Talk:Anti-psychiatry
"The discovery of biological and genetic bases for mental illness have eroded support for the anti-psychiatric movement in recent years, and its more extreme views are no longer mainstream," claims the page. But is this really true, or is it true only that it has now become the fashion to claim, absent hard evidence, that "mental illnesses are biological illnesses"? How can Satcher claim this when it is openly admitted, now, today, in 2002, that such "mental illnesses" as schizophrenia and clinical depression are of unknown etiology, i.e. that the biological mechanism by which they operate is still unknown?
- I'm fairly familiar with the medical research in this area, and I believe the initial summation to be largely correct. Biological mechanisms are increasingly well-known; for instance, the link of depression to the chemical serotonin and its intake into the brain has a great deal of evidence to support it. Likewise, various MRI studies of schizophrenics and others have shown marked differences in brain activity from that of persons not so diagnosed.
- I would also like to point out the irony of one of the implications of the currently fashionable claim that "mental illnesses are biological illnesses": it undermines completely the practice of involuntary commitment. People are not subject to "involuntary commitment" for physical illnesses (except that in some circumstances they may be forcibly quarantined if the illness is contagious, though this is obviously not relevant to the mental illnesses now declared to be "biological"); they are free to refuse medical treatment regardless of how deleterious it may be to their health. If mental illnesses are indeed "biological" in nature what is the justification for forcing treatment on those who "suffer from" them? If "mental illnesses are biological illnesses" they cannot be treated differently than any other biological illnesses. --Daniel C. Boyer 20:21 Dec 15, 2002 (UTC)
- Treatment is routinely forced on people who are deemed unable to make an informed decision regarding treatment, regardless of whether the cause of their inability is biological (severe hyperglycemia, uremia, electrolyte abnormalities, intoxication) or not. -- Someone else 21:10 Dec 15, 2002 (UTC)
- This is failing to distinguish between incompetence or being declared by a court incompetent to consent to medical treatment (and psychiatric treatment has been included in this) and the practice of involuntary commitment. Certainly one can be declared incompetent and thus have medicine or a surgical procedure forced on them to which they do not consent. But there is no parallel to the practice of involuntary commitment for "mental illnesses." You can see the difference in that sometimes people are involuntarily committed but refuse to take the psychiatric medicine prescribed for them in the hospital (although often they are under a court order to take medication in or out of the hospital). Wherever it is dealt with in the Wikipedia a clear distinction (or full account of the subtleties of practice and theory) between involuntary commitment and ["]medical treatment["] (including hospitalization and medication) forced on a patient after his being declared incompetent, needs to be made. --Daniel C. Boyer
- But you have not considered what is often pointed out only in "consumer survivor" and other antipsychiatric writings, but is nevertheless true, that these studies are frequently flawed in that they fail to take into account the possibility that the disabilities seen in the MRIs are the result of medicines used to "treat" "schizophrenia" rather than the schizophrenia itself. Daniel C. Boyer
Indeed, the very success of psychiatric medicine - wherein results for released medicines are far above placebo results in rigorous, double-blind studies - is strong evidence for biochemical causes. One may argue the specifics - "Multiple-personality disorder" being an example of such a contentious case - but the general concept is widely accepted in both the clinical community and by the public at large. As a result, I think the original author is in no way overstating when he calls anti-psychiatry "no longer mainstream." As a "fact about an opinion," that one seems on fairly solid ground. -- April
- That a "medicine" has an effect "far above placebo" on a group of thoughts, actions, speech that have been isolated and called an illness (though any set of thoughts, action or speech -- even if their commonality might seem to some questionable -- could be so isolated) I do not dispute. But what Lawrence Stevens has to say about this might be instructive (piano-player exampe at "Does Mental Illness Exist?". Just as "LSD therapy" does not prove that "normal" people have a disease of "normal thoughts and behaviour" the administration of psychiatric medication changing thoughts and behaviour does not prove that the people to whom they are administered have a disease.
Added information on "sluggishly progressing schizophrenia".
"However, as Thomas Szasz points out, one of the implications of denying the existence of mental illness is to deny the existence of the insanity defense": I believe this should be rewritten "However, as Thomas Szasz points out, one of implications of the argument that mental illness does not exist must be that the insanity defense has to be abolished". Hopefully there will be no objections to my doing this, but Szasz does not argue that the insanity defence does not exist -- obviously this defence still exists in the criminal law of most U.S. states -- but that, if mental illness does not exist, the insanity defence should be gotten rid of.
- The way you've presented Szasz' view, I think he misunderstands the relation between a medical definition of insanity and a legal definition of it. The legal defense of insanity does not rely on whether an individual is medically insane although that condition (if such actually exists) would help inform whether a defendant was legally insane. The legal defense of insanity is formed around the McNaghten rules or some variation of it. Those rules consider whether a person is of a state of mind to know the quality and nature of his act and/or whether the person understands the difference between right or wrong. A person with Down's syndrome or Alzheimer's could just as easily resort to the legal defense of insanity. My point is, contra Szasz, the insanity defense does not rest upon whether mental illness exists or not; it rests upon a person's state of mind which could be informed by any number of conditions. B 23:25 Feb 5, 2003 (UTC)
- This is a well-taken point. I agree that the abolition of involuntary commitment or belief in "mental illness" does not necessarily mean the abolition of the insanity defence; it might mean, at most, its narrowing. --Daniel C. Boyer
Though I would personally agree with most of it, the section on Scientology leaves a lot to be desired from the NPOV viewpoint (ha ha). I don't think non-NPOV words like "vicious" should be employed in this context; it should be mentioned that some people found them "vicious." --Daniel C. Boyer
I don't think it's accurate to list Peter Breggin on the anti-psychiatry page considering he is a member of the APA and has been a practicing psychiatrist for over thirty years. (His Resumé) His main objections to most modern psychiatric treatments are that the supposed beneficial effects stem from causing dysfuntion or damage in the patient's brain. He does believe that some people may in theory be helped with chemicals, but he strongly advocates a social approach and condemns biopsychiatry for what I would term as myopic reductionism. Anyways, there is a lot to critique regarding psychiatry, especially its role in eugenics and the Holocaust. Good luck on working out a wiki entry for this profession.
"Many mentally ill people" is not NPOV. The whole question, in this article, is whether they are mentally ill. --Daniel C. Boyer 17:20 Jan 4, 2003 (UTC)
Aren't mentally ill people entitled to their own opinions, then?
- This is begging the question. One of the main controversial questions in the subject of anti-psychiatry is whether mental illness exists at all. If mental illness does not exist, then there can be no mentally ill people to have opinions or not to have opinions. If mental illness exists, obviously mentally ill people will have opinions, and of course they will be entitled to them. Approaching the question from NPOV will necessitate observing that those who are diagnosed as being mentally ill, or perhaps self-identify as mentally ill, may have opinion x. This gets around the controversial question of whether there is such a thing as mental illness. --Daniel C. Boyer
It depends upon who you ask and how you define mentally ill...Vera Cruz
"Prior to the 1970s, it was not uncommon for electroconvulsive therapy to be used to sedate and punish difficult psychiatric patients, rather than for theraputic purposes." This distorts. ECT is still forced on unwilling patients and is still, if not as commonly as in the 1970s, at least sometimes, used in this way. --Daniel C. Boyer 20:33 Feb 2, 2003 (UTC)
Removed link to suicide article; it is not relevant to this article. --141.219.44.80 18:17 Feb 4, 2003 (UTC)
As a psychiatric patient for near a decade, and someone that has been locked up in a hospital against their will, I think my input is of some value. The assertion that mental patients are just misfits is a terrible insult to everyone with a legitimate mental illness. While I was wrongly held, it was clear that there are many people that simply cannot live free lives without putting themselves and others at serious risk. There may be some argument that schizophrenics represent some sort of advance in evolution due to their increased brain activity, but with the more severe cases it's very clear to any observer that they are not capable of leading a --normal-- life. MarcusAurelius
- Something missing from this article, and not nearly often enought talked about in the debate in general, is that (assuming for the sake of argument that mental illness exists) people who are not mentally ill are put in mental hospitals, typically because they hold unpopular political, religious or philosophical beliefs; they are annoying or an inconvenience to their families; it is a good method of stripping them of land or other property (when they are determined to be "incompetent") -- similar to what we saw in the Salem Witch Trials; and so forth. The entire argument is premised on the assumption that those who are put in mental hospitals are all mentally ill, and then proceeds, To what rights are the mentally ill entitled? But what about -- leaving aside the anti-psychiatric view that mental illness is a myth -- those who are not mentally ill at all, yet are put into mental hopsitals?
- It is a significant irony of many mental health laws that one's own view that one is not mentally ill can be grounds for finding one mentally ill. This utterly absurd damned-if-you-do damned-if-you-don't standard makes it so that if one agrees that one is mentally ill, one will be committed, but if one disagrees that one is mentally ill, this will be taken as a proof of mental illness and one will be committed.
- This article needs to take into account the fact that people who are not mentally ill are involuntarily committed to mental hospitals. What about them? --Daniel C. Boyer 16:24 Feb 5, 2003 (UTC)
As for the chemical explanations for mental illness, all research is very close to being totally worthless. There is no clarity as to whether chemical imbalances are causes or effects, or how to tell the difference. Modern psychiatry is near-alchemy; any psychiatrist that claims to understand how the brain works is lying and should be avoided. --MarcusAurelius
- Hi Marcus - I've not met someone who was wrongly accused of mental illness before, though of course I've read about such cases - most recently the economist Deirdre McCloskey being locked up for being a transsexual. I wonder - would it be correct to say that a milder form of anti-psychiatry would be the claim that while mental illness exists, it is occurs less frequently than psychiatrists would have you believe? [[User:MyRedDice|Martin]
Absolutely Martin, you don't need to look any further than the ADD/ADHD phenomenon for evidence of over-diagnosis. Every parent that tells a doctor their kid is hyper gets instantly diagnosed for the most part. I won't get into using amphetamines to treat hyperactive children, that's a whole other rant. I didn't say I was wrongly accused I don't think, just that I didn't have anything remotely close to the severity of others in tha hospital. Depression over-diagnosis is, in my totally un-humble opinion, ridiculously common. Every cubicle junkie that's sad from his 9-5 monotony gets himself a depression diagnosis and ssri prescription. MarcusAurelius Forgot to watch this page.... I think I should abstain from writing about wrongly jailed (and it is *jailed*, they lock and bar every door and window) to keep NPOV, but i'll be more than happy to provide any input. - Marcus
- Hi Marcus. I worked for a little while at a state mental hospital, and have to agree with you that they are jailed. Whether such jailing is justified or appropriate is a separate issue, with lots of contributing factors, but there can be no doubt that they are effectively imprisoned. Wesley
- Well, I didn't say "jail" or "prison", because those are quite specific terms, but I think "locked up" and "behind bars" are defensible as statements-of-fact, and they get the concept across. Of course, I've got an anti-psychiatry bias, so please review... :) Martin
- Sure is a slippery slope to not be biased here, because even the leaders of the psychiatric world admit to not really knowing anything for sure. I don't think many modern mental health professionals would deny that there is a ridiculous level of overdiagnosis. - Marcus
- Right on Wesley, gotta say interacting with the employees is a strange thing. The nurses acting just as security type folk were pretty fun to talk to, as they weren't in the position of judging the inmates. Working full-time in a psychiatric ward seems to destroy all mediocrity; they were either very cool people like the guards, or total dicks driven to insanity by the sick people they initially tried to help. Forgot to mention that I was a minor at the time, committed by my parents, and stayed in the adolescent psychiatric ward separated from the other over-18 inmates. Long story, but they took me to the ER where i underwent several hours of psychoanalysis and was judged to be of no danger to myself or anyone else, but the parents had me locked up anyhow. Not totally sure on the legality, but it seems that there's really nothing much keeping a parent from locking up a kid outside of the massive hospital costs. - Marcus
I have close to some who have been treated for mental illness (accurately diagnosed with schizophrenia in particular) both in and out of government facilities, and I am also close to some who have been wrongly accused of mental illness. Wrongful accusations of mental illness can be as rampant (or more so) in the U.S. as the number of divorce petitions, but actually proving a borderline case of some one declared "non compos mentis" (or mentally incapacitated) against his/her will or otherwise is very difficult at least in the U.S. Most states in the U.S. require that the party petitioning to have a court declare an individual as mentally incapacitated must prove the individual's mental state by clear and convincing evidence. This legal standard is only surpassed by the beyond a reasonable doubt standard, and any petitioner trying to prove a case under that former standard will fail in a borderline case. I'm not familiar with the McCloskey case noted by Martin, but I'm skeptical that he/she would have been declared mentally incapacitated now in the U.S. merely on the basis of being a transsexual. Sure there may be some merely eccentric folks who have been declared incompetent and are being improperly held in a government facility, but it will be a slim minority. Unlike a convicted criminal, a competent person can always challenge a declaration of incompetency; a criminal's options to overturn a conviction are more limited. Like criminal proceedings, an individual's defense will be affected by their economic status. Statistically, poorer people tend to be convicted more than richer people. The same is true for individual's defending against an incompetency proceeding. There are strong countervailing considerations in the U.S. between protecting someone's personal liberty and protecting society (or even the individual himself) from an incompetent individual. For families with limited financial resources, it is economically prohibitive to seek a court-declaration of incompetence to force or to get an individual the help that he/she needs. And until an incapacitated person becomes a danger to himself or others, government cannot take action either. Sometimes it becomes a waiting game that waits too long until someone is seriously hurt. (On a side note, what we need in the U.S. is a something like a directive to physicans or medical power of attorney that addresses legal guardianship and incompetency issues for individuals who may be at risk.) At any rate, these are some things to consider for this article and related ones. B 18:12 Feb 5, 2003 (UTC)
I could see a higher potential for abuse when a parent wrongfully seeks to commit a child. Where there is no strong evidence of danger to self or others and no judical declaration of incompetency, an individual would/should only stay as long as it takes for government authorities to determine that the individual does not pose a safety risk to himself or society. B
- Yo B, could you elaborate a bit on the appeals a person judged as "mentally incompetent" can make? I was under the impression that it was pretty difficult for someone to challenge their own conviction, especially when they've already been jailed.
Heh, you can obviously see the huge difference in your "would/should" statement, I couldn't agree more (firsthand) that a minor like myself should have been released right quick, but any clue on the actual legality of it? A doctor might have the right to refuse a parents' demand for a child's incarceration, but it didn't seem that way at the time. - Marcus
- In regards to your second question, I cannot say without knowing the specifics of your particular case, but if the detention was illegal, a writ of habeas corpus may not be inappropriate here. The question before that though is: once detained, how does an individual make contact with an attorney to get a writ?! A follow up question would be, assuming the detention was illegal, is there a cause of action worth pursuing? Does the individual sue the parents? psychiatrist? staff? governmental agency? Is it worth it? Can the individual afford it? If the individual is a competent minor, should he seek emancipation?
- In regards to your first question, an appeal of a trial court's determination of incompetence would be treated like an appeal in most other civil or criminal cases; the review would consider abuses of judicial discretion, proper interpretation of law, proper application of law to the facts, etc...but determination of facts themselves are usually not reviewable at the appellate level. Typically at the trial court level a lawyer would either represent the individual in question or would act as a guardian ad litem in a sort of neutral role advising the court whether the individual's rights were being truly represented. When a minor is involved, the matter becomes more complicated; a parent or legal guardian usually makes legal decisions for and in behalf of a minor but when the parent/legal guardian has interests diametrically opposed to the best interests of the minor, there is potential for abuse as may have happened in your case.
- In terms of appeal, I'm not sure that that is the best or correct way to attack a trial court's determination of incompetence. Typically, once a civil trial court has decided a matter, under the rule of res judicata (compare for example with double jeopardy in criminal cases) the case cannot be relitigated. However in the case of incomptence I cannot see how a court could bar a later case given that the individual's comptence might change over time. This is not my area of expertise. So, I would defer to someone who works in this area, but as a guess I cannot see how a court could bar a relitigation of later cases on the same matter. B 22:53 Feb 5, 2003 (UTC)
"Anthropological studies indicate that roughly equivalent percentages of people in a variety of cultures, some very different to modern Western culture, develop a disease (recognised by that culture as such) with similar symptoms to major mental illnesses such as schizophrenia, and subsequent medical examination of afflicted individuals have shown similar physical abnormalities." -- I believe this is completely inaccurate. In the 1980s, for instance, far more people were diagnosed as shizophrenic in the United States and the Soviet Union than were in Western Europe, and in fact there were different and more restrictive criteria for a schizophrenia diagnosis in Western Europe than in the U.S. or USSR. --Daniel C. Boyer
You're right there Boyer, that quote is misleading. Schizophrenia observations vary greatly by culture and time. "Roughly equivalent percentages" could be poor wording; 0.5% and 1% could be called "roughly equivalent" even though one is twice as often. Sorry to be out of this discussion so long, was in jail for drug war. --MarcusAurelius
An argument which can be and has been made against the "advocates" for the "mentally ill" and such organizations as NAMI is that they receive some of their funding from drug-company slush funds. I think that this should be introduced somehow but am not sure how to do it. --Daniel C. Boyer
I'm not comfortable with the groupings of "psychiatry" and "anti-psychiatry". In particular, there are several different groups who criticize psychiatry, from crazy cults to doctors with respectable credentials and researched facts. One such doctor is "Loren Mosher" who was chief of the Center for Studies of Schizophrenia at NIMH from 1968 to 1980.
There is a great deal of politics at the heart of psychiatry. This cannot be avoided in a profession that touches upon so many important aspects of our society. For example, until the year 1973 homosexuality was considered a mental illness and was treated with reparative therapy, which often did more harm to the patients than good.
There is a basic conflict between those who wish to try social-approaches and
those who wish to use drug-approaches. I think rather than grouping everything
into "anti-psychiatry", it would be more appropriate to make a category
for "pro-social" or "nondrug" approaches to treating mental illness.
- Despite the dismissal of the booklets cited above, it is well documented that psychiatists were the original architects of the final solution, whose methods were first employed on German nationals under institutional "care". What has been perceived as (and what might in fact be the) violation of liberty and person has been commonly metaphorically called 'rape'. The use of incendiary language in the presentation of such topics does not invalidate their truth.
Someone removed this from the article as being "nonsense" - while clearly it's partly just advocacy, I was wondering about the allegations of a connection between psychiatry and the final solution. Anyone know? Martin 14:49 17 May 2003 (UTC)
- It shouldn't be too hard to demonstrate a connection between any field you like to mention and the Final Solution: chemistry, dentistry, pharmacy, you name it. To the best of my knowledge, that para was complete crap. Tannin
- CRAP INDEED???? --- The gloves are off. I will remove the POV crap that provoked my response and document the crimes of Nazi psychiatrists here and elsewhere on Wikipedia. BobCMU76
- Bob, I'm not suggesting that psychiatrists were not involved in the Final Solution: what I am suggesting is that plucking out one particular profession and describing its members as the "original architects" of the FS is absurd. (Except, possibly, the "profession" of politics.) My choice of "complete crap" as a description was hurried and unhelpful. I should have said "very misleading and, as a paragraph, incoherent".
- I think that while the paragraph in question is not completely worthless, and may have some value as to explaining a particular POV which is a rejoinder to the dismissal of the CCHR booklets, and while it is certainly true that "The use of incendiary language in the presentation of such topics does not invalidate their truth," the paragraph could stand a lot of reworking if restored. But I'm not sure how this would be done. --Daniel C. Boyer
- If I have stimulated you to research and write up the involvement of psychiatrists in the Final Solution, then good! Go right ahead and document it. Don't stop now. If it is not here already on the 'pedia then it should be. I shall read with ... well ... "interest" is not the right word to use in a distressing context like this, but ... well ... "keen attention". Your changes to the anti-psychiatry entry have improved it a great deal, and suggest that you are a careful worker with a clear grasp on the issues involved. All strength to your pen. Tannin
- Seconded. If you're going to do a lot of work, you might want to start a new article first, and add references/links from other articles (like this one) second. Just a thought :) Martin
The only references I can find to psychiatrists being in any way responsible for the Holocaust come from the Church of Scientology - specifically the CCHR. Unless other references exist, I see no reason to not edit out the reference to the nazi holocaust in the entry on anti-psychiatry. Do any such references exist? -- Michael V.
- There was a book, Mass Murderers in White Coats, about this, and as far as I know it had no connexion to CCHR. --Daniel C. Boyer