Antipsychiatry: Quackery Squared

Preface

vii Preface What Is Antipsychiatry? It is the union of Church and State that has caused all persecution. —L OR D AC T ON (1834–1902), Essays in the Study and Writing of History Merriam-Webster’s defines “psychiatry” as “a branch of medicine that deals with mental, emotional, or behavioral disorders”; Wikipedia says it is “a medical specialty which exists to study, prevent, and treat mental disorders in humans.” These descriptions do not tell us what the psychiatrist does and is expected, legally and professionally, to do. That nondisclosure disguises the ugly truth: psychiatry is coercion masquerading as care. (I realize that quoting Wikipedia is frowned upon in academic circles because it is considered “unreliable.” However, much of what is written about psychiatry and antipsychiatry —even in “reliable” sources—is biased, inaccurate, and misleading . I am interested in illustrating what people believe to be the meaning of certain psychiatric-technical terms, a purpose well served by Wikipedia.) Medical specialists are distinguished by the diagnostic and therapeutic methods that characterize their work: the pathologist examines cells, tissues, and body fluids; the surgeon cuts into the living body, removes diseased tissues, and repairs malfunctioning body parts; the anesthesiologist renders the patient unconscious and insensitive to pain; and the psychiatrist coerces and excuses: he identifies innocent persons as “mentally ill and dangerous to themselves and others” and deprives them of liberty, and he excuses people of their responsibilities for their actions and obligations by testifying in court under oath that persons guilty of lawbreaking are not responsible for their viii | Preface criminal acts. The former practice is called “civil commitment,” the latter “the insanity defense.” These legal-psychiatric interventions constitute the pillars upon which the edifice called “psychiatry” rests. To be sure, psychiatrists also listen and talk to persons who seek their help. However, this does not distinguish them from others; nearly everyone does that. The difficulty peculiar to psychiatry—obvious yet often overlooked —is that the term refers to two radically different kinds of practices: curing-healing “souls” by conversation and coercing-controlling persons by force, authorized and mandated by the state. Critics of psychiatry, journalists , and the public alike regularly fail to distinguish between the linguistic practice of counseling voluntary clients and the legalistic-forensic practice of coercing and excusing captives of the psychiatric system. The bread and butter of the modern psychiatrist is 1) writing prescriptions for psychoactive drugs and pretending that they are therapeutically effective against mental illnesses, 2) prescribing these drugs to persons willing to take them and forcibly compelling persons deemed “seriously mentally ill” to take them against their will, and 3) converting voluntary mental patients who appear to be “dangerous to themselves or others” into involuntary mental patients. Indeed, the modern psychiatrist no longer has the option to reject the use of force vis-à-vis patients: such conduct is considered dereliction of professional responsibility.1 In 1967, my efforts to undermine the moral legitimacy of the alliance of psychiatry and the state suffered a serious blow: the creation of the antipsychiatry movement. Voltaire’s famous aphorism, “God protect me from my friends, I’ll take care of my enemies,” proved to apply perfectly to what happened next: although my critique of the alliance of psychiatry and the state antedates by two decades the reinvention and popularization of the term “antipsychiatry,” I was smeared as an antipsychiatrist, and my critics wasted no time identifying and dismissing me as a “leading antipsychiatrist.” (The term “anti-psychiatry” is sometimes hyphenated, sometimes not. In conformity with American English, I will, for the most part, use it in the nonhyphenated form.) The psychiatric establishment’s rejection of my critique of the concept of mental illness and its defense of coercion as cure and of excuse-making as humanism posed no danger to my work. On the contrary. Contemporary Preface | ix “biological” psychiatrists tacitly recognized that mental illnesses are not, and cannot be, brain diseases: once a putative disease becomes a proven disease, it ceases to be classified as a mental disorder and is reclassified as a bodily disease; or, in the persistent absence of such evidence, a mental disorder becomes a nondisease. That is how one type of madness, neurosyphilis, became a brain disease, while another type, masturbatory insanity, became reclassified as a nondisease. Not surprisingly, the more aggressively critics of psychiatric coercion reminded psychiatrists that individuals incarcerated in mental hospitals are deprived of liberty, the more zealously...