From abuses in asylums to horrific “experiments” in Nazi Germany, the anti-psychiatry movement arose in response to perceived abuses within the mainstream psychiatric establishment. Yet has the movement actually brought about any sort of positive change for those people living with mental illness? Or has it generated more of an academic debate that’s had a minimal impact on the people served by the mental health system?
The term anti-psychiatry appears to have been coined by German doctor Bernhard Beyer in 1912. It became more popular in 1967 with its use by psychiatrist David Cooper. Psychiatrist R.D. Lang was another vocal critic of psychiatry, although he eventually rejected the anti-psychiatry label. He argued that psychosis was not a medical illness but an understandable response to injuries inflicted by schizophrenogenic parents. Well-known philosopher and sociologist Michel Foucault argued that psychiatry, whether inpatient or outpatient, was used primarily for social control. Sociologist Erving Goffman, who did pioneering work on stigma, argued that asylums were “total institutions” that controlled and oppressed those within them.
The role of Thomas Szasz
Psychiatrist Thomas Szasz was a prominent critic of mainstream psychiatry, although he didn’t identify as being part of the anti-psychiatry movement. In his 1961 book Myth of Mental Illness, he argued that what was referred to as “mental illness” was not actually a biological disease, but rather a pattern of behaviour that was viewed by society as problematic. He accused mental hospitals of being more like prisons than hospitals.
Szasz was particularly focused on the role of coercion in psychiatry, likening coerced psychiatric relationships to slavery and rape. He also argued that “suicide prevention is a euphemism for psychiatric coercion.” He added that “To the psychiatrically enlightened, anything connected with death is now a symptom of mental illness.” In The Myth of Mental Illness: 50 Years Later, he wrote:
“Today, the role of the physician as curer of the soul is uncontested. There are no more bad people in the world, there are only mentally ill people.”
In The Therapeutic State, he argued that mental illness was a myth and society viewed psychiatry as useful because it removed unwanted persons from the social milieu. He wrote that Nazi Germany implemented a “therapeutic state”, and psychiatry provided “scientific” justification for mass murder. He wrote that although this was later dismissed as an “abuse of psychiatry”, Nazi and American health ideology actually closely resembled one another, as they were both based on the premise that “the individual is incompetent to protect himself from himself and needs the protection of the paternalistic state”.
Szasz’s opposition to anti-psychiatry
Not only did Szasz not identify as being anti-psychiatry, but he was also openly critical of the movement. In the book Antipsychiatry: Quackery Squared, he wrote that the individuals associated with the anti-psychiatry movement had joined forces with the “therapeutic state” instead of rejecting it, and the movement left an “accursed legacy” of silencing serious criticism of the field of psychiatry.
In Debunking Antipsychiatry: Laing, Law, and Largactil, Szasz expressed his belief that the antipsychiatry movement had actually undermined his own cause. He was openly critical of others who took an antipsychiatry stance. He accused Laing of “psychiatric gobbledygook” and “charlatanry”, and called Cooper, Laing, and Foucault “power-hungry left-wing statists who were interested in taking over psychiatry.”
The Church of Scientology
In 1969, the Church of Scientology established a Citizens Commission on Human Rights, which was co-founded by Thomas Szasz. According to its website, the group “works to expose psychiatric violations of human rights and clean up the field of mental healing.” It accuses the field of psychiatry of “wholesale drugging of children for obscene profits”. The group has established a museum called Psychiatry: An Industry of Death.
In a 1969 article, Scientology founder L. Ron Hubbard claimed that psychiatrists did not actually have any idea how the mind actually worked, and he accused them of hypnotizing politicians. He wrote: “There is not one institutional psychiatrist alive who, by ordinary criminal law, could not be arraigned and convicted of extortion, mayhem and murder.” Chillingly, he went so far as to urge: “We want at least one bad mark on every psychiatrist in England, a murder, an assault, or a rape or more than one.”
Modern anti-psychiatry groups
Aside from Scientology, various organized groups have advocated against psychiatry. One, antipsychiatry.org, specifies that it wants no affiliation with Scientology, and members of the Church of Scientology are not permitted to become members of their organization. MindFreedom‘s stated goal is “a nonviolent revolution in mental health care”, and they oppose “coerced, forced, and fraudulent medical procedures”.
There are also a number of ex-patient groups identifying themselves as psychiatric survivors, including the World Network of Users and Survivors of Psychiatry. The ex-patient organization National Empowerment Center deliberately distances itself from the anti-psychiatry movement, describing it as “largely an intellectual exercise of academics and dissident mental health professionals”.
The University of Toronto in Canada has a scholarship in anti-psychiatry that was established in 2016 by U of T professor Bonnie Burstow to promote anti-psychiatry inquiry. The U of T website states that Burstow’s research group is the “largest single group of anti-psychiatry scholars anywhere in North America.”
Criticism of the anti-psychiatry movement
Controversy persists, and perhaps unsurprisingly, the Wikipedia pages on anti-psychiatry as well as Scientology and Psychiatry have multiple flags for such issues as disputed neutrality, limited worldview, and lack of solid references.
In a pro-psychiatry editorial for Current Psychiatry, Dr. Henry Nasrallah writes that “the original ‘sin’ of psychiatry appears to be locking up and ‘abusing’ mentally ill patients in asylums.” He puts forth lobotomies and labelling homosexuality as a mental disorder as examples of the “perceived misdeeds of psychiatry”. He comments that the anti-psychiatry movement is seen by some as “intellectual halitosis”. This sort of stance minimizing the abusive practices that have been carried out under the guise of psychiatry seems unlikely to provide a strong counterpoint to anti-psychiatry rhetoric.
Conclusion
My biggest question is whether the anti-psychiatry movement has brought about any sort of positive change for those of us with mental illness. If so, I’m not seeing it. Are there problems within the field of psychiatry? Absolutely, but those issues are likely best addressed by narrowing the divide between patient and professional, us and them. The anti-psychiatry movement’s polarizing approach is more likely to shut down dialogue rather than promote it, and this extremist stance actually makes it less likely that the psychiatric establishment will listen to the voices of people dealing with mental illness every day.
Perhaps the most important way to challenge abuses of power that exist within the mental health system is to use our voices. The internet age offers unprecedented opportunities to speak up, and in doing so we are more likely to affect positive change than by trying to fundamentally undercut the very notion of psychiatry and mental illness.
References
- Church of Scientology. (2018). What is the Citizens Commission on Human Rights?
- Dain, N. (1989). Critics and dissenters: Reflections on “anti-psychiatry” in the United States. Journal of the History of Behavioral Sciences, 25, 3-25.
- Hubbard, L.R. (1969). Crime and Psychiatry.
- Nasrallah, H.A. (2011). The anti-psychiatry movement: Who and why. Current Psychiatry, 10(12).
- Ronson, J. (2011). The psychopath test: A journey through the madness industry. New York, NY: Riverhead Books.
- Szasz, T. (2001). The therapeutic state: The tyranny of pharmacracy. The Independent Review, V(4), 485-521.
- Szasz, T. (2008). Debunking antipsychiatry: Laing, law, and Largactil. Current Psychology, 27(2), 79-101.
- Szasz, T. (2009). Antipsychiatry: Quackery squared. Syracuse: Syracuse University Press.
- Szasz, T. (2011). The myth of mental illness: 50 years later. The Psychiatrist, 35, 179-182.
- University of Toronto Ontario Institute for Studies in Education. (2016). Bonnie Burstow scholarship in antipsychiatry.
Making Sense of Psychiatric Diagnosis aims to cut through the misunderstanding and stigma, drawing on the DSM-5 diagnostic criteria and guest narratives to present mental illness as it really is.
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Thanks!
It’s also worth noting that most of the major anti-psychiatric theorists had strong anti-establishment political views. Szasz was libertarian; Laing, Foucault and others were Marxists. They wanted to alter society as a whole, not just psychiatric care.
That said, I think they may have had a valid point that mental illness is a reaction to social/political factors as much as personal ones, although that’s not the same as saying there is no such thing as mental illness or that mental illness is society’s “fault.”
Oh interesting. I’d read that David Cooper was a Marxist, but I wasn’t aware of the others.
I think I would tend to lean more towards our interpretation of mental illness being socially constructed rather than necessarily a causative relationship.
I like some libertarian ideas, but I don’t like their attitude towards society taking care of its poorest, weakest, and sickest. This attitude of “everyone can fend for themselves, no one needs to help take care of each other”. I find it very selfish. You would think Marxists would be in favor of taking care of the mentally ill though, at least in theory.
That’s a very interesting point.
Interesting read. And yeah, psychiatry has its problems and there have been those, through history, who did awful things in the name of ‘science’. Today I think personally (at least in the USA) that psychiatry is a good thing and more evolved than ever before. I recommend therapy to people I meet who might benefit from it and because of the stigma of past bad acts/deeds (like the homosexuality is a mental disorder or the water bath treatment or lobotomies) some of those people wouldn’t go near a mental health clinic or provider. Old sins cast long shadows. Personally? I’m sort of glad for those trial and error days. And there’s always going to be someone who has more to say than wisdom to back it up.
Yes it’s definitely come a long way from back then.
Antipsychiatry is not good. It is just an excuse to push off any society responsibility to help those with mental illness. Yes, there have been abuses by asylums and psychiatric hospitals and those things need to be watched closely and patient rights need to be monitored and protected, but I’m sure many of the homeless mentally ill would love to have a place to go if it wasn’t an abusive or scary environment. I would much rather be institutionalized myself if it came down to that rather than left on the streets.
Yes it accomplishes nothing to throw the baby out with the bathwater, so to speak, and try to get rid of the psychiatric treatments that are helping a lot of people.
Whatever happened to balance, reasoning and research. Why everything has to turn into a war?
Your research is commendable.
I talked to my father today who is bipolar. Anyone who doesnt believe in resistance of mental illnesses probably never had experience with one. But doesnt mean rest of the world is faking it.
He went manic this year after we lost our mother to cancer. He is blessed to have an amazing doctor and support. But he still questions how did this even happen.
He is on medication and therapy or he wouldnt be with us. We have lost an uncle to suicide. I don’t know what else world need to witness to understand gravity of this problem. It’s right there in our faces.
Absolutely. It’s clearly a problem, and there are a lot of people who desperately need treatment. What we need is more and better treatment available, not psychiatry-bashing.
Exactly! My father us one of the luckiest people to have an actually caring doctor. When he went manic everything went out of control and since nobody had even seen anything like that it was hard to comprehend. Thankfully my siblings have studied medicine they literally initiated treatment the same day.
I know what it does to people and families that’s why I started mental health awareness project.
It’s illness. It’s real and needs treatment and support like any other illness. Period!
Yes!
very interesting! I think you are spot on with most of the issues are between doctor and patient.
The person most closely tied to antipsychiatry, Scottish psychiatrist R. D. Laing (1927-1989), made use of psychiatric coercion even in his own family. In 1976, Laing’s daughter Fiona, then twenty-four years old, was rejected by her boyfriend. According to John Clay, Laing’s biographer: She had “cracked up,” and had been found weeping outside a church near the family home [and was committed to a local mental hospital.] He [Adrian Laing] rang his father up and asked him “in despair and anger” what he was going to do about it. Laing reassured him that he would visit Fiona and “do everything in his power” to ensure that she was not given ECT, but when it came to the crunch, as Adrian Laing relates, all he could say was “Well, Ruskin Place [the family home] or Gartnavel [the state mental hospital where Laing received his psychiatric training] —what’s the difference?(a) Fiona was given ECT. -Thomas Szasz On antipsychiatry
Oh interesting!
Thanks for this blog – as a psychiatrist I’m mindful of the social control and serving the state aspects of my role – I don’t think all psychiatrists are and that ignorance contributes to abuses of power. There is bad and good in psychiatry like most things. I do think the medical model has arisen in our individualistic culture whereas a lot of mental illness is a response to cultural and social wrongs through the generations (epigenetics and the transmission of trauma is a really interesting area) but that’s not to say it all is and each individual needs an approach that is meaningful for them. Good treatment should always involve a respectful relationship and honouring someone’s life experiences and the way they wish to frame them but too often that isn’t the case.
I agree. And unfortunately it’s the clinicians that don’t look at it that way and abuse the power they’ve been given that all too often are assumed to reflect the entire field.