Difference between revisions of "Anarchy 70/Libertarian Psychiatry: an introduction to existential analysis"
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{{tab}}In 1965 there were 160,000 people in mental hos­pitals in Britain and an estim­ated 200,000 psy­chotics in the com­mun­ity. Nearly half of all hos­pital beds are oc­cu­pied my the men­tally ill. In a tele­vision pro­gramme on mental health<ref>{{w|BBC}} {{qq|{{w|Panorama|Panorama_(TV_series)}}}} on {{qq|Mental Health}}, 6th June, 1966.</ref> the number of men­tally ill in Britain was given as half a million. The tele­vised psy­chi­atrist sug­gested that there were four main cat­egor­ies of ill­ness: people with mental de­form­ity, {{p|357}}old people with {{qq|mental equip­ment in de­cline}} (… per­haps old people with no­where else to go?{{ref|aster2|**}}), people with physiolo­gic­ally normal mental equip­ment but with ac­quired neur­otic pat­terns, and lastly, vic­tims of {{qq|bio{{-}}chem­ical ill­ness}}{{dash}}in his words, {{qq|Struck down out of the blue}}. The fourth cat­egory per­haps re­flects, more than any­thing else, the cur­rently fa­voured styles of treat­ment! | {{tab}}In 1965 there were 160,000 people in mental hos­pitals in Britain and an estim­ated 200,000 psy­chotics in the com­mun­ity. Nearly half of all hos­pital beds are oc­cu­pied my the men­tally ill. In a tele­vision pro­gramme on mental health<ref>{{w|BBC}} {{qq|{{w|Panorama|Panorama_(TV_series)}}}} on {{qq|Mental Health}}, 6th June, 1966.</ref> the number of men­tally ill in Britain was given as half a million. The tele­vised psy­chi­atrist sug­gested that there were four main cat­egor­ies of ill­ness: people with mental de­form­ity, {{p|357}}old people with {{qq|mental equip­ment in de­cline}} (… per­haps old people with no­where else to go?{{ref|aster2|**}}), people with physiolo­gic­ally normal mental equip­ment but with ac­quired neur­otic pat­terns, and lastly, vic­tims of {{qq|bio{{-}}chem­ical ill­ness}}{{dash}}in his words, {{qq|Struck down out of the blue}}. The fourth cat­egory per­haps re­flects, more than any­thing else, the cur­rently fa­voured styles of treat­ment! | ||
− | {{tab}}By far the largest group is the third{{dash}}the {{qq|neur­otics and psychot­ics}}. Among these {{qq|{{w|schizo­phrenia|Schizophrenia}}}} is the most common dia­gnosis. {{qq|In most European coun­tries about one per cent of the popu­la­tion go to hos­pital at least once in their life­time with the dia­gnosis schizo­phrenia.}}<ref>{{w|David Cooper|David_Cooper_(psychiatrist)}}, {{qq|The Anti{{-}}Hos­pital: An Ex­peri­ment in Psy­chi­atry}}, {{w|''New So­ciety''|New_Society}}, 11th March, 1965.</ref> But what mean­ing can be given to these stat­istics and as­sess­ments without a stand­ard of san­ity or mad­ness? {{qq|Defin­i­tions of mental health pro­pounded by the ex­perts usually re­duce to the no­tion of con­form­ism, to a set of more or less ar­bit­rar­ily pos­ited so­cial norms. …}}<ref>{{w|David Cooper|David_Cooper_(psychiatrist)}}, {{qq|Viol­ence in Psy­chi­atry}}, ''Views'', No. 8, Summer, 1965.</ref> The label­ling of people as mad can have the so­cial func­tion of defin­ing the area of {{qq|san­ity}}{{dash}}per­haps there is a par­al­lel with {{w|Durkheim|Émile_Durkheim}}{{s}} theory of crime and pun­ish­ment as {{qq|neces­sary}} to re­spect­able so­ciety to mark off the limits of per­mis­sible and toler­ated beha­viour. {{qq|So­ciety needs lun­at­ics in order that it may regard itself as sane.}}<ref>ibid.</ref> It could also be argued that cer­tain kinds of so­ciety {{qq|need}} lun­at­ics as their man­agers; a dis­cus­sion in {{w|''Peace News''|Peace_News}} re­cently was con­cerned with the un­certi­fi­able mad­ness of the {{w|Amer­ican Presid­ent|Lyndon_B._Johnson}} in rela­tion to a {{qq|col­lect­ive norm of in­san­ity}}. A Cor­re­spond­ent noted: {{qq|No sig­ni­fic­ant mem­ber of a power estab­lish­ment can ever be {{q|cert­ifi­ably in­sane}} since it is this same estab­lish­ment which de­ter­mines the defin­i­tions of {{q|san­ity}} and {{q|in­san­ity}} and which de­cides{{dash|checked only by the oc­ca­sional con­science of an oc­ca­sional pro­fes­sional medi­cal man}}when {{qq|in­san­ity}} becomes {{qq|{{w|cert­ifi­able|Involuntary_commitment}}}}.}}<ref>Part of a letter by Pierre{{-}}Joseph Brie, {{qq|In­san­ity and the Egg}}, {{w|''Peace News''|Peace_News}}, 1st July, 1966.</ref> | + | {{tab}}By far the largest group is the third{{dash}}the {{qq|neur­otics and psychot­ics}}. Among these {{qq|{{w|schizo­phrenia|Schizophrenia}}}} is the most common dia­gnosis. {{qq|In most European coun­tries about one per cent of the popu­la­tion go to hos­pital at least once in their life­time with the dia­gnosis schizo­phrenia.}}<ref>{{w|David Cooper|David_Cooper_(psychiatrist)}}, {{qq|The Anti{{-}}Hos­pital: An Ex­peri­ment in Psy­chi­atry}}, {{w|''New So­ciety''|New_Society}}, 11th March, 1965.</ref> But what mean­ing can be given to these stat­istics and as­sess­ments without a stand­ard of san­ity or mad­ness? {{qq|Defin­i­tions of mental health pro­pounded by the ex­perts usually re­duce to the no­tion of con­form­ism, to a set of more or less ar­bit­rar­ily pos­ited so­cial norms. …}}<ref>{{w|David Cooper|David_Cooper_(psychiatrist)}}, {{qq|Viol­ence in Psy­chi­atry}}, ''{{l|Views|https://lccn.loc.gov/sf83002178}}'', No. 8, Summer, 1965.</ref> The label­ling of people as mad can have the so­cial func­tion of defin­ing the area of {{qq|san­ity}}{{dash}}per­haps there is a par­al­lel with {{w|Durkheim|Émile_Durkheim}}{{s}} theory of crime and pun­ish­ment as {{qq|neces­sary}} to re­spect­able so­ciety to mark off the limits of per­mis­sible and toler­ated beha­viour. {{qq|So­ciety needs lun­at­ics in order that it may regard itself as sane.}}<ref>ibid.</ref> It could also be argued that cer­tain kinds of so­ciety {{qq|need}} lun­at­ics as their man­agers; a dis­cus­sion in {{w|''Peace News''|Peace_News}} re­cently was con­cerned with the un­certi­fi­able mad­ness of the {{w|Amer­ican Presid­ent|Lyndon_B._Johnson}} in rela­tion to a {{qq|col­lect­ive norm of in­san­ity}}. A Cor­re­spond­ent noted: {{qq|No sig­ni­fic­ant mem­ber of a power estab­lish­ment can ever be {{q|cert­ifi­ably in­sane}} since it is this same estab­lish­ment which de­ter­mines the defin­i­tions of {{q|san­ity}} and {{q|in­san­ity}} and which de­cides{{dash|checked only by the oc­ca­sional con­science of an oc­ca­sional pro­fes­sional medi­cal man}}when {{qq|in­san­ity}} becomes {{qq|{{w|cert­ifi­able|Involuntary_commitment}}}}.}}<ref>Part of a letter by Pierre{{-}}Joseph Brie, {{qq|In­san­ity and the Egg}}, {{w|''Peace News''|Peace_News}}, 1st July, 1966.</ref> |
− | {{tab}}In offi­cial stat­istics there must, in any case, be a murky over­lap area between what comes out as {{qq|crime}} and what as {{qq|lunacy}}{{dash}}and a lot of luck in who ends up in which in­stitu­tion. Per­haps it is the in­stitu­tional bureau­cracy that has most need of the labels: {{qq|Ac­cord­ing to the common­sense defin­i­tion,}} writes Dr. Theodore Szasz, {{qq|mental health is the abil­ity to play what­ever the game of so­cial living might con­sist of and to play it well. Con­versely, to re­fuse to play, or to play badly, means that the person is men­tally ill. The ques­tion may now be raised as to what are the dif­fer­ences, if any between so­cial non­con­form­ity (or devi­a­tion) and mental ill­ness. Leaving tech­nical psy­chi­atric con­sider­a­tions aside for the moment, I shall argue that the dif­fer­ence between these two no­tions{{dash|as ex­pressed for ex­ample by the state­ments {{q|He is wrong}} and {{q|He is men­tally ill}}}}does not lie in any ob­serv­able ''facts'' to which they may point, but may con­sist only of a dif­fer­ence in our ''at­ti­tudes'' toward our sub­ject.}}<ref>{{w|T. S. Szasz|Thomas_Szasz}}, {{qq|Polit­ics and Mental Health}}, {{w|''Amer­ican Journal of Psy­chi­atry''|American_Journal_of_Psychiatry}}, No. 115 (1958) (quoted by {{w|Erving Goffman|Erving_Goffman}} in {{w|''Asylums''|Asylums_(book)}}, p. 509).</ref> What sort of be­ha­viour is likely to lead those with the ap­propri­ate at­ti­tudes to see signs of mental ill­ness and to set going the trans­fer pro­cess from {{p|358}}{{qq|person to pa­tient}}? {{qq|Ordin­arily the patho­logy which first draws at­ten­tion to the pa­tient{{s}} con­di­tion is con­duct that is {{q|in­ap­propri­ate in the situ­a­tion}}. … Further, since in­ap­propri­ate beha­viour is typic­ally beha­viour that some­one does not like and finds ex­tremely trouble­some, deci­sions con­cern­ing it tend to be polit­ical, in the sense of ex­pres­sing the spe­cial inter­ests of some par­tic­u­lar fac­tion or person. …}}<ref>{{w|Erving Goffman|Erving_Goffman}}, ''{{w|Asylums{{dash}}Essays on the So­cial Situ­a­tion of Mental Pa­tients and Other In­mates|Asylums_(book)}}'', New York, Anchor Books, 1961, pp. 363-4.</ref> As an ex­ample of {{qq|in­ap­propri­ate beha­viour}}, con­sider the case of {{qq|The Naked Prisoner}} ({{sc|{{w|freedom|Freedom_(newspaper)}}}}, 16.10.65). Mr. Paul Pawlowski was ar­rested during a demon­stra­tion at the {{w|Spanish Embassy|Embassy_of_Spain,_London}} in {{w|London}}. Eventu­ally reach­ing {{w|Brixton Prison|HM_Prison_Brixton}}, he re­fused to put on the stand­ard pris­on­er{{s|r}} uni­form and was con­sequently locked up, naked, in his cell. Thus he re­mained for ten days. On the tenth day he was inter­viewed by a so­cial worker: {{qq|… You know that two doctors have seen you while you have been in Brixton … they came to the con­clu­sion that what you need is a little stay in a mental hos­pital.}} In fact he did not have the benefit of this con­fine­ment. The hos­pital psy­chi­atrist de­cided that Mr. Pawlowski{{s}} opin­ions were not those of the ma­jor­ity but {{qq|people are not put into mental hos­pitals for their opin­ions. They do that sort of thing in {{w|Russia|Soviet_Union}}.}}{{ref|aster3|***}} Mr. Pawlowski was for­tun­ate in his psy­chi­atrist, but it is inter­est­ing to see how the pre{{-}}exist­ing at­ti­tudes of offi­cials brought him to the brink of ad­mis­sion. The overt polit­ical im­plica­tions may make this ex­ample ex­cep­tional{{dash|but it would not seem to be to the ad­vant­age of a person sus­pected of mental ill­ness to have been {{qq|mixed up in polit­ics}} or {{qq|the dregs of so­ciety in {{w|CND|Campaign_for_Nuclear_Disarmament}}}}}}which it seems, may well be taken as a con­firm­atory symp­tom.{{ref|dagger|†}} The mental health service{{dash|like the edu­ca­tion {{qq|service}}}}is a func­tional part of the present so­cial system and, as such, acts to pre­serve that system and its values. {{qq|The psy­chi­atric pro­fes­sion is a bureau­cracy,}} writes James Green, a con­trib­utor to ''Views'', No. 8, {{qq|making an es­sen­tial con­trib­u­tion to the run­ning of gov­ern­ment and ad­minis­tra­tion. … Most psy­chi­atrists would prob­ably take for granted the struc­ture and values of their own so­ciety, in such a way that the thera­peutic pro­cess becomes a ques­tion of re­turn­ing the sick person to his so­cial con­text or roles, e.g. his family, whether the con­text and roles are them­selves satis­fact­ory.}} Al­though no doubt un­repre­sent­at­ive and redol­ent of {{qq|what they do in Russia}} I can­not resist quot­ing the words of a psy­chi­atrist par­ti­cipant in a re­cently tele­vised dis­cus­sion: {{qq|Our func­tion is to get people well enough to be in­doc­trin­ated.}} It would be mis­lead­ing to sug­gest that any­thing but a tiny minor­ity become in­mates of asylums simply or only because they hold dis­ap­proved {{p|359}}opin­ions, but pos­sibly such cases may lead to a con­sider­a­tion of the far more subtle {{qq|polit­ical}} and so­cial mean­ing of the label­ling and con­fine­ment of the un­vocal ma­jor­ity. | + | {{tab}}In offi­cial stat­istics there must, in any case, be a murky over­lap area between what comes out as {{qq|crime}} and what as {{qq|lunacy}}{{dash}}and a lot of luck in who ends up in which in­stitu­tion. Per­haps it is the in­stitu­tional bureau­cracy that has most need of the labels: {{qq|Ac­cord­ing to the common­sense defin­i­tion,}} writes Dr. Theodore Szasz, {{qq|mental health is the abil­ity to play what­ever the game of so­cial living might con­sist of and to play it well. Con­versely, to re­fuse to play, or to play badly, means that the person is men­tally ill. The ques­tion may now be raised as to what are the dif­fer­ences, if any between so­cial non­con­form­ity (or devi­a­tion) and mental ill­ness. Leaving tech­nical psy­chi­atric con­sider­a­tions aside for the moment, I shall argue that the dif­fer­ence between these two no­tions{{dash|as ex­pressed for ex­ample by the state­ments {{q|He is wrong}} and {{q|He is men­tally ill}}}}does not lie in any ob­serv­able ''facts'' to which they may point, but may con­sist only of a dif­fer­ence in our ''at­ti­tudes'' toward our sub­ject.}}<ref>{{w|T. S. Szasz|Thomas_Szasz}}, {{qq|Polit­ics and Mental Health}}, {{w|''Amer­ican Journal of Psy­chi­atry''|American_Journal_of_Psychiatry}}, No. 115 (1958) (quoted by {{w|Erving Goffman|Erving_Goffman}} in {{w|''Asylums''|Asylums_(book)}}, p. 509).</ref> What sort of be­ha­viour is likely to lead those with the ap­propri­ate at­ti­tudes to see signs of mental ill­ness and to set going the trans­fer pro­cess from {{p|358}}{{qq|person to pa­tient}}? {{qq|Ordin­arily the patho­logy which first draws at­ten­tion to the pa­tient{{s}} con­di­tion is con­duct that is {{q|in­ap­propri­ate in the situ­a­tion}}. … Further, since in­ap­propri­ate beha­viour is typic­ally beha­viour that some­one does not like and finds ex­tremely trouble­some, deci­sions con­cern­ing it tend to be polit­ical, in the sense of ex­pres­sing the spe­cial inter­ests of some par­tic­u­lar fac­tion or person. …}}<ref>{{w|Erving Goffman|Erving_Goffman}}, ''{{w|Asylums{{dash}}Essays on the So­cial Situ­a­tion of Mental Pa­tients and Other In­mates|Asylums_(book)}}'', New York, Anchor Books, 1961, pp. 363-4.</ref> As an ex­ample of {{qq|in­ap­propri­ate beha­viour}}, con­sider the case of {{qq|The Naked Prisoner}} ({{sc|{{w|freedom|Freedom_(newspaper)}}}}, 16.10.65). Mr. Paul Pawlowski was ar­rested during a demon­stra­tion at the {{w|Spanish Embassy|Embassy_of_Spain,_London}} in {{w|London}}. Eventu­ally reach­ing {{w|Brixton Prison|HM_Prison_Brixton}}, he re­fused to put on the stand­ard pris­on­er{{s|r}} uni­form and was con­sequently locked up, naked, in his cell. Thus he re­mained for ten days. On the tenth day he was inter­viewed by a so­cial worker: {{qq|… You know that two doctors have seen you while you have been in Brixton … they came to the con­clu­sion that what you need is a little stay in a mental hos­pital.}} In fact he did not have the benefit of this con­fine­ment. The hos­pital psy­chi­atrist de­cided that Mr. Pawlowski{{s}} opin­ions were not those of the ma­jor­ity but {{qq|people are not put into mental hos­pitals for their opin­ions. They do that sort of thing in {{w|Russia|Soviet_Union}}.}}{{ref|aster3|***}} Mr. Pawlowski was for­tun­ate in his psy­chi­atrist, but it is inter­est­ing to see how the pre{{-}}exist­ing at­ti­tudes of offi­cials brought him to the brink of ad­mis­sion. The overt polit­ical im­plica­tions may make this ex­ample ex­cep­tional{{dash|but it would not seem to be to the ad­vant­age of a person sus­pected of mental ill­ness to have been {{qq|mixed up in polit­ics}} or {{qq|the dregs of so­ciety in {{w|CND|Campaign_for_Nuclear_Disarmament}}}}}}which it seems, may well be taken as a con­firm­atory symp­tom.{{ref|dagger|†}} The mental health service{{dash|like the edu­ca­tion {{qq|service}}}}is a func­tional part of the present so­cial system and, as such, acts to pre­serve that system and its values. {{qq|The psy­chi­atric pro­fes­sion is a bureau­cracy,}} writes James Green, a con­trib­utor to ''{{l|Views|https://lccn.loc.gov/sf83002178}}'', No. 8, {{qq|making an es­sen­tial con­trib­u­tion to the run­ning of gov­ern­ment and ad­minis­tra­tion. … Most psy­chi­atrists would prob­ably take for granted the struc­ture and values of their own so­ciety, in such a way that the thera­peutic pro­cess becomes a ques­tion of re­turn­ing the sick person to his so­cial con­text or roles, e.g. his family, whether the con­text and roles are them­selves satis­fact­ory.}} Al­though no doubt un­repre­sent­at­ive and redol­ent of {{qq|what they do in Russia}} I can­not resist quot­ing the words of a psy­chi­atrist par­ti­cipant in a re­cently tele­vised dis­cus­sion: {{qq|Our func­tion is to get people well enough to be in­doc­trin­ated.}} It would be mis­lead­ing to sug­gest that any­thing but a tiny minor­ity become in­mates of asylums simply or only because they hold dis­ap­proved {{p|359}}opin­ions, but pos­sibly such cases may lead to a con­sider­a­tion of the far more subtle {{qq|polit­ical}} and so­cial mean­ing of the label­ling and con­fine­ment of the un­vocal ma­jor­ity. |
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{{r|Roger Moody: {{qq|Driving The Mad In­sane}}, {{w|''Peace News''|Peace_News}} ({{popup|3.6.66|3 June 1966}}).}} | {{r|Roger Moody: {{qq|Driving The Mad In­sane}}, {{w|''Peace News''|Peace_News}} ({{popup|3.6.66|3 June 1966}}).}} | ||
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+ | {{tab}}In his ac­count of {{qq|[[Anarchy 4/Where the shoe pinches|de{{-}}in­sti­tu­tion­al­isa­tion]]}} ([[Anarchy 4|{{sc|anarchy}} 4]]) [[Author:Colin Ward|Colin Ward]] re­ferred to the prison as {{qq|the most sin­is­ter of in­sti­tu­tions}} and no doubt it is. But as anarch­ists are aware, the state can make skil­ful use of the {{qq|ap­proved}} con­cepts of crime and crim­in­ality to di­vert at­ten­tion from its own more grandi­ose but identical activ­it­ies: so we should be alert to the pos­si­bil­ity that the in­sti­tu­tions openly la­belled as prisons are not the only ones serving that func­tion. Sup­pose, as Roger Moody says in his art­icle that mental hos­pital and prison are {{qq|dif­fer­ent terms for the same thing}}? If there is some truth in this there is con­sequently an ad­di­tional danger in that any­thing called a {{qq|hos­pital}} has auto­mat­ic­ally a pro­tect­ive cocoon around it as a result of its claim to pro­vide ther­apy. But surely the {{qq|volun­tary}} presence of many of the pa­tients in mental hos­pitals en­sures that they can­not have a pun­it­ive char­acter or ef­fect? A dif­fer­ent ap­proach is sug­gested by the Amer­ican so­ci­olo­gist {{w|Erving Goffman|Erving_Goffman}}: {{qq|… We must see the mental hos­pital, in the re­cent histor­ical con­text in which it de­veloped, as one among a net­work of in­sti­tu­tions de­signed to pro­vide a res­id­ence for vari­ous cat­egor­ies of so­cially trouble­some people.}}<ref>ibid., p. 354.</ref> | ||
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+ | {{tab}}Goffman states that only a small number of pa­tients enter mental hos­pital will­ingly, in the sense that they believe it will be good for them, having come to see them­selves as {{qq|men­tally un­bal­anced}}{{dash}}and as Laing and Cooper argue, even in these cases this self{{-}}per­cep­tion as being {{qq|ill}} or {{qq|mad}} can be in­duced by the beha­viour or strat­egy of the person{{s}} im­medi­ate relat­ives and con­tacts. The sequence from {{qq|person to pa­tient}} can follow a series of as­so­ci­ated stages set in mo­tion by a {{qq|com­plain­ant}} who sees an action on the part of the pre{{-}}pa­tient as per­haps a {{qq|last{{-}}straw}} and re­fers him to a suc­ces­sion of {{qq|medi­ators}}{{dash|prob­ably drawn from among teach­ers, so­cial workers, clergy, psych­iatrists, law­yers, po­lice}}one of whom, with co{{-}}opera­tion from the {{qq|sick}} man{{s}} relat­ives, will com­mit the indi­vidual to hos­pital with legal sanc­tion. {{qq|The so­ciety{{s}} offi­cial view,}} writes Goffman, {{qq|is that in­mates are there because they are suf­fer­ing from mental ill­ness. However, in the degree that the {{q|men­tally ill}} out­side hos­pitals numer­ically ap­proach or sur­pass those inside hos­pitals, one could say that mental pa­tients dis­tinct­ively suf­fer not from mental ill­ness, but from con­tin­gen­cies.}}<ref>ibid., p. 135.</ref> In other words, good or bad luck{{dash}}de­pend­ing on your point of view. One might debate the degree to which this whole pro­cess is {{qq|volun­tary}}{{dash}}bear­ing in mind that the indi­vidual is un­pre­pared for the nature of his future life in the hos­pital, is prob­ably living {{p|360}}in so­cially dis­tres­sing circum­stances which would have the ef­fect of making most al­tern­at­ives seem favour­able, and is sub­ject to col­lus­ive pres­sure from both relat­ives and {{qq|medi­ators}}. | ||
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+ | {{tab}}As {{w|Malatesta|Errico_Malatesta}} noted in his essay {{qq|{{l|Anarchy|http://theanarchistlibrary.org/library/errico-malatesta-anarchy}}}}, {{qq|Organs and func­tions are in­separ­able terms. Take from an organ its func­tion, and either the organ will die, or the func­tion will re­in­state itself.}} The ex­ist­ence of the mental hos­pital is just­ified by its func­tion of curing the men­tally ill. {{qq|The pa­tient{{s}} pres­ence in the hos­pital is taken as ''{{popup|prima facie|sufficient until proven otherwise}}'' evid­ence that he is men­tally ill, since the hos­pital­iza­tion of these per­sons is what the in­sti­tu­tion is for.}} A very com­mon answer to a pa­tient who claims he is sane is the state­ment: {{qq|If you aren{{t}} sick you wouldn{{t}} be in the hos­pital.}}<ref>ibid., p. 380.</ref> One con­sequence of this for the person ini­tiated into a {{qq|career}} as a mental pa­tient is that his past life will be re­struc­tured in terms of a {{qq|case history}}{{dash|and he may be denied rights of pri­vacy over what he pre­vi­ously re­garded as {{qq|his own busi­ness}}}}any facet of which may now pro­vide evid­ence of {{qq|symp­toms}}.<ref>For a re­con­struc­tion of a psy­chi­atric inter­roga­tion see {{qq|The Case Con­fer­ence}}, ''{{l|Views|https://lccn.loc.gov/sf83002178}}'', No. 11, Summer, 1966. {{w|Elias Canetti<!-- 'Elia Canetti' in original -->|Elias_Canetti}} has written that {{qq|ques­tion­ing is a for­cible in­tru­sion. When used as an in­stru­ment of power, it is like a knife cut­ting into the flesh of the vic­tim. … The most blat­ant tyranny is the one that asks the most ques­tions}} ({{w|''Crowds and Power''|Crowds_and_Power}}, Gollancz, 1962).</ref> Once inside, the pa­tient may find the in­ternal organ­isa­tion of they asylum domin­ated by a {{qq|ward system}} separ­at­ing pa­tients off into {{qq|dis­ease}} cat­egor­ies, the vari­ous levels pro­vid­ing dif­fer­ent stand­ards of ac­com­mod­a­tion, food and grounds{{-}}and{{-}}town {{qq|priv­ileges}}, among other factors of import­ance in the life of the pa­tient. The ma­terial and so­cial pro­vi­sions on each ward level are offi­cially those that are most ap­propri­ate to the mental con­di­tion of the pa­tient. But whilst the system may be just­ified by its par­tis­ans on these grounds, it has an un­ac­know­leged func­tion as an inmate{{-}}con­trol­ling device. There is a direct par­al­lel here with the al­leged pur­pose of the {{w|stream­ing|Tracking_(education)}} system in schools; in­vari­ably de­fended on the basis of its edu­ca­tional value yet actu­ally opera­ting in schools as an im­port­ant com­pon­ent of the dis­ciplin­ary system. And in asylums, as in schools, these {{qq|divide and rule}} dis­ciplin­ary strat­egies have de­veloped as the best method of {{qq|man­age­ment by a small staff of a large number of in­volun­tary in­mates}}. | ||
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+ | {{tab}}Because so­ciety needs luna­tics to pro­vide it with re­as­sur­ance of its own san­ity, so it has need of in­sti­tu­tions to con­tain them. But as with prisons, the real enemy is not the ma­terial struc­ture{{dash|{{qq|It is our own anxi­ety which forces us to lock people up}}<ref>A sen­tence of Dr. Joshua Dierer{{s}}, speak­ing at the {{w|World Federa­tion of Mental Health|World_Federation_for_Mental_Health}}, 1960 (quoted by [[Author:Colin Ward|Colin Ward]] in {{qq|[[Anarchy 4/Where the shoe pinches|Where The Shoe Pinches]]}}, [[Anarchy 4|{{sc|anarchy}} 4]]).</ref>}}and it is through anxi­ety about our own san­ity that we build walls around the {{qq|men­tally ill}}. {{qq|Mental hos­pitals are not found in our so­ciety because super­visors, psych­iatrists and at­tend­ants want jobs; mental hos­pitals are found because there is a market for them. If all the mental hos­pitals in a given region were emptied and closed down today, to­morrow relat­ives, po­lice, and judges would raise a clamour for new ones; and these true clients of the mental hos­pital would de­mand an in­sti­tu­tion to sat­isfy their needs.}}<ref>Goffman, op. cit., p. 384.</ref> | ||
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+ | '''SCHIZOPHRENIA{{dash}}A PSEUDO{{-}}DISEASE?''' | ||
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+ | {{tab}}{{qq|In the popular mind the schizo­phrenic is the proto{{-}}typical mad­man{{dash}}author of the totally gra­tu­it­ous crazy act that always has over­tones of viol­ence to others}} | ||
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+ | {{r|{{w|David Cooper|David_Cooper_(psychiatrist)}}: ''Viol­ence in Psychiatry''.}} | ||
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− | <font size="2">{{hang|{{note|aster|*}} See ''The Divided Self'', pp. 41-42. For an ac­count of the con­sequences of the ob­struc­tion of this oc­cur­rence: {{qq|an ex­ist­en­tially dead child}} see p. 183. In ''Views'', No. 8, {{w|David Cooper|David_Cooper_(psychologist)}} writes: {{qq|… the begin­ning of per­sonal de­velop­ment is never pure passiv­ity. … From the first moment of mother-<wbr>child inter­action, where each is an­other to the other, the child is in the posi­tion of having to ini­ti­ate the pro­ject to become who­ever he is to be, and this is in prin­ciple a free choice, his free crea­tion of his essen­tial nature.}} | + | <font size="2">{{hang|{{note|aster|*}} See ''The Divided Self'', pp. 41-42. For an ac­count of the con­sequences of the ob­struc­tion of this oc­cur­rence: {{qq|an ex­ist­en­tially dead child}} see p. 183. In ''{{l|Views|https://lccn.loc.gov/sf83002178}}'', No. 8, {{w|David Cooper|David_Cooper_(psychologist)}} writes: {{qq|… the begin­ning of per­sonal de­velop­ment is never pure passiv­ity. … From the first moment of mother-<wbr>child inter­action, where each is an­other to the other, the child is in the posi­tion of having to ini­ti­ate the pro­ject to become who­ever he is to be, and this is in prin­ciple a free choice, his free crea­tion of his essen­tial nature.}} |
{{note|aster2|**}}<!-- single asterisk in original --> An art­icle in {{w|''The Observer''|The_Observer}} ({{popup|4.9.66|4 September 1966}}) an­nounced the forma­tion of {{qq|Pro­ject 70}}{{dash}}{{qq|a plan to rescue men­tally normal old people from the wards of mental hos­pitals.}} | {{note|aster2|**}}<!-- single asterisk in original --> An art­icle in {{w|''The Observer''|The_Observer}} ({{popup|4.9.66|4 September 1966}}) an­nounced the forma­tion of {{qq|Pro­ject 70}}{{dash}}{{qq|a plan to rescue men­tally normal old people from the wards of mental hos­pitals.}} | ||
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[[Category:Anarchist philosophy]] | [[Category:Anarchist philosophy]] | ||
[[Category:Psychology and psychiatry]] | [[Category:Psychology and psychiatry]] | ||
+ | [[Category:Sociology]] | ||
[[Category:Articles]] | [[Category:Articles]] |
Revision as of 11:38, 1 August 2017
an introduction to
existential analysis
Dr. Laing has written that his main intellectual indebtedness is to “the existential tradition”—
In anarchy 44 J.-P. Sartre is referred to as “one of the foremost anarchist moralists” (Ian Vine: “The Morality of Anarchism”). This description compares intriguingly with another, made by the socialist Alasdair MacIntyre, reviewing Sartre’s book The Problem of Method in Peace News. He refers to Sartre as a newly found “spokesman of genius” for “ersatz bolsheviks” and “imitation anarchists”. Not knowing MacIntyre’s idea of the genuine article, this does not exactly rule the Frenchman out and I believe his work may well justify a place on an anarchist’s book list. Writing with particular reference to Sartre’s recent work, MacIntyre notes that Sartre can offer no bonds, other than reciprocally threatened violence and terror, of sufficient strength to maintain the cohesion of human groups in a world of “impossibly individualist individuals”. Perhaps a spokesman for Stirnerites? Nevertheless, the potentialities of Sartre’s philosophy as a basis for anarchism are incidental to my purpose here.
The first of four episodes of this essay are intended to create a setting against which existential analysis may be viewed.
“Man cannot be sometimes slave and sometimes free; he is wholly and forever free, or he is not free at all.”
Sartre argues against the Freudian three-
R. D. Laing has written that “only by the most outrageous violation of ourselves have we achieved our capacity to live in relative adjustment to a civilisation apparently driven to its own destruction” and has described the “normal” person in the present age as “a half-
“In the context of our present madness that we call normality, sanity, freedom, all our frames of reference are ambiguous and equivocal.”
By far the largest group is the third—
“Many of us, for quite some time have considered that problems of punishment and repression are most acute in the context of imprisonment. But this is not so; the really intractable problem in this sphere is that of the mental hospital.”
In his account of “de-institutionalisation” (anarchy 4) Colin Ward referred to the prison as “the most sinister of institutions” and no doubt it is. But as anarchists are aware, the state can make skilful use of the “approved” concepts of crime and criminality to divert attention from its own more grandiose but identical activities: so we should be alert to the possibility that the institutions openly labelled as prisons are not the only ones serving that function. Suppose, as Roger Moody says in his article that mental hospital and prison are “different terms for the same thing”? If there is some truth in this there is consequently an additional danger in that anything called a “hospital” has automatically a protective cocoon around it as a result of its claim to provide therapy. But surely the “voluntary” presence of many of the patients in mental hospitals ensures that they cannot have a punitive character or effect? A different approach is suggested by the American sociologist Erving Goffman: “… We must see the mental hospital, in the recent historical context in which it developed, as one among a network of institutions designed to provide a residence for various categories of socially troublesome people.”[16]
As Malatesta noted in his essay “Anarchy”, “Organs and functions are inseparable terms. Take from an organ its function, and either the organ will die, or the function will reinstate itself.” The existence of the mental hospital is justified by its function of curing the mentally ill. “The patient’s presence in the hospital is taken as prima facie evidence that he is mentally ill, since the hospitalization of these persons is what the institution is for.” A very common answer to a patient who claims he is sane is the statement: “If you aren’t sick you wouldn’t be in the hospital.”[18] One consequence of this for the person initiated into a “career” as a mental patient is that his past life will be restructured in terms of a “case history”—
Because society needs lunatics to provide it with reassurance of its own sanity, so it has need of institutions to contain them. But as with prisons, the real enemy is not the material structure—
SCHIZOPHRENIA—
“In the popular mind the schizophrenic is the proto-typical madman—
** An article in The Observer (4.9.66) announced the formation of “Project 70”—
*** This may be an allusion to a case which was receiving some publicity at that time. Zenya Belov, a student, was confined in a Russian mental institution around September, 1965—
David Cooper, “Sartre on Genet”, New Left Review, No. 25.
R. D. Laing, The Politics of Experience and the Bird of Paradise, Penguin Books, Autumn, 1966.
R. D. Laing, H. Phillipson, A. R. Lee, Interpersonal Perception: A Theory and a Method, London, Tavistock, 1966.
T. S. Szasz, The Myth of Mental Illness, London, Seeker and Warburg, 1962.
Carl R. Rogers, On Becoming a Person, London, Constable & Co., 1961.
<references>
- ↑ Robert G. Olson, An Introduction to Existentialism, New York, Dover Publications, 1962, p. 52.
- ↑ ibid., p. 105 (a reference to an episode in Being and Nothingness, p. 495).
- ↑ J.-P. Sartre, Situations III, Paris, Gallimard, 1949 (quoted by Olson, p. 121).
- ↑ Olson, op. cit., p. 119.
- ↑ Sartre J.-P. Sartre, Being and Nothingness, London, Methuen, 1956, pp. 461-2.
- ↑ ibid., pp. 471-75 (quoted by Olson, p. 121).
- ↑ The first part of R. D. Laing’s The Self and Others is a lucid argument against the basic concepts of traditional psycho-
analysis. - ↑ “Massacre of the Innocents”, Peace News, 22nd January, 1965.
- ↑ BBC “Panorama” on “Mental Health”, 6th June, 1966.
- ↑ David Cooper, “The Anti-Hospital: An Experiment in Psychiatry”, New Society, 11th March, 1965.
- ↑ David Cooper, “Violence in Psychiatry”, Views, No. 8, Summer, 1965.
- ↑ ibid.
- ↑ Part of a letter by Pierre-Joseph Brie, “Insanity and the Egg”, Peace News, 1st July, 1966.
- ↑ T. S. Szasz, “Politics and Mental Health”, American Journal of Psychiatry, No. 115 (1958) (quoted by Erving Goffman in Asylums, p. 509).
- ↑ Erving Goffman, <span data-html="true" class="plainlinks" title="Wikipedia: Asylums—
Essays on the Social Situation of Mental Patients and Other Inmates">Asylums— Essays on the Social Situation of Mental Patients and Other Inmates, New York, Anchor Books, 1961, pp. 363-4. - ↑ ibid., p. 354.
- ↑ ibid., p. 135.
- ↑ ibid., p. 380.
- ↑ For a reconstruction of a psychiatric interrogation see “The Case Conference”, Views, No. 11, Summer, 1966. Elias Canetti has written that “questioning is a forcible intrusion. When used as an instrument of power, it is like a knife cutting into the flesh of the victim. … The most blatant tyranny is the one that asks the most questions” (Crowds and Power, Gollancz, 1962).
- ↑ A sentence of Dr. Joshua Dierer’s, speaking at the World Federation of Mental Health, 1960 (quoted by Colin Ward in “Where The Shoe Pinches”, anarchy 4).
- ↑ Goffman, op. cit., p. 384.