During the 20th century, many psychiatric treatments for mental disorders have become popular, including some which are very questionable from an ethical and practical point of view. The extreme medicalization of problems such as schizophrenia has had and continues to have, in a large number of cases, frequently criticized coercive elements.
In this article we will talk about the history and main approaches of the anti-psychiatric movement, Which emerged in the 1960s to advocate for the individual rights of people with mental health issues and to draw attention to the unequal methods and power relations present in physician-patient interaction.
History of the anti-psychiatric movement
One of the most significant antecedents of the antipsychiatric movement is moral treatment, promoted by Philippe Pinel and Jean Esquirol in the 18th century. The ideas of these authors must be framed in a context in which large numbers of people with mental health problems in asylums were overcrowded and treated inhumanely.
Although moral treatment had some influence in the development of therapies for severe mental disorders, it also offered restrictive and punitive methods. However, this precursor and the following ones illustrate well that, since the beginnings of psychiatry, it has been criticized for similar methodological and ethical reasons.
On the other hand, by the 19th century, it had become evident that the number of patients per psychiatrist in mental health establishments was very excessive; this is why the role of physicians has often become more administrative than therapeutic. Although the general conditions have improved, this description is not uncommon today.
During the twentieth century, the perception of psychiatry as a discipline that dehumanizes people with mental health problems. The emergence of the DSM and CIE diagnostic classifications has helped to label people in treatment, putting the disorder – ultimately a social construct – ahead of the person.
Emergence of this phenomenon
Between the 1930s and 1950s, very aggressive medical procedures became popular in the United States, such as electroshock (which at the time caused serious side effects) and lobotomy, which involves cutting connections to the frontal lobe.
In addition, in the 1950s, chlorpromazine, the first widely used antipsychotic drug, appeared. Despite the serious side effects associated with its use, this drug and other moderately effective and not too safe drugs continued to be developed and used en masse. We are talking about the so-called “golden age of psychotropic drugs”.
In 1967 psychiatrist David Cooper coined the term “antipsychiatry” to give a name to the movement of which he was part, and which at that time had an international scope, whereas it had previously been quite specific to the Anglo-Saxon world. Many professionals have now joined the movement, strongly influenced by Marxism.
Over the following decades, the brief anti-psychiatry unit was diluted, although similar demands strongly arose. around the rights of homosexual and transgender people, Pathologized by diagnostic classifications. The same can be said of other groups, such as people with functional diversity and severe mental disorders.
Classic approaches to the anti-psychiatric movement were defined in the 1960s by mental health professionals such as David Cooper, RD Laing, Theodore Lidz, Ernest Becker, Silvano Arieti, Thomas Scheff or Erving Goffman. The contributions of these authors do not always coincide; a particularly controversial case is that of Thomas Szasz.
In general, the anti-psychiatric movement advocates political action as a method to change the view of the population, and in particular those in charge of institutions, on “mental disorders”, which for those who adhere to this orientation constitute tools of control of citizens, because they stigmatize and pathologize them.
As in any movement, there are notable theoretical differences between the promoters of antipsychiatry, which has considerably hampered its consolidation. In all cases, a general coincidence is detected around the excessive medicalization of psychological problems and the potential dangers of diagnostic labels.
Among other arguments, classical antipsychiatry theorists have argued that behaviors and problems conceived as disorders are the result of certain social values and not of the presence of pathological characteristics in themselves. like that, the disorder can only be designated as such in relation to the socio-cultural context.
Another traditional target of the anti-psychiatric movement has been psychoanalysis, accused of frequently causing iatrogenic effects (i.e. harming clients’ mental health rather than improving it). The same can be said of many other therapies, especially those whose effectiveness has not been proven.
Today, the anti-psychiatric movement is as valid as it was 50 years ago, all – or precisely because of – the clear predominance of medical interventions in the field of mental health. The opposition is strong among many patients and relatives, as well as in clinical psychology, weighed down by the systematic professional intrusion of psychiatry.
One of the areas in which criticism is most intense is that of the medicalization of certain childhood behaviorsIncluding the pattern of behavior called Attention Deficit Hyperactivity Disorder, characterized by overdiagnosis and long-term use of insufficiently studied stimulant drugs.
On the other hand, it is very worrying the growing power of large pharmaceutical companies and its close links with the political class, the media and even many members of the scientific community. All of this generates understandable biases about the reliability of drugs and the studies that support them.
As for serious mental disorders such as schizophrenia and bipolar disorderPharmacological and psychological treatments have improved in recent years, but many psychiatric institutions continue to use non-recommended procedures. Likewise, the stigma of these and other disorders will continue to contribute to less than ideal care.