Philosophy, psychiatry and anti-psychiatry

Julia asked:

I am very interested in anti-psychiatry and what philosophy has to offer in this field today. I believe it is more and better than psychiatry. I am also very interested in the modern philosophers who have accessed this field through existentialism, phenomenology and ethics. Any comments, suggestions or criticism? Or even guidance.

Answer by Craig Skinner

You ask for suggestion, comment, criticism and guidance.

I have all of them for you.

Suggestion: move on from anti-psychiatry. Its job is done.

Comment:

  *psychiatry and philosophy are not in competition

  *psychiatry helps (or can help) people with mental illness

  *philosophy helps (or can help) all of us to achieve inner harmony and live well

Criticism: to be against abuse of psychiatry is fine, but claims that mental diseases are a myth, a social construct or a means of oppression of individuals by institutions are seriously misguided.

Guidance: limited (see below).

To enlarge slightly:

Anti-psychiatry got going in the 1960s as a reaction to perceived abuses. These were real. Patients were often treated inhumanely, typically in forbidding asylums, nasty treatments such as insulin shock therapy, lobotomy and ECT were overused, and in some countries, dissidents were labelled mentally ill and institutionalized by a coercive state abetted by doctors. But all this has changed (my experience is of the UK). Asylums have closed, patients are now mainly in the community, treatment is a partnership between patient and professional, insulin coma and lobotomy are history, ECT is used sparingly. So now, anti-psychiatry is as silly as anti-gynaecology or anti-cardiology. Of course we should oppose abuse whether it be by psychiatrists, cardiologists or anybody else.

My view of mental illness is shaped by my 50 years as a doctor (not a psychiatrist, rather a physician) and by family experience of mental illness. Like all families, mine has all kinds of illness from cancer to heart disease to mental illness. In particular I had two sisters with schizophrenia and have two other close relatives with bipolar disorder. My sisters’ lives were ruined by their disease. To tell them, as some of the anti-psychiatry advocates claim, that their illness was a myth or social construct, would be a cruel joke indeed. I saw them live with it for decades. The only thing that helped was medication backed by psychiatric nursing/ social work. Similarly, my bipolar loved ones benefit from medication, and one has had an intractable severe depressive episode ended with outpatient ECT. Severe mental illness is as real as cancer, and one day we will understand how and why exactly the brain wiring/ chemistry is scrambled, and will be able to arrest, reverse or prevent these conditions. Meantime, drugs and cognitive therapies can help.

The idea that philosophy (as discourse plus a way of life striving for wisdom) aims for harmony of the soul is an ancient tradition and still thriving. It is central to Socrates, Plato, Aristotle. Stoics, Epicurians, Pyrrhonists, and many modern thinkers such as Heidegger and Wittgenstein. One can call this philosophy-as-therapy, but let’s not confuse this with treating illness. Philosophy as therapy aims to help us all, well or ill, lead a good life, whether the latter is seen in terms of reason, virtue, tranquility, suspension of belief, acceptance of fate, contemplation of the Form of the Good, dissolving pseudoproblems and seeing things aright, more than one of these, or whatever.

My own views of philosophy as therapy have been formed mostly by the Stoics ancient and modern (Epictetus, Marcus Aurelius’ Meditations with Hadot’s commentary The Inner Citadel as a must-read companion, and writings by the Stoicism Today team of academics/ psychotherapists), and by Heidegger and Wittgenstein (both difficult, especially the former, even with guidebooks). But I am light on other existentialists and know next to nothing about phenomenology, and so cant offer guidance there.

 

4 thoughts on “Philosophy, psychiatry and anti-psychiatry

  1. So I came here searching for “philosophy antipsychiatry” on Google, and I have to say, Craig, this is an embarrassingly bad answer. No mention of Szasz? No Foucault, no Goffman? No discussion of the issues of biological reductionism and the medical model, the ontological status of “mental illness”, no discussion of power, social deviance, and medical authority? No discussion of human rights and the way institutional psychiatry still has coercive power? Have you even read the arguments of psychiatry’s critics?

    All you’ve given is a naive, slap-dash reiteration of the standard assertions of psychiatry against its critics, and haven’t addressed the philosophical arguments at all!

  2. I feel terribly hated by psychiatry and people just because my mind is different from theirs. Schizophernics kill because of the treatment in these places it’s all abuse. Abuse after abuse makes a person crack to the point of can not take it anymore or madness. It is criminal to treat your fellow men as such, when you are the same. If psychiatry cannot make a difference there is no use for them. You are wrong in saying the mind is activity or anything material. Mind is phenomenal, divine ontologically and you can work out many other descriptions. Mind is the starry sky for Kant in his ‘Practical Reason’. Mind is greater than the beasts, not the body. Mind should work towards perfection and greatness, mind makes us like gods hearts make us worship god..

  3. I am sorry to hear of your long-standing illness,
    I dont myself use the word “mad” when referring to mental illness.
    You speak of the mind as a substance (a la Descartes). My own view is that mind is activity rather than substance, namely the (mental ) activity of the embodied brain embedded in a suitable environment.
    I have known many psychiatrists, but none of them hated philosophers. I dont know so many philosophers, but those I do dont hate psychiatrists or hold an anti-psychiatry view.
    I agree that current medication for mental illness is not great. But it is a lot better than nothing. Lithium for prevention of mania, and antipsychotics for schizophrenia have been particularly helpful in my family members.
    I stand by everything I say in my answer.
    All the best

  4. I am mentally ill since childhood. I could have born with it. Who is to say I am relatively mad compared to the person next door? Who is to say anyone is mad at all? In some cultures it is even divine. My doctor says it was down to philosophy. Asylum conditions for the human were worse than caged animals and have done no favour to shut down. People are still overdosed on drugs and given ECT in high doses and nothing works. I think the reality of a substance like the mind is down to the philosopher to determine not the psychiatrist. You are simply trying to treat an invisible substance by experimenting new drugs. Philosophers are hated by psychiatrists and can only move towards anti-psychiatry which is strong today because it serves a need outof desperation for some to turn to. Anyway I am not interested in psychiatry. Philosophy has opened itself up in this field remarkably providing for itself better treatment and should be given merit.

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