in future editions.

What he ignores is that these “worst changes”, as he puts it, are the result of a process and an idea that is thoroughly unscientific from beginning to end. You don’t find real diseases by inventing them, and voting them into common parlance. You only find fanciful diseases that way.

DSM-5 violates the most sacred (and most frequently ignored) tenet in medicine—First Do No Harm! That’s why this is such a sad moment.

We, in the psychiatric survivors movement, have been something similar for decades. What follows from this sacred tenet is my next question directed at Professor Frances. Why, given this basic tenet, do you need a guide book for doing harm to people at all?

This harm starts with the psychiatric label. The label is a category in the DSM. All further harm follows from this labeling of human beings as flawed or pathologically affected or unworthy. This labeling represents the beginning of a downward slide in perception from discourse between equals to that of discourse between designated authorities and sub-human second class citizens. Even if you’re using a bamboo pole and string rather than a rod and reel, a few of us still aren’t taking the bait.

Thomas Stephen Szasz, 1920 – 2012

“I am probably the only psychiatrist in the world whose hands are clean,” Szasz told the newspaper. “I have never committed anyone. I have never given electric shock. I have never, ever, given drugs to a mental patient.”

~Update: Thomas Szasz, Manlius psychiatrist who disputed existence of mental illness, dies at 92, John Mariani, Wednesday, September 12, 2012, The Post-Standard, Saracuse, New York.

Saturday Morning I saw the close of the historic 30th Anniversary Nation Association for Rights Protection and Advocacy (NARPA) conference in Cincinnati. The grand finale of this event was a rousing and invigorating talk by Bruce Levine lambasting corruption in psychiatry, and in his own profession of psychology. He was, in fact, calling for the abolition of the profession of psychiatry on the grounds of the extent to which it was contaminated by that corruption.

Sometime during the evening of the same day, a giant among giants as far as critics of mainstream psychiatry go, Dr. Thomas Stephen Szasz, passed away.

I flew back to Florida from Ohio on Sunday, September the 9th.

On the afternoon of Monday September 10th, during a teleconference, on a facebook page I ran across a report of Dr. Szasz passing. I immediately made mention of this comment to the people who were taking part in this teleconference. We did a quick Google news search, and decided it was probably nothing more than an internet rumor. There was nothing in Google news to indicate that he had died. Dr. Szasz, although 92 years of age, had just last year presented to an enthusiastic crowd at the International Society for Ethical Psychology & Psychiatry (ISEPP) conference in Los Angeles.

Tuesday I had more than enough reliable reports to conclude that he had expired. First there was an announcement on the ISEPP facebook page, and a link was provided to the article that sparked that announcement.

The New York Times on Wednesday reported on his death with an article that quoted E. Fuller Torrey and Edward Shorter, by no means friends of, nor friendly to, Dr. Szasz and his ideas. Vera Hassner Sharav, president of the Human Alliance For Human Research Protection, uses the occasion to voice his differences in opinion from those expressed by Dr. Szasz rather than emphasizing any places where they might have been in agreement.

Usually when you are remembering a person, you turn to his friends rather than his enemies. Although it is curious that the New York Times should turn to Dr. Szasz’s enemies when remembering him, certainly Dr. Szasz’s legacy neither begins nor ends with the New York Times.

I think it goes without saying that some segments of the mainstream mass media are as corrupt as the psychiatrists they quote. A much more just and balanced appreciation, The Passing of Thomas Szasz, can be found in The New American.

Dr. Szasz’s distinctive voice, and his singular presence, will be sorely missed by many.

Mad About The Middle Ages

I have suggested at one time or another that acting classes, a course in logic, or survivalist training might be good for a person’s mental health. A flyer about a demonstration I played a part in recently suggested protest was therapeutic. Here’s another idea…Maybe archeology could help return a person to his or her wits.

A medieval village in Herfordshire England is slowly resurfacing. The story appears in the BBC News Hereford & Westchester, under the headline, Remains of ‘medieval village’ found in Herefordshire.

Excavation work began a week ago on land in the Brockhampton Estate, near Bromyard and experts say it gives a glimpse of rural 13th Century life.

Seems there was once a village called Studmarsh in a place known as Grove.

Here’s where it gets interesting:

The project is being undertaken by volunteers, including people recovering from mental health problems.

Anybody up for doing a little digging after days of yore.

Some Heritage Lottery funded the Past in Mind dig after hearing how rural history had inspired volunteers from a mental health charity.

The project is run by the mental health charity, Herefordshire Mind.

Really? You mean hopefully ex-loony bird ne’er do wells are good for something besides holding a mop? Jumping Jehosaphat, Batman! What a revelation!

Ignore History At Thy Peril

How do you dialogue with psychiatry when psychiatry doesn’t dialogue with you? You don’t. This leaves psychiatrists rehashing things the psychiatric survivor, mental patients’ liberation, movement dealt with many years ago…as if we had not done so. We, in this case, means people who have endured or survived psychiatric treatment, or perhaps mistreatment is the more apt way of putting it.

This psychiatrist, H. Steve Moffic, M.D., makes an effort to come up with a name for discrimination against people who have had psychiatric labels attached to them. The story in Psychiatric Times bears the heading, Psychism: Defining Discrimination of Psychiatry.

I don’t think by today that there can be any question that there is significant discrimination and prejudice directed against those who are deemed to have some sort of significant mental problem. Many times, that has resulted in trying to keep such people out of mainstream society, whether that be hospitalization, not being able to live in certain neighborhoods, and not being hired for work.

Brilliant deduction, Sherlock! We ex-patients have been saying the same thing for years and years on top of years. When did you first reach this astounding conclusion, sir?

From here he adopts the personal pronoun “we”. An editorial we would presume to speak for everybody. As for this “we”, the “we” he would be speaking for is the “we” of people he treats, we, using the editorial we, will call this “we” the benevolent dictatorial “we” instead. Tonto adds, “He speak like him ownum turf, Ke-mo sah-bee.”

Now we may be seeing more and more of that in our field as the antipsychiatry movement of Scientologists seems to be expanding to former patients and their families who felt they were hurt by psychiatry. While some anger and criticism is surely warranted, the vitriol and call for the end of psychiatrists seems to border on hate speech, as described in the recent Psychiatric Times blog of Ronald Pies, MD.

Families that have lost loved ones to psychiatry might feel they have reasons for identifying with the Church of Scientology. Likewise they might feel they have reasons for not identifying with the Church of Biological Psychiatry. This is not an issue for me. The Church of Scientology is no more open and transparent than is the Church of Biological Psychiatry.

Mental health consumers and psychiatric survivors marched on the APA convention in Philadelphia this May. We had to be adamant. We had some psychiatrist come outside who thought we had something to do with Scientology. We didn’t have anything to do with Scientology, and we didn’t want anybody to think we did. Cult, church, or organization–legimate or illegimate–we were in no way connected with Scientology, nor it’s front group, the Citizens Commission on Human Rights. Apparently these guys only read themselves.

Blacks have racism, woman have sexism, Jews have anti-semitism, etc. Why not come up with an “ism” for people who have done time in the mental health system?

Perhaps the lack of such an “ism” indicates a discrimination and prejudice even more intense or ingrained, so much so that there is not even a term to rally around. Such a term could be psychism. This is a term that is so unused that we can easily adopt it as our own. In theosophy, I found it used on rare occasions to refer to spiritual awakening. Spiritual awakening is indeed what we need, isn’t it?

Where has this man been for the last few decades? Language has long been a major concern for people in the psychiatric survivor, mental health consumer, and ex-patient Mad Pride movement. We’ve even started to sit down with the likes of him. People in this movement have come up with the terms mentalism and sanism to describe prejudice and discrimination directed against them for this very reason. These terms are part and parcel of that discrimination of psychiatry we term psychiatric oppression.

We don’t need a psychiatrist to link our struggle to the struggles of African Americans, women, gays, senior citizens, children, disabled people, homeless people and other often disenfranchised and marginalized peoples. We’ve been a part of those same struggles for many years. If this man took any real interest in the history of the people he treated as a group, he would know these things. Apparently it’s a history lesson he desparately needs.

Straight Bias Is Not Impartiality

If you’re going to write an article about bias, try not to make it biased. The subject of this Opinion Piece in the Philadelphia Inquirer, misleadingly titled, Don’t repeat biases of the past, authored by Jonathan Zimmerman, while claiming to castigate bigotry, would actually have us repeat the prejudices of the past.

Why do we regard one trait as changeable, while the other one is supposedly cast in stone? The question came back to the news this month, when prominent psychiatrist Robert Spitzer renounced his famous 2001 study claiming that some gays could become straight via so-called “reparative therapy.”

Mentioning protests in California and Philadelphia against such “reparative therapy”, Mr. Zimmerman says:

Methinks we doth protest too much. As the gay community has taught us, every human being has the right to determine her or his own sexual identity. By dismissing self-described “ex-gays,” then, we risk repeating some of the same bigoted tactics that have been used to condemn homosexuals themselves.

Considering that 20 % of US citizens are on psychiatric drugs, considering the multi-billion dollar drug companies that are profiteering on death and dying, considering the creeping medicalization that is making artificial invalids of vast swathes of the American public, methinks we doth protest too little. In fact, I was out there with other protesters protesting the American Psychiatric Association, and its labeling bible, at their annual convention in Philadelphia earlier this month.

Mr. Zimmerman, by the way, doesn’t identify himself in this article as an “self-described ex-gay”, but he does go to the heart of the problem.

Yet ex-gays say otherwise, insisting that they — not the psychiatrists — are the best judges of their own mental health. And that’s an exact echo of gays, who were stigmatized as “sick” by the same profession until the early 1970s.

Before the early 1970s homosexuality was listed as a psychiatric disorder in the psychiatrists label bible, the DSM. Heterosexuality was never listed as any such disorder in this label bible. The trans-sexual impulse and inclination, under the guise of gender identity disorder, is still listed as a “sickness” in this catalogue of “disorders”.

If anybody thinks sexual orientation is not set in stone, he or she is free to change their orientation. Betwixt homosexuality and heterosexuality you’ve got the bi-sexual identity as well, and that one Mr. Zimmerman leaves completely untouched. Some people claim to have physical affection for members of both sexes. Is Mr. Zimmerman suggesting this passion is a “sickness”?

My own view is that sexual experimentation is going to happen, and no amount of what amounts to moralistic preaching is going to stop it from happening. We have enough problems with those politicians who wish to look beyond their wives for satisfaction, comfort, solace, support, and/or relief.

If anybody wants to consult a mental health professional about changing their sexual preference they are free to do so. The idea that there must be a special therapy for people who want to change their sexual preference is ludicrous. Nobody is trying to change the sexual preference of heterosexuals, for instance. The implication would be that heterosexuality is wrong, and homosexuality is right. You have always been free to change your sexual orientation if you want to do so. The question here is, if you don’t want to change your sexual orientation, should you change it anyway? I leave that one where it belongs with the specific individuals who happen to be so afflicted, disturbed, curious or smitten. To state the matter in more precise terms, homosexuality is not a “disease”, nor is heterosexuality the “cure”. It would be misleading and prejudicial for us to treat them as such.

Fifty Years Down And Maybe A Clockwork Brown Could Use A Little Touch Up

I have for awhile now been doing almost daily internet searches for the appearence of the term anti-psychiatry in the news. In most instances this word is used as an expression of disparagement, or as an example of a trend from which a journalist or a blogger wishes to disassociate him or herself. If trend it is, it isn’t a very popular trend. These are the primary instances in which the term makes an appearance. There is another instance, too, when the term puts in an appearance, and that is when psychiatrists use the term themselves. Here the term is being used to scapegoat critics of conventional psychiatry. Anti-psychiatry is the great bug-a-boo of mainstream psychiatry today. It doesn’t have much of a substantial existence, and yet psychiatry feels a need to defend itself from this amorphous and mysterious malevolent force it feels is being directed against itself. Anti-psychiatry Disorder is the great white whale of a ‘sickness’ the contemporary megalomaniacal mad Dr. Ahab feels most challenged by.

When it comes down to it, I think there is very little difference between anti-psychiatry and non-psychiatry. Non-psychiatry is basically indifferent to, and not in need of, psychiatry. I think non-psychiatry has a great future. Anti-psychiatry, on the other hand, is more dependent on psychiatry. Anti-psychiatry is antipathetic to psychiatry, and this creates no end of problems for psychiatrists. Its future is tied up with the future of psychiatry. I don’t think it very ironic at all that a psychiatrist came up with the term anti-psychiatry. Disciples of Christianity came up with the beast 666, the Anti-Christ, to describe the nemesis and antithesis of their own faith. Atheism is altogether another creature entirely. Faith is the key-word here, and faith is not a matter for scientific inquiry. Science itself demands a certain amount of healthy skepticism.

Recently Dr. Edward Shorter, a psychiatrist, a historian, and a critic of critics of contemporary psychiatric practice co-authored with Susan Belanger, another partisan of coercive treatment, an article for the Oxford University Press blog, Anti-psychiatry in A Clockwork Orange. A Clockwork Orange is turning 50. One Flew Over the Cuckoo’s Nest, another classic, achieved 50 not so long ago as well, but these two experts were not so enthused about celebrating that momentous occasion.

Political interest in behavioural programming is represented by the Minister of the Interior (whom Alex nicknames Minister of the Inferior, or — in a nod to the truncations of George Orwell’s dystopian classic 1984 — Int Inf Min). The “Min” visits the prison to implement the treatment in order to fight crime “on a purely curative basis. Kill the criminal reflex.” He reappears as Alex’s “cure” is demonstrated and boasts to the media about government efforts to suppress “young hooligans and perverts and burglars.” In fact the police are now recruiting former hooligans to rough up whomever they choose and round up enemies of the Government, an agenda suggested by the Minister’s earlier comment about clearing the prisons for “political offenders.” This combination of political tyranny and abusive (Pavlovian!) conditioning in a future Britain where adolescent thugs speak a mixture of Cockney rhyming slang, archaisms, and anglicized Russian (“Propaganda. Subliminal penetration,” a doctor suggests) creates an additional sinister note that would have been especially potent in the Cold War era when A Clockwork Orange was published.

Now if we interpret this work in the way that Dr. Shorter and Ms. Belanger interpret this work it has something to do with the cold war era in which it came out. What neither of them are looking at is the way this work relates to the increasing medicalization of life taking place in our own time. After calling insulin shock, metrasol therapy, and ECT used extensively durring the 1930’s “highly effective”, a claim I find highly dubious. The authors point out ECT gained popularity in the 1950s. Then we get this paragraph.

Beginning in the 1950s, a series of revolutionary drug treatments arose: antipsychotics, antidepressants and anxiolytics. So widespread was their use that, by the time Burgess penned Clockwork, they had become the subjects of cocktail party chitchat. Medical psychotherapy, which had ruled the roost in previous decades, was wobbling (the Brits never had much interest in Freud’s psychoanalysis) and was about to be pushed out the door. All these innovations lent themselves marvelously to being parodied, sent up, and pulled down by scornful novelists.

This is hardly the end of the story. Those revolutionary treatments didn’t turn out to be so revolutionary after all. This psychiatric drug treatment revolution has lead, rather than to an end of “psychosis” in our lifetime as was hoped, to the favoring of drug maintenance over any approach emphasizing the possibility and hope of achieving complete recovery from, say, the youth, immaturity and thuggish nature exhibited by the chief protagonist of A Clockwork Orange, Alex. People in mental health treatment are also dying off at an earlier age than the rest of the population because of these drugs. Rather than eluding the “laws and conditions appropriate to a mechanical creation”, those “laws and conditions” are incorporated into a lifetime prescription drug taking regimen.

I’d say the times haven’t changed so much as these mental health professionals would envision them to have changed, and maybe the Anthony Burgess classic novel, and the movie based on that novel, could use a serious update to illustrate how similar the treatments parodied in his book are to treatments still being practiced on a widescale and regular basis today.

Psychiatric labeling, prejudice, and the media

The Ottawa Citizen has a story on a study conducted by the Mental Health Commission of Canada. There are good things and bad things to say about this study. A bad thing was the consistent use of the word “stigma”. People who have experienced the mental health system from the inside are not tattooed, or marked, the way Jews were required to wear yellow stars during the German Third Reich. The study bore the headline, ‘Lazy’ media stigmatize mentally ill. The claim that the media has created a slanderous spin is perhaps a better way to put it in this instance.

“Danger, violence and criminality were direct themes in 39 per cent of newspaper articles, and in only 17 cent was recovery (or) rehabilitation a significant theme. Shortage of resources and poor quality of care was discussed in only 28 per cent of newspaper articles, even though these are perennial problems.”

Danger violence criminality themes 39%
Recovery or Rehabilitation theme 17 %
Shortage of resources and inferior quality 28 %

People in the mental health system often end up there because they would get a low score on a charisma or popularity test anyway. Like jews, and other minority groups, they serve as a convenient scapegoat. Seeing as “mental illness” labels come between people, and the opportunities they might have previously seen in the world, I prefer to approach the matter in terms of prejudice and discrimination. Law enforcement officers do racial profiling targeting African Americans, likewise, here you’ve got the news media aiding and abetting in a similar type of profiling directed at people labeled “mentally ill”.

The analysis was based on 8,838 articles published between 2005 and 2010 that mentioned any of the terms “mental health,” “mental illness,” “schizophrenia” and “schizophrenic.”

The “schizophrenia” label is generally at the bottom of the mental health salvageable people list status-wise. Mood swing disorders, personality disorders, every other sort of label is seen as less severe, and more likely to respond to treatment than psychosis. This, in some measure, is due to the drugs used to treat the label. Long term use of neuroleptic drugs, the drugs used on schizophrenia, can exasperate the symptoms of schizophrenia, and are associated with overall cognitive decline.

[Researcher Rob] Whitley said 12 per cent took an optimistic or positive tone about mental health, while 29 per cent were “directly stigmatizing.” Fully 84 per cent did not quote a person with a mental illness, and 74 per cent did not quote an expert.

Optimistic or positive tone 12 %
Prejudicial and denigrating 29 %
Patient/ex-patient voice absent 84 %
Other expert voice absent 74 %

The media is owned by big money and corporate interests. It should not come as all too much of a surprise that the mass media demands a scapegoat. The mental patient has traditionally served as a scapegoat. It was no accident that NAZI Germany prepared for exterminating the Jews with eugenic policies aimed at exterminating the so-called “feeble minded”, and what were then termed “useless eaters”.

Sensationalism, a common phenomenon in media coverage, was contrasted with “advocacy journalism” that sought to bring the matter of “mental illness” labels to the attention of the general public.

The article concludes blaming the media on public stinginess, and suggesting that if the media claimed people in the system could recover, the public would be more responsive.

As corporate controlled media sources are always going to be prejudicial, it is important for people who have known the psychiatric system from the inside to use the internet for generating their own media. It is also important for mental patients and former mental patients to ally themselves with other movements for social justice and systemic change. Only by facing this prejudice head on, and by challenging corporate control of the media, are mental health consumers, psychiatric survivors, and former mental patients likely to make much of a dent on the long standing tradition of prejudice and discrimination that they are still enduring in the present day.