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Wednesday, September 22, 2010

Antipsychiatry: Quackery Squared

In this latest work, Freeman columnist Thomas Szasz fires another salvo in his continuing critique of the disasters wrought by contemporary psychiatry—specifically its penchant for coercive pseudomedical interventions that masquerade as treatment while depriving people of their liberty. Here, however, the focus is more specific, with Szasz providing the definitive critique of what has erroneously come to be known as the anti-psychiatry movement.

As is customary with Szasz’s work, there is painstaking historical analysis, beginning with the term “anti-psychiatry movement.” That term originated not, as might be thought, in the 1960s, when it became synonymous with the work of Scottish psychiatrist R. D. Laing and his colleague David Cooper, but in late nineteenth-century Germany. Then as now the term was employed, Szasz writes, to “divert people’s attention from the core moral-political problems of psychiatry, coercion and excuse making.” In short, it was a dismissive label to prevent serious criticism of psychiatry.

The “antipsychiatry movement” was largely ignored until the late 1960s when Laing and his allies sought to draw attention to themselves by appropriating the label for their critique of conventional psychiatry. Szasz argues that despite some differences between mainline psychiatry and Laing and his followers, their actions were in fact fully in accord with psychiatry’s central precepts. Laing and his allies held a core belief in the existence of mental illness as a medical entity—to be treated with drugs if necessary—and a belief in their own power to cure people of purported mental illness, with the use of force if required. As such, rather than challenging, as is usually thought, psychiatry’s customary mores, Laing and his associates are described as practicing an alternative form of it and thereby reinforcing the myth of mental illness that Szasz has correctly challenged for almost 50 years now.

Readers coming to the book with some knowledge of Laing’s work will be disappointed and somewhat shocked to see his inconsistencies exposed. His employment of forced “treatment” at Kingsley Hall (the anti-psychiatric “residence” in the East End of London ) is dissected in detail. Disconcerting though it may be, we are better and wiser for this knowledge. As is well known, Laing’s behavior, often fueled by alcohol, could be particularly unpleasant. Szasz highlights his inconsistencies: While he made lucid attacks on the barbaric nature of psychiatric treatment, he was ultimately incapable of rejecting the movement that gives rise to them. Laing compromised and sacrificed the potential strength of his arguments in pursuit of establishment recognition and fame.

Szasz meticulously documents Laing’s desire to work both within and outside the established system at the same time and depicts him as a “trickster”—willfully exposing psychiatric brutality at the start of his career, but subsequently endorsing the “standard of care” of modern biological psychiatry as his swan song. Laing and Cooper emerge as sad and rather disturbing people, notwithstanding the effect they had on others.

To describe Laing as a “bad person,” as Szasz does, seems somewhat harsh, but that probably reflects Szasz’s disappointment in him. Laing had the potential to contribute greatly by exposing the medical myth-making at the dark heart of psychiatry, but threw it away amidst a trinity of drink, abuse, and desire for celebrity.

In sum, Szasz makes a strong argument that the “antipsychiatrists” have presented only a very limited vision of liberation for the psychiatric service user. The changes that are required in society to restore freedom and dignity to those said to be “mentally ill” need a greater vision than theirs.

This is an important book, and it deserves to be read closely alongside Szasz’s other works. For those with an earnest desire to support human freedom, it provides more food for thought about the damage wrought, under the guise of benevolence, by the relentless psychiatric machine.