530 likes | 591 Vues
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”.
E N D
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
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