Antipsychiatry: Quackery Squared

1. Antipsychiatrie: Querulantenwahnsinn

8 1 Antipsychiatrie Querulantenwahnsinn [David] Rosenhan rediscovers psychiatry’s oldest problem, “false commitment ”: “How many people, one wonders, are sane but not recognized as such in our psychiatric institutions?” He thus reinforces the legitimacy of depriving people of dignity and liberty, provided they really have real mental illnesses. His premise reeks of the odor of bad faith. Rosenhan identifies himself and his fellow frauds as sane pseudo-patients and the other inmates in the hospital as insane “real” patients, even though the latter were diagnosed as insane by the same psychiatrists whose inability to make such a diagnosis Rosenhan claims to have demonstrated. —T HOM A S S Z A S Z , Psychiatry: The Science of Lies Prior to the nineteenth century, persons considered mad lived in their own homes, or in the homes of their relatives, or were homeless beggars, vagabonds, wanderers. The forcible expulsions of the “mad” from their homes and their rehousing in other domiciles began in England in the eighteenth century. The first mental hospitals were revealingly called “private madhouses”: they were profit-making enterprises, initially operated by apothecaries and clergymen in their capacities as “mad-doctors.” Private madhouses catered to members of the propertied classes and functioned in part as substitutes for divorce, which the law did not recognize. In the typical case, it enabled a husband to dispose of his troublesome or otherwise unwanted wife. In wealthy families, dependents—the aged, the physically sick, the “mad”—used to be housed in their own homes, cared for by servants. Relocating them in madhouses served solely the convenience of their (more Antipsychiatrie | 9 powerful) relatives. From the start, the difference between the uses and abuses of private madhousing was entirely arbitrary. The so-called mad person ’s forcible relocation was a personal-political-economic matter masquerading as a legally and medically valid “therapeutic” measure. In the course of the past three hundred years, this disguise has become set in stone: the distinction between true/valid commitment and false/invalid commitment became—and remains to this day—an article of faith, immune to rational examination and popular-political repudiation.1 No sooner did the practice of involuntary mental hospitalization begin than it was denounced as too prone to abuse. In 1728, Daniel Defoe (1661– 1731) criticized “false commitment” and proposed to remedy it by mandating the “public control” of private madhouses.2 His wish was fulfilled. A century later, the building of public insane asylums—all over the Western world—became the rage. The reform increased the problem it was intended to correct by a thousandfold. A letter to the editor of the London Daily News in 1858, by John Stuart Mill, is illustrative: It has become urgently necessary that public attention should be called to the state of the law on the subject of Lunacy. . . . A perfectly innocent person can be fraudulently kidnapped, seized, and carried off to a madhouse on the assertion of any two so-called medical men, who have scarcely seen the victim whom they dismiss to a condition far worse than penalty which the law inflicts for proved crime. Convicts are not delivered over to the absolute power of their gaoler; nor can they be subjected to the ruffianly treatment revealed by the York inquiry. Convicts can appeal against ill treatment; but to other unfortunates the ordinary use of speech is virtually denied; their somber statements of facts, still more their passionate protests against injustice , are held to be so many instances of insane delusion. . . . The obvious remedy is to require the same guarantees before depriving a fellow-creature of liberty on one pretext as on another. . . . Many other improvements in the law and procedure in these cases are urgently needed. . . . I earnestly entreat you to continue your efforts at rousing public opinion on a matter so vital to the freedom and security of the subject.3 Defoe and Mill were public figures. The credibility of their protest was not compromised by their having been incarcerated as mad, but was undermined 10 | Antipsychiatry by their being laymen, “outsiders” unfit to judge the complexities of madness and mad-doctoring. The belief that mad persons are best cared for and hence “belong” in insane asylums and the systematic establishment of large madhouses began and reached their zenith during the nineteenth century. As the practice of involuntary mental hospitalization became more common, so too did fears of, and protests against, “false commitment”—the...