As anti-psychiatry one is political and social movement referred to the psychiatry facing critical or hostile. It developed between 1955 and 1975 in Great Britain, Italy, the USA and the Federal Republic of Germany, among others. The antipsychiatric movement encompasses different groups with different backgrounds.
Criticisms of psychiatry relate to the facilities of the psychiatric clinics and the compulsory treatment there, the patient-doctor relationship, the stigmatization of the sick , the current treatment methods and the general question of the societal nature of the classification of mental illnesses. In antipsychiatry, therefore, not only the grievances in psychiatric institutions are denounced, but psychiatry as such is fundamentally questioned. It is often described as the mechanism of the existing social system to maintain the ruling order. The explanation of schizophrenia as a mental illness is particularly criticized (see also schizophrenia # criticism of the concept of the illness ).
David Cooper, along with Ronald D. Laing and Thomas Szasz , is counted among the most important representatives of the anti-psychiatry movement. In addition, the psychiatrists Jan Foudraine , Franco Basaglia and Félix Guattari as well as the sociologist Erving Goffman and the philosopher Gilles Deleuze are assigned to the movement. Antipsychiatric theses have attracted the greatest attention since 1961 through Michel Foucault's work Wahnsinn und Gesellschaft: A History of Madness in the Age of Reason , but he himself is usually not counted as part of the antipsychiatry movement.
As a forerunner of the antipsychiatry movement of the 1960s , the romantically oriented French psychiatry-critical movement that followed the French Revolution of 1789 can be seen. A movement of bourgeois groups also formed around 1900 in Germany , such as a league founded in 1907 by the engineer and former psychiatric patient Georg Wetzer (1878-1914) to protect the interests of the mentally ill , which criticized the internment practice and the finding of a mental illness practiced. The term “antipsychiatry” was also used here. The term "antipsychiatry" was first used in its current meaning in 1967 by David Cooper .
There are different views among anti-psychiatrists, ranging from criticism of institutional psychiatry (especially everyday clinical practice), their descriptions of illnesses and treatments, to the complete rejection of psychiatric diagnoses and treatment methods. Psychiatry is often described as the mechanism of the existing social system to maintain the ruling order (see the sections on Foucault and Goffman).
There is consensus in the rejection of coercive measures. A majority is also strongly against the use of neuroleptics and sees only side effects and harm from them. Few (e.g. Cooper), however, also used drugs in their antipsychiatric experiments. The controversial electroconvulsive therapy is also often criticized.
When it comes to diagnoses, the criticism of classical psychiatry is mainly directed towards schizophrenia, with which the majority of patients in psychiatric clinics are diagnosed. For the explanation of the symptoms of schizophrenia which was double bind (double bind relationship trap), based on the family of the patient, consulted. According to this, paradoxical messages that contradict themselves and occur frequently in human relationships would lead to paralysis and severe confusion of the person concerned. This could then lead to the symptoms associated with schizophrenia but considered a normal response to confusing conditions.
Despite their criticism, some of the anti-psychiatrists see themselves as psychiatrists and doctors.
The philosopher and historian Michel Foucault published his work Wahnsinn und Gesellschaft: A History of Madness in the Age of Reason in 1961 , which deals with the question at which point in European intellectual history “Enlightenment reason finally renounced madness as its manifest opposite has. ”Important influences on the anti-psychiatry movement of the 1960s stem from this and other works. Foucault continued to question the medical definition of mental illness. The diagnosis of mental illness is primarily the product of social, political and legal processes and is therefore historically conditioned. The classification of individuals as mentally ill and the respective treatment are based on procedures of power , in particular the exclusion and displacement of subjects classified as ill from the social discourse . In this sense, medicine and psychiatry are instruments with the help of which exclusion is rationalized and scientifically legitimized. In particular through mechanisms of naturalization , "illness" appears from now on as a fact that exists independently of social conditions and ascriptions; For example, homosexuality has long been considered a mental disorder that requires treatment.
In his work, the sociologist Erving Goffman presented the living conditions of patients in psychiatric asylums. Together with popular representations in the media (such as the novel One Flew Over the Cuckoo's Nest by Ken Kesey ) this led to a critical attitude among intellectuals and the public towards psychiatry. For Erving Goffman, psychiatric clinics were an example of a “ total institution ” in which the patients were systematically at the mercy of those responsible (doctors, nurses and administrators). Goffman's condemnation of clinical institutions was based on experience gained in 1955 during field studies at St. Elizabeth's Hospital (then with over 6,000 patients).
The Rosenhan experiment
The American psychologist David L. Rosenhan suggested through his studies on the validity and reproducibility of psychiatric diagnoses that the diagnoses correspond more to an arbitrary "labeling" of individuals. In the Rosenhan experiment , mentally healthy test persons were admitted to a psychiatric institution by reporting symptoms of mental illness ( delusional symptoms ). Although they no longer presented any symptoms afterwards, they were only released after a long time - not as "healthy" or "cured", but merely as "symptom-free". Since 2019, however, it has been doubted whether Rosenhan actually carried out the experiment as described.
The Swiss lawyer Edmund Schönenberger has been defending forced psychiatrists with his controversial association Psychex since 1975 and sums up his experience in the thesis that forced psychiatry ultimately serves to maintain the prevailing order.
Another important point of criticism is the inadequate processing of the history of psychiatry, in particular the crimes in totalitarian regimes such as National Socialism . This is an important issue mainly in Germany, since the forced sterilization and murder of mentally ill people after the Second World War had not been dealt with sufficiently. The role of probably the most famous Swiss psychiatrist Eugen Bleuler , who was also the textbook author and director of the Burghölzli psychiatric institution in Zurich, has never been officially questioned: “A question that is not so easy to answer is whether it should be allowed, objectively To destroy 'life unworthy of life' of others without the express wish of the bearer. (...) Even with incurable mentally ill people who suffer severely from hallucinations and melancholic depression and are incapable of acting, I would ascribe the right and, in severe cases, the duty to a medical college to shorten the suffering - often for many years. "
Antipsychiatry has in part contributed to raising awareness of the stigma of the mentally ill . It has stimulated a critical approach to nosology and terminology and initiated important reforms in the care of psychiatric patients. Unsustainable conditions and treatment methods were and are denounced. This was including Italy, Sweden and Austria impetus for reform of psychiatry, leading to a partial reversal of the psychiatric hospitals or excessive shortening the length of stay and more accurate control of the so-called involuntary commitment and Zwangsanhaltungen (ie briefing and detention against the will of or of those affected).
- Antipsychiatry called for the establishment of so - called refugee shelters , which, in analogy to women's shelters , should give those affected shelter and protection. Implement experiments, anti psychiatric concepts into practice, have included that of Ronald D. Laing and David Cooper designed "Households" ( shared apartments ) in the Kingsley Hall in London, station 21 . Attempts in this direction in Germany were the Socialist Patient Collective (SPK) founded by Wolfgang Huber in Heidelberg in 1970 and the insane offensive founded in 1980 . The deinstitutionalization of the treatment of the mentally ill, as it was propagated by some branches of antipsychiatry, partially led to the impoverishment and criminalization of those affected. In Berlin, from the mad offensive, a later split off Weglaufhaus group was founded, which has been running the Villa Stöckle as a Weglaufhaus since 1996.
- While in the 1960s mainly experts from the university sector stood up for the interests of those affected by psychiatry, self-help groups have come together since the 1970s and 1980s and use the term antipsychiatry . They partially fall back on the demands and formulations of the original anti-psychiatry movement. Antipsychiatry is also a branch of the Federal Association of Psychiatry Experienced Persons (BPE).
- The anti-psychiatry movement gave impetus to improve the quality of psychiatric care. This is how the Soteria concept came about, which aims to achieve equal relationships between caregivers and patients. In Germany in September 1975 the report of a psychiatry enquête commission was presented, in which a number of demands of the anti- psychiatry environment were taken up and which led to the German psychiatry reform.
- In Italy, the therapeutic successes, the high-profile appearance of Basaglia and favorable political conditions led to the passing of the law for the reform of psychiatry on May 13, 1978, which among other things ordered the abolition of psychiatric institutions. Considerable problems arose during the implementation in practice - not least because, due to a change of government, the implementation was in a different hand. The World Health Authority described the law in 1985 as "revolutionary".
- In the USA, antipsychiatry has developed into a patient-based consumer protection movement that no longer pursues the abolition of psychiatry, but aims to reform it in the sense of increased “consumer protection” in the “market for mental health”.
- Another success of the anti-psychiatry movement is the principles for the protection of people with mental illnesses adopted by the UN General Assembly in 1991 .
- The Mad Pride movement, which originated in Canada in 1996, combats the stigmatization of people with psychiatric and other deviations from social normality through self-confident and public representation of their otherness and diversity. To this end, Mad Pride parades are held annually in many cities .
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- cf. T. Rechlin, J. Viegen: Die Psychiatrie in der Critique. Springer-Verlag, Berlin / Heidelberg 1995, p. 5 ff.
- David Cooper: Psychiatry and Anti-Psychiatry. Suhrkamp, Frankfurt am Main 1971, p. 135
- See T. Rechlin, J. Viegen: The Psychiatry in Criticism. Springer-Verlag, Berlin / Heidelberg 1995, p. 9
- Cf. Juan Obiols, Franco Basaglia: Antipsychiatrie. Rowohlt, Reinbek bei Hamburg 1978, p. 44.
- See T. Rechlin, J. Viegen: The Psychiatry in Criticism. Springer-Verlag, Berlin / Heidelberg 1995, p. 74 ff.
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- Cf. Michel Foucault : Madness and Society. A story of madness in the age of reason. Suhrkamp, Frankfurt am Main 1993, especially p. 68 ff .; See also E. Shorter: History of Psychiatry. Rowohlt Verlag, Reinbek 2003, p. 410.
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- See David L. Rosenhan : Healthy in a sick environment. In: Paul Watzlawick (Ed.): The invented reality. How do we know what we think we know? Contributions to constructivism. Piper, Munich 1985, pp. 111-137; critical to this see RL Spitzer: On pseudoscience in science, logic in remission, and psychiatric diagnosis: a critique of Rosenhan's "On being sane in insane places". In: Journal of Abnormal Psychology. No. 84 (5), pp. 442-52 (1975).
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