In the 1950s and 1960s, several books were published criticizing the psychiatric profession and calling for its reform. The authors included therapists, psychiatrists, politicians, philosophers, and even novelists. In spite of their different backgrounds, however, most agreed that psychiatric hospitals often resembled prisons and that the patients were frequently subjected to cruel and inhuman treatment. Indeed, many argued that patients were being denied the most basic human rights. Some went still further, arguing that it was society itself that was mad!
The phrase ‘anti-psychiatry movement’ can be misleading: it was never an official movement, with a headquarters, membership lists, and universally agreed aims. Neither was it original. Even in 18th century England, men like William Tuke were expressing disgust at the cruelty shown towards so-called “lunatics”. And hostility towards the pharmaceutical industry is more intense today than ever before.
Nevertheless, between the 1950s and 1970s criticism of the psychiatric profession intensified. Undoubtedly, the anti-establishment mood of the 1960s gave added momentum to these criticisms. Indeed, some of those involved were themselves sympathetic to the ’60s counterculture. The British writer R. D. Laing, for example, himself a professional psychiatrist, took LSD, inspired the Beatles, and was photographed with long hair, sitting cross-legged in a bright, psychedelic shirt.
During the 1960s, several books were published questioning the nature of psychiatric institutions and the way mental illness was defined. In 1960, for example, the American academic and psychiatrist Thomas Szasz published The Myth of Mental Illness, in which he questioned the very idea that it was an illness from which the patient needed to recover. Instead of trying to cure him, argued Szasz, the psychiatrist should help his patient to learn and grow. The following year, Erving Goffman, a Canadian sociologist, published Asylums. Goffman focussed on the psychiatric hospitals themselves, arguing that such places were more concerned with institutionalizing patients than with curing them.
One of the most interesting works was published in 1961 by the French philosopher Michel Foucault. Titled Madness and Civilization, this work described how attitudes towards the mentally ill had changed over time.
Foucault begins in 16th century Europe, where the mad were thought to possess secret wisdom and see beyond the normal limits; in other words, the madman was a visionary. Gradually, however, reason and rationality were valued more and more. The mad were now seen as unreasonable, even deviant. So, from the middle of the 17th century they began to be locked away – a period Foucault describes as ‘The Great Confinement’. To be mad now meant to be immoral, and there was a fear that such people would infect the general population.
Once people are locked away, however, they become objects of study, and out of this a new idea developed: that the mad are unwell and need to be cured. For Foucault, “the language of psychiatry” was nothing more than a monologue by ‘reason’ about madness. Just as, for example, gay people are labelled and defined by the heterosexual mainstream, so the mad are defined by the ‘sane’. Thus, for Foucault, the mentally ill are an oppressed minority.
Those involved in the movement questioned the way mental illness was defined and diagnosed. In the early 1970s, for example, an experiment was conducted to show just how arbitrary these judgements could be. Eight researchers were sent to different American psychiatric units, each claiming to hear voices – but nothing more. Seven were labelled schizophrenic and admitted! Once inside they behaved normally, yet they were dismissed or ignored when they asked what was going to happen to them. And in spite of their normal behavior, none were acknowledged to be sane until they revealed their true identity.
The problem with labels like ‘schizophrenic’ or ‘split personality’ is that they trap people. Once someone has such a label they are treated differently – and thus begin to feel differently. In other words, people live up to their labels.
Critics also point out that it is impossible to be objective. Diagnoses are influenced by the historical, social, and cultural context – as Foucault had demonstrated. Others argue that labels are tools of oppression, designed to belittle and limit the way people perceive and experience the world. Advocates of mind-altering drugs like LSD (whose effects have been compared to schizophrenia) argue something similar: that it is banned not because it is harmful but because it transforms experiences and beliefs.
Another common belief is that the ‘mad’ have often been made that way. Psychiatrists, so the argument goes, are too quick to explain mental illness as a kind of malfunctioning – as if the brain were like a computer or car engine that needed fixing. Instead, we need to look at ourselves. In many cases, people are literally driven mad by the sickness and dysfunction they encounter in the family unit or in society at large.
R. D. Laing and the Madman as Visionary
The name most often associated with anti-psychiatry is probably that of the British writer R. D. Laing. In the 1960s, Laing became something of a celebrity, much to the annoyance of his fellow psychiatrists. But he was also a serious scholar with a genuine concern for the lives of his patients.
In 1960, Laing published The Divided Self, in which he offered a new explanation for schizophrenia. Some schizophrenics, he argued, never feel that their self is stable and secure. When they come into contact with others, they fear this self might be somehow overwhelmed or, in Laing’s words, “engulfed”. So they keep it hidden behind a series of masks. Unfortunately, if it is denied contact with the real world, this self effectively dies. Eventually, the masks can be maintained no longer and a breakdown occurs. Laing had offered an explanation that did not rely upon biology or neuroscience.
But it was his 1967 work The Politics of Experience that caused the most controversy. Inspired by people like William Blake and Carl Jung, Laing argued that “madness need not be all breakdown, it can also be breakthrough”. In other words, psychotics are not always ill. On the contrary, many are striving for spiritual transcendence. Rather than locking them away and pumping them full of drugs, the psychiatrist should be more like a shaman, helping the patient to complete a spontaneous and natural process.
Many professional psychiatrists bitterly resent such criticisms. They would point out that however unpleasant psychiatric hospitals may appear, the staff do have the patient’s best interests at heart. They would also add that many of these patients would suffer a great deal more if they were taken off all medication and released. It is easy for hip intellectuals like Foucault to criticise – they do not have responsibility for someone who is hearing a voice telling him to cut himself. Then again, people like Laing never claimed that all psychotic breakdowns are positive. Of course, ultimately it is not a question of who is right or wrong but of what most benefits those in distress.