By Dr David Laing Dawson
As a personal addendum to Marvin’s piece:
In the years before I studied medicine and then entered psychiatry, the mental hospitals, the Asylums, were full. I believe the largest in North America housed about 13,000 patients. There were no effective treatments (with the exception of ECT) though many things were tried, from field work and prayer to cold baths, spinning chairs, and insulin coma. These Asylums themselves grew from an increasing social awareness, acceptance of social responsibility, and recognition of the need for the state to look after the intellectually, cognitively, emotionally, and socially disabled among us. (roughly 1850 to 1990)
The doctors, the Alienists, and then the psychiatrists were given wide latitude to hold, to keep, and to treat.
Curiously I do not recall any active anti-psychiatry movement then or through the years 1960 to 2000 (with the exception of Scientology). And it was through those years that actually effective treatments were developed. And by effective I mean scientifically proven to be effective.
I can now prescribe something that quells mania in a few days, that pulls someone from a stuporous depression in two weeks, that reduces panic attacks, that eliminates the excruciating pain of agitated depression, that tempers debilitating obsessions and compulsions and that gradually returns the insane to a state of sanity – if my patient will let me.
And it is now, again curiously, at a time when psychiatrists do have effective tools to treat mental illness and when they are very restricted in any use of these treatments without explicit consent and when those Asylums have been reduced to a tenth the capacity they once had, that an anti-psychiatry movement has developed.
I have to conclude that the motivation for this anti-psychiatry movement is not the welfare of others but of professional rivalry and fear. And like some other attitudes today (anti-vaccination, anti-global alliances, pro-alternative medicine, anti-fluoridation), it has to be based on memory loss – that is, a profound memory loss of childhood death from diphtheria, WWI & II, the crippling polio epidemics of the 1950’s, the rotten teeth of the average kid in 1930, and the wards of catatonic or raving and tormented souls in the lunatic Asylums, and, before that, in the jails and stockades, tied to poles, or expelled from villages.
Of course there is much to discuss in the liberal arts and social sciences about how societies have defined normal and abnormal, and all the forces at play in each Era, and about the uses and abuses of power, and about the benefits of capitalism (all effective modern medicines have been developed within capitalist systems) and the horrors of unregulated capitalism.
And these (along with the philosophy of science and the successes and limitations of the disease model of human ailments) can all be discussed and investigated within schools of social work and medicine in an academic fashion without prejudice. In fact, a really good academic question to ask would be: Why is there now a strong anti-psychiatry, anti-vaccination movement? Is it related to the anti-science zeitgeist of Trump world? Is it a failure to teach real history? Is it fear of a loss of the sense of a perfect God-made homunculous within each of us? Is it the fault of the internet? Have our entertainments (think Dr. House, Hannibal Lecter, and Jack Nicholson receiving ECT) overwhelmed our perception of reality?
Or is it just some social workers and psychologists wanting more power and status?
Mind You Reflections on mental illness, mental health and life 
I first heard of mental illness through CMHA and these people
http://www.psychiatricsurvivorarchives.com/phoenix.html
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I can only speak from my perspective as a social worker and a family caregiver of someone with a serious mental illness. No, I do not believe the rise of anti-psychiatry comes from a need for power from psychologists and social workers. It comes from a genuine lack of accountability. I am speaking primarily about the Ontario College of Physicians and Surgeons who do not respond appropriately to real complaints about bad psychiatrists. That might be something to do with the “old boys network” (not my words but someone else’s) protecting themselves.
In an ideal world, all three professions need to learn from each other so that their respective skills can be used in a collaborative fashion for the good of the individual with the illness and for the family who are supporting that individual.
The fact that an anti-psychiatry course is being taught in a recognized university is an outrage. What a waste of money that could be rechanneled into adequate mental health services. But I would imagine that some of the anti psychiatry sentiment comes from bad experiences that people have had at the hands of some psychiatrists. Perhaps psychiatry could be improved not only by better monitoring but also in the teaching of student psychiatrists. Then some of these awful things will not happen. For example, in our family support group, one caregiver said that the psychiatrist redirected any questions that she had about the illness back to her son who had just been given the diagnosis of schizophrenia. There he was grappling with the implications of a profound illness and he was expected to tell his family about the illness! There are so many stories of bad judgment and insensitivity from some psychiatrists and other professionals.
Now, we families have the implications from the anti psychiatry movement to deal with. The local agency which gets funding from the LHIN to run family programs openly advertises that “Recovery is possible”. I believe they need to qualify this and say that a state of wellness may be achieved but serious mental illness is a chronic condition. But they don’t. So their message comes across like an example of state sanctioned and state funded misinformation.
And history is full of examples of where other entities have used misinformation leading to disastrous results. In this case, we only need to look at the number of our loved ones who are in prison or on the street.
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I’m not aware of the anti-psychiatry movement. From what I’ve seen there’s not enough affordable access to psychiatrists. There’s so much encouragement to get mental help but it’s not that easy. I see some trying to promote psychiatry as similar to regular maintenance on a car. Again, nice if you have access.
As for the other things, it’s worth looking at the evidence.
I agree with Erin Brockovich and others who’ve looked at fluoride. I don’t think we should be medicating our water supply. There is no benefit to taking fluoride internally and concerns about effects.
Fluoride is said to accumulate in the body, particularly in the human pineal gland. Depositing the heavy chemical into drinking water, Brockovich argues, is unfair given that people essentially don’t have a choice in how much they’re consuming, particularly in children.
Children using fluoridated toothpaste and drinking fluoridated water can actually end up consuming higher than recommended amounts.
Most European countries have experienced substantial declines in tooth decay without fluoridating their water. The European Commission finds no advantage to water fluoridation compared with topical use
Those of us with thyroid issues may want to avoid or reduce fluoride exposure too. Why should we pay for fluoridated water, then have to pay extra to buy or filter our drinking water?
Let those who want to drink fluoride or use it buy those products or subsidise it. Subsidizing dental care would be and additional way to improve oral health. Why not spend time, money and energy supporting things proven to help?
Like many other people, I grew up drinking fluoridated water and brushing my teeth twice a day. I had lots of cavities. So do my siblings. My mother’s teeth are in better shape and not overcrowded either. She also doesn’t have allergies. She grew up on a small farm with spring or well water, raw milk and mostly eating food they grew themselves.
If I was a parent or needed shots, I’d educate myself about vaccinations. There are reportedly Russians posting misinformation so you need to be careful. I would try to choose the safest ones, take precautions and not do several at a time, as recommended by Weston A. Price Foundation. I’m aware of infants dying when their doctor administered several at once.
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Well said, Kathleen, thank you. Fuller Torrey notes that when you have a loved one with schizophrenia, there is no avoiding “the doctor-finding issue.” It comes as a shock to most family members to find out how few psychiatrists are actually working with seriously ill patients–AND–how few of those are competent and keen to include the family in treatment planning because they know it’s in the patient’s best interest to have as much support as possible. If good psychiatrists want the respect that is their due, they must speak more loudly and more clearly on behalf of patients and their families. E.g., the Canadian Psychiatric Association should be lobbying government for (a) an end to the tragic scandal of the homeless mentally ill who are dying in our streets and jails; (b) timely access to the best possible care and treatment for all patients with serious mental illness; (c) respite services for family caregivers; etc., etc.
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I agree Jane. perhaps they do not walk on Main Street and witness the neglect.
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How can we light a fire under them? I have heard that some psychiatrists will not take on difficult cases but where does that leave the person with the illness and the family?
The situation with the seriously mentally ill in Canada and other parts of the world is beyond an outrage yet there appears to be no political will to change things.
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Thank you Annick for producing the bibliography and names involved in the anti-psychiatry movement. I met many of the protagonists on the list either at meetings, on committees, or at lectures.
More history of the anti-psychiatry movement can be gained by reading “Madness on the Streets” (Isaac and Armat) and Fuller Torrey’s “Nowhere to Go” covers much the same ground.
As for folks on the list, I have duelled with them face-to-face on Committees or at lectures. Most of them have a very destructive agenda. Once in a while they have a point,which they manipulate to the full. Few of them know what it is like to see someone seriously tortured by an untreated psychosis. I saw people in my training hospital (Holloway Sanatorium circa 1962) who were benefiting from new drugs. Imperfect treatments but much better than the folks who had entered a decade earlier. I did not then sense the anti-psychiatry movement but it was beginning to emerge when I worked at Fullbourne Hospital in Cambridge, where I believe Dr Dawson later worked. Looking back on those group therapy sessions I distinctly remember some false notions emerging. Madness was being reinterpreted.
The anti-psychiatry movement began not too long after antipsychotics became available. So it is important to recognize that has been around for a very long time. The book “One Flew over the Cuckoo’s Nest” was published in 1962 and the film came out in 1975. I bought Thomas Szasz’s book “The Myth of Mental Illness” in 1962. It was convoluted and wordy and talked in circles. In a word GUFF!
In the early nineties the infamous Szasz was invited at great expense by the medical students at Queen’s University. I heard by the grapevine that the Department of Psychiatry had objected, but was powerless to stop his coming. The lecture hall was packed and he received much applause. I, and the fraternal twin of a man severely afflicted with schizophrenia, challenged him. I was booed and shouted down by a student who told me I had a problem! Many years before that, R. D. Laing was invited by the Psychology Department at Queen’s. Grant Hall was full to the gills. The man was either drunk or manic!
As for the Ontario anti-psychiatry people, they were going strong in the early eighties and many came to Kingston. They were everywhere and heavily influenced the CMHA. They got themselves on District Heath Council Committees and peddled much rubbish. They got the high ground, and got funding for some extremely worthless programmes. And how they got through the money! They influenced policy and and got rid of hospital beds.
In my view social workers and psychologists and even medical doctors (including some psychiatrists) have been on the wrong tract in their understanding of these terrible brain diseases. Sad to say, many do not have a basic background in neurology.
The hospital where I trained was for paying patients. It was a very fine piece of architecture. It now is a gated community for the rich and famous. One thing I know for sure is that schizophrenia and allied disorders attacks all races, and all social levels, the poor and the rich. When will the system understand that poverty is a consequence of these afflictions and not the cause? Meanwhile families are robbed of their resources, are made ill with worry, are still blamed, and are more often than not powerless to bring care and compassion through understanding. And many of the agencies that are meant to advocate are tied up with side issues, such as stigma, and deny the biological nature of serious mental illness.
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I mostly agree with Dr. D, except:
1) when he stated, “Curiously I do not recall any active anti-psychiatry movement then or through the years 1960 to 2000 (with the exception of Scientology).” Curiously, he may not remember that most anti psychiatry writers were psychiatrists and other physicians.
And 2)when he said, “Or is it just some social workers and psychologists wanting more power and status?” Is his next blog going to discuss his professional rivalry with psychologists and social workers?
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You are right about much dissent in those years, 1960 to 2000, and I read them all and attended a few sessions with Fritz Perls, argued with Marxist sociologists, but I think I saw them not as an anti-psychiatry movement but a rich exploration within psychiatry of the complexity of being human. All part of the nature nurture spirit social organization argument. Our community mental health teams made up of psychiatrists, nurses, psychologists and social workers often mirrored these complex questions. “He needs his depression treated; he needs a good relationship; he needs some care; he needs a job; he needs to change his thinking.”
And even then never losing sight of the prime goal to reduce suffering.
But I still think it not a coincidence that it is only when we have such effective tools to treat serious mental illness that a full-throated anti-psychiatry movement develops. These drugs that can change mood and thinking so dramatically are a threat to the sanctity of the “I”.
And I apologize for the cheap shot at the end, but….
David
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Yes and yes and no. One thing one gets to know is the “i” gets swallowed up by an active psychosis. How many times have we heard relatives say.” he or she is not himself” In fact with some psychoses the person refers to themselves in the third person.
In other word identity gets lost in the mess. As for Capgrass Syndrome the person believes in their relatives being impostors. The altered brain certainly causes a lot of confusion. Time place identity gets into a royal muddle. The drugs as we all know are far from perfect for some individuals but they often give back more than they take. My 97 year olds friends son was at her birthday and enjoying himself . In early thirties forties etc he was lost for well over a decade until the ninth review board allowed treatment. Drugs did the miracle and now as a senior himself, he functions pretty well, is highly intelligent ,charming and has allowed his mother to get some rest. It is a joy to see given what was for so long torture for everyone.
In my experience a good relationsionship does not restore a splintered brain when it is a case of a psychosis, but it is a persistent family that plods forward for restorative help.
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Why is there now an antipsychiatry movement? Because so many people are not being helped by medication. It all comes down to ‘take your meds’ when the problem may lie in early trauma, life circumstances, or some other condition. Of course, psychiatrists now recommend medication plus talk therapy, but many of them just use meds because they don’t have the time or inclination to do therapy. That is most certainly the case with GPs who don’t know their psych drugs the way they should. Also, the 10-minute time slot doesn’t allow for any meaningful therapy.
Biological psychiatry has to move beyond this idea that mental illness is just a “broken brain: and that’s that. Only now is data emerging concerning what causes that broken brain and early life trauma plays large. It is not just a complicating factor, as you have written, but it is CAUSATIVE, even in chronic psychosis. Many papers on that and they are not all ‘data mining.’
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