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
David Cooper (1931-1986)
Psychiatry and anti-psychiatry (1967)
David Cooper (1931-1986)
Psychiatry and anti-psychiatry (1967)
“[P]sychiatry … has aligned itself far too closely with the alienated needs of society”
David Cooper (1931-1986)
Villa 21 – an experiment in anti-psychiatry
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”
Definition by mainstream psychiatry
International movement against psychiatry which is “anti-medical, anti-therapeutic, anti-institutional and anti-scientific” (Roth, 1973)
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
RD Laing (1927-1989)
Not an anti-psychiatrist
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”
RD Laing (1927-1989)
Madness is much more understandable than commonly assumed
RD Laing (1927-1989)
Madness is much more understandable than commonly assumed
So-called normality is too often an abdication of our true potentialities
Thomas Szasz (1920-)
Not an anti-psychiatrist
Thomas Szasz (1920-)
Not an anti-psychiatrist, although also not a “psychiatrist”, as psychiatry is associated with coercion
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”
Thomas Szasz (1920-)
Mental illness is a myth, as disease is physical
Thomas Szasz (1920-)
Mental illness is a myth, as disease is physical
State should not interfere in mental health practice or medicine in general
The “anti” element in anti-psychiatry
Psychiatry objectifies people and therefore becomes part of the problem rather than the solution to mental health problems
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
Excesses of anti-psychiatry
Cooper and Laing ultimately more interested in personal authenticity than changing psychiatry
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
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
Critical psychiatry
Does not deny its roots in anti-psychiatry
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
Critical psychiatry
Psychiatry can be practised without the justification of postulating brain pathology as the basis for mental illness
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
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
Encouraging self-criticism
Inclined to find fault, or to judge with severity
Encouraging self-criticism
Inclined to find fault, or to judge with severity
Characterised by careful, exact evaluation and judgement
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
Reflective practice
Preparedness to think critically
Reflective practice
Preparedness to think critically
Tolerate the uncertainty and ambiguity required during reflection
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
Critical theory
Loose collection of theories critical of society and the human sciences
Critical theory
Loose collection of theories critical of society and the human sciences
Frankfurt Institute for Social Research
Critical theory
Rational basis of social existence theoretically impossible
Critical theory
Rational basis of social existence theoretically impossible
Systems of collective beliefs legitimate various power structures
Scientific basis of critical psychiatry
Critique of science as positivism
Scientific basis of critical psychiatry
Critique of science as positivism
Interpretation important in establishing “facts”
Scientific basis of critical psychiatry
Corporate interests are compromising objective research
Scientific basis of critical psychiatry
Corporate interests are compromising objective research
Bias in interpretation of randomised controlled trials
A simplified comparison
Biomedical psychiatry
Anti-psychiatry
Critical psychiatry
Science Positivist Non-positivist
Non-positivist
A simplified comparison
Biomedical psychiatry
Anti-psychiatry
Critical psychiatry
Science Positivist Non-positivist
Non-positivist
Focus Brain mechanisms
Person Person
A simplified comparison
Biomedical psychiatry
Anti-psychiatry
Critical psychiatry
Psycho-pathology
Yes No Yes
A simplified comparison
Biomedical psychiatry
Anti-psychiatry
Critical psychiatry
Psycho-pathology
Yes No Yes
Empirical Yes No Yes
A simplified comparison
Biomedical psychiatry
Anti-psychiatry
Critical psychiatry
Psycho-pathology
Yes No Yes
Empirical Yes No Yes
Social control
Yes No Yes
Conclusion
Mental disorders are not brain diseases
Conclusion
Mental disorders are not brain diseases
Psychiatrist is agent of social control
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