biomedical paradigm is bullshit. There is a biochemical basis for
behaviour and personality, individuality and emotion and all manner of
facets of the human condition. Mental illness is a myth. It is religion
more than science or medicine. Choices and systems and ways of
understanding people rather than biological problems, though the idea
can be applied just as it couple be applied to pathologise women, black
people or homosexuals. In fact the latter have been directly
pathologised up until the late 20th century. Black slaves who kept
running away were given the diagnosis of drapetomania two centuries before.
Amongst other things the mental health system is a form of behavioural
control and enforces norms on people. It judges behaviour and 'treats'
to rid individuals and society of problematic behaviours. This can be
done out of compassion but the action can still be harmful regardless of
the goodness of the intent. The "Great Confinement" is an alternative
view of what happened when the asylum system was created and psychiatry
conceived They housed those who were outcast by society, a malformed
society which excluded people who were different, in the old leper
houses but in doing so they incacerated the mentally ill and hid madness
from the world. As generations past people forgot about the extremes of
madness hidden in the 'hospitals' dotted around the world (facilities
where water boarding and all manner of inhumane treatments were forced
on the mad to change them) and the pathologisation of ever broader
swathes of the population ensued. This accelerated across the 20th
century and psychiatric illness became confused with ideas of
psychological distress.
This wasn't the progress of medical science discovering new illnesses
and ways to treat. It was the paradigm of medicine and the techniques of
medical science applied to something that wasn't an illness.
Homosexuality is the last major example of an 'illness' which had all
the evidence at the time to support the idea it was a medical illness
but when society changed to stop making these morality judgements
through medical diagnosis and accepted homosexuality was a normal part
of the human race the 'disease' was depathologised.
This was around the same time as the antipsychiatry movement was
lambasting the mainstream. Thomas Szasz's The myth of mental illness
ripped into the science - or lack thereof - as Richard Bentall and other
'critical' psychiatrists (really antipsychatrists who create neologisms
because we live in a time of the politically correct movement which has
shifted language away from describing true concepts) have elucidated
upon today. There's a great paper by Richard Bentall which shows how it
could be possible, using the techniques of medicine applied in
psychiatry, to pathologise happiness. The paper is useful to see how
it's just a judgement.
BUT. And it's a capitalised "but" antipsychiatry and critical psychiatry
offer limited value to the people, the mad or the service users or the
mentally ill. Bentall's award-winning book Madness Explains slates the
science of schizophrenia then proposes an unscientific complaints-based
system which appeals to the feminine epistemology of mental health which
dominates the field. There is a good and compassionate reason that
distress should be understood better by some group in society but the
modern view of distress as without purpose or value is something which
is very dangerous.
The human condition is far more complex than the assumption that
suffering and pain have no purposed. I feel like I'm sounding like a
fucking cold bastard when I talk like that but...well...there is an
alternative idea. Perhaps pain and suffering do lead to good things. For
example people who are depressed may be more critical. Being critical is
not very acceptable in modern society and employment environments. We
live in a time when yes men are more valued that people who think hard
and critically. There could be a negative social and occupational
outcome for people who are critical but there's nothing wrong with being
critical. There's something wrong with a society that makes people who
criticise do worse in life and pathologises their being to 'treat' them
to criticise less (because this could be what would benefit their
outcomes). The sad critic is redoubled in their sadness because of
society's malformation but they are valuable units within the teams and
organisations and social circles and tribes if society is to make fewer
mistakes.
#The problem of distress is that fuck all which psychiatry has to offer
eases the suffering. Some people do ok with narcotics like
antidepressants but many others self-medicate successfully. Those that
do are pathologised too. It's not an illness though. It's just a
judgement to which science can be applied to justify. Just as easily
science can be applied to show the pathologisation of self-medication is
wrong. Dr Joanna Moncrieff, a critical psychiatry lecturer at UCL, has
recently published a book called The Myth of the chemical cure. The
thing is a lot of people do find drugs work - from alcohol to cannabis
to all the others.
The application of the paradigm of illness has some unique facets. The
biomedical model can induce more fear of the mentally ill whereas the
psychological model brings much more compassion. The biomedical paradigm
brings with it the "privilege of the invalid" (Thomas Szasz's phrase).
The psychological one doesn't as easily. The sociological one is where
this is least easily understood by the common person.
There is an alternative epistemology. One might describe this as the
masculine epistemology of mental health. It's the harsh one. It's the
one I apply to myself and no one else. It is encapsulated in concepts
like resilience. It's what I was taught by my grandfather and father as
well as the private school mentality which breed it even further into
me: suck it up and just get on with it. It is more complex than that of
course but I feel those words communicate both the inner harshness and
the harshness of this way of thinking about mental health.
Both sides of this argument are still trying to understand and explain
the human condition. This was the work of religion before psychiatry. I
hope in the future there's a better system than both, one than
understands that what it being done is making judgements rather than
declaring any truths.
But there's still the problem of what value this has for people who are
going through the experiences or the behaviours which are pathologised.
Some who is experiencing daily suicidal thoughts doesn't care what the
theory is. They just want help.
Antipsychiatry is the turht but as yet provides no useful truth.
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