“Mental illness”, the belief

Among the major tenets of the Church of Biological Psychiatry is the belief, for there is no evidence supporting the claim, that what is commonly referred to as “mental illness” is an actual disease. Disbelief, to the converts to this faith, amounts to heresy, and they refer to this heresy as “stigma”. The idea is that if you belong to this church, you must believe in “mental illness”, and not to do so is to mistreat people thought to be diseased.

A couple of decades ago, a revisionist and protestant sect of dissident evangelists split from the Church of Biological Psychiatry.  This protestant church initially arose around the cathartic and redemptive power of mental health recovery. People infected with the “mental illness” bug were thought, by this church, to be capable of recovering their mental competence and, in many cases, completely so.

More recently, the Church of Mental Health Recovery has evolved into the Church of That Recovery That Is Not Recovery.  So many members of this church with the bug, were not losing that bug, and so it became incumbent upon parishioners to start in a new direction. I guess they’d grown attached to it. The feeling is that if the Church of That Recovery That Is Not Recovery continues to evolve in the direction in which it is going, it will eventually be entirely reabsorbed back into body of the mother church, the Church of Biological Psychiatry.

The “mental illness” lifestyle, ironically enough, is equivalent to the mental health lifestyle, that is, it is a lifetime of perpetual treatment for the affliction a person is presumed to have. Accompanying the initial curse of diagnosis (I do hereby pronounce thee “mentally ill”, and beyond hope of remedy or consequence), comes the attendant chronicity.  This chronicity, or lifelong path, is a matter of realizing the negative prognosis, or curse-fulfilling prophesy, issued by psychiatrists, the churches priestly caste of sorcerers.

The news is not all bad. Given advances made by the Church of That Recovery That Is Not Recovery, converts are learning to better enjoy their afflictions. Within the limitations of their debilities, the stricken are learning to carve the modicum of a decent existence out for themselves, however beset by hardship and suffering. The key to this silver lining, so to speak, is to be found in total compliance with mental health treatment plans.

If it weren’t for the great therapist who dwells in the sky, the creator of the drug research and development department, the “mentally ill” person, left to his or her own devices, would be lost. He or she would be just one more homeless refugee scrounging dumpsters for a bite to eat, mumbling to him or herself, and irritating business owners. He or she could even be squatting in the city jail for a spell. No more, he or she now can be diverted from that fate to a fate equally inane courtesy of Joe Tax Payer.

Believing in “mental illness”is not the same as believing in mental health. Believing in mental health is not the same as disbelieving in “mental illness”.  We could arrange this sentence in all its possible permutations regarding belief and disbelief, and it still boils down to pretty much the same thing. Maintaining a healthy skepticism, while keeping one’s feet squarely on solid ground,  creates a stabilizing effect. In a world where Big Foot, Nessy, ghosts and flying saucers still manage to captivate the popular imagination, it’s best to keep a wary eye out for wooden nickels and, one might add, false gods.

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.

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