Critical psychiatry in practice (original) (raw)

Critical psychiatry: a brief overview

BJPsych Advances

SUMMARYCritical psychiatry has often been confused with what is widely known as ‘anti-psychiatry’. In this article the distinction is clarified and the particular contribution critical psychiatry makes is outlined. That contribution is constructive criticism: of the relationship between medicine and mental health practice, of the way drug and psychotherapeutic treatments for mental health difficulties might be better understood. These have implications for everyday clinical practice and there is much to be gained by openly embracing the controversies critical psychiatry highlights.LEARNING OBJECTIVES•Understand the origins of critical psychiatry and recognise some of the difficulties that arise from identifying psychiatry with medicine•Appreciate the differences between disease-centred and drug-centred approaches to prescribing psychiatric medication•Become aware of implications that arise from psychotherapeutic outcomes researchDECLARATION OF INTERESTSH. M. and J. M. are co-chairs ...

Critical psychiatry: an embarrassing hangover from the 1970s?

BJPsych Bulletin

Summary Critical psychiatry is associated with anti-psychiatry and may therefore seem to be an embarrassing hangover from the 1970s. However, its essential position that functional mental illness should not be reduced to brain disease overlaps with historical debates in psychiatry more than is commonly appreciated. Three examples of non-reductive approaches, like critical psychiatry, in the history of psychiatry are considered.

Critical Phenomenology and Psychiatry

Whereas classical Critical Theory has tended to view phenomenology as inherently uncritical, the recent upsurge of what has become known as critical phenomenology has attempted to show that phenomenological concepts and methods can be used in critical analyses of social and political issues. A recent landmark publication, 50 Concepts for Critical Phenomenology, contains no reference to psychiatry and psychopathology, however. This is an unfortunate omission, since the tradition of phenomenological psychiatry – as we will demonstrate in the present article by surveying and discussing the contribution of Jaspers, Minkowski, Laing, Basaglia, and Fanon – from the outset has practiced critical thinking, be it at the theoretical, interpersonal, institutional, or political level. Fanon is today, a recognized figure in critical phenomenology, even if his role in psychiatry might not yet have been appreciated as thoroughly as his anticolonial and antiracist contributions. But as we show, he is part of a long history of critical approaches in psychopathology and psychiatry, which has firm roots in the phenomenological tradition, and which keeps up its critical work today.

Introduction: The Importance of Critical Approaches to Mental Health and Illness

Routledge International Handbook of Critical Mental Health, 2018

Introducing the rationale for the Routledge International Handbook of Critical Mental Health, Cohen surveys the history of critical approaches from the 1960s and 1970s, and theorises as to why there has been a retreat from critical thinking in the social and health sciences—and consequently a move back to conservative “social causation” approaches—since that period. With the evidence base on mental illness remaining highly contested, he argues that now more than ever critical perspectives are necessary to effectively problematise the practices, priorities, and knowledge base of the mental health system.

1 Introduction : Psychiatry at a Crossroads

2016

Psychiatry today faces challenges on many fronts, with vigorous critiques of its theory and practice from clinicians, scholars, and people with lived experience of mental health problems. These critiques target the slow progress in understanding and treating mental illness, overreliance on medications and other biomedical treatments, and the lack of attention to patients’ lifeworlds and aspirations, but extend to much broader concerns about the medicalization of everyday life, and even wholesale condemnation of psychiatry as a source of heavy-handed social control, stigma, and harmful interventions that actually undermine recovery. In recent years, many of the concerns of the antipsychiatry movement of the 1960s have been reasserted by a new critical psychiatry literature that builds on these earlier critiques but includes attention to contemporary questions of epistemology, political economy, and globalization (Bracken et al., 2012 Cohen & Timimi, 2008; Fernando, 2014; Mills, 2014;...

From Szasz to Foucault: On the Role of Critical Psychiatry

Philosophy, Psychiatry & Psychology

In this article, we examine the different ways in which Thomas Szasz and Michel Foucault have challenged dominant perspectives within psychiatry. We identify, analyze, and compare the central elements of their respective discourses on psychiatry and show that although they are often bracketed together, in fact there are certain fundamental differences between Szasz and Foucault. Of most importance is their contrasting ways of characterizing the nature and role of critical thought. Whereas Szasz’s analysis is predicated on a number of binary distinctions, Foucault works to overcome such distinctions. In the past ten years, a new movement of critical psychiatry has emerged. Although this shares certain concerns with the critical psychiatry of the 1960s and 1970s, there are substantial differences. We argue that this discourse is more resonant with the Foucauldian approach.

Demanding ‘more and better’ psychiatry: Potentially liberatory or worse than the disease?

This paper takes as its starting point Peter Sedgwick’s Psycho Politics (1982) in which he called for “more and better” psychiatric treatment in response to significant “anti-psychiatry” movements by patients, carers and clinicians. In the 30 years since he wrote, mental health services have been dramatically reshaped by neoliberalism — where patients are “consumers”, the state demands greater coercion to control “risk”, and Big Pharma has created massive new markets for drug treatments — while public resources have been eroded. Equally, campaigns around psychiatric treatment have often been delimited by and adapted to hegemonic neoliberal frameworks. Does Sedgwick offer us the basis for challenging these reverses and building resistance that can provide renewed hope? And how does his approach square with arguments that, if done right, modern, scientific psychiatry can itself promise liberation?

Sociological Critique of Modern Psychiatry

This paper explores the contrasting views of Thomas Szasz and Michel Foucault and their critical thoughts in psychiatry in relation to aspects such the enlightenment, biomedicine and psychotherapy.