A friend reported
to me the other day that she was at a conference with other “progressive professionals”
in which her colleagues kept passing questionable judgments on antipsychiatry
positions and theorists, this on the basis of fallacious beliefs. Indeed, one
of the colleagues in question stated as if it were a matter of fact that all
antipsychiatry activists were right wing, then proceeded to cite as an example thereof
an activist who is neither right wing nor antipsychiatry. By the same token,
over the last decade, people have commonly made statements to me of the ilk, “What
bugs me about antipsychiatry people is they only care about tearing down; there
is no commitment to actually helping people.” All of which suggests that there
is a serious dearth of awareness about antipsychiatry, the range of its
adherents, and what they stand for. This is minimally unfortunate. It impedes
our working together. What is likewise relevant, with psychiatry’s power and
capacity to harm continuing to grow by leaps and bounds, the antipsychiatry
message has never been so important as it is today. This being the case, over
the last few years, I have taken upon myself the task of attempting to dispel
confusions and to promote clarity.
In other publications, I have focused broadly,
providing overall accounts of antipsychiatry (see Burstow 2014a and b). My intent
in this piece is considerably more modest. It is to respond in abbreviated form
to some very specific confusions/misconceptions surrounding antipsychiatry. I
am drawing in this regard on the myth/fact distinction—a helpful heuristic, despite
its obvious shortcomings.
Myths/Facts
Myth: Antipsychiatry theorists deny or
minimize the enormity of the personal/emotional distress into which people can
sink.
Fact: While no doubt some so minimize, they
are decidedly in the minority. It goes without saying that people can end up in
truly abysmal states, and like many who coalesce on this territory, antipsychiatry
folk are deeply concerned about the welfare of people in distress. What is
being maintained, rather, is that emotional difficulties and confusion are not
in themselves “diseases” and hence should not be approached as such. In this regard, antipsychiatry theorists
oppose the medicalization of problems in living. Additionally, they draw a sharp
distinction between two phenomena that are routinely conflated—being distressed
oneself (which may or may not be something for which services are needed/wanted)
and being found distressing by others (which can often be traced to societal intolerance
or unawareness).
Myth: Antipsychiatry activists have no
interest in people receiving the help which they need.
Fact: As people who care deeply about those
in distress, antipsychiatry activists commonly lobby for increased services,
albeit the commodification of help which is part and parcel of the concept
services is something they challenge. More broadly speaking, we strive to
co-create a society which is less “distressing” in the first place, wherein
everyone has ready access to an abundance of help, moreover, where people in
distress are reached out to. What we oppose is “psychiatric treatment” (pseudo-medicine,
which is inherently harmful) on the one hand and coercion and manipulation on
the other—as distinguished from genuine help which people are truly free to
accept or refuse.
Myth: Antipsychiatry activists are
anti-drug.
Fact: While some of us have a critique of
medicine overall, antipsychiatry activists see a legitimate place for the medical
use of drugs (drugs which address bone
fide medical conditions). Many of us would additionally decriminalize
street drugs. Moreover, we recognize and respect that since time immemorial
people have coped with the use of substances which, as it were, “take the edge
off”, that allow people who are floundering for any number of reasons to get
through the day. What we are against is the “medical” pushing and the prescribing
of pseudo-medicine on one hand, and the government support for and legitimation
of such substances and practices on the other.
Myth: Antipsychiatry theorists oppose
professional services.
Fact. While antipsychiatry theorists reject
psychiatry and commonly critique other disciplines, there is no uniform
rejection of other disciplines (except in insofar as they have become colonized
by psychiatry). More concretely, besides that antipsychiatry advocates have
often joined forces with others in lobbying for more non-medical services
(e.g., supportive house, drop-ins, befriending services), there are
antipsychiatry activists who are themselves practicing social workers and
practicing psychologists. This notwithstanding, as people with a vision of a
very different kind of society, the vast majority of antipsychiatry theorists
oppose the wholesale transferring of human help into the hands of experts,
whatever those experts may be called, and would prioritize instead more organic
and more community-based services. Correspondingly,
many hold a Foucauldian analysis of disciplinary regimes.
Myth: Antipsychiatry theorists are all
right-wingers.
Fact: Class analysis is not one of the
bases of unity among antipsychiatry advocates. As a consequence, there are antipsychiatry
advocates on the left (e.g., Don Weitz), and antipsychiatry advocates on the right
(e.g., Thomas Szasz). Who predominates? The left, the anarchistic, the
feminist, the gay and trans positivist, and the anti-racist.
Myth: Antipsychiatry theorists are all followers
of R. D. Laing.
Fact: The name “antipsychiatry” originated
with Laing’s colleague Cooper (1967). This notwithstanding, the meaning of
antipsychiatry has shifted over the years to one of psychiatry abolition. Of
these abolitionists, some are influenced by Laing, while others are not, with the
latter in the majority. Nonetheless, while rejecting his use of terms like
“schizophrenia”, all would agree that society is deeply implicated in the
seemingly individual angst that people feel. And by the same token, all would
agree that the current targeting of individuals
as “the problem” is woefully off base.
Myth: If I am critical of psychiatry, then
I am antipsychiatry.
Fact: While all antipsychiatry theorists
are critical of psychiatry, not all
such critics are antipsychiatry. The
difference is that in the absence of an abolitionist stance, one is not antipsychiatry.
Myth: Antipsychiatry folk look down on
people who take psychiatric drugs.
Fact: Antipsychiatry folk take a position
on the drugs and their “pushers”, in essence on the institution—not on the
people who use these substances. It is generally understood and accepted that
people cope as best they can, often very heroically, under less than ideal
circumstances.
Myth: Antipsychiatry activists only work
with activists and thinkers who are likewise antipsychiatry.
Fact: Most actively participate in broad-based
coalitions. Correspondingly, they put on conferences with others in the
community. And they routinely include non-abolitionists in their publications
and themselves contribute to publications theorized from alternate perspectives
(in this last regard, note the large number of antipsychiatry contributors—e.g.,
Weitz, Burstow, Diamond, and Starkman—to the mad politics book Mad Matters, edited by LeFrançois,
Menzies, and Reaume, 2013).
Myth: Antipsychiatry theorists are hyper-critical
of families.
Fact: This misconception stems largely from
the ongoing conflation between antipsychiatry and R. D. Laing (who again is at
most peripheral in current antipsychiatry). Laing saw family dynamics as
pivotal to the emotional distress in which people find themselves, much as
psychoanalysts do. In the process, while some of his analyses were highly
insightful, he could without question also be blatantly unfair to family
members—mothers in particular (see, for example, Laing and Esterson, 1970)—none
of which, note, has any bearing on antipsychiatry. The point is, while individuals
vary, antipsychiatry per se has no position
on the family. That said, where one or more family member has been subjected to
psychiatry, insofar as there is a tendency among theorists, it would be to see the
family as a whole as a victim of psychiatry, however that psychiatrization came
about and whether or not cooptation was involved. What is likewise relevant, in
the world for which antipsychiatry activists strive, there would be far more
support (read: noncompulsory and non-pathologizing support) available to
families in distress.
Myth: To be antipsychiatry is to be a
follower of Thomas Szasz.
Fact: At this juncture, it would be hard,
if not impossible, to be an antipsychiatry theorist without being substantially
influenced by Szasz. And indeed, to date Szasz remains the most pivotal figure.
Obvious influences include rejecting the notion of mental illness and seeing
the psychiatrist as an agent of state control. Being a “follower”, however, is
a separate matter altogether. Besides that the very idea of being a follower runs
counter to how most antipsychiatry activists operate, while respecting the
foundational works of Thomas Szasz, most antipsychiatry activists have substantial
differences with him. Difference include: Unlike Szasz, few are right wing.
Unlike Szasz, more or less none see prisons as any kind of solution (in this
regard, we are more influenced by Foucault, 1995 than Szasz). Unlike Szasz,
most have a strong commitment to transformative justice. And what is absolutely
pivotal, all by definition are abolitionists, whereas despite his foundational critique,
strictly speaking, Szasz himself was not an abolitionist (see in this regard,
Szasz, 1961 and Szasz, 2009).
Myth: Antipsychiatry folk are all ivory
tower intellectuals.
Fact: This is at once factually and
interpretively incorrect. While academics for sure figure in antipsychiatry
circles, it is survivors, whether academic or otherwise, who constitute the
majority and indeed the core. Correspondingly, few of the academics could be depicted
as “ivory tower”. More generally, people from all walks of life gravitate
toward and find a base and a home in the antipsychiatry community. These
include: survivors, activists, professionals, academics, artists, family
members—and a subsection that is getting larger by the moment—every day people
who began with no such politic but found themselves on a steep learning curve having
lost family members and/or loved ones to psychiatry.
Myth: To be antipsychiatry is to be
unreasonable and impractical.
Fact: On an individual basis, antipsychiatry
folk, like everyone else, can be reasonable or unreasonable, practical or
impractical. The antipsychiatry mandate, on the other hand, (working to phase
out an institution that is serving us poorly and constitutes a threat to
everyone), on the face of it, is eminently reasonable. By contrast, positions predicated
on continuing to tinker with psychiatry, when, arguably, such positions have
themselves contributed to the current state of affairs, are minimally
questionable.
Myth: Antipsychiatry folk think that all
psychiatrists are bad and deny that some people are helped by their
psychiatrists.
Fact: Antipsychiatry theorizing operates on
a very different level. It is a position on an institution—not a position on individuals. Advocates in no way deny
that some people may be helped by their psychiatrist, just as some are helped
by their priests. What antipsychiatry is maintaining rather is that
psychiatry’s fundamental tenets and practices are insupportable—both epistemologically
and morally.
Myth: Antipsychiatry theorists oppose all psychiatric
reform.
Fact: Antipsychiatry theorists hold that reform
can never be sufficient for the paradigms and tenets of psychiatry are faulty. What
goes along with this, they see reform as having a tendency, irrespective of
intent, to reinforce the status quo. As such, it would be fair to say antipsychiatry
does not focus on reform and in no way can be seen as reformist. This
notwithstanding, as with most revolutionary movements, being antipsychiatry
inevitably also involves supporting more limited agendas, this, while keeping
an eye on the larger goal. Which? And how are such choices made? Here once
again there is no unanimity. Some antipsychiatry organizations support only
those initiatives related to increased rights for psychiatric survivors. Some
would prioritize support for initiatives around homelessness, others, safety. Correspondingly,
those who employ the attrition model as a guide (see Burstow, 2014c) make
decisions based on the answer to the question: If successful, will the actions
or campaigns that we are considering move us closer to the long range goal of
psychiatry abolition? What is likewise significant, a distinction must be made
between “not actively supporting” and “opposing”. Antipsychiatry activists
seldom oppose reforms that on the surface seem benign. The point is, as with
everyone else, our assessment can be wrong, and regardless, we are not in the
business of undermining our allies. However, we may or may not endorse or
support such initiatives, and where we do not, once again, generally it because
we see them in the long run as running counter to the abolitionist agenda, as
re-entrenching psychiatry, or more worrisome still, helping it expand.
Myth: Antipsychiatry would deny people the
right to protect themselves against “violent others”.
Fact: An antipsychiaty position in no way
involves denying that people can be violent or opposing protective measures. Rather,
it involves opposing measures based on the assumption that the people deemed “mad”
tend to be violent—for statistics show that the “mad” are no more violent than
anyone one else. Correspondingly, it involves opposing solutions that are
inherently incarceral, controlling, individualizing, pathologizing, harmful,
and otherwise oppressive.
Myth: To be antipsychiatry is to be anti-choice.
Fact: Herein lies an ever recurring and
profound confusion. The confusion is not limited to antipsychiatry. It also
extends to psychiatry and to the nature of choice itself. From a radical
vantage point, it is institutional psychiatry that is in the business of
depriving people of choice—not antipsychiatry. What goes along with this, to theorize
choice in the context of harm, of underlying intrusion, of artificial options,
of rampant misinformation, and of ruling institutional agendas, is to fall into
a liberal notion of choice (for elaboration, see Burstow 2014d). What is
likewise relevant, antipsychiatry activists are working toward the creation
of a society wherein people have considerably
more choices, correspondingly, where services arise organically from felt needs
and desires—not from the vicissitudes of industry profit.
Myth: If antipsychiatry activists had their
way, everyone who uses psychiatric drugs would soon find themselves robbed of
their life line.
Fact: No abolitionist would find it
acceptable for anyone to be put in such straits—irrespective of their position
on these substances.
Myth: Antipsychiatry theorists ignore what
history teaches us—that if we rid ourselves of psychiatry, some other tyranny
would take its place.
Fact: Antipsychiatry theorists are well
aware of the history of madness—and of how one type of oppressor succeeded
another. We focus on psychiatry because for centuries now, it has been in
charge of the “madness turf, moreover because it has expanded that terrain in
unprecedented ways. At the same time, as people who do not see any form of
tyranny as acceptable, nor tyranny itself as inevitable, we work toward the
creation of a more egalitarian and caring society (in particular, see Burstow,
2015, Chapter Nine—in press).
Myth: Antipsychiatry activists are stuck in
the past.
Fact: Besides that a case could be made
that antipsychiatry has never been so relevant and so pressing as it is today,
paradoxically, the problem is in in some ways the opposite of what is expressed
above. That is, while antipsychiatry is rooted in a vision for the future, to
varying degrees, when thinking about change (and I in no way am denying that some
of our allies here are highly progressive), most folk have difficulty thinking
very far beyond the present—hence the paradigmatic reformist position. As a
result, they keep falling into what institutional ethnographers like Smith
(2005 and 2006) call “institutional capture”. What antipsychiatry activists are
doing, in essence, is inviting people to think further, to see beyond the structures
and conceptions that are now taken as “givens”, and dare to entertain a
radically different, more humane, more accepting, more respectful, and more
relational way of operating.
* * * * *
(For elaboration on many of these points,
see: http://www.bizomadness.blogspot.ca.)
References
Burstow, B. (2015; in press).
Psychiatry and the business of
madness: An ethical and epistemological accounting. New York: Palgrave
Macmillan.
Burstow, B. (2014a). On antipsychiatry. Retrieved from http://bizomadness.blogspot.ca/2014/07/on-antipsychiatry.html.
Burstow, B.
(2014b). On the attrition model of psychiatry abolition. Retrieved from http://bizomadness.blogspot.ca/2014/07/in-recently-released-article-i-provided.html.
Burstow, B.
(2014c). The withering of psychiatry: An attrition
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(Eds.), Psychiatry disrupted: Theorizing
resistance and crafting the revolution (pp. 34-51). Montreal: McGill-Queen’s University Press.
Burstow, B. (2014 d). Consent and psychiatry: Problematizing the
problematic. Retrieved from http://www.madinamerica.com/2014/07/consent-psychiatry-problematizing-problematic/.
Cooper, D. (1967) (Ed.). Psychiatry
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Szasz, T. (2009). Antipsychiatry: Quakery squared. Syracuse, New York: Syracuse University Press.
