Is critical psychiatry the same as

1
Is critical psychiatry the same as
anti-psychiatry?

• D B Double

2
David Cooper (1931-1986)

• Psychiatry and anti-psychiatry (1967)

3
David Cooper (1931-1986)

• Psychiatry and anti-psychiatry (1967)
• Psychiatry has aligned itself far too
  closely with the alienated needs of society

4
David Cooper (1931-1986)

• Villa 21 an experiment in anti-psychiatry

5
David Cooper (1931-1986)

• Villa 21 an experiment in anti-psychiatry
• Positive non-action, an effort to cease
  interference, to lay off other people and give
  them and oneself a chance

6
Definition by mainstream psychiatry

• International movement against psychiatry which
  is anti-medical, anti-therapeutic,
  anti-institutional and anti-scientific (Roth,
  1973)

7
Definition by mainstream psychiatry

• International movement against psychiatry which
  is anti-medical, anti-therapeutic,
  anti-institutional and anti-scientific (Roth,
  1973)
• Generally seen as a passing phase in the history
  of psychiatry

8
RD Laing (1927-1989)

• Not an anti-psychiatrist

9
RD Laing (1927-1989)

• Not an anti-psychiatrist
• Athough agreed with anti-psychiatric thesis that
  by and large psychiatry functions to exclude and
  repress those elements society wants excluded and
  repressed

10
RD Laing (1927-1989)

• Madness is much more understandable than commonly
  assumed

11
RD Laing (1927-1989)

• Madness is much more understandable than commonly
  assumed
• So-called normality is too often an abdication of
  our true potentialities

12
Thomas Szasz (1920-)

• Not an anti-psychiatrist

13
Thomas Szasz (1920-)

• Not an anti-psychiatrist, although also not a
  psychiatrist, as psychiatry is associated with
  coercion

14
Thomas Szasz (1920-)

• Not an anti-psychiatrist, although also not a
  psychiatrist, as psychiatry is associated with
  coercion
• Because both the anti-psychiatrists and I oppose
  certain aspects of psychiatry, our views are
  combined and confused

15
Thomas Szasz (1920-)

• Mental illness is a myth, as disease is physical

16
Thomas Szasz (1920-)

• Mental illness is a myth, as disease is physical
• State should not interfere in mental health
  practice or medicine in general

17
The anti element in anti-psychiatry

• Psychiatry objectifies people and therefore
  becomes part of the problem rather than the
  solution to mental health problems

18
The anti element in anti-psychiatry

• Psychiatry objectifies people and therefore
  becomes part of the problem rather than the
  solution to mental health problems
• May have gone too far in abandoning notion of
  mental pathology

19
Excesses of anti-psychiatry

• Cooper and Laing ultimately more interested in
  personal authenticity than changing psychiatry

20
Excesses of anti-psychiatry

• Cooper and Laing ultimately more interested in
  personal authenticity than changing psychiatry
• Few would want to go as far as Szasz in proposing
  no mental health law

21
Excesses of anti-psychiatry

• Cooper and Laing ultimately more interested in
  personal authenticity than changing psychiatry
• Few would want to go as far as Szasz in proposing
  no mental health law
• Coopers excursion into family, sexual and
  revolutionary politics

22
Critical psychiatry

• Does not deny its roots in anti-psychiatry

23
Critical psychiatry

• Does not deny its roots in anti-psychiatry
• Seeks to avoid excesses of anti-psychiatry and
  polarisation in the debate about nature of mental
  disorder

24
Critical psychiatry

• Psychiatry can be practised without the
  justification of postulating brain pathology as
  the basis for mental illness

25
Critical psychiatry

• Psychiatry can be practised without the
  justification of postulating brain pathology as
  the basis for mental illness
• Minds are enabled but not reducible to brains

26
Critical psychiatry

• Psychiatry can be practised without the
  justification of postulating brain pathology as
  the basis for mental illness
• Minds are enabled but not reducible to brains
• Genes set the boundaries of the possible
  environments define the actual

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Encouraging self-criticism

• Inclined to find fault, or to judge with severity
  

28
Encouraging self-criticism

• Inclined to find fault, or to judge with severity
  
• Characterised by careful, exact evaluation and
  judgement

29
Encouraging self-criticism

• Inclined to find fault, or to judge with severity
  
• Characterised by careful, exact evaluation and
  judgement
• Of the greatest importance to the way things
  might happen

30
Reflective practice

• Preparedness to think critically

31
Reflective practice

• Preparedness to think critically
• Tolerate the uncertainty and ambiguity required
  during reflection

32
Reflective practice

• Preparedness to think critically
• Tolerate the uncertainty and ambiguity required
  during reflection
• Ability to think about own thinking processes and
  critically assess assumptions and beliefs

33
Critical theory

• Loose collection of theories critical of society
  and the human sciences

34
Critical theory

• Loose collection of theories critical of society
  and the human sciences
• Frankfurt Institute for Social Research

35
Critical theory

• Rational basis of social existence theoretically
  impossible

36
Critical theory

• Rational basis of social existence theoretically
  impossible
• Systems of collective beliefs legitimate various
  power structures

37
Scientific basis of critical psychiatry

• Critique of science as positivism

38
Scientific basis of critical psychiatry

• Critique of science as positivism
• Interpretation important in establishing facts

39
Scientific basis of critical psychiatry

• Corporate interests are compromising objective
  research

40
Scientific basis of critical psychiatry

• Corporate interests are compromising objective
  research
• Bias in interpretation of randomised controlled
  trials

41
A simplified comparison
Biomedical psychiatry Anti-psychiatry Critical psychiatry
Science Positivist Non-positivist Non-positivist

42
A simplified comparison
Biomedical psychiatry Anti-psychiatry Critical psychiatry
Science Positivist Non-positivist Non-positivist
Focus Brain mechanisms Person Person
43
A simplified comparison
Biomedical psychiatry Anti-psychiatry Critical psychiatry
Psycho-pathology Yes No Yes


44
A simplified comparison
Biomedical psychiatry Anti-psychiatry Critical psychiatry
Psycho-pathology Yes No Yes
Empirical Yes No Yes

45
A simplified comparison
Biomedical psychiatry Anti-psychiatry Critical psychiatry
Psycho-pathology Yes No Yes
Empirical Yes No Yes
Social control Yes No Yes
46
Conclusion

• Mental disorders are not brain diseases

47
Conclusion

• Mental disorders are not brain diseases
• Psychiatrist is agent of social control

48
Conclusion

• Mental disorders are not brain diseases
• Psychiatrist is agent of social control
• Mental disorders must show through the brain but
  not always in the brain