Anti-psychiatry

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lem
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Nov 8 2006 18:59
Anti-psychiatry

I don't seem to be able to find the discussions on this - so I thought it would be OK to start a new thread smile

I'm actually writing a dissertation on this now, so I could post up that when its done. It will be a bit shit mind.

Anyway, the reason that I did this now, is I would like to know if US medical insurance can be condiered socialistic - as the patient does not have to pay for the treatment he recieves.

Szsaz is a bit of a nut and seems think that medicine should revert back to pre-WWII - only then the physican would be the agent of the patient.

Anyway, can it? I would guess that the insured can not be said to have capital - so in this snese it is not capitalistic. But it hardly seems socailistic if the health services are owned by capitalists - anything to add?

More interesting stuff to follow, I hope anyway, everyone seems to be talking passed each other and there are no good guys angry

Cheers

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Jacques Roux
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Nov 8 2006 21:02

Don't you have to pay for the medical insurance though?

lem
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Nov 8 2006 21:18

confused

Yes, why that does not convince Szasz I do not know. He claims that insurance is a socailist model, I assume that his definition of socialist is something like loss of freedom.

I mean LazyRiser was claiming to be a socailist last I heard.

Dunno if could just say "but you have to pay" if I can't find a universal definition of communism/capitalism that says that this is the defining feature.

Why can't I find old threads anyway?

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Khawaga
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Nov 9 2006 09:03

Insurance is basically a form of income smoothing, i.e. a way of tackling risk collectively. It is basically the same as taxation, though obviously one is private and the other is public. Obviously, taxation does not mean a welfare state, but the principle of smoothing risks remains.

Insurance is far from a socialist model. Insurance is a capitalist commodity like anything else. It is exclusionary as not everyone can afford it. Health insurance is often prevalent in those places where the health sector is completely privatized, or where the public health provisioning is shite (in terms of quality or quantity). I don't know if this can be a generalization, but I would assume that health insurance must rely on there being at least some private hospitals, clinics etc.

Its traditional "opposite" is universal health care as provided by a welfare state that does not discriminate based on control of market exchange. However, having complete state control over the health sector does not necessarily make it socialist, but welfareist.

In any case, how can being turned away at a hospital because of no insurance be socialist?

Quote:
zsaz is a bit of a nut and seems think that medicine should revert back to pre-WWII - only then the physican would be the agent of the patient.

Sounds strange, but interesting. Can you post somthing more about that?

In any case the doctor-patient relationship should not be more balanced. Nowadays we're too ready to believe anything that a doctor tells us...

What is your dissertation about anyway? Just insurance?

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Steven.
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Nov 9 2006 09:56

lem - old thread here:
http://libcom.org/forums/thought/anti-psychiatry

lem wrote:
Why can't I find old threads anyway?

Have a look at this:
http://libcom.org/forums/feedback-and-content/how-to-find-old-threads

lem
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Nov 9 2006 19:44
atlemk wrote:
Sounds strange, but interesting. Can you post somthing more about that?

In any case the doctor-patient relationship should not be more balanced. Nowadays we're too ready to believe anything that a doctor tells us...

What is your dissertation about anyway? Just insurance?

Hi! If I come across anything else I'lll post it up, but that is all I have at the moment. The dissertation is on Szasz's views, mostly around whether mental illness is imposible without physiological lesions - which apparently have not been found.

I would have thought that it would be a bad thing to outlaw insurance - chronically ill poor people would be in a lot of trouble, surely.

lem
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Nov 9 2006 21:38

As far as I can tell, medical insurance is immoral because the physician does not need the patient (he needs the insurers money) - though the patient needs the doctor - thusly the doctor is frustrated (as someone is in all socialist relationships) in treating the patient. So I guess that Szsaz is saying that insurance is unequal in favour of the patient (he does not make it very clear who the inequality is in favour of)- though it does have certain immoral advantages for the doctor too as he does not need to please the patient to get a secure salary. The patient get Rolex treatmemnt for Timex prices - and this is immoral. The guy is a nut.

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jason
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Nov 9 2006 23:15
Quote:
I would like to know if US medical insurance can be condiered socialistic - as the patient does not have to pay for the treatment he recieves.

No way. In this country we used to have a good welfarist system of tax-funded healthcare. Now the public system is shit and its up to individuals to decide to pay a grand per year for private health cover or not. So you basically gotta take a gamble with your health. So the only demographic that is getting "Rolex treatment for Timex prices" is the high income bracket that can write-off private healthcare insurance as a minor expense in the first place. Now that's immoral (whatever that means).

lem
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Nov 9 2006 23:40

Yeah, cheers, Its really interesting to get different perspectives on such a simple question. I would just say that of course its not immoral for someone who is profoundly ill to get cheaper treatment.

ANother bit that had me morally outraged was him saying that it is unjust for intelligent people to e.g. call people with low IQ "special".

What does anyone think of the insanity defense? Szasz is dead against it, says that it deprives people of their responsibility and liberty.

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Khawaga
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Nov 10 2006 01:33
Quote:
I would just say that of course its not immoral for someone who is profoundly ill to get cheaper treatment.

Through insurance treatment is usually more expensive (for the patient) as opposed to a welfare system based on taxes.

Insurance can never be considered socialist as it is a commodity pure and simple.

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jason
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Nov 10 2006 01:44

Who is Szasz? embarrassed Is he some UK political figure?

revolutionrugger
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Nov 10 2006 01:57

healthcare. Whats that? Here in the wild wild third world of the USA; you've got two options, dayquil or the emergency room.

lem
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Nov 10 2006 12:47
jason wrote:
Who is Szasz? embarrassed Is he some UK political figure?

No, just a psychiatrist, relatively well-known one. He's a right libertarian, and thinks that epistemology/philosophical arguments are either immoral or unproductive - so he likes to keep things vaguely political - in that we wants to abolish psychiatry

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Khawaga
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Nov 10 2006 15:46
Quote:
thinks that epistemology/philosophical arguments are either immoral or unproductive - so he likes to keep things vaguely political - in that we wants to abolish psychiatry

Seems to me a bit of a far stretch, but then again I haven't read any of his stuff.

What would you recommend (preferably something short-ish).

lem
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Nov 10 2006 18:19

When I say political I mean he likes to paint all psychiatrists as Socialists/Fascists/amoral etc while shying away from science and philosophy. Imo at least. His critics are a bit lame as well though.

His most famous and first book (which I have not read) is The myth of mental illness. I am reading Szsaz under fire at the moment - it's got quite a few interesting anecdotes in (e.g. his testamony in specific trials as an expert witness) but is a bit long.

It would be nice to agree with him, but it seems unrealistic.

The main sticking points seem to be his claims that psychotics do not suffer from diminished responsibility (which he has not given a reason for yet), that addicts and psychotics do not suffer because they often do not seek help, addiction does not exist because people can escape of their own free will, delusions are stubborn lies (again he has not yet given a reason for this), and that behaviour cannot really be ill because there are no identifiable lesion in the brain.

He does agree that "depressives" suffer more than most people but claims that under no circumstances can this be an illness, because there is no lesion.

He does not give the reasoning behind the claim that all illnesses must be accompanied by lesions (and there are plenty of othrr definitions out there), and I see no reason to agree - why would specifically a lesion and not untoward suffering or a failure of action or the ability to help etc. create the peculiar ethical relationship to someone who is ill (does anyone think that physical illness does not demand attention in a way that physical health does not?).

Anyway, I must do some more reading. I am falling behind.

lem
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Nov 11 2006 00:10

What does anyone think about suicide?

Should a sane person be forcibly prevented from killing themselves?

How about mentally ill people?

Clearly both should be discouraged.

Dave Smith
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Nov 11 2006 00:26

Sazazs sounds a right wanker to me, Bi polar disorder allmost distroyed my life but 6 months in the local mental hospital
and caring doctors have returned a quality of life to me that
I was missing for 20 years. Yes I do take a bucket of pills
every day but the alternative is death by my own hand.
All free on the british NHS as I cannot work.
And if any small minded bigot wants to call me a fucking
nutter go ahead.

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Lone Wolf
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Nov 11 2006 01:04

Dave Smith

No I think this is excellent. I think it is really good that you received the care you need. cool So what if you need to stay on meds?? I don't differentiate between meds used to help physiological or mental/emotional/psych. probs.

So I disagree with this Sazacs guy. You are quite right lem- this lesions definition is way too narrow.

I DO harbour great misgivings at mental health provision in general under the State however. Abuses go on behind closed doors just as they do in prisons, childrens homes, care homes etc. But it IS particularly scary with high-ranking medicos as they wield such enormous power and are rarely questioned. So of course post-rev we could keep the expertise and not allow the powerbase to re-establish itself. And we would need less experts as society would be less fucked-up. And more people would have a chance for a mentally secure future from the outset. cool

Love

LW X

lem
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Nov 11 2006 01:26
Dave Smith wrote:
Sazazs sounds a right wanker to me, Bi polar disorder allmost distroyed my life but 6 months in the local mental hospital
and caring doctors have returned a quality of life to me that
I was missing for 20 years. Yes I do take a bucket of pills
every day but the alternative is death by my own hand.
All free on the british NHS as I cannot work.
And if any small minded bigot wants to call me a fucking
nutter go ahead.

Yeah.I don't know what it would have been like to live as I was for 20 years. Probably quite different to the 6 months running around the place I did before I got institutionlized - so that the cure seemed a bit shite.

Dave Smith
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Nov 11 2006 01:29

Nice one LWX

I do feel that the "system" has a lot to do with mental health ,I saw a lot of screwed up people in the funny farm who,s only
probem was that they were labeled and catagorised by a regeme
that could not allow for the diverse nature of the human
condition. So they were drugged and electrocuted into mindless
conformity, this was NOT good for me to witness when I was so
fragile. But I was lucky as the team treating me were ok.
It is important to recognise that some people trapped in
the mental health system should be seen as political prisoners
as they are not that insane at all

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Lone Wolf
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Nov 11 2006 01:41

Yes yes and this quote aussi seems apposite.

"It is no measure of health to be well-adjusted to a profoundly sick society." (Krishnamurti. ) cool

Dave Smith
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Nov 11 2006 02:06

In the USSR many people were banged up in funny farms because
they saw the "system" was a sham and dared to speak out.
Fuck that for a game of toy whotsits. Beware! the men in white
coats are knocking at the door. So who is mad or more important who is sane, mad is more fun.

cph_shawarma
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Nov 11 2006 10:28

For fuck sake, has anyone here even had any contact with people who have had psychiatric diseases or had one yourself? If not, shut the fuck up, until you know what you're talking about. I have myself had a depression and I've seen people with active psychosis and anyone who thinks it's "fun" or that psychiatry merely is "oppression" should seriously think about what the fuck they are saying.

If a person has a broken leg noone here would argue that it needs some sort of attention in order to heal properly (I assume). But why would then a broken soul be any less in need of attention to heal properly? Sure, psychiatrists are keen on getting people to work again (if it's possible), but what doctor is not keen on this? Saying that psychiatry is "twisting your mind into accepting wage labour" is saying that medicine in general is "altering your body functions and anatomy in order for them to work in wage labour again". Of course this is a part of the problem in capitalistic society, but the anti-psychiatry movement is completely lacking of any perspective of context or respect for other human beings.

Anyone who thinks it's funny to lay in bed all day never eating and just thinking of reasons to kill yourself, or who thinks it's "more fun" to have paranoid delusions than not is totally lacking of any form of empathy for people with serious problems and are themselves in need of serious therapy.

The bullshit idea of anti-psychiatryism (Foucault and Althusser are worth-while reading in the case of psychiatry, but the use of these great authors within the anti-psychiatry movement is evidently idiotic) is mainly liberal demagogy.

Steggsie
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Nov 11 2006 11:16

Fair comment cph. It's true that the ideas of anti-psychiatry can be misapplied to imply that mental distress isn't real. You're right, Foucault is great up to the point where you ask what he would actually recommend in terms of treatments for individuals.

On the other hand, can't we agree that many people have serious problems which require intervention AND that psychiatry can be used oppressively?

Psychotherapy helps many people - and drugs can be useful - but on the other hand, it's used as a means of social control, naming and controlling deviance. To wheel out the old examples: homosexuality was in the DSM up until 1974, I think, and never mind the Soviet Union, mental institutions are still used as political prisons the world over - there's a lot of terrifying info out there about China, Uzbekistan, etc. So I can't agree that anti-psychiatry is just liberal bullshit.

Let's also remember that biopsychiatry, in particular, is extending its empire (Szasz noted this long ago, along with Illich and many other contemporary anti-psychiatrists) in conjunction with the pharma industry.

Incidentally, Szasz doesn't anywhere claim that people don't suffer. He just makes the (rather obvious) point that since there's no biological causation of schizophrenia, bipolarity, etc., mental distress can't unproblematically be termed 'illness' (although as Lem points out, other definitions of illness are out there). Even the term 'mental' is in question, as it is Eurocentric. In other cultures the condition we know as 'depression', for example, is described as 'heavy heart', etc.

cph_shawarma
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Nov 11 2006 12:35

Steggsie: Psychiatry is definitely a part of the reproduction of capitalistic subjectivity in the form it exists today, but then again, what isn't? The medical doctors, surgeons, orthopedics etc. are all a part of the reproduction of a subjectivity which returns to wage labour. To exclusively separate psychiatry from this spectrum of capitalistic reproduction and making it a special problem is the problematic of anti-psychiatry which I do not adhere to.

And the problems of psychiatry's integration in a system of value accumulation are obvious whenever you set foot in a psychiatric ward or reception. First and foremost people with problems which are often quite deep and need some sort of psychotherapy are not given the resources needed to actually go to the bottom of the problem, but rather psychotherapists are dealt small resources and heavy restrictions from their superiors (10 sessions maximum is one common restriction, for instance).

There is no single causation of schizophrenia, bipolarity etc. However, there are biological factors which increase the likelihood of getting the disease. One fact which would suggest a genetic factor is the fact that schizophrenia exists at about the same ratio in all societies at all times (from tribes in the Amazon forest to New York City). However, the separation of biology from the social interactions of everyday life is also quite problematic in terms of making biology "real" and society "imaginary" (which you very correctly criticized).

A critique of psychiatry and its function in capitalistic society is necessary, but anti-psychiatry is often combined with a culturally relativistic perspective which is highly problematic and thus I do not think of anti-psychiatry as a critique of psychiatry, but rather as its complement. Psychiatry and anti-psychiatry are both parts of the same paradigm and we need to surpass them both in order to critique the paradigm.

lem
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Nov 11 2006 14:17

Erm, Szsaz is not trying to abolish psychiatry in the same way as most Anti-Psychiatrists (e.g. Cooper) in that he only wants to take away their powers - of involuntary commitment, presecription (by legalizing all drugs), and the insanity defense. He thinks that psychiatrists ought to be allowed to practice (even though it would just be ritual with no grounding in fact, like religion), though being a right libertarian he thinks that people should not have recourse to either the welfare state or medical insurance (wrt physical illness too).

So, like Steggsie says, this shouldn't really be a discussion on whether depressives suffer, but whether they are diseased and whether there is anything about them that means we ought to treat them involuntarily - something which is not permitted wrt physical illness either.

cph_shawarma
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Nov 11 2006 17:07

lem: In Sweden, you can not be treated involuntarily for psychiatric disease, with some exceptions. Depression is not grounds for involuntary treatment, but suicidal behaviour is (which of course can be discussed). But in my opinion, it's still liberal moralism to be "against" force, like there was such an option in any setting or any context. The whole idea of free will (and thus the concepts of voluntary/involuntary) are basically liberal dogmas. This does not mean that I am a proponent of the welfare state, the psychiatric laws of involuntary treatment etc. What I'm saying is basically that it is not as simple as posing the question on the level of "oppression" or on the level of free will, since these concepts are problematic themselves.

We should treat psychiatry as we treat all other aspects of capitalistic society, critically and willing to surpass these aspects as a part of surpassing the whole.

lem
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Nov 11 2006 18:42
Quote:
"against" force, like there was such an option in any setting or any context.

I agree that freedom from coercion is on some level liberal dogma, but I do not see how one argues against the liberal conception of "freedom from coercion" to whatever conception is relevent? I mean, I still feel a little bit sick that they don't let you out until you agree that its right for you to be there. I would say that this is abuse, maybe.

With regards to suicidal ideation: I would like to discuss that, I think. I should note that in England if they think you are a danager to other people then that is also grounds for involunatry commitment and treatment.

I would have thought that no-one here knows if psychiatrists have the ability to predict this, so I suggest that that is just ignored.

Ho hum. I do not know how to write a 9000 word socialist critique of psychiatry - bar throwing in a few comments about valorization.

Philosophically Szsaz is a bit weak. The claim that some people get better of their own will so everyone can, is stupid. And the only reason I can find for the definition of 'disease' he gives is that modern scientists are intersted in the way that nature works - so they would be intersted in lesions. He also says this definition is not immutabile, so presumabely it is only by convention that people are not mentally diseased - if so I would have thought that it is not logically necessary that mental illness does not exist - which he often claims. I may have worked this out wrong, but there is vceratinly very little punch to his philosophy as a critique if 'disease' is not immutible, imo.

Pepe
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Nov 11 2006 18:54
cph_shawarma wrote:
schizophrenia exists at about the same ratio in all societies at all times (from tribes in the Amazon forest to New York City).

Do you have a citation? If that's true that's really interesting. I thought I'd heard that it varies loads, but I think I was thinking of depression....

As far as I understand 'anti-psychiatry' isn't about abolishing psychiatry or denying that people suffer from mental disorders. It would be better described as 'radical psychiatry' - recognising the social and cultural factors around mental illness (I don't have a problem with calling it an illness), seeing it as a response to an insane world, instead of just looking at the neurobiology of it and viewing the mentally ill as seperate from the rest of us.

Apparenly Laing described schizophrenia as "a wonderful journey of self-discovery" but that must have been taken out of context. eek

lem
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Nov 11 2006 18:58

I think radical psychiatry is what is left of anti-psychaitry now.

What about: Does medicine have too much power?

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Lone Wolf
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Nov 11 2006 19:12
lem wrote:
I think radical psychiatry is what is left of anti-psychaitry now.

What about: Does medicine have too much power?

No. The medical establishment does, however. cool