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Uniting critical voices (Part I): What are the sources of conflict within the anti-psychiatry movement?

If we are to achieve the much-needed paradigm shift in the way we respond to human suffering, it is imperative that the various strands of the anti-psychiatry movement unite. Given the powerful vested interests sustaining the dominant bio-medical model, a fragmented opposition will possess insufficient power to transform the current mental health system. Indeed, the adage, ‘united we stand, divided we fall’, has never been more apt.

Courtesy of Stuart Miles - FreeDigitalPhotos.net(10)

As a vocal critic of Western psychiatry I actively engage in a variety of social media and, like many others on this side of the debate, often find myself embroiled in arguments regarding the most appropriate ways to help people who are experiencing emotional distress and overwhelm. Predictably, many of these spats are with biological psychiatrists and others wedded to ‘broken brain’ explanations. But – perhaps more surprisingly – I’ve witnessed a growing number of passionately expressed differences between people who each identify with the anti-psychiatry movement.

What are the sources of these conflicting ideas?

I suspect that tensions within the diverse range of voices striving for radical change in our approach to emotional distress originate from three major sources.

1. Abolitionists versus reformers?
One important line of division seems to be around whether the ultimate goal of our efforts should be total eradication of psychiatry or its radical reform.

Many argue that the inherent inadequacies of Western psychiatry are so deeply engrained as to render the current system beyond repair. It is reasoned that the ‘illness like any’ approach to human suffering, justifying the gross overuse of psychotropic drugs and a perverse approach to risk, is now so energetically defended by vested interests – the pharmaceutical industry and a psychiatry profession desperate to retain its status as a bona fide medical speciality – that the prospect of meaningful change in our mental health services is remote.

The abolitionists often highlight the human-rights violations, and the mental health legislation that legitimises them, as justification enough for calling for an end to psychiatry. They claim that the collusion between the state and medicine, enabling doctors to incarcerate law-abiding people and enforce ‘treatments’ without their consent, propels a psychiatrist into the role of enforcer of the government’s desire to control those who they deem to be troublesome. These discriminatory practices, it is argued, can only be halted by the total dismantling of the institution of psychiatry.

In contrast, the reformers draw attention to pockets of good practice within the existing mental health service, where innovators are striving to change the system from within. Promising initiatives, such as Open Dialogue, are held up as evidence that radical change can be realised within the existing psychiatric service. They propose that critical voices need to focus on incremental, evolutionary improvements rather than demanding a revolution.

2. Service-user versus professional perspectives
The relative weights given to the views of service users and mental health professionals is another major source of tension within the anti-psychiatry movement.

At one end of the continuum are those people who have – understandably – been alienated by their direct experience of receiving ‘treatments’ from psychiatry, and often feel traumatised by their time spent in the services, who assert that anyone who has worked as a mental health professional (medical or otherwise) is automatically rendered incapable of being an ally in the struggle for psychiatric reform. Making a living from collusion with psychiatry’s human rights abuses, the argument goes, is unforgiveable and strips the person of any credibility as an opponent of the current system.

On the other side of the spectrum are those critics of psychiatry who assert that the vast majority of mental health professionals entered into these careers expecting to learn skills that would help reduce human suffering, rather than for the opportunity to control, dominate and abuse. Furthermore, from a pragmatic point of view they argue that, if radical change is going to be realised, agents of change need to be operating within the psychiatric system as well as outside it. And given that psychiatric professionals typically possess much more power than the people they are paid to serve, it would be foolish and self-defeating to disqualify this potentially influential ally.

3. Societal influences versus individual responsibility
Critical voices pushing for alternatives to biological psychiatry all recognise that societal ills (such as homelessness, poverty, discrimination and inequality) contribute in a significant way to the level of mental health problems within our communities. Nonetheless, there seems to be diverse views about the magnitude of societal change that is necessary to achieve a radical shift in the way we approach human suffering.

Many people within the anti-psychiatry movement argue that a marked improvement in the emotional wellbeing of our citizens cannot be achieved within the political systems that currently dominate the Western world. They claim that globalisation, and the capitalist philosophy that underpins it, are engine rooms for the divisions and inequalities that fuel mental distress and that the total rejection of these political systems is an essential prerequisite for radical change to the way we prevent, and respond to, human suffering.

Activists who support this revolutionary stance typically emanate from the left of the political spectrum and champion socialist ideologies. Within this frame, mental health problems are viewed as inevitable consequences of a sick society with the individual sufferers having little or no power to improve their plights.

In contrast, others arguing for alternatives to biological psychiatry put greater emphasis on personal responsibility as a vehicle for recovery. Espousing the virtues of choice and free will, those on this side of the debate typically seek to minimise state involvement – via policies or laws – preferring to allow individuals to navigate their own routes to wellbeing, unfettered by government interference. In a more extreme form of this philosophy, it is assumed that each of us, irrespective of the environmental context, possess the inherent capability to steer our escape from emotional pain via a sequence of rational decisions – in effect, to think our way out of our problems.

 

 

The above describes my personal musings on the sources of divisions within those opposed to the traditional psychiatric system. I would be keen to hear the views of others in the comments section (below).

In the second part of this blogpost I will suggest that there may be common goals around which the various strands of the anti-psychiatry movement can collaborate, thereby enabling a collective effort to radically change the damaging and relatively ineffective bio-medical paradigm that continues to dominate our approach to human suffering.

 
Photo courtesy of Stuart Miles at FreeDigitalPhotos.net

7 thoughts on “Uniting critical voices (Part I): What are the sources of conflict within the anti-psychiatry movement?

  1. S. Randolph Kretchmar / Reply 7th March 2017 at 4:03 pm

    The “abolitionist v. reformers” split should be resolved in favor of simply abolishing coercion. Psychiatry itself may or may not wither away, as Thomas Szasz predicted, without its current facility of state force. Ban involuntary “hospitalization” and “treatment” and eliminate the insanity defense. Then we’ll see.

    • Gary Sidley / Reply 10th March 2017 at 4:23 pm

      I agree that we can’t overstate the importance of the mental health legislation, and the human-rights violations that it legitimises. Interesting to think as to whether repelling these laws would naturally lead to the atrophy of psychiatry.

  2. Judy Gayton / Reply 8th March 2017 at 4:24 am

    I would add that the key source of conflict is the failure to stand against the very source of the evil itself; which is the utter lack of scientific credibility of the DSM from which fraudulent diagnosis’s about people’s “mental health” are invented and used to justify abuse and experimentation. Discussions about people being “mentally ill”, is based on flawed, fraudulent thinking, leads to state abuse enacted by supportive systems maintaining the status quo. Labeling people is an act of accusatory discriminatory, libelous, slander and defamation of character based on already exposed failed theory, which is not only illegal, it is a massive constitutional and human rights violation resulting in endless social harm across the globe. These violations must be abolished in courts of law and replaced with the humane non-judgmental practice of “Public Health”. The massive waste of resources pointlessly fueling “mental health” abuse in all its guises, must be reallocated towards the actual social causes of human suffering. Supported by overwhelming body of evidence, the law can and will eventually be the tool that stops this evil, restores human dignity, saves lives, and the ability to trust our fellow beings not to be sitting in wait to profit off our individual misfortunes in life. BAN THE DSM. Thank you

    • Gary Sidley / Reply 10th March 2017 at 4:24 pm

      I wouldn’t argue with any of that.

  3. Jacquie M B / Reply 8th March 2017 at 10:55 am

    An excellent discussion of various approaches to the anti-psychiatric movement. I err on the side of reforming the system having the privileged but challenging role of mental health peer worker in the govt community system. I want to change the system from within with a change of language and attitude and an understanding that mental distress is caused by extreme pressure that a human simply cannot bear.

  4. Jane / Reply 15th March 2017 at 12:38 am

    I’m glad to see such a thorough breakdown of the mess that is the antipsychiatry movement. I have serious doubts we will ever be able to unite because of the nature of the movement; there not really and antipsychiatry center we all sign up at- there’s no central point of organization. In a way that is a strength; if one group takes stances that violate another’s, they are free to leave that group and start their own. We’re not committed to a determined stance.

    And unfortunately, many of these differences aren’t petty. A big one for me and other shock survivors is David Healy. For those who have been injured by drugs and not ECT, he’s a god. For those injured by ECT, he’s a wolf in sheep’s clothing. People injured by drugs tend to gravitate towards anyone who appears to be an ally and his promotion of ECT has led many to harm and he blames their damage on the drugs they took before.

    For people like myself, he is still part of the system and is not seen as an ally and we don’t do well in drug support groups where he’s treated like a rock star and in many cases, unshocked members don’t care about his ECT position because it doesn’t affect them.

    That’s just one example of points of contention that exist below the goals abolition or reform.

    I also think that many in the movement aren’t necessarily looking for either– just justice for their losses, appropriate drug labeling, etc, so people don’t get hurt like they did, or so they can have reparations for their injuries.

    Anywho, this is a good piece and I look forward to your next post on possible solutions for making this movement more effective.

    • Gary Sidley / Reply 16th March 2017 at 3:19 pm

      Hi Jane
      Thank you for taking the time to read my blog and leaving an interesting and thought-provoking comment.

      It’s not the first time that I’ve heard of David’s Healy’s views polarising opinion.

      I share your observations about the tensions that remain in those broadly seeking alternatives to traditional psychiatry, but perhaps I’m a bit more optimistic about achieving change. I believe the range of stakeholders critiquing bio-medical approaches to human suffering has never been so broad and convincing. And I think (and hope) there are centrally important issues that we can all unite around (? repealing the Mental Health Act; ? moving away from diagnostically-driven services; ? seeking marked reduction in prescribing of psychotropic drugs; ? abolition of ECT etc.). I’ll say more about these in my next blog.

      Thanks again for your comment.

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