This is a study of psychiatry. It is a study of an area officially a branch of medicine and overwhelmingly seen as legitimate, benign, progressive, and effective. That psychiatry is typically so viewed is readily apparent and may seem a “no-brainer”. Doctors specialize in it. It is covered by our health insurance, overseen by ministries of health. A high percentage of the population uses it treatments. People encourage their loved ones to consult a psychiatrist when encountering “personal problems”. And the media routinely report its “discoveries” and “improvements”, much as they report “breakthroughs” in the treatment of cancer. But what if society had it wrong? What if this were not legitimate medicine? (Burstow, 2015, p. 1)
So begins the book Psychiatry and the Business of Madness. And so began my speech on June 12th.
Less than a week ago, in London, on June 12th at 7:00 p.m., what I see as a historic event took place—the U.K. launch and indeed the very first launch of the book Psychiatry and the Business of Madness: A Ethical and Epistemological Accounting.” Was this my book? It was. And why, you may be wondering, do I think of the launch as historic? In short, because an uncompromisingly psychiatry abolitionist book had not come out in decades. And yet here it was; and here were folk attending the launch, hailing from as far away as Cork Ireland. Against all odds—the event itself was in competition with a free showing of the film Asylum—between 31 and 40 determined souls had made their way to the well nigh impossible-to-find Palgrave headquarters—the location of the launch. And the evening was memorable, the speeches electrifying!
Dipping into the central tragedy in her life—the able m.c. Julie Wood set the tone for the evening by being deeply personal. She courageously revealed that the initial manuscripts used as an entry point into the investigation of psychiatry which forms the core of the book were documents associated with her psychiatrized son’s suicide. London ECT activist and psychiatric survivor Cheryl Prax spoke next; and she told the audience, “By page 5, I was crying with joy that such a book was written.” A consummate scholar, the third speaker, psychologist Ian Parker began by drawing attention to the subtitle and inviting people to see the careful tying together of epistemology, ethics, and accounting so integral to the book. He went on to highlight the significance of feminist and Marxist standpoint theory. Finally, as the author and the last speaker, I suggested that two things united all of us in the room—1) the knowledge that something was profoundly wrong with psychiatry, and 2) the commitment to do something about it. I went on to outline the major findings of my research, also, the core recommendation that the state sever its ties with psychiatry.
What followed was an animated and insightful question-and-answer period, with person after person coming up to the microphone to pose their question. What do you think of the Soteria movement?” asked one. Picking up on the discourse employed in the book, another asked, “wouldn’t you say that Open Dialogue is being colonized by psychiatry?” That the problem is that psychiatry can colonize anything?”
Then came the highlight of the evening—the survivor speak-out. Survivors generously shared their stories, their analysis, their dreams, one survivor making it clear that the primary injury done her was the erosion of her self-confidence; another commenting that hearing the stories of other survivors is invariably a moment of learning. That the evening should have ended with survivors, I would add, is apt, for in the final analysis, whether we are antipsychiatry or critical psychiatry, whether we are professionals or survivors, the standpoint that we need to adopt is precisely the psychiatric survivor standpoint. By this I do not mean that whatever any survivor thinks is ipso facto correct. Only that this location itself offers a privileged glimpse into the regime of ruling known as psychiatry, just as the standpoint of workers yields a privileged glimpse into capitalism. To use an institutional ethnography term (see Burstow, 2014a), it highlights the disjuncture which happens when psychiatry enters people’s lives—and, indeed, running with that juncture and mapping institutionally how it is created and recreated is integral to what this book is about, part of why I see it as important.
The strength of Psychiatry and the Business of Madness is precisely that it begins with the standpoint of the survivor, that it shows how various problems or “disjunctures” that occur in people’s every day life can be traced to the day-to-day working of the institution—whether it be its use of “treatments”, its activation of diagnoses, the filling out of forms. Its strength, to put this another way, is its holism—the fact that in the process of exploring the disjuncture, it shines a light on every single facet of the institution. Its strength on a whole different but related level is its no-holds-barred antipsychiatry perspective, together with the solidity of the research and the arguments. This is significant. Insofar as Psychiatry and the Business of Madness makes this case and does this mapping, it takes us where we need to go, provides ammunition needed for meaningful social change.
The point here is that reformism will not serve usAs I have argued elsewhere (see Burstow, 2014b), and as the history of psychiatry clearly shows, reform agendas have always culminated with a return of biological psychiatry with a vengeance, and far from ridding us the problems posed by the institution, have guaranteed the continuation of those problems. What we need to do rather is to acknowledge that psychiatry was a colossal misstep, and in essence to begin again. For this to happen, we need determination. We need to know when we are being led astray. We need vision. We also we need texts capable of making a truly convincing case for abolition. What I am referring to here is not just demonstrating that psychiatry does “more harm than good”—significant though this is—but demonstrating that psychiatry has no validity and, what goes along with this, that it is not a legitimate branch of medicine. That is precisely what Psychiatry and the Business of Madness sets out to do, and what I would suggest, it achieves. To quote in this regard from the first review of the book, Philip Hickey (2015) states, “This book is a major milestone in the antipsychiatry effort and it stands as a monumental challenge to psychiatry’s continued existence as a branch of medicine.” And Don Weitz and Simon Adam, whose respective reviews will be coming out shortly, make similar points.
What are my hopes for this book? To name a few, I hope that people threatened by family members with institutionalization—and we all know how psychiatry preys on families—give it to their family to read, and the family finds itself seriously entertaining second thoughts. That upon perusing Chapter Six, psychologists, nurses, and social workers take in the colonization of both their discipline and of themselves outlined here, reflect on their practice, get back in touch with why they entered a “helping profession” in the first place, and begin speaking up. Having intricately traced not only the government backing and legitimation, but also the legal stranglehold that the state has created, I hope that government officials and our elected representatives are led to look more critically at what they are mandating, making possible—and in this regard, I am delighted that both member of the Ontario legislature Cheri DiNovo and renowned mental health lawyer Anita Szigeti will be speaking at the Toronto launch (September 18, 5:30, 12th Floor, 252 Bloor St. West).
First and foremost, however, my hope for this book is quite simply that it be read—more particularly that it be read widely and carefully. The point is, I believe that the book genuinely has the capacity to be a game-changer for it clarifies the territory, even I have found, for people who do not wish to see it. “I just didn’t realize, I think maybe because I did not want to realize” said a friend to me, “but now that I see it, I can’t go back and not see it.” However, the book can do this heavy lifting only if it is widely read and discussed.
My invitation? Pick up a copy, read it, form your own judgment. And if your evaluation is similar to mine, call it to the attention of others. Perhaps give it to your mother for her birthday. Perhaps write a review for your local paper. Maybe mention it to a coworker.
My invitation to people more generally?: Whether or not you ever pick up this book or indeed, any book of its ilk: Dare to imagine a world where helping is not professionalized, where caring is not commodified. Where decisions do not come from on high, but where in the spirit of community, we go about the business of life together (the subject of the last chapter).
To end these reflections by focusing back in on the launch itself, albeit I was present via Skype only, I felt very much a part of the gathering in that room that evening. How wonderful to actually see folk with whom I had heretofore but exchanged emails! And we all of us walked away, knowing that together we had just pulled off an important piece of work. One small indicator of which is that the m.c. and her husband were up until the wee hours that night discussing psychiatry—exactly the kind of seriousness which one prays that a book launch will inspire.
Burstow, B. (2014a) Liberal mental health reform: A fail-proof way to fail. Retrieved June 13, 2015 from http://www.madinamerica.com/2014/11/liberal-mental-health-reform-fail-proof-way-fail/.
Burstow, B. (2014b). Taking an entry point. On investigating the psychiatric-psychopharmaceutical complex. Retrieved June 13, 2015 from http://www.madinamerica.com/2014/08/taking-entry-point-investigating-psychiatric-pharmaceutical-complex/.
Burstow, B. (2015). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave.
Hickey, P. (2015). Review: Psychiatry and the business of madness. Retrieved June 13, 2015 from http://www.madinamerica.com/2015/04/book-review-psychiatry-business-madness-ethical-epistemological-accounting/.