The quandary over mental illness.

• Author: Vatz, Richard E.
• Position: Psychology

IN 2001, there was an important event concerning the decades-old struggle between critics of psychiatry and worldwide institutional psychiatry. The Fifth International Russell Tribunal on Human Rights in Psychiatry--of which the author was a member of the jury--a concept based on the Vietnam War Crimes Tribunal of the 1960s, heard accusations regarding the historical, legal, and rhetorical abuses of human rights committed in the name of psychiatry, particularly in the mid 20th century.

Individuals who believed they were victimized by psychiatric coercion provided testimony relevant to their experiences, which consisted of events regarding forced drugging, electroshock, involuntary hospitalization, etc. The accused (international psychiatry), which could be construed as establishmentarian institutional psychiatry, was not represented at the hearings.

The findings of the Tribunal's jury concluded with the statement, "We find psychiatry guilty of the combination of force and unaccountability, a classic definition of totalitarian systems. Compensation should be made for harms ... done. Public funds should be made available for humane and dignified alternatives to coercive psychiatry."

Some of the hearings would have been protested as an anachronism by representatives of American psychiatry. Indeed, the verdict represented a compromise worked out by the disparate members of the jury.

In the present-day U.S., there are millions who have engaged in talk therapy, as well as 20,000,000 or so who are using--or have used--Prozac, other selective serotonin reuptake inhibitors, and various psychoactive drugs through prescription. This widespread usage constitutes the normalization of pharmacological mood enhancers; normalization marked by the extensive prescribing of these drugs, often by nonpsychiatric physicians, arguably, in some cases, merely for the enhanced happiness of their users. This is called cosmetic psychopharmacology, a term coined by psychiatrist Peter Kramer in his landmark work, Listening to Prozac.

This brave new world hardly puts to rest the tension among those who dispute the concept, if not the experience, of mental illness. Even some traditional psychiatrists deplore the casual use of pharmacological measures to solve the problem in living that are an inescapable part of life. The battles between mental health advocates and critics generally seem not only to be endless, but completely irresolvable.

We wish to stipulate that, by the following attempt at a partial meeting of the minds, if not a rapprochement, between psychiatry and its critics, we do not include many in the latter group often referred to as "anti-psychiatry." Although, at times, the amorphous anti-psychiatric movement is depicted by some as including almost anyone critical of psychiatry, the term is more accurately associated specifically with the late R.D. Laing and, to a lesser degree, with David Cooper (who invented the term) as well as Gregory Bateson.

Szasz steps up

Thomas Szasz, who often is erroneously labeled as personifying anti-psychiatry, promotes views that are, in fact, antithetical to some of the seminal views held by authentic anti-psychiatry scholars. Szasz's positions correctly are distinguished from those of the anti-psychiatry movement by his conservatism and belief in individual responsibility and control, and it is that perspective of psychiatric criticism for which we are trying to create a limited reconciliation. The views of Szasz, Peter Breggin, Ron Leifer, Jeffrey Schaler, and others are not all, we maintain, completely irreconcilable with each and every view of modern-day psychiatry.

[Before we procede further, however, let us be clear: Szasz is a personal friend and subject of a book of ours, but he was not consulted regarding this piece, nor has he approved any of the text which follows.]

The major tenets of...