Antipsychiatry: Quackery Squared

Afterword: Freedom from Violence and Lies

152 Afterword Freedom from Violence and Lies My holy of holies is . . . freedom from violence and lies in whatever form they express themselves. —A N T ON PAV L OV IC H C H E K HOV (1860–1904), letter to his editor, A. N. Pleshcheev, October 4, 1888 Some three hundred years ago, mad-doctors began to deprive innocent individuals of liberty. Unsurprisingly, ever since, the practice of involuntary mental hospitalization has been a source of contention as well as sporadic and ineffective criticism. The incarceration of an innocent person for an indefinite period—often for life—is a fact, impossible to deny or obscure. The imposition of a “diagnosis of mental illness” on a person against his will and of measures ostensibly protecting him from his alleged illness is a more subtle phenomenon. Individual liberty—supported by limited government, the rule of law, and the right to property—is the foundational value of the United States. Yet never before in history has the practice of psychiatric coercion been as widespread and popular as it is in the United States today. In the nineteenth century, before psychiatry became a “science,” it was still possible to acknowledge the truism that psychiatric “treatment” is a synonym for deprivation of liberty—imprisonment under nominally medical auspices. In 1889, the famous German neurologist Karl Wernicke (1848–1905) stated, “The medical treatment of mental patients begins with the infringement of their personal freedom, which necessitates the presence of the physician who, in the most urgent cases, by means of his expert medical testimony, places the sick persons—against their will and by means of coercive interventions Afterword | 153 [Zwangsmitteln]—in a closed institution or incarcerates them in their own homes.”1 With mental illness redefined as brain disease and psychiatric incarceration recognized as medical care, acknowledging Wernicke’s observation is now professional heresy. Undeterred by this and related “lying facts,” I have for more than half a century insisted that mental illness is a metaphor, that incarceration in a mental hospital is deprivation of liberty disguised as diagnosis and treatment , and that the psychiatric system as we know it cannot be reformed and ought to be abolished. Understanding this perspective and recommendation requires that we reconsider our basic ideas about freedom and our limited options for its effective protection against “benevolence.” In 1970, in the preface to my book The Age of Madness: The History of Involuntary Mental Hospitalization Presented in Selected Texts, I compared the relationship between the institutional psychiatrist and his involuntary patient with that between master and slave, and added: Like slavery, institutional psychiatry is a complex social-economic phenomenon of long standing and great practical importance. For millennia, slavery flourished. While it did, the greatest minds sincerely believed that slavery was a boon not only for the master but also for the slave. Only recently did the people of the Western world feel ready to abolish this institution and replace it with labor relations based on contract. In comparison, hospital psychiatry is a young institution; indeed, it seems probable that it is still in the ascendancy, and that it will grow and flourish before mankind will feel morally moved and socially prepared to replace it, too, with patterns of social welfare based on mutual consent.2 The extension of coercive psychiatric practices from the mental hospital into every nook and cranny of the community is tragic evidence of the accuracy of this prediction.3 Viewing involuntary psychiatry as an institution similar to involuntary labor, the aim of my critique was the abolition of psychiatric slavery, not its “reform” and replacement by a “better” system. Psychiatrists regard the incarceration of mad persons as the medical solution to a medical problem, the “treatment of mental illness.” Antipsychiatrists have not opposed this practice. I have long maintained that civil commitment (called “sectioning” in the United Kingdom) is not a medical problem; 154 | Antipsychiatry it is a legal and moral solution for some types of “problems in living.” This solution may or may not be perceived as a problem, either by the incarcerated individual or by others who sympathize with his predicament. My point is that the only remedy for slavery of any kind is freedom: in our case, the freedom of the denominated mental patient from his psychiatrist—and, at the same time, the freedom of the psychiatrist from his legally enforced duty to protect the mental patient by coercing him...