Psychiatry Today (2001)
Excerpt (slightly altered) from essay in Review of Existential Psychology and Psychiatry (2001, 25th Anniversary Issue) "Against Psychotherapy and Biological Psychiatry"
It is well known that in the last decade the traditional models of talk therapy have been replaced by Biological Psychiatry which minimizes the significance of any kind of interactive process between professional and client. The fortune of the biopsych industry has been augmented by the emergence in the last decade of a number of influential critiques of both Freud as a person and psychoanalytic theory and practice. Probably the first loud volley of the attack on psychoanalysis was fired by Jeffrey Masson, a disillusioned Freudian scholar. It dented the neo-Freudians slightly but it was easy for them-- because of some of Masson's own statements--to discredit Masson as a man with questionable motives.
But by the time the dust had settled from the widespread 1980s phenomenon of therapists' involvement in the unwittingly induction of false memories in children and adults of experiencing sexual abuse (as children), the sober-minded but excoriating reassessment of psychoanalysis by the former Freudian, eminent literary critic and Berkeley professor emeritus Frederick Crews managed to seriously undermine the intellectual credibility of psychoanalysis. Crew's evaluation was probably the first intellectual attack on Freud to be published in New York Review of Books where over the years Freud had been treated with nothing less than unqualified reverence--as one would expect from high-brow East Coast, often Jewish, intellectuals.
The new breed of Freudian debunkers did not attempt to deconstruct Freudian metaphysics, as I have done in my books and essays. Rather they effectively demonstrated that Freud's interpretations of his patients--his case studies--were fanciful and influenced by opportunistic motives (see Watters and Ofshe, 1999 for an account; also Swales, 1977; Porter, 1987). Thus neither Freud's case studies nor his broader theoretical generalizations were warranted by the empirical data he presented. Furthermore, hundreds of studies in the last two decades have led ineluctably to the conclusion that although conversing about one's problems is often therapeutic, the trained therapist is no more helpful to the troubled experimental subject--usually a college student--than a person with comparable social status but no education, training or experience as a therapist at all (Dawes, 1994). In one experiment psychoanalysts did no better than non-Freudian therapists or than English professors with no experience as therapists. As Watters and Ofshe point out (1999, p.131), if one were comparing trained and untrained surgeons one would end up with dead patients.
The mystique of the Freudian initiate, the psychoanalytic priest uniquely qualified to administer the psychoanalytic sacraments, was exposed as merely a scientistic superstition. Even the more modest claim that the therapist in general by virtue of her graduate studies and her specialized training has acquired skills that endowed her with superior ability to help troubled persons did not withstand examination. What justifies then all those years and money devoted to professional education and training for "mental health professionals"? This was a question that very few psychotherapists--including critics of modern psychiatry--or journalists were prepared to ask; thus despite all the evidence indicating that therapy is in large part a con job, the public remains convinced that the psychotherapist is an indispensable expert in how to cope with life, whose specialized skills are analogous to that of a heart surgeon.
During this same period--the 1980s and 1990s--the status of Biological Psychiatry began to rise meteorically. Unfortunately many of the critics of Freudianism, such as Crews, have accepted credulously the propaganda of biological psychiatry--particularly its fraudulent claim that it has been "scientifically" demonstrated that most of the problems in living experienced by individuals, particularly those with "serious mental illnesses", are caused by "brain disorders." Yet as Valenstein (1998) has demonstrated there is no evidence to support the claim that most unhappiness or strange behavior (e.g. "schizophrenia") is caused by brain disorders. The brain disease or chemical imbalance theory may sound more scientific than the idea of "mental illness" but it is based ultimately on the same false premise: that something is wrong with a person who is unhappy, that something must be wrong, that happiness is more "natural" than unhappiness, that the aspiring individual who is having problems and confronting obstacles in life must be damaged in some way. Once this premise is accepted it becomes a self-fulfilling prophecy, i.e., it generates "facts" that seem to support it but on closer examination lend themselves to a better explanation.
Furthermore, the pharmaceutical companies are able to devote billions of dollars to marketing, which includes buying--in effect--psychiatrists who deliberately manipulate the research data to come up with conclusions that enable the drug companies to convince the FDA that their products are safe and effective--and thus to grant FDA authorization for their products (Kirkpatrick, 2000). Although the propaganda of the "psycho-pharmaceutical complex" (Breggin) has been debunked by Valenstein (1998) and Breggin (1991,1997), and a few others (including journalists), their criticisms seem to have little impact on the mental health professions. Breggin has written close to a a dozen books demonstrating the brain-damaging and brain- disabling effects of "anti-psychotic medication," and the generally iatrogenic effects of subjecting children and adolescents (who do not manifest sufficient docility) to psychiatric drugs. But the American Psychiatric Association does not welcome debate on this topic and does everything to minimize Breggin's influence, while the mainstream press rarely even reviews his books--thus he has been effectively marginalized. Although Valenstein's credentials are more conventional than Breggin's and thus he appears more "respectable," his deconstruction of the biopsychiatric model (1998) has received little attention and has had virtually no impact on the mental health professions. The public remains convinced that millions of people suffer from biochemical imbalances.
At this point many of the opponents of biological psychiatry--led by Breggin--are fighting a rearguard action to save old fashioned psychotherapy (and in many cases their careers) and to restrict the influence of biological psychiatry. What is overlooked by both sides is how neo-Freudianism throughout the course of the 20th century created the foundation for biological psychiatry, as I have attempted to demonstrate (see Farber, 2001), by establishing in the public mind the belief that virtually all problems adjusting to life are due to "mental disorders." The current witch-hunt in the schools for children with "attention deficit disorders" (who now number several million) is a product of that very same secular Augustinianism that was based at its inception on the premise that the majority of human beings are existentially deficient.
Is there any reason to believe that had the circumstances been propitious (e.g. ample financial resources) that the neo-Freudians would not have carried out the same witch-hunt--in the interest of children, of course--that bio-psychiatrists are currently responsible for?
Obviously there are radical ontological differences between neo-Freudianism and biological psychiatry, but the exploration of this topic would take us far beyond the scope of these comments. In closing I will point out two similarities: Whether the patient is defined as a dysfunctional biochemical machine or a mentally diseased person, in either case his or her full ontological worth is not recognized. In some ways bio-psychiatry is less pernicious than neo- Freudianism. It is more democratic: Almost everyone suffers today from a biochemical imbalance--perhaps even the psychiatrist. In the neo-Freudian view the therapists are depicted as so far superior to ordinary (un--analyzed) persons that they resemble Plato's philosopher-kings. Even highly accomplished persons-- here in New York City where therapy is the dominant religion among professionals--seem to believe their therapists are supernatural beings. This attitude is reminiscent of pre-democratic societies, where the commoner groveled before his aristocratic masters. If the neo-Freudian view is correct why have a democracy at all? From this perspective it seems more consistent to vest all power in the hands of the psychotherapist-kings.
Second, this brings us to consideration of the political function of both ideologies, Therapy and Biological Psychiatry: Both obscure the political and social roots of individuals' problems and offer their products--therapy or drugs--as solutions to the human dilemma. Therapy and Prozac--these are both the "the opium of the people," both are species of "psychologism" as Ken Barney has termed it: "The Western world is steadily deteriorating, producing even more conflict, violence, alienation, despair and psychopathology. Yet with the help of the cultural industries and psychology, all of this is mystified."
Barney believes that the more humanistic therapeutic approach is not a genuine alternative: "It transcends the crude reductionism of the medical model but it is still part of the bigger problem of psychology, which both mystifies the wider reality and also plays a central role in legitimizing and sustaining the mental health system, including its overtly oppressive practices" (Barney, 1994, p.29).
Mental health professionals view the human being essentially as a deficient entity in need of fixing by experts. Both schools overlook the potentialities and unutilized capacities and talents of each individual--yet it is these qualities that are the basis of a truly democratic community. This point has been made by both James Hillman (1991) and John McKnight (1995) among others. Hillman has critiqued the therapeutic (neo-Freudian, in my terms) vision of human beings at the basis of the "recovery movement." People come together not on the basis of common interests or goals but only in terms of their problems, their deficiencies: "For everyone to sit around a room because they're fat--I don't know if that's a way a civilization can continue... Suppose we begin seeing ourselves not as patients but as citizens... Suppose the man or woman coming to you as the therapist is above all else a citizen? Then you are going to have to think about these people a little differently; they're no longer just cases" (p.64).
McKnight notes that the therapeutic vision has replaced the democratic vision. "The power to label people deficient and declare them in need is the basic tool of control and oppression in modern industrialized societies..."(p.16). This power is given to therapists and others in the "helping professions." He continues, "Politics is the act of citizens pooling their intelligence to achieve the maximum human good. Medicalized politics is the disavowal of that common intelligence, for it individualizes--by bestowing clienthood and replacing policy with the placebos of technique and technology... The chief requirement is to restore politics, for we can find no cure in any medical function that is... [anything] more than a substitute for politics. The central reform is the conversion of clients to citizens" (pp. 61-2).
Thus utopian as it may be, I propose as the alternative both to psychotherapy (which has now been exposed as a sham, insofar as training does not contribute to efficacy) and to bio-psychiatry, a renewed effort to re-think and to actualize the ideal of "participatory democracy," as it was conceptualized by Jefferson, implemented during the early days of the republic (with the obvious limitations) as described by De Touqueville, and as it was reaffirmed this century by the student radicals in the mid-1960s (when the term was coined by Tom Hayden) before they capitulated to the lure of the totalitarian ideology of Leninism. The ontological equality and worth of each person posited by original Christianity (and by other religions) and by the founders of our country calls for this kind of political transformation. And conversely the quest for democracy is doomed as long as it does not rest on an ontological foundation that recognizes the full worth of each individual, each citizen.
NETWORK AGAINST COERCIVE PSYCHIATRY
Board of Advisors
Stanley Aronowitz, Ph.D. * Peter Breggin, M.D. * Judi Chamberlain * Phyllis Chesler, Ph.D. * Ramsey Clark * George Ebert * Leonard Frank * Kenneth Gergen, Ph.D. * Jay Haley * James Hillman, Ph.D. * Jill Johnston * Ken Kesey * Rev. David Kossey * Cloe Madanes * Jeffrey Masson, Ph.D. * James Mancuso, Ph.D. * Kate Millett, Ph.D. * Kirkpatrick Sale * Dorothy Tennov, Ph.D. * Eileen Walkenstein, M.D. * John Weakland * Monty Zimmer, Ph.D. * Lynn Zimmer, Ph.D.
Board of Directors
* Kyle Christensen * Sandra Everett * Seth Farber, Ph.D. * Ronald Leifer, M.D. * Susan Thornton-Smith
Network Against Coercive Psychiatry is an organization comprised of psychotherapists (including psychiatrists), survivors of psychiatric incarceration
(commonly known as "mental patients"), scholars and other concerned citizens.
OUR POSITION IS UNCOMPROMISING. WE BELIEVE THE "MENTAL HEALTH" ESTABLISHMENT HAS CONNED THE AMERICAN PEOPLE. The idea of "mental illness" is a misleading and degrading metaphor. "Psychiatric treatments" in mental hospitals are for the most part forms of physical and emotional abuse. Psychiatric "diagnoses" are demeaming labels without any scientific validity. The psychiatric Establishment is pushing dangerous drugs which they euphemistically call "medication." Treatments in this century have ranged from revolving chairs to lobotomies
to electrical assaults on the human brain to neurologically damaging drugs. There has been no revolution in the treatment of individuals who are
psychiatrically labeled: it is an unbroken history of barbaric practices, justified by professionals as medical procedures designed to control patients' ostensible mental diseases.
THE STRUCTURE OF DEMOCRACY IS BEING UNDERMINED BY THE MENTAL HEALTH SYSTEM
The Network is emerging at an historical juncture that constitutes a time of potential danger as well as opportunity. The danger lies in the continued expansion of psychiatric power and of the merger of the "mental health" system with the American government. This forebodes a social control apparatus as totalitarian as that forseen by George Orwell in 1984. In this case conformity to social norms would be enforced by mental health professionals playing the role of Big Brother. The opportunity lies in the possible development of a social movement against the mental health system.
FOR WELL OVER THIRTY YEARS THEORISTS AND THERAPISTS
HAVE BEEN WRITING DEVASTATING CRITIQUES OF THE MEDICAL MODEL OF HUMAN BEHAVIOR
Thomas Szasz, M.D., was the first to argue that to describe individuals who are having "problems in life" as mentally ill is to use a metaphor that is misleading and demeaning. It obscures the individuals real problems and it serves to justify psychiatric coercion and the gratuitous deprivation of individual liberty. R.D. Laing, the British psychiatrist, argued that "psychiatric treatment" of "schizophrenia" typically aborts what is essentially a natural process tending toward the reconstitution of the self on a more mature level.
Theodore Sarbin and James Mancuso conclude in their exhaustive study that despite 80 years of popularity, the "disease model" has failed to establish its value as either an explanatory theory or a practical tool. Family therapists like Jay Haley, Salvador Minuchin and the Mental Research Institute have demonstrated the extraordinary success of an approach that is not based on the metaphor of mental illness. These theorists/practitioners have had virtually no effect on public policy.
IF THE CRISIS IN THE MENTAL HEALTH SYSTEM IS TO BE RESOLVED THE "DISEASE MODEL" MUST BE REPLACED
Viable models must be based on a development perspective. In the context of this perspective psychological and spiritual crises, despair, anxiety, unusual behavior, and emotional ups and downs are not symptoms of chronic mental illnesses but natural manifestations of processes of individual and social growth and maturation. If this change in orientation is effected, the helping profession will be able to help people: it will provide asylum and reassurance to frightened individuals, it will offer individual and family counseling, it will help individuals overcome their addiction to psychiatric drugs that impair their ability to think and create, it will help reintegrate individuals into society by making available to them education and job training, housing and jobs--it will give them the vision of a future worth struggling for.
In the absence of this fundamental philosophical change, mental health workers will continue to impede individuals' reintegration into society by branding them "mentally ill" and by withholding from them opportunities for social and spiritual advancement. The disastrous and unseemly results of the stunting of individual growth by the mental health system will continue to be blamed on "the tragedy of mental illness."
A MONSTROUS ABUSE OF POWER IS OCCURRING RIGHT NOW
The American public is aware through exposure to a variety of documentary materials--including such realistic works of the imagination as One Flew Over the Cuckoo's Nest by Ken Kesey--that "mental health" professionals in the public sector in another era abused the authority vested in them. The public has not confronted the fact--and the media has not exposed the fact--that the same kind of monstrous abuse of power is occurring right now. If the radical humanitarian changes advocated by the critics of the mental health system are to be implemented, it will be because the American people will begin to realize that they have been abused and mystified by the mental health professions and because they will seize the opportunity to assert their rights and to demand accountability from those who claim to serve them.
PEOPLE ARE BEING TORTURED, OPPRESSED AND DENIED OWNERSHIP OF THEIR LIVES
Psychiatric survivors have been organizing for human rights and against psychiatric oppression since the mid-1970s. George Ebert, a psychiatric survivor, recently described the reason for his twelve year involvement in the movement against psychiatric oppression. "As long as the psychiatric state remains, as long as people are being tortured, oppressed, dehumanized, and denied ownership of their lives, we who have survived are obligated to struggle to break the silence." The Network Against Coercive Psychiatry calls upon all socially conscious persons to join the movement.
YOU CAN HELP!
For more information please write or call:
Dr. Seth Farber
Network Against Coercive Pshychiatry
172 West 79th Street, #2E
New York, NY 10024
"The problem with psychiatric diagnoses is..that they are swung as semantic blackjacks: cracking the subject's dignity and respectability destroys him just as effectively as cracking his skull. The difference is that the man who wields a blackjack is recognized by everyone as a thug, but one who wields a psychiatric diagnosis is not."
--Thomas Szasz, M.D., 1991