Academic journal article Ethical Human Psychology and Psychiatry

Nonpsychiatry: An Alternative to Contemporary Mental Health Work

Academic journal article Ethical Human Psychology and Psychiatry

Nonpsychiatry: An Alternative to Contemporary Mental Health Work

Article excerpt

The central theme of this article is nonpsychiatry. The implication of this term is illustrated in the mental health system and its significance is shown as an alternative to the established psychiatry. The article differentiates between genetic and social psychiatry on the one hand and antipsychiatry on the other when dealing with nonpsychiatry. An example of a psychosocial self-help group in Germany illustrates the nonpsychiatric services and strategies.

Keywords: nonpsychiatry; mental health system; psychotherapy; social therapy

Two main strategies are characteristic of the contemporary mental health field: The first involves medically diagnosing an individual as mentally ill or as having a disorder that results in a person being defined as mentally deviant; the second includes a certain technology of intervention, according to which a person constructed by psychiatry as mentally ill will be treated with medicine as well as a course of psychotherapy and/or social therapy. The main targets of my critique are the definition of and treatment for illness and treatment. My major objective of this article is to show a nonpsychiatric alternative to the hitherto widespread practice of psychiatric work. I want to illustrate this alternative practice in the area of professional work and self-help and show that professionals can develop a new perspective: persons who psychiatrists would consider "mentally ill," but who we consider as people who are "psychosocially distressed or distressing" (see Dallaire et al., 2000).

A self-help project initiated and organized by psychosocially distressed and distressing individuals within Europe and supported by psychosocial workers provides a good example of the alternative discourse to the presently dominating categories of illness and treatment. I will discuss the concept and the practice of nonpsychiatry in regard to the new professional attitude in relation to self-help and show its alternative nature and its transformative possibilities in the mental health system.

AN ATTEMPT TO DEFINE NONPSYCHIATRY BY CONTRASTING IT TO BIOPSYCHIATRY, SOCIAL PSYCHIATRY, AND ANTIPSYCHIATRY

From its inception, psychiatry has been exclusively dominated by the medical model which posited that distressed and distressing behavior could be understood to be symptoms of "mental illnesses" or "mental disorders." In turn these mental illnesses were based on organic or biological factors. The body of the "mentally ill" person was treated by psychiatrists as an isolated entity. Psychosocial conditions were mostly ignored.

The transformation of biopsychiatry into social psychiatry was the development of a biopsychosocial model. This kind of psychiatry tries to understand a "mentally ill" person in biological, psychological, and social terms. No longer was one theory supposed to be dominant but rather psychiatry was to be the integration of many disciplines and theories. This integration is now desired in diagnosing and treating the psychosocially distressed or distressing person (see Dilts, 2001). But reality shows that the bio(logical) strategy is still predominant when dealing with this population. Psychosocial attempts are marginal as shown by the psychiatrist Rufer in the cases of a "manic" and a "schizophrenic" person (see Rufer, 1991).

Antipsychiatry is in some ways dialectical. It is an antithesis to the existing psychiatric establishment (thesis), a continuous protest and struggle against psychiatric conceptions and practices. It defines itself and develops its identity by opposing and rejecting the psychiatric concepts of illness and treatment by trying to invalidate them (see Kempker &. Lehmann, 1993).

A search in the Internet of the term "nonpsychiatry" reveals that it is mostly used to differentiate nonpsychiatric personnel from the psychiatric ones, nonpsychiatric hospitals from psychiatric ones, and problems of people being of a psychiatric or nonpsychiatric nature. …

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