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The need for a critical approach to psychiatry in Ireland
psychiatry's answer to mental health problems is psychiatric drugs which they believe help to correct the 'patient's' brain chemistry or bio-chemical imbalance. Critical psychiatry seeks a more holistic approach seeing personal/interpersonal, social and environmental contexts as the origins of severe mental distress. Psychiatric drugs with their damaging effects on the individual and the genetic hypothesis that psychiaty operates behind have failed and must be replaced with a new social and holistic model which can truly help people. Today there is an urgent need to challenge the dominance of psychiatry and its control over the lives of people it deems ‘mentally ill’. Psychiatry believes that ‘mental illness’ is related to an underlying biological pathology or genetic defect. There are though no reliable diagnostic tests whereby it can be proven that someone has a so-called mental illness, such as schizophrenia for instance, which is related to or caused by biological factors. Psychiatric diagnosis rests on the assessment of a psychiatrist categorising reported symptoms. The cause of a person’s severe mental distress or ‘mental illness’ as psychiatry would judge it is very often not seen as the result of personal, societal or psychosocial factors but instead the problem is seen as one residing within the patient’s brain. Psychiatry’s answer is psychiatric or neuroleptic drugs which they argue help to redress the ‘bio-chemical imbalance’ in the brain and thereby treat the symptoms of the ‘disease’. The fact is though that these drugs have been proven to have a debilitating and blunting effect on a person’s emotional and mental capabilities. Psychiatry admits that these drugs can and do lead to tardive dyskinesia and other serious neurological disorders and yet it continues to prescribe them.
There needs to be a much greater recognition that severe mental distress is often the result of people’s sense of alienation and fragmentation within the political and economic structure of society where meaning and value is attributed only to the pursuit of money, privilege and status. In today’s consumerist and capitalist driven societies people have largely lost a sense of meaning and belonging. It is no coincidence that this has been accompanied by a rise in people reporting symptoms of severe mental distress. Psychiatry often removes these perspectives from its practice. People need to question psychiatry and its adherence to the biological model which labels mental suffering as illness. One should examine psychiatry in the context of its ignoble history and on the grounds of sound and holistic treatment. The anti/critical psychiatry movements are pointing the way forward when they say that people should be helped to come to terms with their suffering and not feel that they must endure a lifetime of disabling drug ‘treatments’. It is appalling that today the degrading practice of Electro Conclusive ‘Therapy’ (ECT) continues. There is a serious attempt to revive this brain damaging ‘treatment’ as a more widely practised ‘intervention’ in psychiatric practice.
Unlike in many other countries, Ireland, north and south, has no critical or anti- psychiatry movement. Psychiatry, it has to said, exists to protect its own prestige and professional power and in certain respects it shares an interesting similarity with colonialism. Given the experience of colonisation in Ireland, cultural oppression and emigration, we know that there is a link between this experience and high levels of mental suffering. It does not mean that Irish people, blacks, or any other oppressed ethnic group or indigenous population, are more genetically predisposed to ‘mental illness’ than others. As with colonialism, psychiatry today continues to extend its borders in the whole area of human behaviour. Many aspects of human variation and behaviour have been drawn into its territory of pathology and colonised. This has been done through a close alignment with the multi-national pharmaceutical companies. There now exists ‘a pill for every ill’ culture, pills for shyness, social phobias, and so on. Children are now being targeted with drugs for so called attention deficit disorder. These are now all viewed as disorders related to bio-chemical imbalances in the brain which can be treated through new drugs. We are expected to think and act in certain ways, a ‘project of homogenisation’ as described by the anti –psychiatrist R D Laing. Any deviation from this as such is often regarded as a sign of pathology or disease in the individual. Like colonial powers psychiatry does not welcome resistance. Psychiatry’s role in eugenics and racism is well documented and the writings of Michel Foucault and Thomas Szasz have been instrumental in making this visible. We in Ireland need a critical or anti-psychiatry movement that can offer real alternatives and support, a movement that rejects the biological model of so-called mental illness.
Thankfully, courageous individuals highly qualified in psychiatry who became disillusioned with the practice have challenged this model. The most controversialist perhaps of the 20th century was R D Laing. His book, The Divided Self, was an attempt to portray the inner world of a ‘schizophrenic’ which he presented as an attempt to live in an unliveable situation. His work was centred on understanding and treating the person with support in the form of daily group and individual therapy in a caring environment without mind disabling drugs. He believed that the experience of a breakdown could lead to a breakthrough. David Cooper, a contemporary of Laing, was ideologically more Marxist and believed that a whole new socio-economic cultural shift was needed to end psychiatric oppression.
One of the most brilliant anti-psychiatrists and thinkers of our time is Thomas Szasz, Professor of Psychiatry Emeritus at the State University of New York Health Science Centre in Syracuse, New York. Throughout his long and distinguished career Szasz has waged a relentless battle against biological psychiatry. According to Szasz, the very concept of ‘mental illness’ is a myth. He has argued effectively that a ‘disease of the mind’ is not the same as a disease of the brain. He has brilliantly taken issue with the semantics of psychiatry, the definitions, who gains from the definitions, and who loses out as a result of them. Also psychiatrists present themselves as scientists and psychiatry and the political system through it gain the power to effectively ‘detain’ and control people, subjecting them to forced psychiatric drug ‘treatment’. His latest book, Liberation by Oppression, is a strong and insightful debunking of the psychiatric pseudoscience that demeans the human spirit and has hurt countless lives.
In relation to the multi-national pharmaceutical companies producing these psychiatric drugs, Ireland today is an attractive base. They are amongst the biggest companies operating in Ireland. The profitability of the industry is reflected in the amount of corporate tax paid to the 26 county government in the last two years, over $250 million. No other ‘medical speciality’ is underwritten by the drug industry to a degree even vaguely approaching that of psychiatry. There is no disputing the fact that these drugs for many people act as chemical straitjackets and cause a wide range of serious and distressing symptoms.
Given that there is no empirical and reliable evidence to prove a biological cause to mental illness we need to recognise how society can cause people mental suffering which can then get labelled as ‘mental illness’. The way forward therefore is not a practice that is fundamentally flawed and loaded with an ignoble history which largely benefits drugs companies and can act as a form of social control. The dehumanising ideology of psychiatry must be replaced. We need a re-connecting of the individual with a meaningful culture, a re-visioning of medicine as the art and science of holistically healing body and mind. Given the growing control that psychiatry is exercising this is one form of oppression that must be resisted and the Irish experience should place people in a position to understand and inspire opposition to it.
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Jump To Comment: 1 2 3 4 5 6keep with it, consistent as ever, though I don't agree with a lot of what you think, finding it too "holistic" in approach. I do maintain that there are conditions which have physical basis, but I do agree that there are far too many people being administered treatments which should properly be seen as cruel and unusual. What interests me is the constant presence of "bitter unhappiness" in our supposed tippy-toppy civilisation. And also the opposition posed to many simple therepeutic activities to restore self-esteem, develop character and earn peer recognition.
I have always thought the okupe movement has served many people in such a way, offering them through co-operation and collective direct action, solutions not only to economic marginalisation and homelessness but also routes to personal development without reliance on a completely internalised and reified materialist capitalist exchange system. So it was with surprise that last week something quite odd happened here in BCN. For some time now a 8000metre site has been occupied accomodation permenant residents and a lot of guests (some Irish stayed there last year). The place is called CSO Makabra. A lot of work went into it, an organic kitchen garden was sown, a circus space was built, and offices and infoshop were begun, all the usual acitivities happened: workshops (bikey things), trapeze, the odd night of wild dancing, the occasional video show, the regular theatre/cabaret thing. In short okupe life as normal, poor people who no longer find themselves centred on their poverty but the common advantage of sharing talents and resources however meagre.
Then a neighbour living in the grant maintained tower block adjacent, decided he had had enough. He jumped several stories and landed in a puddle of his own mess in the yard of CSO Makabra. The young guy who found the corpse was understandably sickened and remained in shock for quite a few days. The police came cleaned up the mess, asked a few questions (in the typical way), identifying the okupe who found the body seemed more important than indentifying the suicide. Moreover establishing whether the okupe was a "legal" or "without papers" was the priority, after the rather heartless inquiries as to whether said okupe had had a role to play. Imagine- you find a body splat, and the Gardaí (not liking squatters decide you must be responsible somehow). Anyway the police to prove how constant they may be, returned in mass several days later and _illegally_ evicted CSO Makabra. For whatever reasons they might have. The good news is that CSO Makabra has been re-okupied by the great squamily of BCN in the last 24 hours.
No-one will ever properly explain why the neighbour suicided, perhaps it was statistically probable, every 10,000 people produce several male suicides in the age group 17-30 every month. Nor will anyone explain why the rate of suicide is remarkably less in the okupe section of community, not one in the last four months.
anyway, hope I'm not irritating by using up comment space, just hope everyone realises that the answers to many (if not most) of our current psychological alienation from society may be found within our movements, within our friendships, within our jokes and smiles.
And not in the marketed molecules of the pharmaceutical corporations, nor the cruel and unusual practises of passing electric current through the brain.
in short, you, we, all of us may learn with a little practise to "be happy", and to "be sad" in balance and sincerity. The world we have been sold is mad and sick, we must make ourselves a sane world to live in.
An excellent summary of the anti-psychiatry position - very well written. Sean has a lot of insight into the systems of modern psychiatry.
But what about the people - doctors, nurses, administrators, housekeepers, etc. - working in the field. If there is no "truth" in their work then life must be indeed difficult for them. But they are not bad people.
What are the alternatives? Spirituality, "Healing," Personal Development, Training, Education, Democracy in school, hospital, work, etc. The trouble is that these things are not tried as an alternative to drugs but in tandem with them.
Anyway, Sean, the best of luck and keep it going.
S. Fleming. Can you please contact me via email at eoinf@gofree.indigo.ie. I would be very interested in talking with you. Regards, Eoin.
I wholeheartedly agree with the general drift of this thread, and with Eoin's call for an anti-psychiatry movement - to parallel those already in progress in e.g. the US and Australia. And I have another suggestion.
Does anyone know if the twelve-step approach to various kinds of addiction has been applied, even experimentally to depression?
Reasons for asking this are:
(1) Addicts often suffer also from depression, or, to put it another way, depressives are often also addicts;
(2) The increasing support for therapies for depression that either replace or supplement drug based therapies, and the frequent unavailability of counselling/psychoterapeutic services, point towards the desireability of exploring the group therapy avenue.
(3) Depression is often, like, addiction, rooted in shame - a sense of personal worthlessness;
(4) Group-therapeutic approaches to addiction that employ the twelve-step approach have had considerable success in restoring self-esteem and positive mental habits, helping addicts to cope with depression as well;
(5) 'Aware' groups exploring the mutual help route could do with a commonly-understood and well-explored process that can avoid the danger of depressives merely depressing one another further;
(6) 'Aware' groups seem to work best when those in worst pain receive empathic support and understanding from the rest of the group - which is what happens in twelve-step groups also.
(7) The twelve-step process has already been applied successfully to problems other than addiction - including co-dependency.
I am now convinced that reliance on the 'biological imbalance' diagnosis of depression that leads to exclusive reliance on drug therapy is inadequate, and fails to address the life-challenges to personal morale that are part of everyone's experience. Psychiatry commonly provides no opportunity for people to tell and understand their own life stories in a safe and supportive environment - and this cannot be conducive to recovery. I would welcome an opportunity to explore the twelve-step route, adapting it to the special case of depression, and wonder if anyone else has explored this route.
I think what you say is excellent. Could I suggest a book,
Depression: The Way Out of Your Prison by Dorothy Rowe as a guide.
It is an excellent book which takes a critical view of the present methods used to treat depression and is very forward thinking.
all the best
http://theblackdog.net/