Psychiatry and the Control of Dangerousness: On the Apotropaic Function of the Term "Mental Illness"

Article excerpt

Life is full of dangers. Our highly developed consciousness makes us, of all living forms in the universe, the most keenly aware of, and the most adept at protecting ourselves from, dangers. Magic and religion are mankind's earliest warning systems. Science arrived on the scene only about 400 years ago, and scientific medicine only 200 years ago. Some time ago I suggested that "formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic." (1)

We flatter and deceive ourselves if we believe that we have outgrown the apotropaic use of language (from the Greek apostropaios meaning "to turn away").

Many people derive comfort from magical objects (amulets), and virtually everyone finds reassurance in magical words (incantations). The classic example of an apotropaic is the word "abracadabra," which The American Heritage Dictionary of the English Language defines as "a magical charm of incantation having the power to ward off disease of disaster." In the ancient world, abracadabra was magic word, the letters of which were arranged in an inverted pyramid and worn as an amulet around the neck to protect the wearer against disease or trouble. One fewer letter appeared in each line of the pyramid until only the letter "a" remained to form the vertex of the triangle. As the letters disappeared, so supposedly did the disease or trouble.

I submit that we use phrases like "dangerousness to self and others" and "psychiatric treatment" as apotropaics to ward off dangers we fear, much as ancient magicians warded off the dangers people feared by means of incantations, exemplified by "abracadabra." Growing reliance on compulsory mental health interventions for protection against crime and suicide illustrate the phenomenon. Physicians, criminologists, politicians, and the public use advances in medicine and neuroscience to convince themselves that such interventions are "scientific" and do not violate the moral and legal foundations of English and American law. This is a serious error. There is no scientific basis whatever for preventive psychiatric detention, also known as involuntary mental hospitalisation or civil commitment. And the procedure is a patent violation of due process and the presumption of innocence.

We call all manner of human problems "(mental) diseases," and convince ourselves that drugs and conversation (therapy) solve such problems. Solutions exist, however, only for mathematical problems and some medical problems. For human problems, there are no solutions. Conflict, disagreement, unhappiness, the proverbial slings and arrows of outrageous fortune are challenges that we must cope with, not solve. Only after we admit that our solutions are illusions can we begin to develop more rational and more humane methods for dealing with "mental illness" and the "dangerous mental patient."

We are proud that we do not punish acts or beliefs that upset others, but do not injure them and hence do not constitute crimes. Yet, we punish people--albeit we call it "treatment"--for annoying family members (and others) with behaviours they deem "dangerous" and also for "being suicidal." To be sure, persons who exhibit such behaviors--labeled "schizophrenics," "persons with dangerous severe personality disorders," and "suicidal patients"--frighten others, especially those who must associate with them. Unable to control noncriminal "offences" by means of criminal law sanctions, how can the offended persons and society protect themselves from their unwanted fellow men and women?

One way is by "divorcing" them. However, this method of separating oneself from an unwanted companion--especially when it involves relations between disturbing and disturbed spouses or between disturbing adult children and their disturbed parents--strikes most people as an unacceptable rejection of family obligation. …