Archive-Name: psychiatry/alt-flame/faq
Posting-Frequency: biweekly
Last-modified: 1996/09/19

           The alt.flame.psychiatry Frequently-Asked Questions File

     OFFICIAL POSTING

     You may also obtain this FAQ via FTP from rtfm.mit.edu from the
     following directories:

      /pub/usenet-by-group/news.answers/psychiatry/alt-flame/faq
      /pub/usenet-by-group/alt.answers/psychiatry/alt-flame/faq
      /pub/usenet-by-hierarchy/news/answers/psychiatry/alt-flame/faq
      /pub/usenet-by-hierarchy/alt/answers/psychiatry/alt-flame/faq


         Thanks for the suggestions and changes so far. I have added a
     list of recommended readings in Question 15. Feel free to 
     suggest more. 

     Welcome to afp!

     This is a FAQ file for a long-overdue newsgroup called
     alt.flame.psychiatry (I guess you knew that). 

     If there are any questions I haven't thought of, please write to
     me at pking@idirect.com

    The main thrust of this FAQ is to take a philosophical look at
    the whole science of psychiatry. This must begin by asking
    ourselves "what is a science?" Can we ask "what is personality"
    in the same sense that we can ask "why is the sky blue?" Or are
    psychiatrists simply asking the wrong questions? OR, as we
    suspect in this FAQ, are they only asking questions (wittingly 
    or unwittingly) that serve ideological purposes? In other words, 
    we can observe that asking "what is personality" is a great way 
    to include certain people and exclude others. There will always
    be those who do not meet medical criteria by simply distinguishing 
    between "healthy" and "unhealthy" personality types. This is very
    convenient if our goal is to create a community of outcasts. While
    one may deny that this is the goal, there are few who can deny that
    this is the outcome.

    1. What is meant by "flame"?

        To insult and heap invective on someone, something, or an
        idea. But in psychiatric terms, to simply offer valid and
        balanced criticism of psychiatry is enough to pass as
        "flaming". Remember, good patients are totally uncritical, while 
        valid, thoughtful criticism of psychiatry is seen as hostility.

    2. So, why flame psychiatrists?

        The short answer is because there are several factors that
        invalidate psychiatry as a scientific enterprise. In fact,
        rather than having a scientific basis, a solid case can be
        made for psychiatry having an ideological basis.

    3. What's that mean in English?

        It means:
            i. That inmates of  psychatric wards are there to fulfill
            medical ideology rather than because they are "sick". The
            corollary is that mental illness is a myth.

            ii. Outpatients who visit psychiatric clinics are milder
            victims of the same ideology, and thus are rarely helped.

    4. What about other mental health professionals: psychologists,
    social workers, nurses, and so on? [Thanks to Allan Clifton
    (aclifton@clark.net)]

        Therapists other than doctors present more of a mixed bag. The
        theoretical orientation of social workers or psychologists
        need not be based on the medical model, or on behaviour
        modification. And unless the patient is obligated to see the
        therapist, then there is the element of choice of seeing or
        not seeing the therapist. Unlike psychiatrists, psychologists
        use intelligence tests, personality inventories, inkblots, and
        other nonsense to diagnose a patient. 

        Really, if any of these types of therapists pose a problem to
        an individual, they are fair game in our newsgroup.

    5. As it applies to psychiatry, what is meant by "medical
    ideology"? Is that a political faction that I don't know about?

        No, ... no political faction. Let's break that down: 
        i. medical: applies to medicine: fever, appendicitis,
            broken bones, that kind of stuff. 
        ii. ideology: that great killer of humanness. This one takes a
            bit more exlpaining. 

            When we espouse an ideology, regardless of what it is, we
            fill our thoughts with: "wouldn't the world be a better
            place if everyone did 'X'?" Psychiatry takes on the
            ideology that what we think of as medicine should apply to
            the mind. That is, the definition of "illness" should
            apply to our thoughts, mental processes, intelligence, and
            behaviour. Wouldn't the world be a better place if
            everyone behaved normally? (ugh...)

    6. When we make something an ideology, what are we really doing
    when we try to put it into practice?

        CARRYING OUT the ideology in the real world makes it a
        totality (as in totalitarianism). It is like saying "Wouldn't
        the world be a better place if everyone was in love?" Then,
        making it a requirement in your institution that everyone MUST
        be in love (or else). Kind of kills the whole concept, doesn't
        it? What we are doing when we practice to carry out an
        ideology is we are breaking spirits, and crushing wills.
        Communism is an ideology in many parts of the world, and is
        practiced as a totality: "Share everything you own with your
        neighbour, or else!" is what we often heard from Stalin, Mao,
        and others. It killed once and for all the natural, human will
        to share, which only exposes itself when there are no laws
        inhibiting the freedom to share or to not share.

        Totality is the removal of choice, resulting in our being
        treated, in the words of Stalin, "as obedient as a corpse."

    7. Are psychiatrists totalitarian?

        Whether they want to or not, yes. It is an integral part of
        their training, and is often referred to as "patient
        management."

    8. Are there examples of totalitarianism in other professions?

        Well, corporations are very totalitarian. They fulfill the
        needs of the owners, and all endeavours in a company is in the
        service of increasing profit. That is quite a totality, and
        takes precedence over issues of job security, and if no one
        protests, workers' rights also. 

        Why stop there? Educational institutions are totaitarian in
        their own agendas. Grade schools release objective-seeming
        report cards where a child's entire self-esteem is changed by
        the casual judgements of strangers as to how well-moulded they
        are to the needs of the school and classroom. Academic
        institutions also have similar agendas. 

        The military is bent on forming "killing machines" out of mere
        mortals. This requires strong ideological indoctrination, and
        is thus a totality.

    9. So, you appear to be saying that totalitarianism is
    everywhere. If everyone does it, then what's the problem? If
    everybody's guilty of everything then nobody's guilty of
    anything, right?

        Wrong. Nice try, though! 

        The problem is, that in the areas mentioned under question 8
        there is usually a way out. There are the courts, there are
        appeals, tribunals, committees, so on. The individual has
        certain discrete rights that can challenge totalitarian
        decisions. So, in the end, they are not that totalitarian,
        except that they serve to atomize the individual. Rights even
        exist in jails. 

        In psychiatry, there *really is* no way out. When a person is
        institutionalised involuntarily, there is no avenue for the
        patient to say that he/she has been wrongfully
        institutionalised. There is no appeal, the patient has only
        the rights given to him by the doctor, and the patient may or
        may not be told of these rights. In the true sense of the
        word, institutionalisation results in the breaking of human
        spirits. Even in the courts, the inpatient has few or no legal
        rights, and won't have them after he leaves the asylum. The
        patient becomes a non-person. 

        And, psychiatrists have rarely admitted to being wrong about
        committing a patient. 

        So, oh yeah, there's a big problem.

    10. Do you mean to say that psychiatry is invalid as a scientific
    enterprise? (see question 2)

        More or less. Psychiatry has been widely accused of lacking a
        sound theoretical basis to justify its existence as a medical
        profession. It is a profession where "personality" has no
        agreed definition, yet they feel conversant in the area of
        "personality disorder". "The mind" also has no agreed
        definition, yet the phrase "mental illness" is coined with an
        air of precision and crisp professionalism that makes it sound
        that the speaker knows what he is saying. 

        To see the absurdity of this, we must look at another
        science for which there are well-established definitions and
        theories. Let's look at chemistry. Look at any high school
        chemistry text, and the definitions of "the atom" are pretty
        much the same. "The atom" is precisely defined, so that higher
        concepts such as "atomic bonding" become discussable between
        chemists. Even chemists from different countries, provided
        they both speak the same language, will immediately know what
        is being spoken about when the word "atom" or the phrase
        "atomic bonding" is mentioned. 

        Could you imagine the chaos we would be in if mathematicians
        spoke of "algebra" without having agreed on the definitions
        for addition, subtraction, multiplication and division? 

        Such is the progress of psychiatry. 
        
        A psychiatrist can attempt to justify psychiatry's existence 
        by showing us rooms full of unhappy people for which no other 
        branch of medicine can offer relief. To say that this justifies 
        psychiatry is an appeal to emotion, and is not a valid explanation 
        on the level of establishing a sound theory that would justify its
        existence among the sciences.

    11. So, how can I best understand how psychiatry works?

        Psychiatry is by its existence an apologetic for the
        failures of society to provide adequate living conditions to
        its people. Though the lion's share of psychiatric inmates are
        from the poorer classes, psychiatry has evolved as a means of
        containing the destructive effects of uncontrolled and
        unregulated capitalism - that is, widespread poverty and
        unemployment or under-employment, and the abused and broken
        homes that result. 

        Psychiatrists are the janitors of capitalism. 

        The way to best understand how psychiatry works is if we try
        to understand it from the point of view of ideology and
        totality. In other words, the profession of psychiatry is most
        easily understood as an enforcer of social norms, and as an
        adjunct to the police, the government, and society's other
        major institutions. The patients under their care are most
        easily characterised as either a defeated race, a slave class,
        or as concentration camp inmates. 

        At best, they are second-class citizens with few rights. At
        worst, they are permanent wards of the state with no rights.
        But in so far as they put away persons stressed out from dire
        poverty, they can be seen as cleaning up the mess left behind
        by unfettered capitalism.

    12. Isn't it more politically correct to refer to patients as
    "clients"?

        There are varying opinions. In my opinion, "client" sounds a
        tad Orwellian. 

        "Patient" is a much more accurate and descriptive term for how
        the doctors regard the patient, both in theory and in
        practice. This hasn't changed. Calling them "clients" obscures
        this relationship, making it unclear that psychiatrists will
        still use the medical model, treat the mind as passive, and
        refer to the patient's problems as "illnesses" worthy of
        "treatment", in keeping with medical ideology. 

        The recent trend to call patients "clients" or "mental
        health consumers" is merely window-dressing P-R which does
        nothing whatsoever to change the role of either the outpatient
        or inpatient in relation to the doctor. The only thing these
        politically-correct terms do is give a false sense of dignity
        to the patient. Recall that in the Old South, during the days
        of the slave trade, slaves were also given similar lip service
        to enhance their dignity. But they were still slaves. Women
        are often called "the fair sex", and are held in "high esteem"
        by many cultures. Yet they continue to be widely debased and
        discriminated against by those same cultures. 

        The referral to patients as "clients" arises from the same
        mentality, and should only be used when buying a car or taking
        out a loan. As for "mental health consumers": well, ... aren't
        we all?

    13. What is "the medical model" as it applies to the mind?

        Let's look at an obvious "medical problem" - a broken bone. If
        a patient presents with a broken bone, there is obviously
        something wrong. There is a lot of bleeding, bruising, and
        pain; and if the bone is on an arm or leg, then the patient
        can no longer use that limb until the break is healed. 

        In comes medical intervention. Painkillers, antibiotics and a
        splint all help the body in mending the broken bone. The
        administration of these drugs and splits are referred to
        collectively as "treatment". The bone, in the scientific
        sense, is a treatable substance like wood or leather. It is
        passive, and thus "something must be done to it" to make it
        function better, assuming that chances are pretty slim that
        the bone would have set properly without such intervention.
        This assumption is largely correct, and the theoretical basis
        underlying the healing of broken bones is pretty sound. 

        So, the assumption underlying psychiatry is that the mind
        (which has no agreed definition, remember) is passive in
        exactly the same sense as a bone. It begs the question: what
        does that make the mind of the psychiatrist, since his mind
        must be passive as well. Of course, I'm not supposed to ask
        that. But since I did, I'll answer: If the test for
        "passivity" is a broken bone, then we observe that the person
        doing the treating, the doctor, is not passive. 

        So, even though all human minds must be passive to fulfill the
        medical model, the doctor's mind must not be considered
        passive in order to fulfill the same medical model. 

        No wonder psychiatric patients go crazy. But it goes without
        saying that the very medical model that psychiarty rests on is
        also invalid, making any rational discussion about the
        validity or invalidity of psychiatry as being a complete waste
        of time.

    14. Hey ... Isn't this more an afp manifesto or polemic than a
    FAQ? [Thanks to Tracy Lowery (ppadkho@ionet.net)]

        "Psychiatric Inmates of the world unite ... ?" Hmmm. 

        Well, I personally disagree that it is either one, although it 
        could be taken that way by someone who has never needed to 
        question the conventional thought surrounding psychiatrists. I 
        think the FAQ fulfills a need for the "un-initiated" to get 
        oriented to the way of thinking of this group. One can say that
        the FAQ for sci.bio.food-science is a food scintist's
        interpretation of the world. But it would hardly qualify as
        being a manifesto or a "substitute ideology" for something.

        The main thrust of this FAQ is to take a philosophical look at
        the whole science of psychiatry. This must begin by asking
        ourselves "what is a science?" Can we ask "what is personality"
        in the same sense that we can ask "why is the sky blue?" Or are
        psychiatrists simply asking the wrong questions? OR, as we
        suspect in this FAQ, are they only asking questions (wittingly 
        or unwittingly) that serve an ideological purpose? In other words, 
        we can observe that asking "what is personality" is a great way 
        to include certain people and exclude other people who do not meet 
        the criteria for the definition by simply distinguishing between 
        "healthy" and "unhealthy" personality types. This is very
        convenient if our goal is to create a community of outcasts.

        The same goes for afp. The hope is: 1. afp subscribers will find 
        it as a voice, and 2. non-subscribers or newbies will get a sense 
        of orientation to the group. Only time will tell if these objectives 
        have been satisfied.  Contributions from other subscribers will help.

    15. Well, it just sounds as though what you are saying is well,
    ... crazy, because it sounds so different from what you hear from
    other sources, like TV and newspapers.

        Indeeed, these views are at great variance with most of what 
        society thinks of psychiatrists. We live in a psychiatric age 
        where we are encouraged to revere our therapists as Gods. Afp's 
        views are so much at variance with psychiatric propaganda, that 
        they appear, more like a crackpot polemic or a manifesto, rather
        than an attempt at reasoned, level-headed, and enlightened
        discourse on important matters of human rights.

        There is nothing in the afp FAQ that is even *mildly*
        controversial, even in psychiatric circles. The points
        brought up are the standard fare in philosophy, medicine, you
        name it. If you ask a doctor or a social worker if applying
        the medical model to the mind is problematic, he will say
        "yes", and he will give you pretty much the same reasons I
        gave. The same goes for the notions of freedom. There are all
        kinds of books written on this subject, even by the doctors
        themselves. Thomas Szasz has written several books on this
        topic. Szasz was the President of the American Psychiatric
        Association when he wrote "Ideology and Insanity: Essays on
        the Psychiatric Dehumanization of Man" in 1970. So when I use
        the term "ideology" in the FAQ, or say that "psychiatry has an
        ideological basis", that isn't even original. Psychiatrists
        are aware of these issues, and of the precariousness of their
        status as a science. If you want documentation to back up
        anything I said in the FAQ, you never need to go far to look. 

        The only *real* problem it may cause is that reading it will
        probably make you a poor candidate to succeed in your
        psychiatric visits. (or a better one, depending on your
        viewpoint) :-)

    16. Is there any recommended reading? (Please send in any further
    suggestions to pking@idirect.com) These are in no particular order
    as of this draft. I am including a key passage from each.

        Szasz, Thomas, 1970. "Ideology and Insanity: Essays on the
        Psychiatric Dehumanization of Man". Doubleday Anchor. ISBN
        0-385-02033-3. Quote from page 121: "In short, I hold--and I
        submit that the historical evidence bears me out--that people
        are committed to mental hospitals neither because they are
        'dangerous,' nor because they are 'mentally ill,' but because
        they are society's scapegoats, whose persecution is justified
        by psychiatric propaganda and rhetoric."

        Lasch, Christopher, 1976. "The Culture of Narcissism:
        American Life in an age of diminishing expectations." Warner
        Books. ISBN 0-446-32104-4. Quote from Page 359, in critiquing
        Gail Sheehy's book "Passages": "Measuring experience against a
        normative model set up by doctors, people will find themselves
        as troubled by departures from the norm as they are troubled
        by the 'predictable crises of adult life' themselves, against
        which medical norms are intended to provide reassurance. ...
        It rests on definitions of reality that remain highly suspect,
        not least because they make it so difficult to get through
        life without the constant attention of doctors, psychiatrists,
        and faith healers."

        Marx, Karl and Fredrick Engels, 1848 (this one published in
        English, 1983). The Communist Manifesto. International
        Publishers Co., Inc. ISBN 0-7178-0241-8. Quote from page 44:
        "Workers of the world, Unite!"

        Rius, 1976. "Marx For Beginners." Pantheon Books, New York.
        ISBN 0-394-73716-4. Gives a compelling history of all the
        other ways we have been oppressed throughout history, as well
        as clearly explaining the developments that led to the concept
        of "dialectical materialism," and of course Communism itself.

        Bentall, Richard P, 1992. "A Proposal to Classify Happiness as
        a Psychiatric Disorder", from "Journal of Medical Ethics",
        1992, n18, pp94-98. The Abstract: "It is proposed that
        happiness be classified as a psychiatric disorder and be
        included in future editions of the major diagnostic manuals
        under the new name: 'Major Affective Disorder, Pleasant Type.'
        In a review of the relevant literature it is shown that
        happiness is statistically abnormal, consists of a discrete
        cluster of symptoms, is associated with a range of cognitive
        abnormalities, and probably reflects the abnormal functioning
        of the central nervous system. One possible objection to this
        proposal remains -- that happiness is not negatively valued.
        However, this objection is dismissed as scientifically
        irrelevant."

        Harris, John, JLT Birley, and KWM Fulford, 1993. "A Proposal
        to Classify Happiness as a Psychiatric Disorder", from
        "British Journal of Psychiatry." Harris, Page 540: "Whenever I
        tease psychiatrists about their lack of a theory for mental
        illness or their inability to answer charges that mental
        illness is a myth, they always answer by showing me really
        distressed, unhappy people who need help which no other branch
        of medicine is offering. If this is a convincing answer, it is
        not so on the level of theory, and it is doubtful whether
        answering scepticism about the scientific validity of
        psychiatry by showing rooms full of happy, contented people
        will ever have quite the same force."
            Birley, Page 540, commenting on Bentall: "[Bentall's]
        serious ethical purpose is not stated, but I take it to be a
        concern with the dangers of 'over-classification' and
        'over-medicalisation' of human behaviour, particularly by
        psychiatrists."
            Fulford, Page 542: "[Bentall's paper] shows that the concept
        of disease itself is far more subtle than is generally
        recognised. There is some evidence that this is important
        practically. If it is, then Bentall may inadvertently achieved
        more for psychiatry in a few thousand words than other authors
        have achieved in a whole series of scholoarly tomes."

        Skinner, Bhurris Frederick, 1976. "Walden Two." Macmillan, New
        York. ISBN ?. This is the argument from the "other side". It
        tells a story about a utopian society based on the principles
        of behaviour modification and behaviour engineering."
        Meanwhile, the book is a rejection of philosophy - symbolised
        by a character named Castle, who ends up sputtering incoherent
        junk by the end of the book. A real-life philosopher can
        debunk the book in five minutes. Like the medical model,
        b.mod. assumes that the human mind is passive, and the
        therapist's mind is not passive. Does that make the therapist
        a Martian? 
            Page 16, commenting on sheep on the compound: "'They stray',
        Frazier conceded, 'but they cause no trouble and soon learn to
        keep with the flock. The curious thing is -- you'll be
        interested in this, Burris -- the curious thing is that most
        of these sheep have never been shocked by the fence. Most of
        them were born after we took the wire away. It has become a
        tradition among sheep to never approach string. The lambs
        acuire this from their elders, whose judgement they never
        question.' 
            'It's unfortunate sheep don't talk,' saud Castle. 'One of
        them would be sure to ask "why" - the Philosophical Lambkin.'
            'And someday, a Sceptical Lambkin would put his nose on the
        string and nothing would happen and the whole sheepfold would
        be shaken to its very foundations,' I added. 
            'And after him, the stampede!' said Castle.

    17. All that being said, what is left for this newsgroup to post?

        Flames! Righteous flames!

        It's a damn sight better than therapy!

                            ------ o ------

Email your comments and suggestions to pking@idirect.com

 -- Paul King

    Copyright ((C)) 1996 by Paul King. If this is to be re-posted to a
    newsgroup other than afp, or stored at an FTP site, you can do
    that so long as you 1) post the entire FAQ with this copyright
    notice, and 2) have the courtesy to inform me of your intentions.
    This FAQ is intended as educational, and can be used free for
    private or non-profit purposes. Other uses of this FAQ require my
    permission. Email pking@idirect.com 

 ---------------------------------------------------------------------
 : Internet Direct (416)233-2999  1000 lines SLIP, 9600 - 33,600 bps :
 ---------------------------------------------------------------------
