Anti-psychiatry

Anti-psychiatry, sometimes spelled antipsychiatry without the hyphen,^[1] is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historical critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive therapy or insulin shock therapy.^[2] The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of whom agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.

Beyond concerns about effectiveness, anti-psychiatry might question the philosophical and ethical underpinnings of psychotherapy and psychoactive medication, seeing them as shaped by social and political concerns rather than the autonomy and integrity of the individual mind. They may believe that "judgements on matters of sanity should be the prerogative of the philosophical mind", and that the mind should not be a medical concern. Some activists reject the psychiatric notion of mental illness.^[3] Anti-psychiatry considers psychiatry a coercive instrument of oppression due to an unequal power relationship between doctor, therapist, and patient or client, and a highly subjective diagnostic process. Involuntary commitment, which can be enforced legally through sections, is an important issue in the movement. When sectioned, involuntary treatment may also be legally enforced by the medical profession against the patient's will.

The decentralized movement has been active in various forms for two centuries.^[4][2] 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.^[5] Psychiatrists identified with the anti-psychiatry movement included Timothy Leary, R. D. Laing, Franco Basaglia, Theodore Lidz, Silvano Arieti, and David Cooper. Others involved were Michel Foucault, Gilles Deleuze, Félix Guattari, and Erving Goffman. Cooper used the term "anti-psychiatry" in 1967, and wrote the book Psychiatry and Anti-psychiatry in 1971.^[4][2][3] The word Antipsychiatrie was already used in Germany in 1904.^[6] Thomas Szasz introduced the definition of mental illness as a myth in the book The Myth of Mental Illness (1961). However upon reading his literature he very clearly states that he was directly undermined by the movement led by David Cooper (1931-1986) and that Cooper sought to replace psychiatry with his own brand of it. Giorgio Antonucci, who advocated a non-psychiatric approach to psychological suffering, did not consider himself to be part of the antipsychiatric movement. His position is represented by "the non-psychiatric thinking, which considers psychiatry an ideology devoid of scientific content, a non-knowledge, whose aim is to annihilate people instead of trying to understand the difficulties of life, both individual and social, and then to defend people, change society, and create a truly new culture".^[7] Antonucci introduced the definition of psychiatry as a prejudice in the book I pregiudizi e la conoscenza critica alla psichiatria (1986).

The movement continues to influence thinking about psychiatry and psychology, both within and outside of those fields, particularly in terms of the relationship between providers of treatment and those receiving it.^[3][2] Contemporary issues include freedom versus coercion, nature versus nurture, and the right to be different.^[8]

Critics of antipsychiatry from within psychiatry itself object to the underlying principle that psychiatry is harmful, although they usually accept that there are issues that need addressing.^[9] Medical professionals often consider anti-psychiatry movements to be promoting mental illness denial, and some consider their claims to be comparable to conspiracy theories.^[10]