Category Archives: Anti-psychiatry

Anti-Psychiatry

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?

 

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Cockamamie Views From Anti-Psychiatric Advocate

By Marvin Ross

Bonnie Burstow, the anti-psychiatry scholarship donor at the University of Toronto, gave a lecture in December on her book called Psychiatry and the Business of Madness. The lecture is on youtube for those of you who have the stomach to watch it. I managed 38 minutes of the hour talk and it is so full of absurdities that, frankly, it defies reality.

I recently wrote about her scholarship on the Huffington Post and that was followed by a number of other critiques of that endeavour – none favourable. Tom Blackwell, the National Post medical writer, called it an affront to science that could do harm. “This is a case where academic freedom should be quashed,” Edward Shorter, a U of T professor and expert in the history of psychiatry, told Blackwell. Dr. Joel Paris, a McGill University psychiatrist, is quoted saying he is ashamed of the University.

I can only imagine what they would have said if they saw this lecture so allow me to summarize the first half and point out the errors.

Bonnie begins by saying that psychiatry is so inherently wrong that it just cannot continue. She points out that psychiatrists are so powerful that they are the only ones in society who have the right to take away someone’s freedom. They have king like power like those of the 16th and 17th centuries who had the power to exile citizens forever.

Now she says these views are based on thousands of interviews and attending 15 consent and capacity board hearings. If she really did attend those meetings, she could not believe what she said and by equating shrinks to autocratic monarchs, she suggests that there is no recourse to anything they do. Each jurisdiction allows for holding someone for observation and the rules differ but are all basically the same. For the purpose of this blog, I will comment on Ontario since Bonnie lives in Ontario as do I.

To begin with, psychiatrists are not the only ones to have the power to put someone in the hospital for observation. Any MD can do that based on very specific criteria. It is not arbitrary. The initial period is for 72 hours only after which the person is to be discharged, or can agree to remain voluntarily. If they still pose a threat to themselves or others, they can be held for a further 2 week period but that cannot be ordered by the doctor who originally signed the 72 hour committal. A second doctor must agree that it is necessary and sign the forms.

The patient is then told by the patient rights advocate that they can appeal if they do not agree and they will be supplied with a legal aid lawyer. This results in a capacity hearing before a board 15 of which Bonnie attended.

This is hardly imprisoning anyone nor is it done without respect for individual rights. Bonnie describes this as bringing the weight of the entire state, police, hospitals, families, universities who have been all sucked into this system. At the very centre of this conspiracy are the big pharma companies.

To illustrate what she calls the lack of substance to psychiatry, she recounts the experiences of her friend, Amy. For about 30 years, Amy has periodically taken off all her clothes and run down the street pounding on doors yelling “emergency, emergency”. Concerned homeowners call the cops who come and take her to hospital where she is locked up for a period of time. This has happened in various jurisdictions all over North America and Bonnie feels it is ridiculous. Her activities are simply “outside our comfort zone” so we define her as dangerous and sick. Bonnie does not even think people should call the cops.

I don’t know about you but if this happened in my neighbourhood, I’d call 9-1-1. I’m not sure what I would think but escaping a rapist would come to mind, or an abusive spouse or having been held against her will would be at the top of my thinking. The police are best able to deal with that. If they can find no reasonable reason for this behaviour, then of course they would take her to the emergency room.

This example led her to talk about violence of the mentally ill and a long discussion on the impossibility of psychiatrists being able to predict who may or may not become violent. She is correct on that score but her argument that is often heard about those with mental illness never being violent is absurd. Those who are untreated and those who are untreated and substance abusers are at far greater risk of violence than others. This link from the Treatment Advocacy Centre lists all the studies that demonstrate this fact.

She then goes on to talk about how mass shootings involve people who are often on psych meds and that it is the meds that likely cause these shootings. Psychiatrist Joe Pierre writing in Psychology Today argues that “In the vast majority of cases, we don’t have access to their medical records and we certainly don’t know if the medications, even if prescribed or otherwise obtained, were actually being taken.”

“And then, of course, there’s the issue of correlation vs. causality. After all, I’m fairly certain all known mass murderers were drinkers of tap water, which has also been linked to violent outbursts.”

At this point, Professor Burstow switches into “refuting” the concept of mental illness. She states that only a body can have an illness. A mind cannot be ill as it is only used for thinking. I kid you not! That is what she said.

She then goes on to say that the hallmarks of paranoid schizophrenia are paranoia and delusions of grandeur. What happens to the paranoia and the grandeur when the person dies and there is just a corpse. She asks her audience if any of them have ever seen a corpse with delusions and, since no one has, schizophrenia fails the test of an illness.

What can anyone say when confronted with this? Professor Burstow has failed the test of physiology. The brain is an organ that allows us the ability to think, speak, make decisions, and so on. Does she have any idea how it is that we can think in the first place? Obviously not. This summary provides an overview of the differences in the brains of those with schizophrenia compared to normal brains. There are numerous differences.

And this is a study showing the abnormalities in the brain of autopsied people with schizophrenia. Which of these abnormalities results in paranoia and delusions of grandeur is not known but the brains are different.

I gave up when she began talking about the longitudinal studies by Harrow in Chicago. This researcher followed a group of people with schizophrenia for 20 years and checked on them every five. What he found was that some people were able to go off meds and do well and they were doing better than those on meds. I’ve written about this a number of times and, in one of my Huffington Post blogs, I had this to say:

79 per cent and 64 per cent of the patients were on medication at 10- and 15-year follow ups. Those who were not on medication, did better on the outcome measures than those who were on but would that not be expected? Why they stopped the medication or were removed from it by their doctors was not explained, but we can presume that it was because they did not need the medication. In fact, Harrow states that not all schizophrenia patients are alike and that one treatment fits all is “not consonant with the current data or with clinical experience.” His data suggests that there are unique differences in those who can go off medications compared to those who cannot. In a paper Harrow just published in March, he points out that it is not possible to predict who may be able to go off medication and those who need the long term treatment. Intensified research is needed.

It just isn’t that simple, Bonnie. She did go on but I could not take anymore so ended there.