Psychiatry’s Giant Step Backwards

A few years back, while in a bookstore in Seattle’s University District, I overheard a student discussing the topic of schizophrenia. This student was telling his friend how the belief that schizophrenics are able to recover their sanity has been wholly discredited due to a recent medical breakthrough which has firmly established that schizophrenia is a totally incurable disease.

The so-called “medical breakthrough” mentioned above refers to a recent trend in psychiatry: for the most part, psychiatrists have abandoned the idea that schizophrenia is a transitory emotional disorder in favor of the view that schizophrenia is an irreversible biological process. This new psychiatric pessimism in regard to schizophrenia is stated succinctly by Joseph Coyle, a Johns Hopkins University psychiatrist:

The natural history of the disease is one of deterioration. That has been the case in every schizophrenic I have ever seen.1

However, the “deterioration” Dr. Coyle speaks of has not occurred in us schizophrenics but in psychiatry itself. Since the early 1980s, psychiatry has been in the process of reviving the long-discredited late nineteenth-century notion that schizophrenia is a brain disease, and is currently advertising this ignominious retreat from reality as a glamorous medical advance.

Three trends—one ideological, one economic, and one political—have prompted psychiatrists to rally around the medical model  and proclaim its truth with all the fervor of born-again true believers.

The Ideological Trend

During the 1960s and 1970s, a number of authors, including Thomas Szasz.; , R. D. Laing.D.; , Erving Goffman , Michel Foucault , Thomas J. Scheff, David L. Rosenhan, Ronald Leifer, Theodore R. Sarbin.;  and James C. Mancuso.; , published scholarly books and essays giving solid reasons for rejecting the medical model . Thomas Szasz.;  in particular has argued that the concepts of mental illness and schizophrenia have no more scientific validity than the earlier notions of witchcraft and demoniac possession. Dr. Szasz.;  points to the undeniable fact that no one is diagnosed as schizophrenic because he is ill in the accepted medical sense, but rather because his behavior has violated certain social norms. Szasz.;  also points out that there is obviously a vast difference between social deviance and disease. Unlike social deviance, disease is a physical concept: it refers to cellular pathology: to histopathological lesions and pathophysiological processes. Szasz.;  also reminds us that despite claims to the contrary, no one has been able to demonstrate a physical basis for schizophrenia. (Indeed, if a physical basis for schizophrenia actually exists, psychiatrists would utilize objective laboratory tests to diagnose this so-called “illness” rather than relying on such vague subjective criteria as the presence of delusions and hallucinations !)

Furthermore, according to Dr. Szasz.; , the act of diagnosing a person as schizophrenic is nothing more than a pseudoscientific ritual in which a person is degraded to a less than human status so that his basic human rights need no longer be given any consideration. Moreover, since psychiatry's inception back in the seventeenth century, its function has always been to keep certain individuals from being a nuisance to society—and this remains true even to this day. Since psychiatrists are committed to controlling socially deviant behavior, and since they also see themselves as legitimate medical practitioners, they have adopted the comfortable and self-serving delusion that socially deviant behavior is somehow equivalent to disease.

In short, it is the view of Thomas Szasz.; —as well as a number of other authors—that schizophrenia is a fake disease and that psychiatry is fraudulent medicine.2

To some extent, psychiatry’s recent return to the medical model  must be understood as an inevitable backlash against the school of thought represented by Thomas Szasz.; . Due to the fact that the views of Dr. Szasz.;  have won increasing acceptance in many circles, organized psychiatry has been compelled to launch a massive propaganda campaign to convince the general public that they are a wholly legitimate branch of medicine—that the “illnesses” they treat are every bit as real as diabetes or cancer.

However, to fully comprehend the reactionary mindset of contemporary psychiatry, it is first necessary to realize that the views of Thomas Szasz.;  are not nearly as radical as they may at first seem. As far back as 1906, Adolf Meyer  had expressed views similar to those of Szasz.; . Moreover, throughout most of the twentieth century many eminent psychiatrists, including Harry Stack Sullivan and Theodore Lidz , have built upon the foundations laid by Freud  and Meyer , and have not only expressed the view that schizophrenia is an emotional disorder with an environmental cause, but have also shed a considerable amount of light on exactly what causes schizophrenia. If the findings of Lidz  and Sullivan are correct, then the truth of Szasz’s view, that schizophrenia is not a disease, is virtually self-evident. For this reason the ideas of Freud , Meyer , Sullivan, and Lidz  are no more accepted in contemporary psychiatry than are the ideas of Thomas Szasz.; . In short, in reacting against Dr. Szasz.; —and against others who share his views—psychiatry has been forced by logical necessity to totally repudiate its entire psychological heritage—and in so doing it has revealed its complete moral and intellectual bankruptcy.

The Economic Trend

The economic uncertainties and stagflation prevailing in the 1970s and early 1980s had a traumatizing effect on everyone—especially on psychiatrists. Psychiatry was being seriously hurt. While being assailed by its critics, psychiatry was encountering difficulties of an altogether different sort: it was being plagued by competitors. During the 1960s and 1970s, nonmedical psychotherapies were springing up like mushrooms: encounter therapy, reality therapy, existential therapy, gestalt therapy, client-centered therapy, family therapy, behavior modification, transactional analysis, primal scream therapy, rolfing, Lifespring, Scientology, and est. As different as these therapies were from one another, they all had one thing in common: they all took clients away from psychiatry. In addition to these new therapies, psychiatry was also facing competition from psychologists, clinical social workers, psychiatric nurses, and a variety of counselors, all who were entering the field of psychotherapy in droves.

Faced with competitors encroaching on its once exclusive domain, psychiatry fought back. It unleashed a massive advertising and propaganda campaign to convince the general public that all mental disorders—including schizophrenia—were of a biological nature and could only be properly treated by therapists who were medical doctors.

The mendacity of this psychiatric propaganda campaign was exceeded only by its effectiveness. In the repressive, anti-intellectual social climate of the 1980s and ‘90s—in this era of social and intellectual conformity—no one any longer listens to anyone who questions the authority of psychiatry or the notion that all mental disorders stem from biological causes.

The Political Trend

It was certainly no coincidence that psychiatry returned to the medical model  just as the political climate in this country was becoming markedly more conservative, for political and psychiatric reactionaries share a common ideology: biological determinism .

Biological determinism  has always been an attractive ideology for political reactionaries since it seems to justify both the inequality of races, sexes and social classes, and a do-nothing social policy. Indeed, if biological determinism  is correct, and the poor are poor because they are inherently stupid or inferior, then why should the taxpayers’ money be wasted in a futile effort to remedy their plight?

During the Reagan and Bush (Sr.) administrations—and especially during the Republican juggernaut during the Clinton administration—every social program that had been set up to help the poor, the elderly, the handicapped, and racial minorities has been drastically cut. As a result of this callous penny-pinching policy, more and more people have been tossed on the human scrap heap.

Schizophrenics are among those people who have been ruthlessly discarded by society. Since the early 1980s it has become an unquestioned dogma that until medical science discovers a cure for schizophrenia sometime in the future—in perhaps five, ten, or a thousand years—people afflicted with this disease are totally beyond help. Therefore psychotherapy, counseling, vocational training, and other social rehabilitation programs aimed at helping such people are a total waste of time and money. Schizophrenics should be drugged to the point of stupor and simply left to rot.

Those who cling to the medical model  will of course deny that they do so out of motives of social expediency. They will claim that over the past few decades psychiatry has accumulated a massive amount of facts which prove beyond a reasonable doubt that schizophrenia is a real disease—and that such discoveries will ultimately be the salvation of such pitiful, biologically inferior specimens as myself.

I will now examine the so-called “facts” that purportedly prove that schizophrenia is a disease much like cancer or syphilis.


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