THE EXHUMATION of ANTI-PSYCHIATRY

Volume 2 Number 3

THE EXHUMATION  OF ANTI-PSYCHIATRY

Recently The Ontario Institute for Studies in Education announced that it has set up a scholarship in “anti-psychiatry” reprising intellectual viewpoints from the middle of the last century long considered expired.

Anti-psychiatry was a group of disparate ideas that have long been superceded by scientific and cultural advances..

The anti-psychiatry movement arose in the 1950s and 60s when two psychiatrists Ronald Laing in Scotland and Thomas Szasz in New York became popular within the prevailing countercultural zeitgeist.

While Laing and Szasz had an energizing effect on psychiatric discourse, the ideas of both of these psychiatrists have been largely discredited.

MENTAL ILLNESS IS NOT A MYTH

Szasz and Laing held the view that psychiatrists were agents of social control and state repression.

Szasz’s main thesis was that mental illness is a myth and that individuals should be held accountable for whatever behaviour they display.

Laing postulated that “schizophrenia” was the product of coercive family and social dynamics.

However serious discrepancies in Laing’s accounts of his own practice and the outcome of the patients under his care, at the Gartnavel Royal Mental Hospital in Glasgow Scotland in the 1950s where discovered by British Psychiatrist David Abrahamson.

Abrahamson undertook a meticulous review of archival material and the medical records of six patients that had been under Laing’s care. This reveraled that claims made by Laing and relied upon by his followers did not reflect the documented experience of these and other patients.

PSYCHIATRY IS CENTRAL TO THE MEDICAL ENDEAVOUR

There is a mistaken view that psychiatry is different from other branches of medicine in having its origins only in social deviance and social adversity. There is also a belief that psychiatry is a late edition to the field of medicine.

In fact the identification of what we now call mental disorders goes back as far as Aristotle and Plato. Throughout the ancient world there was a recognition that certain individuals exhibited alterations in behaviour, emotions and demeanour.

The elements of modern psychiatry are more recognizable when we come to the 18^th-century. In particular the work of Philippe Pinel. In 1792 he became the chief physician at the Paris asylum for men, Bicêtre and began reforming the institution byunchaining the male patients, many of whom had been restrained for decades.He did the same for the women patients at the Salpêtrière when he became the director there in 1794.

Pinel regarded mental illness as the result of  social and psychological stresses,

heredity and physiological damage. In his “Traité médico-philosophique sur l’aliénation

mentale ou la manie” published in 1801, he put forward the idea of “moral treatment”.

“Moral” in this context means nonphysical but rather humane psychological.

These views remain valid. Sociological and environmental factors have a major role in all illnesses. One of the largest predictors of general health is socioeconomic status.

Psychiatric illnesses have been identified for thousands of years and while the classification of these illnesses and the understanding of their course have changed the fact of their existence is an established and scientifically verified fact.

To deny this is to propagate stigmatization and ostracizaction of those with mental illness. Anti-psychiatry trivializes and minimizes the profound impact of mental illness..

Psychiatry is a discipline with a strong scientific foundation derived from affective and cognitive neuroscience, biochemistry, genetics, developmental psychology, attachment theory, epidemiology, sociology and anthropology.

Tens of thousands of scientific papers on psychiatric topics are published every year.

Psychiatric research adheres to the practice of evidence-based medicine.

Psychiatric treatments are in many cases more effective than current medical treatments for conditions such as diabetes, hypercholesterolemia and arthritis for example when measured in terms of numbers needed to treat and numbers needed to harm.

While anyone is free to express  opinions about psychiatry it is disturbing that a University would confirm academic respectability to anti-psychiatry

This would be similar to the university granting scholarships for anti-vaccinaters or Holocaust deniers, anti-obstetrical studies or anti-surgery.

The establishment of the anti-psychiatry scholarship is profoundly invalidating to all those people who have experienced mental illness and also to those who dedicate their lives to alleviate suffering and promote healing and cure.

References

David Abrahamson Laing and long-stay patients: Discrepant accounts of the refractory ward and “rumpus room” at Gartnavel Royal Hospital. International Journal of Psychotherapy: 2011,

15, (2) 21-32.

Thomas Szasz: The myth of mental illness: 50 years later

The Psychiatrist May 2011 35:179-182.

Dora Weiner: Philippe Pinel’s ‘Memoir on Madness’ of December 11, 1794.

The American Journal of Psychiatry; June 1992 149: 725-32.