Anti-psychiatry is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients. It considers psychiatry a coercive instrument of oppression due to an unequal power relationship between doctor and patient and a highly subjective diagnostic process. It has been active in various forms for two centuries.[1][2]

Anti-psychiatry originates in an objection to what some view as dangerous treatments.[2] Examples include electroconvulsive therapy, insulin shock therapy, and brain lobotomy.[2] An immediate concern is the significant increase in prescribing psychiatric drugs for children.[1][2] There were also concerns about mental health institutions. All modern societies permit involuntary treatment or involuntary commitment of mental patients.[1]

In the 1960s, there were many challenges to psychoanalysis and mainstream psychiatry, where the very basis of psychiatric practice was characterized as repressive and controlling. Psychiatrists involved in this challenge included Jacques Lacan, Thomas Szasz, Giorgio Antonucci, R. D. Laing, Franco Basaglia, Theodore Lidz, Silvano Arieti, and David Cooper. Others involved were Michel Foucault and Erving Goffman. Cooper coined the term "anti-psychiatry" in 1967, and wrote the book Psychiatry and Anti-psychiatry in 1971.[1][2][3] Thomas Szasz introduced the definition of mental illness as a myth in the book The Myth of Mental Illness (1961), Giorgio Antonucci introduced the definition of psychiatry as a prejudice in the book I pregiudizi e la conoscenza critica alla psichiatria (1986).

Contemporary issues of anti-psychiatry include freedom versus coercion, racial and social justice, iatrogenic effects of antipsychotic medications (unintentionally induced by medical therapy), personal liberty, social stigma, and the right to be different. Critics of anti-psychiatry accept that psychiatry has issues which need addressing, but that the abolition of psychiatry is not a valid option.



The first widespread challenge to the prevailing medical approach in Western countries occurred in the late 18th century.[4] Part of the progressive Age of Enlightenment, a "moral treatment" movement challenged the harsh, pessimistic, somatic (body-based) and restraint-based approaches that prevailed in the system of hospitals and "madhouses" for people considered mentally disturbed, who were generally seen as wild animals without reason.[4] Alternatives were developed, led in different regions by ex-patient staff, physicians themselves in some cases, and religious and lay philanthropists.[4] The moral treatment was seen as pioneering more humane psychological and social approaches, whether or not in medical settings; however, it also involved some use of physical restraints, threats of punishment, and personal and social methods of control.[4] And as it became the establishment approach in the 19th century, opposition to its negative aspects also grew.[4]

According to Michel Foucault, there was a shift in the perception of madness, whereby it came to be seen as less about delusion, i.e. disturbed judgment about the truth, than about a disorder of regular, normal behaviour or will.[5] Foucault argued that, prior to this, doctors could often prescribe travel, rest, walking, retirement and generally engaging with nature, seen as the visible form of truth, as a means to break with artificialities of the world (and therefore delusions).[6] Another form of treatment involved nature's opposite, the theatre, where the patient's madness was acted out for him or her in such a way that the delusion would reveal itself to the patient.


Close up of the "Horrors of Kew Asylum" featured in Lee's Pictorial Weekly Budget Police News in 1876

The techniques and procedures of the asylums at this time included "isolation, private or public interrogations, punishment techniques such as cold showers, moral talks (encouragements or reprimands), strict discipline, compulsory work, rewards, preferential relations between the physician and his patients, relations of vassalage, of possession, of domesticity, even of servitude between patient and physician at times".[7] Foucault summarised these as "designed to make the medical personage the 'master of madness'"[7] through the power the physician's will exerts on the patient. The effect of this shift then served to inflate the power of the physician relative to the patient, correlated with the rapid rise of internment (asylums and forced detention).[8]

The Woodilee Hospital was opened in 1875 in Scotland


Internee being restrained in a bathtub
Internee in a restraint chair at the West Riding Pauper Lunatic Asylum

Various 19th-century critiques of the newly emerging field of psychiatry overlap thematically with 20th-century anti-psychiatry, for example in their questioning of the medicalisation of "madness". Those critiques occurred at a time when physicians had not yet achieved hegemony through psychiatry, however, so there was no single, unified force to oppose.[10] Nevertheless, there was increasing concern at the ease with which people could be confined, with frequent reports of abuse and illegal confinement. For example, Daniel Defoe, the author of Robinson Crusoe, had previously argued for more government oversight of "madhouses" and for due process prior to involuntary internment.[11] He later argued that husbands used asylum hospitals to incarcerate their disobedient wives,[12] and in a subsequent pamphlet that wives even did the same to their husbands.[13] It was also proposed that the role of asylum keeper be separated from doctor, to discourage exploitation of patients.[14] There was general concern that physicians were undermining personhood by medicalizing problems, by claiming they alone had the expertise to judge it, and by arguing that mental disorder was physical and hereditary. The Alleged Lunatics' Friend Society arose in England in the mid-19th century to challenge the system and campaign for rights and reforms.[15] In the United States, Elizabeth Packard published a series of books and pamphlets describing her experiences in the Illinois insane asylum to which her husband had had her committed.


As psychiatry became more professionally established during the nineteenth century (the term itself was coined in 1808 in Germany, as "Psychiatriein") and developed allegedly more invasive treatments, opposition increased.[17] In the Southern US, black slaves and abolitionists encountered Drapetomania, a pseudo-scientific diagnosis for why slaves ran away from their masters.[18]


Early 1900s


His reliance on rich donors and his need for approval from experts led him to hand over to psychiatrists the organization he helped found, the National Committee for Mental Hygiene which eventually became the National Mental Health Association.[16] In the UK, the National Society for Lunacy Law Reform was established in 1920 by angry ex-patients who sought justice for abuses committed in psychiatric custody, and were aggrieved that their complaints were patronisingly discounted by the authorities, who were seen to value the availability of medicalized internment as a 'whitewashed' extrajudicial custodial and punitive process.[20] In 1922, ex-patient Rachel Grant-Smith added to calls for reform of the system of neglect and abuse she had suffered by publishing "The Experiences of an Asylum Patient".[21] In the US, We Are Not Alone (WANA) was founded by a group of patients at Rockland State Hospital in New York, and continued to meet as an ex-patient group.[22]


In this era before penicillin was discovered, eugenics was popular. People believed diseases of the mind could be passed on so compulsory sterilization of the mentally ill was enacted in many countries.

Early 1930s


Holocaust historians argued that the medicalization of social programs and systematic euthanasia of people in German mental institutions in the 1930s provided the institutional, procedural, and doctrinal origins of the mass murder of the 1940s. The Nazi programs were called Action T4 and Action 14f13.[24][25][26] The Nuremberg Trials convicted a number of psychiatrists who held key positions in Nazi regimes. For instance this idea of a Swiss psychiatrist: "A not so easy question to be answered is whether it should be allowed to destroy lives objectively 'unworthy of living' without the expressed request of its bearers. (...) Even in incurable mentally ill ones suffering seriously from hallucinations and melancholic depressions and not being able to act, to a medical colleague I would ascript the right and in serious cases the duty to shorten — often for many years — the suffering" (Bleuler, Eugen, 1936: "Die naturwissenschaftliche Grundlage der Ethik". Schweizer Archiv Neurologie und Psychiatrie, Band 38, Nr.2, S. 206).

1940s and 1950s



Graveyard attached to the Church of St. Thomas in West Yorkshire, England, where thousands of internees from Storthes Hall rest in unmarked graves

In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, slowly came into use. Although often accepted as an advance in some ways, there was opposition, partly due to serious adverse effects such as tardive dyskinesia, and partly due their "chemical straitjacket" effect and their alleged use to control and intimidate patients.[23] Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control.[23] There was also increasing opposition to the large-scale use of psychiatric hospitals and institutions, and attempts were made to develop services in the community.[citation needed]

In 1950, Scientology was founded by L. Ron Hubbard who publicly stated a goal of "eradicating psychiatry from the face of this earth". Instead through his book Dianetics: The Modern Science of Mental Health the discredited use of introspection as treatment as well as auditing was promoted.[29]

The Royal Earlswood Asylum for Idiots was the first hospital for people with learning disabilities, led by Lord Palmerston, Baron Rothschild and Lord Ashley in the 1850s






"In the 1960s fresh voices mounted a new challenge to the pretensions of psychiatry as a science and the mental health system as a successful humanitarian enterprise. These voices included: Ernest Becker, Erving Goffman, R.D. Laing; Laing and Aaron Esterson, Thomas Scheff, and Thomas Szasz. Their writings, along with others such as articles in the journal The Radical Therapist, were given the umbrella label "antipsychiatry" despite wide divergences in philosophy. This critical literature, in concert with an activist movement, emphasized the hegemony of medical model psychiatry, its spurious sources of authority, its mystification of human problems, and the more oppressive practices of the mental health system, such as involuntary hospitalisation, drugging, and electroshock".[31]


Laing, through the Philadelphia Association founded with Cooper in 1965, set up over 20 therapeutic communities including Kingsley Hall, where staff and residents theoretically assumed equal status and any medication used was voluntary. Non-psychiatric Soteria houses, starting in the United States, were also developed[32] as were various ex-patient-led services.




Since 1970

Scientologists on an anti-psychiatry demonstration.


Psychoanalysis was increasingly criticized as unscientific or harmful.[37] Contrary to the popular view, critics and biographers of Freud, such as Alice Miller, Jeffrey Masson and Louis Breger, argued that Freud did not grasp the nature of psychological trauma. Non-medical collaborative services were developed, for example therapeutic communities or Soteria houses.








  1. ^ a b c d e Tom Burns (2006). Psychiatry: A very short introduction. Oxford University Press. pp. 93–99. 
  2. ^ a b c d e f Henry A. Nasrallah (December 2011). "The antipsychiatry movement: Who and why" (PDF). Current Psychiatry. 
  4. ^ a b c d e Cite error: The named reference Dain 1994 was invoked but never defined (see the help page).
  5. ^ Foucault (1997), pp. 39-50
  6. ^ Foucault (1997), p. 42
  8. ^ De la Folie: in Foucault (1997), p. 44.
  10. ^ a b Crossley, Nick (1 October 1998). "R. D. Laing and the British anti-psychiatry movement: a socio–historical analysis". Social Science & Medicine. 47 (7): 877–889. doi:10.1016/S0277-9536(98)00147-6. 
  11. ^ Defoe, Daniel (1697). An Essay upon Projects. London: Cockerill
  12. ^ Defoe, Daniel (1728). Augusta Triumphans: Or, The Way To Make London The Most Flourishing City In The Universe.
  13. ^ Defoe, Daniel (1740) quoted in Somasundaram, O (2008). "Private psychiatric care in the past: With special reference to Chennai". Indian Journal of Psychiatry. 50 (1): 67–69. doi:10.4103/0019-5545.39765. PMC 2745864Freely accessible. PMID 19771313. 
  14. ^ Faulkner, B. (1789). Observation on the General and Improper Treatment of Insanity. London
  15. ^ Hervey N (July 1986). "Advocacy or folly: the Alleged Lunatics' Friend Society, 1845–63". Medical History. 30 (3): 245–275. doi:10.1017/S0025727300045701. PMC 1139650Freely accessible. PMID 3523075. 
  16. ^ a b c d e Dain, N. (1989). "Critics and dissenters: Reflections on anti-psychiatry in the United States". Journal of the History of the Behavioral Sciences. 25 (1): 3–25. doi:10.1002/1520-6696(198901)25:1<3::AID-JHBS2300250102>3.0.CO;2-G. PMID 2647837. 
  22. ^ Reaume, G (July 2002). "Lunatic to patient to person: nomenclature in psychiatric history and the influence of patients' activism in North America". Int J Law Psychiatry. 25 (4): 405–26. doi:10.1016/S0160-2527(02)00130-9. PMID 12613052. 
  25. ^ "The Psychiatric Holocaust – excerpts". 
  26. ^ Strous, Rael (2007). "Psychiatry during the Nazi era: ethical lessons for the modern professional". Annals of General Psychiatry. 6 (8): 8. doi:10.1186/1744-859X-6-8. PMC 1828151Freely accessible. PMID 17326822. 
  27. ^ Nasser, Mervat (1995). "The rise and fall of anti-psychiatry". Psychiatric Bulletin. 19 (12): 743–746. doi:10.1192/pb.19.12.743. 
  29. ^ Desai, Nimesh G. (2005). "Antipsychiatry: Meeting the challenge". Indian Journal of Psychiatry. 47 (4): 185–187. doi:10.4103/0019-5545.43048. ISSN 0019-5545. PMC 2921130Freely accessible. PMID 20711302. 
  31. ^ Ken Barney, Limitations of the Critique of the Medical Model, The Journal of Mind and Behaviour, Winter and Spring 1994. Volume 15. Numbers 1 and 2, Pages 19-34.
  32. ^ Calton, T; Ferriter, M; Huband, N; Spandler, H (Jan 2008). "A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia". Schizophrenia Bullutin. 34 (1): 181–92. doi:10.1093/schbul/sbm047. PMC 2632384Freely accessible. PMID 17573357. 
  33. ^ Szasz, T. (1960). "The Myth of Mental Illness". American Psychologist. 15 (2): 113–118. doi:10.1037/h0046535. 
  34. ^ D Summerfield (March 2001). "Does psychiatry stigmatize?" (PDF). J R Soc Med. 94 (3): 148–149. PMC 1297937Freely accessible. PMID 11285802. 
  36. ^ Douglas A. Smith (December 19, 1999). "Why Outpatient Commitment Laws Change (Almost) Nothing". Antipsychiatry.org. [unreliable source?]
  40. ^ "DACIA MARAINI INTERVIEWS GIORGIO ANTONUCCI" (in Italian). Retrieved 2014-01-13. 

Challenges to psychiatry

Civilization as a cause of distress

In recent years, psychotherapists David Smail and Bruce E. Levine, considered part of the anti-psychiatry movement, have written widely on how society, culture, politics and psychology intersect. They have written extensively of the "embodied nature" of the individual in society, and the unwillingness of even therapists to acknowledge the obvious part played by power and financial interest in modern Western society. They argue that feelings and emotions are not, as is commonly supposed, features of the individual, but rather responses of the individual to their situation in society. Even psychotherapy, they suggest, can only change feelings in as much as it helps a person to change the "proximal" and "distal" influences on their life, which range from family and friends, to the workplace, socio-economics, politics and culture.[1][2]

R. D. Laing emphasized family nexus as a mechanism whereby individuals become victimized by those around them, and spoke about a dysfunctional society.[3][4][5]

Inadequacy of clinical interviews used to diagnose 'diseases'

An etiology common to bipolar spectrum disorders has not been identified. Patients cannot be identified just by clinical interviews. A neurobiological basis of bipolar disorder has not been discovered. In making a bipolar spectrum disorder diagnosis based solely on a clinical interview, a false positive cannot be avoided.

Psychiatrists have been trying to differentiate mental disorders based on clinical interviews since the era of Kraepelin, but now realize that their diagnostic criteria are imperfect. Tadafumi Kato writes, "We psychiatrists should be aware that we cannot identify 'diseases' only by interviews. What we are doing now is just like trying to diagnose diabetes mellitus without measuring blood sugar."[6]

Normality and illness judgments



Reasons have been put forward to doubt the ontic status of mental disorders.[8]:13 Mental disorders engender ontological skepticism on three levels:





Psychiatric labeling


Mental disorders were first included in the sixth revision of the International Classification of Diseases (ICD-6) in 1949.[13] Three years later, the American Psychiatric Association created its own classification system, DSM-I.[13] The definitions of most psychiatric diagnoses consist of combinations of phenomenological criteria, such as symptoms and signs and their course over time.[13] Expert committees combined them in variable ways into categories of mental disorders, defined and redefined them again and again over the last half century.[13]

The majority of these diagnostic categories are called "disorders" and are not validated by biological criteria, as most medical diseases are; although they purport to represent medical diseases and take the form of medical diagnoses.[13] These diagnostic categories are actually embedded in top-down classifications, similar to the early botanic classifications of plants in the 17th and 18th centuries, when experts decided a priori about which classification criterion to use, for instance, whether the shape of leaves or fruiting bodies were the main criterion for classifying plants.[13] Since the era of Kraepelin, psychiatrists have been trying to differentiate mental disorders by using clinical interviews.[6]

Experiments admitting "healthy" individuals into psychiatric care


Critics such as Robert Spitzer placed doubt on the validity and credibility of the study, but did concede that the consistency of psychiatric diagnoses needed improvement.[15] It is now realized that the psychiatric diagnostic criteria are not perfect. To further refine psychiatric diagnosis, according to Tadafumi Kato, the only way is to create a new classification of diseases based on the neurobiological features of each mental disorder.[6] On the other hand, according to Heinz Katsching, neurologists are advising psychiatrists just to replace the term "mental illness" by "brain illness."[13]

There are recognized problems regarding the diagnostic reliability and validity of mainstream psychiatric diagnoses, both in ideal and controlled circumstances[16] and even more so in routine clinical practice (McGorry et al.. 1995).[17] Criteria in the principal diagnostic manuals, the DSM and ICD, are inconsistent.[18] Some psychiatrists who criticize their own profession say that comorbidity, when an individual meets criteria for two or more disorders, is the rule rather than the exception. There is much overlap and vaguely defined or changeable boundaries between what psychiatrists claim are distinct illness states.[19]


Tool of social control

Whitchurch Hospital.


In the opinion of Mike Fitzpatrick, the pressure for medicalization also comes from society itself. As one example, Fitzpatrick claims that feminists who once opposed state intervention as oppressive and patriarchal, now demand more coercive and intrusive measures to deal with child abuse and domestic violence.[23] According to Richard Gosden, the use of psychiatry as a tool of social control is becoming obvious in preventive medicine programmes for various mental diseases.[24]:14 These programmes are intended to identify children and young people with divergent behavioral patterns and thinking and send them to treatment before their supposed mental diseases develop.[24]:14 Clinical guidelines for best practice in Australia include the risk factors and signs which can be used to detect young people who are in need of prophylactic drug treatment to prevent the development of schizophrenia and other psychotic conditions.[24]:14

Psychiatry and the pharmaceutical industry



On the other hand, organizations such as MindFreedom International and World Network of Users and Survivors of Psychiatry maintain that psychiatrists exaggerate the evidence of medication and minimize the evidence of adverse drug reaction. They and other activists believe individuals are not given balanced information, and that current psychiatric medications do not appear to be specific to particular disorders in the way mainstream psychiatry asserts;[26] and psychiatric drugs not only fail to correct measurable chemical imbalances in the brain, but rather induce undesirable side effects. For example, though children on Ritalin and other psycho-stimulants become more obedient to parents and teachers,[27] critics have noted that they can also develop abnormal movements such as tics, spasms and other involuntary movements.[28] This has not been shown to be directly related to the therapeutic use of stimulants, but to neuroleptics.[29][30] The diagnosis of attention deficit hyperactivity disorder on the basis of inattention to compulsory schooling also raises critics' concerns regarding the use of psychoactive drugs as a means of unjust social control of children.[27]


There is evidence that research findings and the prescribing of drugs are influenced as a result. A United Kingdom cross-party parliamentary inquiry into the influence of the pharmaceutical industry in 2005 concludes: "The influence of the pharmaceutical industry is such that it dominates clinical practice"[33] and that there are serious regulatory failings resulting in "the unsafe use of drugs; and the increasing medicalization of society".[34] The campaign organization No Free Lunch details the prevalent acceptance by medical professionals of free gifts from pharmaceutical companies and the effect on psychiatric practice.[35] The ghostwriting of articles by pharmaceutical company officials, which are then presented by esteemed psychiatrists, has also been highlighted.[36] Systematic reviews have found that trials of psychiatric drugs that are conducted with pharmaceutical funding are several times more likely to report positive findings than studies without such funding.[37]

The number of psychiatric drug prescriptions have been increasing at an extremely high rate since the 1950s and show no sign of abating.[38] In the United States antidepressants and tranquilizers are now the top selling class of prescription drugs, and neuroleptics and other psychiatric drugs also rank near the top, all with expanding sales.[37] As a solution to the apparent conflict of interests, critics propose legislation to separate the pharmaceutical industry from the psychiatric profession.


Electroconvulsive therapy




Political abuse of psychiatry

The psychiatric ward at Guantanamo Bay.

Psychiatrists around the world have been involved in the suppression of individual rights by states wherein the definitions of mental disease had been expanded to include political disobedience.[44]:6 Nowadays, in many countries, political prisoners are sometimes confined to mental institutions and abused therein.[45]:3 Psychiatry possesses a built-in capacity for abuse which is greater than in other areas of medicine.[46]:65 The diagnosis of mental disease can serve as proxy for the designation of social dissidents, allowing the state to hold persons against their will and to insist upon therapies that work in favour of ideological conformity and in the broader interests of society.[46]:65 In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials.[46]:65

Under the Nazi regime in the 1940s, the 'duty to care' was violated on an enormous scale.[47] In Germany alone 300,000 individuals that had been deemed mentally ill, work-shy or feeble-minded were sterilized. An additional 200,000 were euthanized.[48] These practices continued in territories occupied by the Nazis further afield (mainly in eastern Europe), affecting thousands more.[49] From the 1960s up to 1986, political abuse of psychiatry was reported to be systematic in the Soviet Union, and to surface on occasion in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia.[46]:66 A "mental health genocide" reminiscent of the Nazi aberrations has been located in the history of South African oppression during the apartheid era.[50] A continued misappropriation of the discipline was subsequently attributed to the People's Republic of China.[51]

K. Fulford, A. Smirnov, and E. Snow state: "An important vulnerability factor, therefore, for the abuse of psychiatry, is the subjective nature of the observations on which psychiatric diagnosis currently depends."[52] In an article published in 1994 by American psychiatrist Thomas Szasz on the Journal of Medical Ethics he stated that "the classification by slave owners and slave traders of certain individuals as Negroes was scientific, in the sense that whites were rarely classified as blacks. But that did not prevent the 'abuse' of such racial classification, because (what we call) its abuse was, in fact, its use."[53] Szasz argued that the spectacle of the Western psychiatrists loudly condemning Soviet colleagues for their abuse of professional standards was largely an exercise in hypocrisy.[24]:220[53] Szasz states that K. Fulford, A. Smirnov, and E. Snow, who correctly emphasize the value-laden nature of psychiatric diagnoses and the subjective character of psychiatric classifications, fail to accept the role of psychiatric power.[53] He stated that psychiatric abuse, such as people usually associated with practices in the former USSR, was connected not with the misuse of psychiatric diagnoses, but with the political power built into the social role of the psychiatrist in democratic and totalitarian societies alike.[24]:220[53] Musicologists, drama critics, art historians, and many other scholars also create their own subjective classifications; however, lacking state-legitimated power over persons, their classifications do not lead to anyone’s being deprived of property, liberty, or life.[53] For instance, plastic surgeon’s classification of beauty is subjective, but the plastic surgeon cannot treat his or her patient without the patient’s consent, therefore, there cannot be any political abuse of plastic surgery.[53]

The bedrock of political medicine is coercion masquerading as medical treatment.[54]:497 What transforms coercion into therapy are physicians diagnosing the person’s condition an "illness," declaring the intervention they impose on the victim a "treatment," and legislators and judges legitimating these categorizations as "illnesses" and "treatments."[54]:497 In the same way, physician-eugenicists advocated killing certain disabled or ill persons as a form of treatment for both society and patient long before the Nazis came to power.[54]:497[55]

From the commencement of his political career, Hitler put his struggle against "enemies of the state" in medical rhetoric.[54]:502 In 1934, addressing the Reichstag, Hitler declared, "I gave the order… to burn out down to the raw flesh the ulcers of our internal well-poisoning."[54]:502[56]:494 The entire German nation and its National Socialist politicians learned to think and speak in such terms.[54]:502 Werner Best, Reinhard Heydrich’s deputy, stated that the task of the police was "to root out all symptoms of disease and germs of destruction that threatened the political health of the nation… [In addition to Jews,] most [of the germs] were weak, unpopular and marginalized groups, such as gypsies, homosexuals, beggars, 'antisocials', 'work-shy', and 'habitual criminals'."[54]:502[56]:541

In spite of all the evidence, people underappreciate or, more often, ignore the political implications of the therapeutic character of Nazism and of the use of medical metaphors in modern democracies.[54]:503 Dismissed as an "abuse of psychiatry", this practice is a touchy subject not because the story makes psychiatrists in Nazi Germany look bad, but because it highlights the dramatic similarities between pharmacratic controls in Germany under Nazism and those that have emerged in the US under the free market economy.[54]:503[57]

The Swiss lawyer Edmund Schönenberger claims that the strongholds of psychiatry have absolutely nothing to do with “care”, the law or justice – instead, they are nothing other than instruments of domination. Fundamental criticism of coercive psychiatry

"Therapeutic state"

The "therapeutic state" is a phrase coined by Szasz in 1963.[58] The collaboration between psychiatry and government leads to what Szasz calls the "therapeutic state", a system in which disapproved actions, thoughts, and emotions are repressed ("cured") through pseudomedical interventions.[59][60]:17 Thus suicide, unconventional religious beliefs, racial bigotry, unhappiness, anxiety, shyness, sexual promiscuity, shoplifting, gambling, overeating, smoking, and illegal drug use are all considered symptoms or illnesses that need to be cured.[60]:17 When faced with demands for measures to curtail smoking in public, binge-drinking, gambling or obesity, ministers say that "we must guard against charges of nanny statism".[23] The "nanny state" has turned into the "therapeutic state" where nanny has given way to counselor.[23] Nanny just told people what to do; counselors also tell them what to think and what to feel.[23] The "nanny state" was punitive, austere, and authoritarian, the therapeutic state is touchy-feely, supportive—and even more authoritarian.[23] According to Szasz, "the therapeutic state swallows up everything human on the seemingly rational ground that nothing falls outside the province of health and medicine, just as the theological state had swallowed up everything human on the perfectly rational ground that nothing falls outside the province of God and religion".[54]:515


Civil libertarians warn that the marriage of the State with psychiatry could have catastrophic consequences for civilization.[61] In the same vein as the separation of church and state, Szasz believes that a solid wall must exist between psychiatry and the State.[54]

"Total institution"

In his book Asylums, Erving Goffman coined the term 'total institution' for mental hospitals and similar places which took over and confined a person's whole life.[62]:150[63]:9 Goffman placed psychiatric hospitals in the same category as concentration camps, prisons, military organizations, orphanages, and monasteries.[64] In Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone 'dull, harmless and inconspicuous'; it in turn reinforces notions of chronicity in severe mental illness.[65]


While the insanity defense is the subject of controversy as a viable excuse for wrongdoing, Szasz and other critics contend that being committed in a psychiatric hospital can be worse than criminal imprisonment, since it involves the risk of compulsory medication with neuroleptics or the use of electroshock treatment.[66][67] Moreover, while a criminal imprisonment has a predetermined and known time of duration, patients are typically committed to psychiatric hospitals for indefinite durations, an unjust and arguably outrageous imposition of fundamental uncertainty.[68] It has been argued that such uncertainty risks aggravating mental instability, and that it substantially encourages a lapse into hopelessness and acceptance that precludes recovery.

Involuntary hospitalization




Psychiatry as pseudoscience and failed enterprise

Many of the above issues lead to the claim that psychiatry is a pseudoscience.[72] According to some philosophers of science, for a theory to qualify as science it needs to exhibit the following characteristics:

  • empirically testable and falsifiable (see Falsifiability);



Diverse paths








Critics of this view, however, from an anti-psychiatry perspective, are quick to point to the industrial aspects of psychiatric treatment itself as a primary causal factor in this situation that is described as "deteriorating". The numbers of people labeled "mentally ill", and in treatment, together with the severity of their conditions, have been going up primarily due to the direct efforts of the mental health movement, and mental health professionals, including psychiatrists, and not their detractors. Envisioning "mental health treatment" as violence prevention has been a big part of the problem, especially as you are dealing with a population that is not significantly more violent than any other group and, in fact, are less so than many.

On October 7, 2016, the Ontario Institute for Studies in Education (OISE) at the University of Toronto announced that they had established a scholarship for students doing theses in the area of antipsychiatry. Called “The Bonnie Burstow Scholarship in Antipsychiatry,” it is to be awarded annually to an OISE thesis student. An unprecedented step, the scholarship should further the cause of freedom of thought and the exchange of ideas in academia. The scholarship is named in honor of Bonnie Burstow, a faculty member at the University of Toronto, a radical feminist, and an antipsychiatry activist. She is also the author of Psychiatry and the Business of Madness (2015).


With the decline of industrial age psychiatric hospitals, efforts to rehabilitate them have begun, like the Traverse City State Hospital becoming the Village at Grand Traverse Commons, complete with homes, offices, and businesses, including a wine bar[84]

In the meantime, members of the psychiatric consumer/survivor movement continued to campaign for reform, empowerment and alternatives, with an increasingly diverse representation of views. Groups often have been opposed and undermined, especially when they proclaim to be, or when they are labelled as being, "anti-psychiatry".[85] However, as of the 1990s, more than 60 percent of ex-patient groups reportedly support anti-psychiatry beliefs and consider themselves to be "psychiatric survivors".[86] Although anti-psychiatry is often attributed to a few famous figures in psychiatry or academia, it has been pointed out that consumer/survivor/ex-patient individuals and groups preceded it, drove it and carried on through it.[87]



Criticism of antipsychiatry from within psychiatry itself object to the underlying principle that psychiatry is by definition harmful. Most psychiatrists accept that issues exist that need addressing, but that the abolition of psychiatry is harmful. Nimesh Desai concludes: "To be a believer and a practitioner of multidisciplinary mental health, it is not necessary to reject the medical model as one of the basics of psychiatry." and admits "Some of the challenges and dangers to psychiatry are not so much from the avowed antipsychiatrists, but from the misplaced and misguided individuals and groups in related fields."[88]

See also


  2. ^ a b c d "Bruce E. Levine's columns".  at AlterNet
  3. ^ Fadul, Jose, ed. (2014). "Anti-psychiatry". Encyclopedia of Theory & Practice in Psychotherapy & Counseling. Lulu Press Inc. ISBN 978-1-312-07836-9. 
  6. ^ a b c Kato, Tadafumi (October 2011). "A renovation of psychiatry is needed". World Psychiatry. World Psychiatric Association. 10 (3): 198–199. doi:10.1002/j.2051-5545.2011.tb00056.x. PMC 3188773Freely accessible. PMID 21991278. 
  8. ^ a b Phillips, James; Frances, A; Cerullo, MA; Chardavoyne, J; Decker, HS; First, MB; Ghaemi, N; Greenberg, G; Hinderliter, AC; et al. (January 13, 2012). "The Six Most Essential Questions in Psychiatric Diagnosis: A Pluralogue. Part 1: Conceptual and Definitional Issues in Psychiatric Diagnosis" (PDF). Philosophy, Ethics, and Humanities in Medicine. BioMed Central. 7 (3): 1–51. doi:10.1186/1747-5341-7-3. ISSN 1747-5341. PMC 3305603Freely accessible. PMID 22243994. Retrieved 24 January 2012. 
  9. ^ Berrios G E (April 1999). "Classifications in psychiatry: a conceptual history". Aust N Z J Psychiatry. 33 (2): 145–60. doi:10.1046/j.1440-1614.1999.00555.x. PMID 10336212. 
  13. ^ a b c d e f g Katsching, Heinz (February 2010). "Are psychiatrists an endangered species? Observations on internal and external challenges to the profession". World Psychiatry. World Psychiatric Association. 9 (1): 21–28. doi:10.1002/j.2051-5545.2010.tb00257.x. PMC 2816922Freely accessible. PMID 20148149. 
  14. ^ a b Rosenhan D (1973). "On being sane in insane places". Science. 179 (4070): 250–258. Bibcode:1973Sci...179..250R. doi:10.1126/science.179.4070.250. PMID 4683124. (Subscription required (help)).  (URL given leads to abstract of study)
  15. ^ Spitzer R.L.; Lilienfeld S.O.; Miller M.B. (2005). "Rosenhan revisited: The scientific credibility of Lauren Slater's pseudopatient diagnosis study". Journal of Nervous and Mental Disease. 193 (11): 734–739. doi:10.1097/01.nmd.0000185992.16053.5c. PMID 16260927. 
  17. ^ McGorry, PD; Mihalopoulos, C; Henry, L; Dakis, J; Jackson, HJ; Flaum, M; Harrigan, S; McKenzie, D; Kulkarni, J; et al. (1995). "Spurious precision: procedural validity of diagnostic assessment in psychotic disorders". Am J Psychiatry. 152 (2): 220–223. doi:10.1176/ajp.152.2.220. PMID 7840355. Retrieved 2006-07-02. 
  18. ^ van Os, J.; Gilvarry, C.; Bale, R.; Van Horn, E.; Tattan, T.; White, I.; Murray, R. (1999). "A comparison of the utility of dimensional and categorical representations of psychosis". Psychological Medicine. 29 (3): 595–606. doi:10.1017/S0033291798008162. PMID 10405080. 
  19. ^ "The Ross Institute – Trauma". The Colin A. Ross Institute for Psychological Trauma. Archived from the original on July 6, 2008. 
  20. ^ Neighbors, HW; Jackson, JS; Campbell, L; Williams, D (1989). "The influence of racial factors on psychiatric diagnosis: a review and suggestions for research". Community mental health journal. Community Mental Health Journal. 25 (4): 301–311. doi:10.1007/BF00755677. PMID 2697490. 
  23. ^ a b c d e f Fitzpatrick, Mike (August 2004). "From 'nanny state' to 'therapeutic state'". The British Journal of General Practice. 54 (505): 645. PMC 1324868Freely accessible. PMID 15517694. 
  25. ^ Moynihan, Ray and Alan Cassels (2006). Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All Into Patients. Nation Books. ISBN 1-56025-697-4. 
  26. ^ "Rethinking Models of Psychotropic Drug Action". 
  29. ^ Gardiner Harris; Benedict Carey; Janet Roberts (May 10, 2007). "Psychiatrists, Children and Drug Industry's Role". New York Times. 
  31. ^ Gosden, Richard & Beder, Sharon (Fall–Winter 2001). "Pharmaceutical Industry Agenda Setting in Mental Health Policies". Ethical Human Sciences and Services. 3 (3): 147–159. PMID 15278977. 
  35. ^ "No Free Lunch (main page)". Nofreelunch.org. Retrieved 2014-01-13. 
  36. ^ "Revealed: how drug firms 'hoodwink' medical journals Society The Observer". The Observer. 
  38. ^ Cite error: The named reference Whitaker was invoked but never defined (see the help page).
  39. ^ Read, John (2010). "Can Poverty Drive You Mad? 'Schizophrenia', Socio-Economic Status and the Case for Primary Prevention". New Zealand Journal of Psychology. 39 (2): 7–19. Archived from the original on 8 February 2013. Retrieved 8 April 2012. 
  40. ^ Prudic, J.; Olfson, M.; Sackeim, H.A. (July 2001). "Electro-convulsive therapy practices in the community". Psychological Medicine. Cambridge University Press. 31 (5): 929–934. doi:10.1017/S0033291701003750. PMID 11459391. 
  41. ^ "Paper on ECT statistics at MH Stats Conference – ect.org". 
  42. ^ Kramer, B. A. (1999-12-01). "Use of ECT in California, revisited: 1984-1994". The Journal of ECT. 15 (4): 245–251. doi:10.1097/00124509-199912000-00002. ISSN 1095-0680. PMID 10614030. 
  43. ^ Leonard Roy Frank (June 2006). "The Electroshock Quotationary" (PDF). Endofshock.com. Retrieved 2014-01-13. [page needed]
  47. ^ Cite error: The named reference Check1 was invoked but never defined (see the help page).
  48. ^ Strous, R. D. (2006). "Nazi Euthanasia of the Mentally Ill at Hadamar". American Journal of Psychiatry. 163 (1): 27–27. doi:10.1176/appi.ajp.163.1.27. PMID 16390885. 
  52. ^ Fulford, K; Smirnov, A; Snow, E (1993). "Concepts of disease and the abuse of psychiatry in the USSR". The British Journal of Psychiatry. 162 (6): 801–810. doi:10.1192/bjp.162.6.801. Retrieved 23 January 2012. 
  53. ^ a b c d e f Szasz, Thomas (September 1994). "Psychiatric diagnosis, psychiatric power and psychiatric abuse" (PDF). Journal of Medical Ethics. 20 (3): 135–138. doi:10.1136/jme.20.3.135. PMC 1376496Freely accessible. PMID 7996558. Retrieved 20 January 2012. 
  54. ^ a b c d e f g h i j k l m Szasz, Thomas (Spring 2001). "The Therapeutic State: The Tyranny of Pharmacracy" (PDF). The Independent Review. V (4): 485–521. ISSN 1086-1653. Retrieved 20 January 2012. 
  58. ^ Baker, Robert (Winter 2003). "Psychiatry's Gentleman Abolitionist" (PDF). The Independent Review. VII (3): 455–460. ISSN 1086-1653. Retrieved 12 February 2012. 
  59. ^ "Curing the Therapeutic State: Thomas Szasz interviewed by Jacob Sullum". Reason Magazine. 
  64. ^ Weinstein R.M. (1982). "Goffman's Asylums and the Social Situation of Mental Patients" (PDF). Orthomolecular psychiatry. 11 (4): 267–274. Retrieved 2014-01-13. 
  65. ^ Lester H.; Gask L. (May 2006). "Delivering medical care for patients with serious mental illness or promoting a collaborative model of recovery?". British Journal of Psychiatry. 188 (5): 401–402. doi:10.1192/bjp.bp.105.015933. PMID 16648523. 
  67. ^ "Mental Illness On Trial: The Rodney Yoder Story". Stopshrinks.org. [unreliable source?]
  68. ^ Szasz, Thomas (2002). "Patient or Prisoner?". Ideas on Liberty. 52: 31–32. 
  70. ^ "Search Content Science News". Science News. 
  71. ^ "Dr. Loren Mosher, 1933–2004". Alliance for Human Research Protection. 13 July 2004. Retrieved 2014-01-13. 
  75. ^ a b Szasz, Thomas (June 2008). "Debunking Antipsychiatry: Laing, Law, and Largactil". Current Psychology. 27 (2): 79–101. doi:10.1007/s12144-008-9024-z. (Subscription required (help)). 
  77. ^ McCommon B (2006). "Antipsychiatry and the Gay Rights Movement". Psychiatr Serv. 57 (12): 1809. doi:10.1176/appi.ps.57.12.1809. 
  78. ^ Rissmiller DJ, Rissmiller J (2006). "Letter in reply". Psychiatr Serv. 57 (12): 1809–1810. doi:10.1176/appi.ps.57.12.1809-a. 
  79. ^ Laffey, Paul (2003). "Antipsychiatry in Australia: Sources for a Social and Intellectual History" (PDF). Health & History. 5 (2): 17–36. doi:10.2307/40111451. JSTOR 40111451. 
  80. ^ Cite error: The named reference Nasser1995 was invoked but never defined (see the help page).
  81. ^ Cite error: The named reference nasral was invoked but never defined (see the help page).
  82. ^ Cite error: The named reference MicalePorter was invoked but never defined (see the help page).
  83. ^ Seyyed Nassir Ghaemi (2006). "Paradigms of Psychiatry: Eclecticism and Its Discontents". Current Opinion in Psychiatry.  (registration required)
  84. ^ "Before and after photos of Traverse City's converted mental hospital", Michigan Radio Newsroom. Michigan Radio. March 19, 2013. Retrieved 8 feb 2017
  86. ^ Everett B (1994). "Something is happening: the contemporary consumer and psychiatric survivor movement in historical context". Journal of Mind and Behavior. 15: 55–7. CiteSeerX accessible. 
  87. ^ Rissmiller, D.J.; Rissmiller, J.H. (June 2006). "Evolution of the Antipsychiatry Movement into mental health consumerism" (PDF). Psychiatric Services. 57 (6): 863–866. doi:10.1176/appi.ps.57.6.863. PMID 16754765. 
  88. ^ Cite error: The named reference Desai 2005 185–187 was invoked but never defined (see the help page).

Cite error: A list-defined reference named "Dain 1994" is not used in the content (see the help page).

Works cited


Further reading

External links