is critical psychiatry the same as anti-psychiatry? d b double

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Is critical psychiatry the same as “anti- psychiatry”? D B Double

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Page 1: Is critical psychiatry the same as anti-psychiatry? D B Double

Is critical psychiatry the same as “anti-psychiatry”?

D B Double

Page 2: Is critical psychiatry the same as anti-psychiatry? D B Double

David Cooper (1931-1986)

Psychiatry and anti-psychiatry (1967)

Page 3: Is critical psychiatry the same as anti-psychiatry? D B Double

David Cooper (1931-1986)

Psychiatry and anti-psychiatry (1967)

“[P]sychiatry … has aligned itself far too closely with the alienated needs of society”

Page 4: Is critical psychiatry the same as anti-psychiatry? D B Double

David Cooper (1931-1986)

Villa 21 – an experiment in anti-psychiatry

Page 5: Is critical psychiatry the same as anti-psychiatry? D B Double

David Cooper (1931-1986)

Villa 21 – an experiment in anti-psychiatry

Positive non-action, “an effort to cease interference, to ‘lay off’ other people and give them and oneself a chance”

Page 6: Is critical psychiatry the same as anti-psychiatry? D B Double

Definition by mainstream psychiatry

International movement against psychiatry which is “anti-medical, anti-therapeutic, anti-institutional and anti-scientific” (Roth, 1973)

Page 7: Is critical psychiatry the same as anti-psychiatry? D B Double

Definition by mainstream psychiatry

International movement against psychiatry which is “anti-medical, anti-therapeutic, anti-institutional and anti-scientific” (Roth, 1973)

Generally seen as a passing phase in the history of psychiatry

Page 8: Is critical psychiatry the same as anti-psychiatry? D B Double

RD Laing (1927-1989)

Not an anti-psychiatrist

Page 9: Is critical psychiatry the same as anti-psychiatry? D B Double

RD Laing (1927-1989)

Not an anti-psychiatrist

Athough agreed with anti-psychiatric thesis that “by and large psychiatry functions to exclude and repress those elements society wants excluded and repressed”

Page 10: Is critical psychiatry the same as anti-psychiatry? D B Double

RD Laing (1927-1989)

Madness is much more understandable than commonly assumed

Page 11: Is critical psychiatry the same as anti-psychiatry? D B Double

RD Laing (1927-1989)

Madness is much more understandable than commonly assumed

So-called normality is too often an abdication of our true potentialities

Page 12: Is critical psychiatry the same as anti-psychiatry? D B Double

Thomas Szasz (1920-)

Not an anti-psychiatrist

Page 13: Is critical psychiatry the same as anti-psychiatry? D B Double

Thomas Szasz (1920-)

Not an anti-psychiatrist, although also not a “psychiatrist”, as psychiatry is associated with coercion

Page 14: Is critical psychiatry the same as anti-psychiatry? D B Double

Thomas Szasz (1920-)

Not an anti-psychiatrist, although also not a “psychiatrist”, as psychiatry is associated with coercion “Because both the anti-psychiatrists and I oppose certain aspects of psychiatry, our views are combined and confused”

Page 15: Is critical psychiatry the same as anti-psychiatry? D B Double

Thomas Szasz (1920-)

Mental illness is a myth, as disease is physical

Page 16: Is critical psychiatry the same as anti-psychiatry? D B Double

Thomas Szasz (1920-)

Mental illness is a myth, as disease is physical

State should not interfere in mental health practice or medicine in general

Page 17: Is critical psychiatry the same as anti-psychiatry? D B Double

The “anti” element in anti-psychiatry

Psychiatry objectifies people and therefore becomes part of the problem rather than the solution to mental health problems

Page 18: Is critical psychiatry the same as anti-psychiatry? D B Double

The “anti” element in anti-psychiatry

Psychiatry objectifies people and therefore becomes part of the problem rather than the solution to mental health problems

May have gone too far in abandoning notion of mental pathology

Page 19: Is critical psychiatry the same as anti-psychiatry? D B Double

Excesses of anti-psychiatry

Cooper and Laing ultimately more interested in personal authenticity than changing psychiatry

Page 20: Is critical psychiatry the same as anti-psychiatry? D B Double

Excesses of anti-psychiatry

Cooper and Laing ultimately more interested in personal authenticity than changing psychiatry

Few would want to go as far as Szasz in proposing no mental health law

Page 21: Is critical psychiatry the same as anti-psychiatry? D B Double

Excesses of anti-psychiatry

Cooper and Laing ultimately more interested in personal authenticity than changing psychiatry Few would want to go as far as Szasz in proposing no mental health law Cooper’s excursion into family, sexual and revolutionary politics

Page 22: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical psychiatry

Does not deny its roots in anti-psychiatry

Page 23: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical psychiatry

Does not deny its roots in anti-psychiatry

Seeks to avoid excesses of anti-psychiatry and polarisation in the debate about nature of mental disorder

Page 24: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical psychiatry

Psychiatry can be practised without the justification of postulating brain pathology as the basis for mental illness

Page 25: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical psychiatry

Psychiatry can be practised without the justification of postulating brain pathology as the basis for mental illness

Minds are enabled but not reducible to brains

Page 26: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical psychiatry

Psychiatry can be practised without the justification of postulating brain pathology as the basis for mental illness Minds are enabled but not reducible to brains Genes set the boundaries of the possible; environments define the actual

Page 27: Is critical psychiatry the same as anti-psychiatry? D B Double

Encouraging self-criticism

Inclined to find fault, or to judge with severity

Page 28: Is critical psychiatry the same as anti-psychiatry? D B Double

Encouraging self-criticism

Inclined to find fault, or to judge with severity

Characterised by careful, exact evaluation and judgement

Page 29: Is critical psychiatry the same as anti-psychiatry? D B Double

Encouraging self-criticism

Inclined to find fault, or to judge with severity

Characterised by careful, exact evaluation and judgement

Of the greatest importance to the way things might happen

Page 30: Is critical psychiatry the same as anti-psychiatry? D B Double

Reflective practice

Preparedness to think critically

Page 31: Is critical psychiatry the same as anti-psychiatry? D B Double

Reflective practice

Preparedness to think critically

Tolerate the uncertainty and ambiguity required during reflection

Page 32: Is critical psychiatry the same as anti-psychiatry? D B Double

Reflective practice

Preparedness to think critically

Tolerate the uncertainty and ambiguity required during reflection

Ability to think about own thinking processes and critically assess assumptions and beliefs

Page 33: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical theory

Loose collection of theories critical of society and the human sciences

Page 34: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical theory

Loose collection of theories critical of society and the human sciences

Frankfurt Institute for Social Research

Page 35: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical theory

Rational basis of social existence theoretically impossible

Page 36: Is critical psychiatry the same as anti-psychiatry? D B Double

Critical theory

Rational basis of social existence theoretically impossible

Systems of collective beliefs legitimate various power structures

Page 37: Is critical psychiatry the same as anti-psychiatry? D B Double

Scientific basis of critical psychiatry

Critique of science as positivism

Page 38: Is critical psychiatry the same as anti-psychiatry? D B Double

Scientific basis of critical psychiatry

Critique of science as positivism

Interpretation important in establishing “facts”

Page 39: Is critical psychiatry the same as anti-psychiatry? D B Double

Scientific basis of critical psychiatry

Corporate interests are compromising objective research

Page 40: Is critical psychiatry the same as anti-psychiatry? D B Double

Scientific basis of critical psychiatry

Corporate interests are compromising objective research

Bias in interpretation of randomised controlled trials

Page 41: Is critical psychiatry the same as anti-psychiatry? D B Double

A simplified comparison

Biomedical psychiatry

Anti-psychiatry

Critical psychiatry

Science Positivist Non-positivist

Non-positivist

Page 42: Is critical psychiatry the same as anti-psychiatry? D B Double

A simplified comparison

Biomedical psychiatry

Anti-psychiatry

Critical psychiatry

Science Positivist Non-positivist

Non-positivist

Focus Brain mechanisms

Person Person

Page 43: Is critical psychiatry the same as anti-psychiatry? D B Double

A simplified comparison

Biomedical psychiatry

Anti-psychiatry

Critical psychiatry

Psycho-pathology

Yes No Yes

Page 44: Is critical psychiatry the same as anti-psychiatry? D B Double

A simplified comparison

Biomedical psychiatry

Anti-psychiatry

Critical psychiatry

Psycho-pathology

Yes No Yes

Empirical Yes No Yes

Page 45: Is critical psychiatry the same as anti-psychiatry? D B Double

A simplified comparison

Biomedical psychiatry

Anti-psychiatry

Critical psychiatry

Psycho-pathology

Yes No Yes

Empirical Yes No Yes

Social control

Yes No Yes

Page 46: Is critical psychiatry the same as anti-psychiatry? D B Double

Conclusion

Mental disorders are not brain diseases

Page 47: Is critical psychiatry the same as anti-psychiatry? D B Double

Conclusion

Mental disorders are not brain diseases

Psychiatrist is agent of social control

Page 48: Is critical psychiatry the same as anti-psychiatry? D B Double

Conclusion

Mental disorders are not brain diseases

Psychiatrist is agent of social control

Mental disorders must show through the brain but not always in the brain