Saturday, 7 March 2015

Anarchism, Psychiatry and Mental Illness in the Age of Anxiety.

The Psychological is political!

"For every diagnostic category there are dozens of aetiological theories. The major problem with most is that they tend to emphasise one domain of existence at the expense of all the others, ending up in a reductionism that does more harm than good when taken on its own. By now we know that biochemical theories of depression espoused by the pharmaceutical industry are lies designed to sell pharmacommodities. As a side-effect that policy makers, healthcare managers and other invested parties are happy to exploit, a neuropharmaceutical imaginary has taken hold that reinforces and becomes part of strategies for the responsibilisation of individuals"

"Circadian disrhythmia hypotheses of depression break explain the syncing of biorhythms to capitalist institutional rhythms. Circadian rhythms are those bodily rhythms that are regulated so as to vary throughout the day with a regular periodicity. Many core processes of the biological body are regulated by these rhythms but the most well know are the sleep-wake cycle and those surrounding temperature. Abnormalities, according to medico-normative ranges, in circadian rhythms have been connected with depression for a while now, while disturbances to sleep have been symptoms of dysphoria since before the diagnostic coding device of depression was created. "

"The circadian rhythms have two components. The endogenous component consists of regulation via an “internal body-clock” that is, in actuality, the suprachiasmatic nuclei [snc] located in the hypothalamus. This area of the brain is also responsible for locomotor activation and selected hormonal secretions. But to say that this form of regulation is “internal” or fully endogenous is misleading as the snc is stimulated via perceptual coupling to the environment following entrainment pathways that proceeding by way of photosensitive ganglion cells in the retina. In other words, there is a complex interplay- mediated by various feedforward and feedback circuits- of the eyes, the perceived object, light waves and the positions of all these in relation to one another and the movement of the perceiving body. This coupling means that there is a circulatory movement toward-into-across-out of the body and the objects of perception. Circadian rhythms as fundamental biorhythms already violate the traditional bounded picture of organisms; they are machinic and not organic. Biorhythms are an evolved biomechanical technology. "

The experience of desynchronised circadian rhythms is familiar to anyone who has ever had jet-lag or has been unemployed for a long period of time or who regularly works nightshifts. In the latter case “shift work maladaptation syndrome” has been linked to all kinds of health conditions, not least among them depression. In a fairly comprehensive review of the evidence up to the point of writing Healey and Waterman put forward what they called a shift work hypothesis of depression that states
The outlines of this would be as follows: depressive disorders are triggered by environmental disruption, that is by altered social routines and, consequently, altered zeitgebers; they involve, at their heart, disturbances that resemble jet lag and shift work, and they respond to the kind of measures that have also proved useful in the management of jet lag and shift work 1."
" Anticipating criticism about the lack of cognitive dimensions to this portrait Healy and Waterman remind their readers that not all depression come with hopelessness, guilt, and/or suicidal ideation. They also hypothesise that depressive disorders may begin with these somatic problems before the sufferer goes on to make attributions about herself that would by mantra-like repetition become self-fulfilling prophesies. I’d add that this picture would also sit well with people who develop depressions after long periods of unemployment, underemployment or enduring chronic pain. It has been documented that experiences that get diagnostically coded as depression are often experienced as aches and pains, a general physical lassitude, sluggishness 2. In Japan Western style depression didn't exist until recently. Instead the Japanese codify dysphoric experience in terms of an illness that is exclusively experienced as a bodily disturbance 3"

"If I am partly this pragmatically coupled brain-body-world then these losses are losses of my subjectivity. This circadian dysrhythmia is also and immediately a social dysrhythmia that profoundly disrupts the existential rhythm that my experience of myself is identified with. In a later article Healey returns to the question of circadian rhythms to assert that those who are persistently desynchronised from the imposed routines of everyday life are suffering from just such a dysrhythmia"

"Depression and anxiety, pathological poles of enervation, wouldn’t be what they are if the machined production of subjective experience didn’t exist. In his phenomenological work psychiatrist Thomas Fuchs has set down some of the conditions of lived depression: slowness, stiffness, heaviness, thickness of the body . This is enacted in bodily performance where the depressive body is one that moves with difficulty, its gait being one marked by all the features we expect from being weighted down- especially in those severe depressions where the sufferer is unable to lift their head, to get out of bed, to move without exhaustion"

Very interesting:-

"As I keep saying, the distinction between depression and anxiety is an economic one. The separation of depression and anxiety followed the production of pharmaceuticals that were sold on the basis of being disease-specific; but these illnesses aren’t disease, and the reality is that the creation of depression is the creation of the anti-depressant market. The same is true for anxiety. The great cynical moment of pharmaco-capitalism is that it produces the illnesses and the treatments."

sometimes explode - "Mental health nurse blogging on anti-psychiatry. Short critical introductions to key figures, events, and ideas of the past and present. Notes towards the second wave of anti-psychiatry. "

"Whatever the case, there is a general feeling that CBT isn’t a panacea that can be applied indifferently to all people in all places. My own feelings as someone who has been trained in CBT up to an introductory level, uses it in microcounselling form and sees it used every day at work, is that it fundamentally misunderstands human beings. It fails to understand how human affectivity and desire operates, and is held in thrall to a model of rationality that is both exclusionary of madness and which generalises a certain capitalist utopian ideal of homo economus, the masculine ideal of the human being who makes rational economic decisions. I have seen women who’ve had their children taken away from them by social services asked to think “how this can be seen as a positive”. I’ve seen people struggle with physiological and phenomenological drug dependencies asked to think about how appropriate their behaviour is when they dare to talk about drugs. I’ve seen schizophrenics challenged on their validity of their beliefs, allowing workers not to have to bother to try to establish any rapport or even attempt to find intelligibility to their paranoias or their voices."

"We’ve also seen how CBT is a quick, cheap method for fixing people up and sending them back to work, for getting all those unproductive bodies back into the workplace, and had hints at the continued use of CBT as self-help, allowing it to act as everyday prophylactic. Capitalism has never just been about the production of material goods, it has always tended to the production of subjectivities as well. Capitalism makes goods, yes; but it makes kind of people too. Psychology of any stripe under capitalism is one of the chief means for producing and regulating those subjectivities. Psychology tells us what our interiority consists of, and in no small part therefore shapes it, conditions it, constrains affordances and lets other blossom. CBT is no exception. It works for capitalism and the state, and, despite the benefits people do reap from it, it forms part of the new authoritarian norm."

" Serialised time is the time of regulated by imposed routines; time lived according to a regime of temporal planning. This segmentation of temporal flows is out of our control. Just as the spatial arrangement of cities is the domain of the knowledgeable practices of urban planners so are the temporal arrangements of our lives often out of our hands, confined to the management of chronocrats. "

"The rush to embody the mind, to bring the soul back down to earth, has resulted in a reductionism wherein the pragmatic coupling of brains to bodies and both to environments that are physical, historical, social, economic and political has been left out of the picture "

"Anxiety, whatever else it is, is a rhythm. It is a series of rhythms; a polyrhythm2. The “unexperienced experience” of the physiology of anxiety that subtends and determines the “experienced experience” of anxiety is thus a specific spatio-temporalising sequence that gives rise to a very definite embodied experience of time. Anxiety can be mild and fleeting. It can also be chronic and low-level, forming a kind of debilitating existential hum (as in generalised anxiety disorder), or it can rise into a terrible cacophonous explosion (as in panic attacks and phobias). Of course anxiety isn’t reducible to the physiological only, but neither is the physiological to be kept outside of the political. If we can talk about precarity inducing anxiety and depression- nervousness- then we can talk about precarity as an abstract machine for the production of nervous bodies. "

"As someone who used to suffer from regular panic attacks I can assure you that every single one “felt” like a heart attack. The production of rhythms of anxiety is the result of the conditions of precarity that all workers find themselves in following the neoliberal recomposition of labour. As such we can see this production as a specific example of a physiological intervention carried out on the social body via the productive body."

"This low-res problem is compounded by the fact that these representations are taken in clinical situations that don’t accurately simulate the complexity of everyday life, and which still require the interpretative labour of technicians and neurologists who operate with various assumptions about what it is they are interpreting. Nonetheless, we can’t simply ignore what these techniques provide us with, even if we have to be careful not to completely reduce subjectivity to its neuroelectrical correlates. "

" The suggestion is that the rhythm of the body and the neural rhythm synchronise with each other and can operate transindividually as shared rhythms. This transcorporeal rhythm- rhythm across bodies and within bodies- has come to be known as “social rhythm”. "

"I can’t advance on what the leading figure of the Italian “democratic psychiatry” movement, Franco Basaglia, said on this subject at a 1964 conference:
The loss of a scheme, the loss of the future, the state of being in the power of others without being able to direct oneself, and having one's day tuned and organised on an impersonal rhythm, dictated only by organisational demands that - such as they are - cannot take into account the single individual and particular circumstances: this is institutionalisation. This is, however, also the rhythm on which society is based. Thus, when the patient - alienated from life, suffering from the loss of relationship with others, and himself - enters the mental home, instead of finding here a place where he can free himself from the burden of others, where he can reconstruct his own personal world, he find new rules, new structures that make him lose himself still more, and push him more and more towards objectiveness, until he identifies himself with them. This is why men still fear each other, why they do not trust one another and why the consequences of madness, that are for the legislator the centre of his apprehension, overcome the value of the mentally sick patient as a man 5. " - Seems pretty true to me.

"The trick is to simultaneously refuse the hopelessness these realisations bring and the coerced positive affect and trained optimism of positive psychology, while also retaining our own rage as a political affect. For this, we require new forms of therapeutic militancy and/or militant therapists. At the core of this is the need to go a level beneath the solidarity that shows up everywhere as an absence and develop its core among ourselves. The core I’m talking about is empathy, and a willingness to reappropriate the very vulnerability that the necropolitics of state and capital seek to turn into weapons against us. If they make us more vulnerable, placing us closer to corporeal harms, they do so in order to generate the phantasy of their own invulnerability. Vulnerability isn’t weakness, although it certainly exposes us to our weaknesses, but is in fact the ontological register of our radical openness to each other. I realise this is all quite abstract but I don’t want to short-circuit what a praxis of vulnerability might look like. In part, I think it will involve consciousness-raising groups, the mutual exposure of neurosocial and psychosocial wounds, the uncovering of the machinery that produces and sustains our affectivities as shared horizons, rather than individual emotional states.Groups like the Icarus Project, Mad Pride, and the Hearing Voices Network might provide models for this kind of political therapeutics. But they don’t come ready made for each situation, each locality, each body, and so have to be forged and reforged."

" In a previous post I asked what a liberatory psychopharmacology would look like but this can only be answered on an experimental basis. This might involve the reactivation of experiments with LSD and psilocybin, but it could also look like the autonomous organisation of psychopharmacological laboratories. Such laboratories could be already existing labs organised under syndicalist principles or they could be the proliferation of underground clandestine operations. "

 Unproductive bodies, part 1: narcotisation of dependency- "A schematic look at positive psychology's deployment within the UK's workfare regime and the position of the substance-dependent body as a model in the production of subjectivity. This forms the first part of a short series on positive psychology, work, and the production of unproductive bodies. "

"If Maslow’s image of self-actualisation seems like a utopianism then we have to reflect on its application today. Everything that Maslow placed under the heading of “self-actualisation” is now commodified, manipulated, and regulated by and for capitalism. Today to self-actualise is to actualise oneself within and for the market. Neoliberal capitalism actively seeks to promote self-actualisation and this is one of the points that the post-autonomia theories of immaterial labour had right: it isn’t enough to go to work, you must love your labour; it isn’t enough to make do, one must be happy. The kinds of affective labour that we are entrained into have been discussed in a number of places so I won’t dwell on them here, but suffice to say that we are all expected to manage our affectivity, our self-presentation, in such a way that we retain a positive outlook. The new entrepreneurial project of the worker-self that works on itself at all times, whether through continuous professional development, psychotherapy, diet, fashion or self-help, is first and foremost an enthusiastic self. If the spirit of capitalism was once the dour duty-orientation of the Protestant work-ethic then the new religion of work is a much more liberated and optimistic one."

"As Barbrara Ehrenreich argues,

if early capitalism was inhospitable to positive thinking, “late” capitalism, or consumer capitalism, is far more congenial, depending as it does on the individual’s hunger for more and the firm’s imperative of growth. The consumer culture encourages individuals to want more—cars, larger homes, television sets, cell phones, gadgets of all kinds—and positive thinking is ready at hand to tell them they deserve more and can have it if they really want it and are willing to make the effort to get it. Meanwhile, in a competitive business world, the companies that manufacture these goods and provide the paychecks that purchase them have no alternative but to grow. If you don’t steadily increase market share and profits, you risk being driven out of business or swallowed by a larger enterprise. Perpetual growth, whether of a particular company or an entire economy, is of course an absurdity, but positive thinking makes it seem possible, if not ordained "
"Part of this problem is the inability to separate out authentic and inauthentic feels, affects and displays. As authenticity is never spontaneous and always belongs to a shared history of learning how to feel, dwelling within affects, and being brought into the semiology of display, it produces the distinction and subsequent confusion around authenticity and inauthenticity"
The questionnaire is a psychometric tool to used to measure motivation in individuals. There is very little dispute about the structural problems that lead to substance misuse but MI and readiness to change eschew those problems in order to shift the burden onto the individual. MI does this in a particularly non-confrontational style. This helps develop the therapeutic alliance but it does so by reducing the client's "resistance". This is important not only because it eases the inducement of self-government but also because it neutralises working class subjects ahead of time. Its for this reason that psychometrics like these are used with those exploited via workfare"

"The substance-dependent body must be recodified as an irresponsible body that has failed to understand itself, its own resources, and its own responsibilities. The substance-dependent body is thus codified ambivalently as both diseased or sick (“addict”) and as a moral failure. At essence, MI embodies the same kind of power that Foucault described as the pastoral power of the confessional: it seeks its subject to produce itself via the production of verbal signs that described its essence. "

"In contemporary capitalism, the dominant reactive affect is anxiety."

" In response to the greatest trauma on the American psyche in recent history the response was an increase in a fervent nationalism, increased intolerance of dissent, more hostility and violence towards people who are different, a desire for revenge and a need to find heroes (whether they be American soldiers going out for revenege, or the firefighters at the scene of the devastation), as well as a desire to help in the cause. In a chapter for a (hopefully) forthcoming book I've written on how capital and governments like to expose us to anxiogenic conditions, to expose us to our vulnerability, in order to illicit precisely these effects. This is the necropolitical side of biopolitics and to my mind it is this that current strategies of the decomposition of labour aim at: the capture, intensification and even production of anxiety. "

" This is compounded by the demand that we self-objectify from the outset, everything about us being reducible to its use and attractiveness to an employer, the "CVisation of life", the making of oneself into a particular brand, with the self-management involved in our behaviours, choices, and speech, and the constant coupling of existence to a deluge of different (economic; psychometic; sexual) measures of performance. "

" Consider the massive increase in diagnosis of social anxiety disorder. Setting questions of the degree of diagnostic fashions to one side, isn't a disorder that describes someone with a crippling fear of being judged or evaluated in social settings exactly what you would expect given the conditions? When you're expected to be creative, to market yourself, to CVise your life, when this is the new conformity, social anxiety is both pathological and protective. Likewise, consider the rise in OCD diagnoses. In OCD people perform ritualistic behaviours (compulsions) in order to stave of vague feelings of impending dread (obsessions). These behaviours range widely from performing actions a given number of times to changing clothing to driving miles past your house. In the case of Yayoi Kusama it involves painting dots, as with the image at the top of this post. This disorder is incredibly debilitating but seems to be fiar play for bad taste jokes and all that crap. What really is so strange about OCD? What it describes is people who are acutely attuned to their anxiety attempting to enact safety behaviours to alleviate that anxiety. In these cases it becomes stunning clear that psychopathology- madness- is the new condition of alienation. "

"Precarity is a machine for anxiety; austerity is a machine for making-vulnerable; psychopathology is the machinery of alienation."

"The society of stimulation seeks to produce bodies that are capable of working all the time, whenever, as perfectly flexible neurochemical and biophysical agents. It plug us into speeds and volumes of information and data that we can't possibly attend to, sort, store, decide on and so on. Our nervous systems just can't handle it. As physiological units we live in an environment that is more complex than that which we evolved for: the primordial Savannah; plus the urban environment, with its militarised facades and police presences, its attention-demanding neon signs, music, ringtones, a cacophonous rhythm that disrupts our own biorhythms, as do the work patterns and the stresses we're expected to endure; plus the infosphere being delivered by hand held devices, head mounted eye wear, delivering us more data, more news, and news as it happens, that we are demanding to have a response to. The news itself is involved in producing affective states, making us fearful, and does so in such a manner as to make sure we don't have time to think"

"If the first wave provided a machine for fighting misery, and the second wave a machine for fighting boredom, what we now need is a machine for fighting anxiety – and this is something we do not yet have. If we see from within anxiety, we haven’t yet performed the “reversal of perspective” as the Situationists called it – seeing from the standpoint of desire instead of power. Today’s main forms of resistance still arise from the struggle against boredom, and, since boredom’s replacement by anxiety, have ceased to be effective.
Current militant resistance does not and cannot combat anxiety. It often involves deliberate exposure to high-anxiety situations. Insurrectionists overcome anxiety by turning negative affects into anger, and acting on this anger through a projectile affect of attack. In many ways, this provides an alternative to anxiety. However, it is difficult for people to pass from anxiety to anger, and it is easy for people to be pushed back the other way, due to trauma. We’ve noticed a certain tendency for insurrectionists to refuse to take seriously the existence of psychological barriers to militant action. Their response tends to be, “Just do it!” But anxiety is a real, material force – not simply a spook. To be sure, its sources are often rooted in spooks, but the question of overcoming the grip of a spook is rarely as simple as consciously rejecting it. There’s a whole series of psychological blockages underlying the spook’s illusory power, which is ultimately an effect of reactive affect. Saying “Just do it” is like saying to someone with a broken leg, “Just walk!”"

"To my mind radicals are exposed to necropolitical manipulation and strategies of stimulation just as much as everyone else. What radicals also face that others don't is that additional level of surveillance and precarity that comes from "being a known face" and receiving ludicrous bail conditions, and the other examples that Plan C discuss. The other thing that radicals face, possibly more than other people, although maybe not, is a visceral experience of the Kafkaesque distributions of power and responsibility through the networks that composed the structures of late capitalism. "

"This became the bedrock of the learned helplessness theory of depression. With the depressed individual, the theory runs, it is possible to suppose that the loss of a job or a relationship can lay in a profound course towards despair. If the person experiences a series of "negative life events" then they become depressed: they learn that everything is shit and there is nothing to be done about it. We need ways to come out of this learned helplessness. I think at least part of this means being humble, starting small, just learning to reactivate struggle, rather than hoping for revolution in five minutes. We have to be pragmatic in this regard: to learn how to fight again. "

" Rather than say we're all anxious, although I think we absolutely are, I would say we are all nervous. This might seem a small point to make but consider the treatments, the meanings, and the political mobilisations surrounding anxiety and depression. Also consider that "nervousness" was always understood immediately by laypeople outside of psychiatry. "Nerves" sounds unscientific, a bit silly, but it is actually part of a language that medicine had to obliterate in order to become the sanctioned discourse of pathologies of experience. The hegemonic affectivity today is nervousness: the co-mingling of depression and anxiety, experiences that almost always appear together anyway and which were really finally separated by the need to produce commodity markets. "

"A lot of people don't like that I've attached this blog to the history of antipsychiatry and that I talk about a second wave of antipsychiatry. All that is finished with. It went too far. It was immature. It was dangerous. Antipsychiatry was always about writing. The radical experiments in with psychiatry- experiments that we could undoubtedly learn from in political struggle- were never attempts to negate care for mentally ill people. And the idea that antipsychiatry was obscene, dangerous and all the rest is one echoes by a psychiatry that has absorbed its theory, minus the radical core. The same thing is said about communism, isn't it?"

"A popular unconscious admission today: keep calm and carry on. Keep calm: This is how the open secret of anxiety, of nerves, and the injunction to destimulate is expressed today. Even our despair is sold back to us; even the recovery of our nervous systems. Carry on: stay in the holding pattern of your safety behaviours, don't go too far, don't go astray. The denial of anxiety and the denial of communism displaced and compressed into one compact knotted slogan.At the moment I'm working with others to create an online space for a new militant mental health movement, and to set up something similar to the Institute for Precarious Consciousness. If there are still those who doubt the importance of these kinds of projects, they might want to consider the fate of Seligman's dogs: keep calm, get electrocuted. "

Thomas Szasz and the antipsychiatry of neoliberalism

"The meaning of the claim that mental illness is a myth or metaphorical story has been much discussed and is often misunderstood. Szasz is not claiming that the "schizophrenic" experience isn't real but that the idea that this experience is an illness to be understood as a biological disease is false, unless we take it metaphorically"

"Despite the radicalism of his critique, Szasz thus thoroughly accords with that aspect of the person-centred approach to therapy that acts as if there were no wider social, economic or political context or causes of mental distress"

"Szasz believes the strength of psychotherapy lies in its ability to individualise the individual and expand her realm of person autonomy without ever having to address capitalism or the state. By acting as if these things didn't exist, Szasz merely reproduces the psychiatry he is so averse to but in place of psychiatric power he would install psychotherapeutic power"

"My contention would be that it is not the abuse of psychiatric power that is problematic, as Szasz thinks, but that psychiatric power is always abusive, and that it often deployed especially to target particular populations (homosexuals, women, PoC). "

"This individualism would be completed by the 'pharmacological autonomy' of a free market in drugs in which the patient would become the consumer free to consume any number of medications to "treat" any number of psychic maladies (Szasz 1992a; 1992b). Again, Szasz's vision is already with us in most high GDP countries, especially in the US where drug companies can advertise direct-to-consumers. Szasz's abolition of enforced psychiatry amounts to little more than the kind of deregulation that has characterised neoliberalism carried into the realm of mental health service provision. A combination of individualism, moralism and faith in market capitalism- and its material root in private property- which he declares as 'a beacon that lights the way for persons and social cooperation' (Szasz 1992, p.2), sounding like a so-called "anarcho-capitalist" or, in other words, a capitalist. "

To draw this together, I think this shows that a renewed anti-psychiatry that was anarchist could take a lot from Szasz's critique in also viewing the disease-model of mental distress as spurious and as a justification for the exercise of power and processes of normalisation. As communist it would need to reject Szasz's emphasis on individualism and take account of the common production of mental distress and how it relates to capitalism. The two-person therapy model would also need to be rejected as it embraces the idea that therapeutic change is necessarily divorced from social change. As anarchist, it would accept concerns about involuntary treatment, medical cognitive authority and extra-legal power of detention and restraint without fetishing consent and choice as the only important considerations. Szasz's insistence on choosing to believe in psychiatry is akin to the false choice of deciding between political parties or consumer products, especially given his defence of a free market for psychiatric drugs.

"Finally, an anarchist anti-psychiatry would need to make clear that while psychiatric reform is welcome and can only be a good thing for people exposed to its services, the idea that people experiencing extreme states of consciousness should be subjected to criminalisation is extremely dangerous, damaging, remarkably statist and in no way liberatory. Szasz talks about separation of psychiatry from the state and in the spirit of a neoliberal capitalist psychiatry whereas we should argue for the supersession of capital, the state and psychiatry."

These specialists seek to persuade us that our troubles stem, not from the world in which we live, but from our lack of insight into ourselves and from our failure to take responsibility for what we think, feel, and do.
- Paul Moloney, The Therapy Industry

"If CBT attempted to depoliticise suffering by making it an issue of individual self-management, and if that self-management was in fact little more than the entrepreneurial production of brand subjectivations, then the third wave therapies go even further by refusing all valuations in the here-and-now (although ACT has a values-work component, its questionable whether orthodox therapists would agree with "destroy capitalism" as a life-value). "

"In the latest edition of the Occupied Times Joanna Moncrieff provides us with a possible new slogan for a repetition of antipsychiatry: "the psychological is political". I'm happy to agree with that slogan as long as it is recognised that "the psychological" is itself a product of forces of subjective deprivation and immaterialisation. "

"To end on a note of caution: there is obviously always the need for survival. I would not advocate starvation in order to avoid being implicated in the cartography of capitalist agriculture, production and distribution chains. Likewise, there is a need for what we might call, admitting the poverty of our language, "psychological survival". In many ways the third wave represents therapeutic advances on traditional CBT, and CBT does work for a lot of people- whether it is because of the "Dodo bird verdict" or the value of specific tools. But to reiterate Guattari one last time, part of the problem of CBT is not whether it works (it seems to work as a short-term "sticking plaster")... but that it works too well! "

"None of which is to claim that the experience of mental distress isn’t biologically mediated. We are bodies and our experience is embodied- there is no “mind” floating independently of our physiology. At the same time though, psychiatry remains unwilling to accept that our embodiment exists in complex ecological relationships that includes our sociality."

"Similarly, none of this is to claim that the original critiques of the anti-psychiatrists were unproblematic. For instance, Szasz’s critique was motivated by his right-wing libertarian philosophy and included the desire to see people stand trial for acts they committed while experiencing distress, acts they may not otherwise have performed."

"Foucault’s position in some of his work seems to embrace a kind of romanticism of mental distress, while Laing expressed some dubious ideas about “schizophrenia” as a shamanic journey of self-discovery. Many of the anti-psychiatrists also rejected the benefits of therapy and medication as if these were evil in-itself, in a move that would remind many anarchists of primitivism’s rejection of technology."

"Clinical psychologist Richard Bentall has (not unproblematically) heralded the need for a new ‘rational anti-psychiatry’ while people like Pat Bracken are spear heading a ‘critical psychiatry’. Yet without linking this to thorough analyses of the relationship of mental health and psychiatry to corrosive powers of capitalism and the state such a renewed anti-psychiatry is pointless. The critique has been swallowed whole by the system and turned into the justification for today’s aggressive colonisation of our lives by that very system."'_Collective

"The pharmaceutical industry (not “big pharma”) is an industry, which is to say no more or less than that it is a section of capital. For pharmaceutical capitalism to continue accumulating profit it must have an audience to sell its products to and it has that in the form of psychiatry, itself a wing of state power that has a captive market who can be legally compelled to take their medication. Psychopharmacology and psychiatry have been entwined since psychiatry’s birth, and even in the heydays of psychoanalytic psychiatry in the USA benzodiazapines were still regularly prescribed."

In separating actually existing psychiatry from “big pharma”, and in separating “big pharma” from capitalism and the interests of a particular class protected by state power, Will Self’s analysis effectively decouples his critique from any economic or political implications. What we are left with is a weak moralism that he himself even calls ‘ lily-livered liberal’, that also misrepresents certain aspects of the history of the two disciplines. This moralism is born out in Self’s comparison of psychiatrists as “drug-pushers” where it is clear that we’re supposed to read “drug-pusher” as a good go-to caricature of a bad person. This moralism of the psychiatrist as unscrupulous bastard getting kids hooked on downers is conjoined to the weak assertion that ‘we are all to blame’. Our responsibility, according to Self, comes from the fact that we are
‘absolutely bloody miserable, we can’t get up in the morning, we are dirty and unkempt, and we go along to our GP and are prescribed an antidepressant and lo and behold we recover.
For Self, the bad dealer-man gives us misery guts a pill and we feel better and therefore “we” are to blame for having been miserable and/or for the ‘chemical repression of the psychotic’ (it isn’t clear which). This complete obliteration of a perspective willing to recognise, analyse and critique the structural causes and consequences of psychopharmacological psychiatric treatment completely mirrors the prevailing ideology under which that structure justified itself (the same problem is found in the second half of Soderbergh’s recent film, Side Effects). Presumably this morality also extends to the parents of children, or the children themselves, who are desperate to find some way to ameliorate the incredibly stressful situation that hyperactivity can cause. It is also telling that people who experience psychotic phenomena are given only fleeting mentions in the article, as if concern over psychiatric power is really only important when it concerns the middle class readership of the Guardian. People diagnosed with psychotic illness tend to be either live in poverty at onset or to drift into poverty as a result and Self only real reflection on economic position seems is his correct reference to ‘socio-medical discrimination: no sick note – and no social benefits’, although he leaves out any reference to the fact that today many people who should not be working are having their welfare revoked and forced back to work."

"Yet another explanation for the epidemic may also be evolving from radical to mainstream, thanks primarily to the efforts of investigative journalist Robert Whitaker and his book Anatomy of An Epidemic (2010). Whitaker argues that the adverse effects of psychiatric medications are the primary cause of the epidemic. He reports that these drugs, for many patients, cause episodic and moderate emotional and behavioral problems to become severe, chronic and disabling ones"

Underlying many of psychiatry’s nearly 400 diagnoses is the experience of helplessness, hopelessness, passivity, boredom, fear, isolation, and dehumanization—culminating in a loss of autonomy and community-connectedness. Do our societal institutions promote:
Enthusiasm—or passivity?
Respectful personal relationships—or manipulative impersonal ones?
Community, trust, and confidence—or isolation, fear and paranoia?
Empowerment—or helplessness?
Autonomy (self-direction)—or heteronomy (institutional-direction)?
Participatory democracy—or authoritarian hierarchies?
Diversity and stimulation—or homogeneity and boredom?"

"But criticising the NHS while the government is undermining it and selling it off is a dangerous move, but not one we can never make. It wasn’t long before those of us using the #failedbytheNHS hashtag were politely informed that we hadn’t been failed by the NHS, we’d been failed by budget cuts, a point that I thought barely needed raising, and one that the programme itself made pretty clear. We were also reminded that NHS workers themselves were not to blame, that some people have good experiences of the NHS, that some NHS staff are fantastic on mental health issues, and that while the NHS may not be perfect, it’s better than privatised healthcare. All valid points, none of which I’d disagree with, nor would most of the mental health service users whose blogs and tweets I’m familiar with. The implication being that the programme and the hashtag and the vocal criticisms of the NHS are all lending legitimacy to the destruction and privatisation of the NHS, which of course will exist for as long as there are people left to fight for it etc etc. And soon enough, #savedbytheNHS appeared, with heartwarming stories of NHS doing its job well. "

"So we end up with a really frustrating and immobilising false dichotomy, where you can either get behind the NHS 100%, or you’re more or less an unwitting propagandist for neocon privatisation. There is no room, it seems, for those who have undeniably been failed by the NHS to speak out, group together, and imagine models of mental health care that actually work. That would be divisive, it’d be giving points to the opposition, it’d undermine the movement, we’ll deal with that after the revolution. Sound familiar?1" Dennis Fox Critical Psychology and anarchist.


No comments:

Post a Comment