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.
References
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/.
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