This philosophical current criticizes the use of psychotropic drugs and the stigmatization of patients.
During the 20th century, many psychiatric treatments for mental disorders became popular, including some highly questionable in an ethical and practical sense. The extreme medicalization of problems such as schizophrenia have had and continue to have, in a large number of cases, coercive components that are frequently criticized.
In this article we will talk about the history and main approaches of the antipsychiatry movement, which emerged in the 1960s to defend the individual rights of people with mental problems and draw attention to the methods and unequal power relations present in the interaction between doctor and patient.
History of the antipsychiatry movement
One of the most significant antecedents of the antipsychiatry movement is the 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 problems were crowded into asylums and treated inhumanely.
Although moral treatment had some influence on the development of therapies for severe mental disorders, it also proposed restrictive and punitive methods. However, this precursor and subsequent others are illustrative to understand that, since the beginning of psychiatry, it has been criticized for similar methodological and ethical reasons.
On the other hand, as early as the nineteenth century it had become evident that the number of patients per psychiatrist in mental health institutions was very excessive; it was for this reason that the role of physicians frequently became more administrative than therapeutic. Although the general conditions have improved, this description is not strange at the present time.
During the 20th century, the perception of psychiatry as a discipline that dehumanized people with mental problems continued to grow . The emergence of the DSM and CIE diagnostic classifications contributed to the labeling of those who came to treatment, putting the disorder – after all a social construct – before the person.
Emergence of this phenomenon
Between the 1930s and 1950s, very aggressive medical procedures, such as electroshock (which at that time caused serious side effects) and lobotomy, which involves cutting the connections of the frontal lobe, became popular in the United States.
Furthermore, in the 1950s, chlorpromazine, the first widely used antipsychotic, appeared. Despite the severe adverse reactions associated with its use, this and other moderately effective and not too safe drugs continued to be developed and used on a massive scale. We refer to the so-called “golden age of psychoactive drugs”.
In 1967 the psychiatrist David Cooper coined the term “antipsychiatry” to give name to the movement of which he was a part, and which at this point had an international scope, whereas previously it had been quite specific to the Anglo-Saxon world. Many professionals now joined the movement, influenced in a key way by Marxism.
In the decades that followed, the brief unity of antipsychiatry waned, although similar demands around the rights of gay and transgender people emerged strongly , pathologized by diagnostic classifications. The same can be said of other groups, such as people with functional diversity and severe mental disorders.
The classic approaches of the antipsychiatry 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 are not always coincident; a particularly controversial case is that of Thomas Szasz.
In general, the antipsychiatry movement advocates political action as a method to change the vision of the population, and especially of institutional leaders, regarding “mental disorders”, which for those who adhere to this orientation constitute tools of control of citizens, as they stigmatize and pathologize them.
As within any movement, there are notable theoretical differences between the promoters of antipsychiatry, which has significantly hampered its consolidation. In any case, a general coincidence is detected regarding the excessive medicalization of psychological problems and the potential dangers of diagnostic labels.
Among other arguments, the theorists of classical antipsychiatry defended that the behaviors and problems that were conceived as disorders were the result of certain social values, and not of the presence of pathological characteristics in themselves. Thus, the disorder can only be designated as such in relation to the sociocultural context.
Another of the traditional targets of the antipsychiatry movement was psychoanalysis, which was accused of frequently causing iatrogenic effects (that is, damaging the mental health of clients rather than improving it). The same can be said for many other therapies, particularly those whose efficacy has not been proven.
Today the antipsychiatry movement is as valid as 50 years ago, despite -or precisely because- of the clear predominance of medical interventions in the area of mental health. The opposition is strong in many patients and relatives, as well as in clinical psychology, weighed down by systematic professional intrusion on the part of psychiatry.
One of the areas in which criticism is most intense is that of the medicalization of certain childhood behaviors, among which the behavior pattern known as Attention Deficit Hyperactivity Disorder stands out, characterized by overdiagnosis and long-term use. term of insufficiently studied stimulant drugs.
On the other hand, the growing power of large pharmaceutical corporations and their close ties with the political class, with the media and even with many members of the scientific community are very worrying . All of this generates understandable prejudices regarding the reliability of drugs and the studies that support it.
Regarding severe mental disorders, such as schizophrenia and bipolar disorder, pharmacological and psychological treatment has improved in recent years, but many psychiatric institutions continue to use poorly recommended procedures. Also, the stigmatization of these and other disorders will continue to contribute to less than ideal management.