Academic journal article Ethical Human Psychology and Psychiatry

Psychiatry and the Business of Madness: An Ethical and Epistemological Accounting

Academic journal article Ethical Human Psychology and Psychiatry

Psychiatry and the Business of Madness: An Ethical and Epistemological Accounting

Article excerpt

Psychiatry and the Business of Madness: An Ethical and Epistemological Accounting. Bonnie Burstow. London, United Kingdom: Palgrave Macmillan, 2015, 316 pp., $40.00 (paperback) $95.00 (hardcover).

This book is arguably the most comprehensive and brilliant critique of psychiatry that I've ever read; it's a devastating expose of psychiatry's discredited medical model and institutional psychiatry, "a regime of ruling." Bonnie Burstow's book is absolutely awesome in its numerous, thoroughly researched facts and original insights and scholarship frequently voiced with passion. Burstow uses the research analytic tool of institutional ethnography-"ruling happens through texts, particularly through the activation of texts" (p. 18). With this powerful intellectual probe, she deconstructs "boss texts" and takes us on an incredible journey into psychiatry, its alarming methods of social control, its intrusive brain-damaging drugs and electroshock. Burstow ends this awesome work in the spirit of hope and humanity she calls "Eutopia," a vision of a better world of compassion, empathy, mutual caring, respect for freedom and human rights.

She begins with a short and concise history of psychiatry featuring mad doctors and "alienists" (an apt word) during the 18th century, including Philippe Pinel who unchained poor people with mental illness in a Paris asylum but instituted a reign of terror of close surveillance and control. In the 19th century, there's Benjamin Rush, the notorious "father of American psychiatry" whose face appears on the American Psychiatric Association's logo; he invented the traumatic "tranquilizer chair" and advocated fear as therapeutic; he also labeled black slaves with the disease of "drapetomania," running away to be free; he also committed his son to an insane asylum. The gentler "moral treatment/moral management" of country retreats in the late 18th and early 19th centuries soon died; by the late 19th and early 20th century, it was replaced with eugenics/genetics-based, physically intrusive biological psychiatry, which unfortunately dominates today. This is a small but telling fragment of psychiatry's dark history of social control, medical fraud, coercion, and violence.

Burstow asserts that two fundamental principles underlie psychiatry and the book: parens patriae and police powers. Parens patriae (literally "father of the country") refers to power of the state to control, imprison, and forcibly treat citizens; police powers are mainly expressed as coercion, arrest, and use of force. Psychiatry, Burstow asserts, is essentially a regime of ruling; however, given psychiatry's hegemonic social control, the terms psychiatric dictatorship and psychiatric police state seem more appropriate.

In Chapter 4 ("Probing the Boss Text: DSM-What? Whither? How? Which?"), Burstow brilliantly analyzes the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatry's bible of fraudulent diseases. Unlike medical diagnoses, the approximately 350 diagnostic labels in DSM-5 (the current edition) are not only subjective and unscientific but also frequently lead to serious life-changing consequences such as loss of freedom (involuntary commitment), psychiatric drugging, and/or electroshock (electroconvulsive therapy [ECT]). DSM labels, Burstow asserts, serve no medical or scientific purpose, instead they routinely marginalize and stigmatize. Burstow succinctly summarizes major problems of the DSM, "subjectivity . . . masquerading as objectivity . . . nothing less than the essence of who the person is . . . constitutes a disorder" (pp. 94-95). She calls this activating text a "patient-processing system," denounces it as having absolutely no scientific validity or reliability; like the late psychiatrist Thomas Szasz and other dissident health professionals, Burstow correctly states there is "no mental illness" because there is no biological or medical evidence of cellular disease in anybody labeled mentally ill. …

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